UnitedHealthcare's HouseCalls Program Advances In-Home Care in Medicare Advantage

Medicare Advantage plans continue to gain traction among American seniors, now holding a majority share over traditional Medicare. UnitedHealthcare's HouseCalls program exemplifies this shift by providing in-home clinical visits through nurse practitioners or physician assistants at no extra cost to members. These visits, which last longer than traditional office appointments, include comprehensive health assessments and screenings designed to prevent illness and manage chronic conditions effectively, aligning with Medicare Advantage's emphasis on coordinated, preventive care rather than reactive treatment.

HouseCalls visits enable providers to identify social determinants impacting health, such as medication adherence, nutrition, and transportation issues. Clinicians make referrals to social services accordingly, supporting a holistic approach to patient well-being. Importantly, these visits complement, rather than replace, primary care relationships, fostering communication between HouseCalls clinicians and patients' primary care providers to ensure continuity and follow-up. Approximately 75% of patients pursue additional medical appointments within 90 days after a HouseCalls visit.

Data demonstrates that HouseCalls significantly reduces healthcare utilization in vulnerable populations. Among patients with chronic diseases like coronary artery disease, diabetes, hypertension, and depression, there is a notable decrease in hospital admissions and emergency room visits post-visit. The program’s impact is especially pronounced among dual Medicare and Medicaid beneficiaries and those in rural or low-income communities, with hundreds of thousands of visits completed annually.

Despite recent critiques suggesting these in-home assessments are financially motivated, UnitedHealthcare maintains that the program is grounded in clinical best practices and adheres to strict quality assurance, diagnosis accuracy, and audit protocols. Most added diagnoses have no reimbursement impact, and government audits have affirmed compliance and accuracy. The program reflects the Medicare Advantage model’s original intent to incentivize preventive, integrated care.

Medicare Advantage overall has expanded rapidly since its inception, growing from 13% enrollment in 2003 to over 50% in 2025. The plans offer enhanced benefits such as lower copayments, out-of-pocket cost caps, and coverage for non-traditional services like healthy food and transportation. These advantages contribute to improved access and affordability while reducing costs relative to traditional Medicare, evidencing a significant shift in senior healthcare preferences and payer strategies.

UnitedHealthcare views the HouseCalls program as a demonstration of how spending more time with patients in their homes leads to improved health outcomes and lower costs. It illustrates an evolution in care delivery motivated by preventive health and addressing social factors influencing patient health, consistent with current Medicare Advantage regulatory frameworks and healthcare market trends.