Healthcare Without Boundaries
Coordinated Care Wherever the Patient Calls Home
Hospitals Without Walls™ is building an integrated healthcare delivery model that connects patients, families, clinicians, healthcare organizations, health plans, and community resources across traditional healthcare boundaries.
Our mission is to bring appropriately selected healthcare services closer to the patient through coordinated home based care, mobile health delivery, telehealth, transitional care, chronic disease management, palliative support, and technology enabled monitoring.
A More Connected Model of Care
Healthcare is often divided among hospitals, physicians, specialists, home health agencies, pharmacies, laboratories, rehabilitation providers, caregivers, and insurance organizations.
Patients particularly older adults and people living with multiple chronic conditions may be left to navigate these separate parts of the healthcare system with limited coordination.
Hospitals Without Walls™ is designed to help connect those parts.
We bring healthcare professionals, organizations, information, technology, and support services together around the needs, goals, preferences, and circumstances of each patient.
Our objective is straightforward:
Deliver the right care, through the right qualified professionals, in the right setting, at the right time.
WHAT WE DO
Extending Coordinated Healthcare Beyond Traditional Walls
Depending on the patient’s needs, clinical eligibility, geographic availability, applicable law, payer authorization, and the services offered by participating providers, the Hospitals Without Walls™ model may incorporate
Comprehensive Geriatric Care
Multidimensional assessment and care planning for older adults, including medical, functional, cognitive, emotional, social, environmental, and caregiver-related need
Chronic Disease Management
Longitudinal support for patients living with conditions such as heart disease, diabetes, chronic pulmonary disease, kidney disease, dementia, mobility limitations, and other complex illnesses
Palliative Medicine and Supportive Care
Relief of symptoms, stress, and suffering for patients living with serious illness—provided alongside appropriate disease-directed treatment when clinically indicated.
Transitional Care
Structured support during transitions between hospitals, rehabilitation facilities, skilled nursing facilities, physician practices, home health services, and the patient’s residence.
Mobile Health Delivery
Appropriately authorized healthcare professionals and services delivered in the patient’s home, residential setting, or other permitted community location.
Telehealth and Virtual Care
Technology-enabled clinical communication, follow-up, education, and care coordination when appropriate and legally permitted.
Remote Patient Monitoring
Collection and review of selected health information outside conventional clinical settings when ordered, clinically appropriate, operationally available, and supported by applicable payer requirements.
Care Coordination
Deliberate organization of care activities and communication among the patient, family, caregivers, clinicians, facilities, health plans, and community resources..
Caregiver and Family Support
Education, communication, resource navigation, and care-planning support for the individuals who help patients remain safe and supported.
Hospitalization and Readmission Prevention
Early identification and management of clinical, functional, medication-related, environmental, and social risks that may contribute to avoidable deterioration or unnecessary healthcare utilization.