⚠ Home Visits Are What the Auditors CheckModerate threat

UnitedHealth Group (UNH) — threat to the moat

UnitedHealth says its HouseCalls diagnoses are more accurate than government audits suggest, but those audits are still running.

Care in the home is also where diagnoses are recorded, and diagnoses decide how much Medicare pays. UnitedHealth commissioned a review of its HouseCalls program and said its error rate was "nearly three times lower" than the rate reported by the government's most recent audits1. Risk adjustment data validation audits by the government continue2.

Home care and scrutinyHouseCalls visits 20253.1 millionAmedisys priceabout 3.3 billion dollarsLocations divested164 in 19 statesDivested revenueabout 528 million dollarsUnitedHealth 10-K FY2025; Q2 2026 release; Hospice News; Fierce Healthcare
A large home business under audit.

The company defends the program as preventive care. The scrutiny exists because the visits generate information used to set payments.

The scale is large: 3.1 million HouseCalls visits in 20253. A change in how such visits may be used for payment would reduce the value of the home program.

The company treats the audits as ongoing business. Its 10-Q notes that risk adjustment data validation audits continue4, and its second-quarter release cited the company-commissioned review of HouseCalls5 as evidence that the program's diagnoses are accurate.

The event to watch is the outcome of the government audits. Findings that require repayment would put a price on the program's diagnoses.

References
  1. ReportedUnitedHealth commissioned a review of its HouseCalls program and said its error rate was "nearly three times lower" than the rate reported by the government's most recent audits.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - commitments on prior approvals, rebates, ACA profits and the United Health Foundation, and recent transactions. — Q2 2026 · publ. 16 July 2026 · source ↗
  2. ReportedRisk adjustment data validation audits by the government continue.
    UnitedHealth Group Form 10-Q for the quarter ended 30 June 2026 - segment note on the 2026 basis, share repurchases, legal matters and the IRS notices. — Q2 2026 · publ. 10 August 2026 · source ↗
  3. ReportedThe scale is large: 3.1 million HouseCalls visits in 2025.
    UnitedHealth Group Form 10-K for fiscal 2025 - Item 1 business: segments, products, people served and leadership. — FY2025 · publ. 2 March 2026 · source ↗
  4. ReportedIts 10-Q notes that risk adjustment data validation audits continue, and its second-quarter release cited the company-commissioned review of HouseCalls as evidence that the program's diagnoses are accurate.
    UnitedHealth Group Form 10-Q for the quarter ended 30 June 2026 - segment note on the 2026 basis, share repurchases, legal matters and the IRS notices. — Q2 2026 · publ. 10 August 2026 · source ↗
  5. ReportedIts 10-Q notes that risk adjustment data validation audits continue, and its second-quarter release cited the company-commissioned review of HouseCalls as evidence that the program's diagnoses are accurate.
    UnitedHealth Group second-quarter 2026 results release, Form 8-K exhibit 99.1 - commitments on prior approvals, rebates, ACA profits and the United Health Foundation, and recent transactions. — Q2 2026 · publ. 16 July 2026 · source ↗
Sources
Generated September 26, 2026