According to a recent Brookings Institution report, older people with chronic conditions suffer "repeated cycles of crisis, hospitalization and expensive but ineffective or even counterproductive treatment — leading to still more of the same." This is one reason our healthcare system is so expensive. Patients like this who constitute the top 10% of Medicare beneficiaries account for 57% of Medicare spending. Home care medicine makes so much sense for these patients, and could cut those costs significantly. Multiple studies have found that even among the ill and elderly, at least 30% of hospitalizations are potentially avoidable.