Doesn't scale compared to what, though? Because if the comparison point is the more typical modern care-work organization where tasks are divided into a fine-grained categories of "high skill" and "low skill" work, outsourcing the "low skill" tasks to the low-trained workers as an attempt to save costs, then Buurtzorg shows that that approach is not a net savings.

Because Buurtzorg has been shown to have lower costs and higher job satisfaction than its competitors, and the reasons are quite obvious too: the hierarchical outsourcing solution adds extra communiciation costs, administration costs, and similar organizational overhead. On top of that patients are in a situation where they see many different unfamiliar care workers briefly, meaning they do not get to form a bond of trust with any one of them. That is a pretty heavy costs that I don't even know how to categorize.