Listen now (21 mins) | Beyond hospital care's considerable expense and at times questionable quality, it can be often times unnecessary. We spend over $900 billion, or one-third of all health care spending, on hospital care annually. Despite these costs the quality of hospital care can be poor if not harmful. A 2013 study published in the Journal of Patient Safety concluded between 210,000 and 440,000 patients hospitalized annually are fatally harmed. Beyond cost and quality, according to federal Agency for Healthcare Research & Quality (AHRQ) approximately ten percent of all hospital admissions for certain chronic and acute conditions are avoidable.