How Optum's HouseCalls pivoted to virtual when houses couldn't be visited during the pandemic

Optum’s HouseCalls Program sought to close gaps in care and improve care coordination by having clinicians and nurse practitioners visit Medicare Advantage beneficiaries.

But the program had to quickly pivot when providers couldn’t go into patients’ homes due to the pandemic.

“We only had in-home offerings, and so, in 11 days, we stood up a virtual program, so we are able to continue to offer care to MA members,” said Hope Miller, vice president of clinical field operations for HouseCalls, during a panel session at Fierce Health Payer's virtual summit this week.

The HouseCalls program aims to offer robust assessments and comprehensive exams, screenings and education for its MA members.


“We do an environmental scan of the home, a medication review, we conduct preventative tests,” Miller said. “When you compare a typical primary care provider visit, three to five minutes potentially, we are in the home for 45 to 60 minutes.”

But all that was forced to change when the COVID-19 pandemic emerged and house calls had to be put on hold.

Miller said Optum was forced to pause in-home visits for a little while, so nurse practitioners had to change how they cared for patients.

"We wanted to make sure that our members were cared for and had what they needed," Miller said. 

The night before each scheduled visit, providers did a screening of members to see whether they or a family member were symptomatic and then connected them to any services needed.

Optum also had to figure out how to aid its providers.

“We had to work to get [personal protective equipment] for our practitioners … and provide them to our members as well. We continued to make sure we were connecting them to services needed,” she said.

She added Optum plans to continue the virtual visits component of the program, the latest effort by providers and payers to expand the use of telehealth that emerged in popularity since the onset of the pandemic.

“We have all this tech with the virtual visits and behavioral health, [and] prior to the pandemic not a lot of our members were accessing that tech,” Miller said.

She added that the program can help tackle social determinants of health, a major priority for the program under the Biden administration.

“We complete a thorough social determinants of health assessment. Last year we completed 1.7 million house call visits,” she said, adding that the program expects to have 2 million visits this year.

RELATED: Humana: How Medicare Advantage helps deliver value-based senior care

The data from those visits could help address key equity gaps that some MA beneficiaries can face, Miller said.

“When we complete these assessments, we are connecting members with resources to help them close the gaps,” she said. “It’s a great way for data to be gathered.”

Mary Beth Donahue, president of the advocacy group Better Medicare Alliance, said in the same session that the MA program can be a leader in tackling health disparities.

“As much as Medicare Advantage is serving low income and minority populations, we all realize that health disparities ais a challenge in healthcare system today,” she said.