Anthem Inc. (NYSE: ANTM) and a number of its affiliated health plans were among the relatively few Medicare Advantage (MA) entities to actually offer home care-related supplemental benefits for the 2019 plan year.
The Indianapolis-based Anthem was one of the first major insurers to publicly promote that fact as well, highlighting its expanded benefits packages — which included personal home helper, food delivery and transportation services — during an October 2018 Home Health Care News interview.
It’s now doubling down on its commitment to home care and other services that revolve around whole-person wellness for the 2020 plan year, Anthem announced Tuesday.
“What we filed in June 2018 for the 2019 year was an … approach to innovative benefit design that addressed whole-person health,” Martin Esquivel, VP of product management and strategic initiatives for Anthem, told HHCN. “Our experience — though we’re all of nine months into 2019, so it’s still new — has been very much in line with our expectations.”
Similar to this year, Anthem’s 2020 benefits packages crafted around whole-person health and wellness will be branded under the names Essential Extras and Everyday Extras, depending on which state an affiliated health plan operates in. Packages in California and Arizona will not have a specific name, according to Anthem.
For the most part, individuals enrolled in Anthem MA plans offering the Essential Extras or Everyday Extras package will be able to select one of 10 services that help address their health and social needs.
Those services include up to 124 hours of an in-home personal care aide for assistance with activities of daily living (ADLs), in addition to up to one visit per week for adult day center services for some older adults.
“We recognize that beneficiaries that experience limitations in [ADLs] are at … greater risk for a fall, greater risk of social isolation and more likely to have access-to-care issues,” Esquivel said. “Helping create a stable, safe environment in the home, we see that as a first step toward helping beneficiaries down a path toward a more comfortable, sustainable health care experience.”
Other perks include 60 one-way trips per year to health-related appointments, 64 delivered meals annually and up to $500 in allowances for the installation of home safety devices.
‘We’re going to learn a lot’
Anthem is doubling down on its expanded supplemental benefits packages in three main ways, Esquivel said.
On a basic level, that simply means offering more services in 2020 than in 2019.
But it also means opening up the benefits to more beneficiaries: In 2019, about 165,000 beneficiaries had access to Anthem’s expanded benefits packages. That figure will more than double to 360,000 in 2020.
Additionally, while some plans require individuals to select one of 10 services, others will test out different approaches. For example, MA plans from Anthem Blue Cross in California and Amerigroup in Arizona will give individuals access to all services — at the same time.
State policies and financial projections factor into what Anthem and its affiliated plans decide to offer in certain markets.
“I don’t want to call it a test, but in some ways, it is,” Esquivel said. “We’re going to learn a lot about what changes in utilization patterns when you make it all available.”
A natural alignment
Looking back at the first few months of 2019, certain benefits “sort of jumped to the lead” in terms of popularity, according to Esquivel. In the early part of the year, beneficiaries gravitated toward transportation and alternative medicine services, in particular, though food delivery and personal home helper services were likewise popular.
Interest has since leveled out, a sign of successful benefits design.
“As the months have progressed, we’ve seen most of the rest of the benefits sort of pick up,” Esquivel said. “We’re seeing very well-distributed utilization across the various offerings.”
When it comes to home care partners, Esquivel declined to name any one, specific agency that Anthem and its affiliated plans are working with.
“It’s too broad a list,” he said.” As a result of our discussion [with HHCN] a year ago, we received a lot of inquiries from agencies that were looking to partner with us. We brought many of them on board.”
In general, Anthem and its team values agencies that have scale and solid data capabilities when looking for potential partners. Data — being able to see the impact certain benefits have on a day-to-day basis or in reducing re-hospitalizations — is probably the most important characteristic.
In the past, some home care providers have been down on MA partnerships, noting that plans often only want to cover a small number of hours of care every now and then.
But on its end, Anthem only expects its interest in home care to grow moving forward.
“Because it was an entirely new program, the need was initial small upfront,” Esquivel said. “But it has grown. We continue to be open to partnering with the types of organizations that make the most sense here. … The home care environment very much aligns with our goals, which are focused on whole-person health.”
Companies featured in this article:
