Cityblock Health Makes The Home ‘Even More Central,’ Expands Long-Term Services, Supports

Why It Matters

Integrating risk‑based LTSS with primary care lets Cityblock address high‑need, dual‑eligible populations more efficiently, potentially reducing overall health‑system expenditures while improving patient outcomes.

Key Takeaways

• Expanded LTSS to over 10 states, beyond Massachusetts pilot
• Focus on dually eligible Medicare‑Medicaid members
• Risk‑sharing model links LTSS and medical spend
• Home‑based care enables early intervention, unmet need detection
• Integrated team “right‑sizes” services, accelerating care transitions

Pulse Analysis

Home‑based long‑term services are rapidly becoming a cornerstone of value‑based care, especially for the nation’s growing cohort of dual‑eligible beneficiaries. These individuals often grapple with chronic conditions, limited mobility, and social determinants such as housing instability and food insecurity. By delivering care directly in the residence, providers can capture real‑time data on daily routines, medication adherence, and environmental risks, enabling clinicians to intervene before health crises emerge. Cityblock’s expansion leverages this insight, pairing in‑person visits with telehealth and phone outreach to create a seamless continuum of support.

What sets Cityblock apart is its willingness to assume financial risk for both LTSS and medical expenditures. This risk‑sharing arrangement incentivizes the organization to invest heavily in preventive services, medication management, and coordinated care plans that reduce hospital readmissions and emergency department visits. By aligning reimbursement with outcomes, Cityblock can allocate resources to the most effective interventions, such as pre‑packaged medication deliveries that accelerate discharge from visiting nurse programs. The model demonstrates how integrated interdisciplinary teams can “right‑size” services, delivering just enough support to maintain health while avoiding unnecessary cost burdens.

The broader industry is watching Cityblock’s rollout as a potential blueprint for scaling home‑centric care across fragmented markets. As Medicare and Medicaid policymakers push for greater HCBS spending—now over 60% of LTSS dollars—organizations that can blend technology, risk contracts, and community‑based services are poised to capture market share. If Cityblock’s approach yields measurable cost savings and improved outcomes, it could accelerate adoption of similar risk‑based LTSS frameworks, reshaping how health systems address the complex needs of vulnerable populations.