Health and medicine. (Credit: LevittownNow.com)
Imagine a young lawyer in Center City, fresh from knee surgery at Penn Medicine, returning home alone. They don’t have a roommate to help with meals, no partner to grab medications, and their family lives across the country. Similarly, there’s a widowed and retired grandmother in the western suburbs, post-cataract procedure at Jefferson Health, facing recovery challenges without wanting to disrupt her grown children’s busy lives. She does the best she can post-surgery on her own, but help would improve her days significantly.
These scenarios are increasingly common across Philadelphia, a national medical powerhouse where outpatient care is booming, yet recent assessments of lacking community support and hospital discharge practices reveal deeper strains that residents feel firsthand.
The 2025 Regional Community Health Needs Assessment, conducted in partnership with several of the largest health systems in the Philadelphia region, highlights increasingly limited healthcare options due to hospital and pharmacy closures, forcing patients into overburdened outpatient settings and straining access to dental, behavioral health, and follow-up care, particularly in underserved areas of the city.
This outpatient shift promises efficiency and cost savings, but it also exposes critical gaps in home-based recovery, heightening risks of complications and readmissions while undermining patient safety. As Philly expands its healthcare infrastructure going into 2026, it must strengthen the support systems that meet people where they are: at home. Building real community networks ensures that no one recovers alone.
And the need for these networks is only increasing. Outpatient volumes are growing rapidly nationwide, with JLL projecting 10.6 percent growth over the next five years, amplified in Philadelphia by the city’s dense network of hospitals and ambulatory centers. The Pennsylvania Health Care Cost Containment Council reports hundreds of thousands of outpatient endoscopy procedures performed at Pennsylvania ambulatory surgery centers in 2024. Add in cataract, carpal tunnel, ear tube, and other common outpatient procedures, and the numbers reveal a system that is ill-equipped to meet home support demand.
Philly’s hospital systems’ expansions highlight this surge. Penn Medicine opened a $376 million immunology and autoimmunity research center in West Philadelphia in September, also breaking ground on a new multi-specialty outpatient center in Montgomeryville in April that includes comprehensive Abramson Cancer Center services. And Jefferson Health began modernizing its two Level I trauma centers in summer 2025. These recent examples reflect a broader push for accessible, convenient care, driven by an aging population and high patient demand for outpatient options.
Yet this progress also masks troubling vulnerabilities. Without hospital-based support, patients recover amid fragmented family structures. So it’s no surprise that readmission risks remain high, with millions of cases annually costing the healthcare system billions. Home health care can lower these rates significantly, as multiple studies have shown, revealing how crucial the home healthcare industry has and will become in ensuring patient safety during recovery.
In Pennsylvania, workforce shortages are driving longer ER waits and strained access, with a projected shortfall of 20,000 nurses by 2026. And according to the Pennsylvania Homecare Association, more than 112,500 home care shifts go unfilled every month. Nationally, nearly one in four adults provides unpaid caregiving; Pennsylvania’s rate is comparable and places heavy burdens on families, especially the sandwich generation caring for aging parents while raising children.
These challenges hit hardest in underserved areas of the city, widening inequities as home-based care demands grow. A study using data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project found that unplanned hospital visits after ambulatory surgery occur at a risk-adjusted rate of 4.8 percent within 30 days, with higher risks for certain procedures, highlighting the need for proper home support to mitigate complications like pain mismanagement or postoperative issues.
The solution lies in equitable support networks. We must advocate for stronger home care systems that connect hospitals with community agencies for seamless post-discharge care. Hybrid transitional care models, such as the Transitional Care Model developed by Mary Naylor at the University of Pennsylvania, have been shown to significantly lower readmissions through nurse-led interventions that bridge hospital and home.
Philly can lead the way by reimagining what care and recovery looks like when someone leaves the hospital, building partnerships around systems like Main Line Health, Penn, Jefferson, and Temple. Policymakers should incentivize these through increased state Medicaid funding and workforce investments to address Pennsylvania’s caregiver crisis. For example, support ongoing efforts like Governor Shapiro’s 2025-26 budget investments, which include $21 million to raise wages for 8,500 direct care workers in Medicaid’s participant-directed model, providing paid time off and affordable insurance.
Philly’s outpatient expansions enhance access, but without strong home support, they invite higher costs and worse outcomes for deserving patients. Hospitals, policymakers, and residents must act: invest in community networks, advocate for funding to address the looming nurse shortage, and prioritize equity in future budgets. By bridging the hospital-to-home divide, Philadelphia can set a national standard for compassionate, efficient, and equitable care.
Arianna Hairston is the Director of External Affairs and Customer Engagement at AideChoice, an app-based platform connecting users with short-term, non-medical home care from licensed agencies in Greater Philadelphia. Visit aidechoice.com or download the app to learn more.
