Designing care at home as an integrated continuum: insights from Singapore and application to U.S. health systems

Abstract Many U.S. hospital-at-home programs operate primarily as substitutes for inpatient admission. Singapore has instead pursued a nationally coordinated care-at-home framework: Healthier SG re-anchors chronic disease management in primary care, while MIC@Home mainstreams acute hospital care at home. We examine the governance, financing, workforce, and digital infrastructure designed to connect these programs, and draw design insights for U.S. health systems building integrated care-at-home continuums.