Post-Acute, Home Health and Senior Care

When a patient leaves a hospital, or when an older person can no longer manage alone, care moves to a set of providers that most healthcare business discussions ignore: skilled nursing facilities, home health agencies, hospices, rehabilitation hospitals, assisted living communities and programs like PACE. Together they absorb tens of billions of Medicare dollars a year and most of Medicaid's long-term care spending, and they sit at the center of two forces: the ageing of the baby boomers (the first of whom turn 80 in 2026) and the push by Medicare Advantage plans and value-based care groups to move patients out of expensive institutional settings. This section explains the settings, how each is paid, why margins differ so much between Medicare and Medicaid patients, the real-estate structures behind nursing homes and senior living, the move of hospital-level care into the home, and the consolidation of home health and hospice by insurers such as UnitedHealth and Humana.