UnitedHealth Group’s (NYSE: UNH) in-home health program, HouseCalls, coincided with up to 5% fewer inpatient stays and 4% fewer emergency room visits for older adults with conditions such as diabetes and hypertension in the year after their visit, according to a Tuesday announcement.
In the announcement, the healthcare giant shared initial results of an external examination of HouseCalls’ diagnosis coding practices. An external consulting firm found that 97% of the home health program’s diagnoses were supported by the medical record.
“These visits make up a small but meaningful share of the more than 19 million home visits UnitedHealth Group clinicians make each year,” UnitedHealth Group CEO Steve Hemsley wrote in a statement.
UnitedHealth Group’s HouseCalls program offers older adults in-home, clinician-led medical visits. HouseCalls aims to identify health issues, care gaps, safety risks, behavioral health needs and social barriers that are often unobserved through in-office visits, according to the company. Through the program, 75% of participants follow up with medical appointments within 90 days of HouseCalls visits.
UnitedHealth Group tapped the business advisory firm FTI Consulting to independently review the accuracy of diagnoses derived from HouseCalls visits submitted to the Centers for Medicare & Medicaid Services (CMS). FTI randomly sampled 200 HouseCalls visits addressing 494 diagnoses to find 97% of the diagnoses were supported through medical records or paid claims. The company said the resulting 3.4% rate of unsupported diagnoses was nearly three times lower than the error rate CMS reported in its most recent Medicare Advantage medical record audit.
In reviewing diagnoses that were not initially supported, FTI confirmed 12 of 17 previously unvalidated diagnoses after conducting a second review.
“Taken together, these results validate the integrity of the HouseCalls program, but we will continue to strive to ensure that only appropriately supported diagnoses are submitted to CMS,” Hemsley said in the statement.
Additionally, UnitedHealth Group announced the establishment of CareConnectors, which schedules follow-up appointments for older adults with worsening conditions. It also helps members find providers, connects them to community resources and tracks follow-up care.
UnitedHealth Group came into the home health spotlight when it acquired home health care services provider Amedisys after a two-year gridlock spurred by antitrust concerns, Home Health Care News previously reported.