Case management and the controlled utilization of the home environment may facilitate the safe and effective earlier discharge of infants from intensive care. A pilot program was designed, combining resources of a medical college, pediatric home care company, and an insurance carrier, to provide specialized case management and home support to infants and families. Infants insured by Keystone Health Plan East (KHPE) in several hospitals were eligible. Exclusions included unstable medical status, unwilling or incapable caregiver, and an unsafe home environment. Case management included early identification of infants, family involvement in discharge planning, assessment of home and community environment, and establishing neonatology support and nursing care at home. Discharge criteria were: weight > 1800 grams, chronic TPN or full enteral feeds, thermostability in a crib or incubator, and stable medication regime. Supplemental oxygen, gavage feeds, phototherapy, incubator care, cardiorespiratory monitoring, and Intravenous medication were permitted at home. Infants and their families were followed for changes in health status and parental comfort. In addition, hospital days saved were determined with a validated tool based on conventional discharge criteria. 93 KHPE infants were identified over 6 months, and 43 enrolled in the program. 41 infants did not require home intervention, and 6 parents refused involvement. 4 infants were readmitted, 2 for scheduled procedures, 1 for exacerbation of status, and 1 for parental anxiety. 1 infant was admitted to the emergency room for intravenous access. Of 29/43 families, 89% rated the care as very good to excellent and 83% stated they were very satisfied to completely satisfied. It is estimated that 400 hospital days and $300,000 (approximately$7,000/patient) were saved, with similar clinical outcome. This Pilot program suggests that a mulitidisiplinary approach to case management may permit the earlier discharge of selected infants. Supported in part by KHPE and PAIDOS home care corp.