Home Care Driving Medicare Advantage Plan Growth

With 2020 just a few months away, Medicare Advantage (MA) plans are popping up left and right. Home care benefits continue to be a driving force behind the growth.

In the past week alone, the 2020 market gained at least two new MA plans. Anthem Blue Cross and Blue Shield of Maine and MaineHealth announced a new joint venture to offer MA plans in the state, while California-based Health2047 launched Zing Health, a new plan focused on addressing the social determinants of health of its members in the Midwest.

Meanwhile, another — Orange, California-based Alignment Healthcare, an AI-driven MA plan — said it will double its footprint in the year ahead.


This comes after a similarly booming 2019.

The number of MA plans available for individual enrollment this year was up 18% from 2018, with 2,734 plans total nationwide, according to data from the Henry J. Kaiser Family Foundation.

Before that, the number of plans available nationwide since 2011 remained largely stagnant, barring a 14% spike in 2018, the same data suggests.


Given the timing of the increased interest, it’s hard to deny the role that in-home care benefits have played in making it happen.

In April 2018, the Centers for Medicare & Medicaid Services (CMS) first announced personal care services would be allowed as a supplemental benefit in 2019. A year later, they expanded those flexibilities even further, allowing plans to cover any benefits that could be expected to improve or maintain the health of beneficiaries with chronic conditions.

Even CMS has said the new home care flexibilities are responsible for drawing new plans to the market, driving down premiums for members and attracting new enrollees as a result.

“The steps that the Trump Administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits, and lower costs for seniors,” CMS Administrator Seema Verma said in a statement. “The popularity of programs, such as Medicare Advantage, and with the various new supplemental benefits and policy changes that have been adopted, we expect plan choices to be even more robust moving forward.”

However, recent research suggests that the MA program may cost the government more than traditional Medicare, according to findings published in Health Affairs.

On top of that, enrollment actually remained steady between 2018 and 2019, according to Kaiser. In both years, MA beneficiaries made up 34% of total Medicare beneficiaries. One reason could be that few plans — only 3% — actually offered in-home care benefits in 2019, according to AARP.

That’s likely to change dramatically going forward.

While it’s still too early to tell exactly how many new plans and beneficiaries MA will gain next year, many industry experts believe 2020 will be the year things really start to take off.

“2019 is a very skinny, little, experimental year that is just reflective of some regulatory changes CMS made,” Medicare Advantage expert Anne Tumlinson, founder of Washington, D.C.-based research and advisory services firm Anne Tumlinson Innovations, previously told HHCN. “2020 is really year one.”

Companies featured in this article:

, , , , , , ,