Over $70 billion a year in avoidable cost. Most of it starts at home.
Every risk-bearing entity carries the same burden: ED visits that didn’t need to happen, admissions and readmissions that were preventable, seniors placed in facilities before they had to be. The events are avoidable — but the moments that cause them happen in the home, between clinical visits, where you have no reach today.
The cost you already pay for.
For a health plan, ACO, MA plan, or any entity bearing medical risk, avoidable acute care is the single largest pool of recoverable spend — and the hardest to reach, because it’s driven by what happens to members on the days no clinician sees them.
Industry estimates: avoidable hospital ED visits ~$32B/yr (UnitedHealth Group); preventable readmissions ~$17B/yr (CMS); the $70B+ figure combines these with avoidable admissions and premature long-term facility placement.
Reducing it is hard. But value-based care is already doing it.
Avoidable cost has defeated a long list of good intentions. What’s changed is that a cohort of value-based operators has actually cracked it — and they’re among the fastest-growing companies in all of healthcare.
Aledade
Saved Medicare more than $1B in 2024, preventing roughly 96,000 hospitalizations and 167,000 ED visits. 93% of its ACOs earned shared savings — versus 73% of all others.
Main Street Health
The #1 fastest-growing private company in America (Inc. 5000, 2026). The company reports 53% fewer readmissions, 51% higher Star scores, and 11% lower medical cost — in rural markets, no less.
Oak Street & ChenMed
The high-touch senior primary-care model, proven enough that CVS bought Oak Street Health for ~$10.6B and Amazon bought One Medical for ~$3.9B.
The question has shifted. It’s no longer whether value-based care can reduce avoidable cost — it’s which settings haven’t been brought into it yet.
Home care has been the missing setting — until now.
One care setting has sat almost entirely outside value-based payment: non-skilled, in-home care. Insiders have long suspected it could be one of the most powerful levers on avoidable cost — it’s the highest-frequency touchpoint a senior has, in the exact place decline begins. But three features of the industry kept it out. And two changes just opened the door.
The industry’s barriers
- Highly fragmented — thousands of small, local agencies, none at scale
- Misaligned incentives — paid by the hour, with no stake in outcomes
- Operators and workforce lacking the data and clinical sophistication to plug into value-based models
- No measurement layer tying in-home activity to downstream medical cost
What finally changed
- A decade of value-based care in primary care proved which activities cut avoidable cost — and nearly all of them live in the home
- AI makes it possible to coordinate, measure, and manage a fragmented agency network at scale
- Together, they make the potential insiders always saw finally realizable
One integration point into the home.
Aponot is the single integration point that lets you tap the massive home-care infrastructure that already exists — without contracting thousands of agencies or building a measurement layer yourself. You connect once to us; we manage the network and the data, and put home care’s unique attributes to work on your avoidable cost.
What we target
Emergency department visits
Catching decline and closing gaps in the home before they become an avoidable ED trip.
Hospital admissions & readmissions
Post-discharge follow-through, medication reconciliation, and early escalation — the proven levers, executed daily.
Premature facility placement
Keeping members safely and independently at home longer — deferring the highest-cost transition of all.
Star ratings & quality
Better adherence, engagement, and experience in the home flow straight through to Star and quality performance.
We’re partnering with a small number of risk-bearing entities on pilots now. If you carry medical risk and want to reach the avoidable cost that lives in the home, we’d welcome a conversation about what a pilot could look like on your population.