The urgent need for healthcare transformation in the United States has long been evident. The traditional system of healthcare in a community has typically revolved around the acute care center, whether these communities are in large city neighborhoods or in remote rural areas, hundreds of miles from tertiary or quaternary services. One way in which healthcare leaders can transform systems of care is by considering local acute care centers as one aspect of a larger care ecosystem. Healthcare’s most expensive work is in the acute care center. By most estimations, 25 percent of that work is waste (Bauchner and Fontanarosa 2019). According to the most recent data by the Centers for Medicare & Medicaid Services (CMS), national health expenses grew 7.5 percent in the year ending 2023, with hospital expenses experiencing double-digit increases (Centers for Medicare & Medicaid Services 2025). Building systems of care with the highest quality of service in the most coordinated and cost-efficient manner is needed more than ever. Despite limited resources, we must begin to invest capital dollars in value-based care and promote it in capital investment conversations as the leading strategy for healthcare systems.
Robert Millette (Mon,) studied this question.