Advancing the Future of “Care Without an Address”: Recommendations from International Health Care Leaders

The demand for home- and community-based care will intensify across the world as populations age and technological advancements support innovative delivery approaches. The Future of Health, an international community of senior health leaders, collaborated with the Duke-Margolis Center for Health Policy to identify what priority actions health delivery organizations and policy leaders can take to implement the “Care Without an Address” model — a fundamental paradigm shift where care is centered around the patient in a comprehensive, coordinated manner regardless of location. This article describes recommendations, which the authors derived through a consensus-building exercise and supported with a targeted literature review and an expert discussion group. The four major action areas include: promoting a vision and strategy to achieve Care Without an Address; establishing partnerships with innovative “insurgents” operating outside the traditional clinical setting to build and expand models; investing in the workforce to support new ways of delivering care; and developing standards to ensure high-quality care across sites. However, questions remain as to whether this is sustainable and whether traditional brick-and-mortar institutions, or alternatively new market entrants, will drive this change.