Technological advances and operational imperatives are pushing more and more care and care management into the home environment. How are remote monitoring and hospital-at-home programs evolving forward? There are policy, payment, operational, clinical, and technological aspects to consider. Among the topics to be discussed: how to architect a broad, comprehensive strategy around remote care delivery; the structural impediments and challenges to creating an architecture of remote care delivery; and some of the technological trends that are making new forms of care delivery and care management possible.