DispatchHealth has rolled back its emergency room-alternative care model, laid off workers in the process and pivoted to help health systems deliver complex care at home rather than operating as a full-service provider. Following the pivot, the company also named its president, Erin Bartley, as its next CEO, effective Nov. 1.

Bartley told Home Health Care News, ahead of the announcement of her new role, that DispatchHealth now aims to be the infrastructure layer for complex care at home and that the reimbursement landscape helped drive the pivot.

“Everybody is, if you will, fighting for their fair share of the healthcare dollar,” Bartley said. “And I would say we don’t always see the payers making the same kind of investments that they may have once made.”

The incoming CEO added that the challenging reimbursement landscape cannot be fully attributed to payers, because more must be done to prove that complex care in the home delivers savings for health plans, employers and members.

Bartley, who joined DispatchHealth as chief operating officer in 2025 following its merger with Medically Home, where she served as chief operating officer, will succeed Jennifer Webster, who has led the company since 2023. The company simultaneously announced that Brian Ko will join as chief financial officer.

Denver-based DispatchHealth acted as a hospital-at-home pioneer, offering in-home medical care for individuals facing serious health issues. The company’s 2025 merger with Medically Home created the country’s largest provider of this model.

Rollback and layoffs

As part of DispatchHealth’s pivot to focus on relationships with health systems, the company is discontinuing its full-service, payer-facing ER-alternative care model. The rollback includes ending relationships with six health systems, Bartley told HHCN.

DispatchHealth declined to disclose how many employees it laid off as part of the restructuring.

Bartley said the company had already exited many markets originally centered entirely on direct payer contracting.

“We had admittedly already closed a lot of the markets that were centered 100% on a direct-payer contracting, direct-to-consumer model,” she said. “A lot of that work had been done over the last couple of years, and what remained were places where we had health system partnerships. But it was still sort of a dual model, like one foot in each canoe of payer relationship and health system relationship.”

In some cases, DispatchHealth transitioned existing partnerships to services available under its new model. Other such partnerships were sunset.

The move is part of an effort to focus on what DispatchHealth does best, Bartley said. The company will still offer versions of an ER-avoidance model, but as an extension of health systems rather than as a stand-alone, full-service provider.

DispatchHealth’s strengths lie in its clinicians and teams who care for patients in their homes, supported by the company’s technology to improve efficiency and effectiveness, according to Bartley.

“What we’re no longer doing is trying to own all of the patient selection, all of the onboarding,” she said. “The health systems are really in a better position to do that, and to navigate those waters with the payers, if you will, in a way that it just wasn’t our strength to do.”

The company will continue to offer clinical services, such as those provided by nurses or paramedics, but moving forward, ordering clinicians will belong to health system partners.

A larger pivot

The rollback and layoffs reflect a broader strategy to make health systems DispatchHealth’s core customers.

“We do the care best, and in this innovative way, in a flexible way, in a way that’s efficient,” Bartley said. “That is the nut that we have sought to crack, and we have done really, really well. The other sort of nut [to crack is] how do you really influence the patient behavior? With this change, [we’re] leaning on health systems, risk-bearing provider groups to be solving that part of the equation, and not trying to take that on ourselves as much.”

Bartley described DispatchHealth’s go-to-market model as underpinned by its proprietary technology that serves as the common operating system whether health systems use their own staff or rely on DispatchHealth’s clinical services.

Across its active customer base, a growing number of relationships are technology-only agreements. These currently account for approximately 40% of the company’s customers, Bartley said. These relationships include mature health systems that have already invested in their own clinical teams and choose to use DispatchHealth’s platform to power internal workflows without taking on third-party clinicians.

Approximately 60% of the company’s customer base uses care delivery network management. Through this service, DispatchHealth coordinates care from contracted community providers rather than delivering it through its own clinicians. Those providers include local home health agencies, mobile imaging providers and specialty services such as wound care.

Direct clinical services have the smallest footprint, reaching roughly one-third of the company’s customer base. For these relationships, DispatchHealth deploys its own clinicians to provide care in patients’ homes. These service layers overlap, rather than representing separate slices of the business.

These proportions will evolve over time, Bartley said, with partners often starting with full-service clinical delivery and network management, then gradually bringing elements in-house and shifting toward network coordination or tech-only enablement.

Growth and the path ahead

In the years ahead, Bartley envisions DispatchHealth as the infrastructure layer for complex care in the home. This includes the company’s technology platform as well as its care delivery network and flexible in-home clinical services.

To grow, the incoming CEO said she aims to help health systems fill gaps across the health care continuum, including by supporting oncology care in the home.

The industry remains far from making complex care at home the norm, Bartley said, but the care model has a major tailwind: the five-year extension of the hospital-at-home waiver. She also pointed to the pace of technology development, particularly AI, as an opportunity to help the model scale.

“Our velocity on that is as fast as it’s ever been, and I’m excited about what we’re going to be able to continue to deliver,” she said.

DispatchHealth will spend the next year maintaining a disciplined focus on health system relationships and aims to bring on a “handful plus” of new customers, she said. But a day will likely come when the company reassesses some of the services it previously offered, such as serving payers and risk-bearing provider groups directly.

For now, the company will resist the temptation to reopen those services, Bartley said.