UnitedHealthcare’s (UHC) decision to label Remote Patient Monitoring (RPM) as “not proven” and to cut coverage for most conditions, may reflect not only a lack of understanding of the evidence, but a financial calculation — one shaped by medical loss ratio pressure, near-term utilization metrics, and the expectations of consistent quarterly financial performance. 

For more than a decade, RemetricHealth, a leader in RPM, has worked alongside physicians, health systems, and care teams to implement RPM programs at scale. When implemented correctly, with the proper care team and clinical workflows in place, RPM works. It reduces hospitalizations, emergency department visits, and total cost of care. This is a reality supported by years of real-world implementations and peer-reviewed evidence.  

The Centers for Medicare & Medicaid Services (CMS) also continues to recognize the value of RPM and has steadily expanded coverage over the years. In the latest update, CMS introduced two new Medicare codes to further support RPM. Today, over 66 million people are enrolled in Medicare, and 64% live with two  or more chronic conditions. This vulnerable population faces challenges of accessing in-person care and may need on-going support between office visits. RPM offers a vital solution by helping clinicians monitor health status, track medication adherence, and catch changes early.  

RPM does what evidence-based medicine demands: it empowers patients, detects deterioration early, and escalates care before conditions spiral into emergencies. Early intervention may result in visits, diagnostics, or specialist involvement in the short term; because that is how prevention works. Those actions prevent strokes, heart failure exacerbations, and avoidable hospitalizations. The fact that these benefits are realized over time does not make RPM unproven; it makes it incompatible with a financial model that prioritizes short-term optics over long-term outcomes. 

A recent Guardian investigation into UnitedHealthcare’s nursing home programs examined initiatives framed as reducing unnecessary hospitalizations. According to reporting, these were linked to allegations of delayed or denied medically necessary care, including wrongful death claims. When coverage and care decisions are engineered primarily to satisfy short-term financial metrics rather than longitudinal patient outcomes, clinical judgment is constrained, and patients bear the risk.  

RPM represents the opposite philosophy. It increases clinical visibility and surfaces risks earlier. It empowers care teams to act before deterioration becomes irreversible. 

Narrowing RPM coverage seems to be less about insufficient proof and more about limiting interventions that generate fast, easily attributable claims reductions within a single plan year, while abandoning care models that deliver measurable, life-saving value over time. If UHC continues to dismiss longitudinal, evidence-based care as “unproven,” it may succeed in deferring costs…  until they return later, higher, and at the expense of millions of older adults. 

Update: In December, UnitedHealthcare announced a hold on its position to pull RPM coverage, postponing the change until later in 2026 and offering no additional clarification.