Home- and Community-Based Care Takes Center Stage in 2020 Medicare Advantage Plan Designs

From national plans such as Humana and Cigna to smaller regional ones like SCAN Health Plan, a large number of Medicare Advantage (MA) plans are set to expand their home- and community-based supplemental benefit offerings in 2020.

While details remain somewhat sparse, plans officially began announcing their 2020 offerings Monday, ahead of the upcoming annual election period, which runs Oct. 15 through Dec. 7. 

The news is in line with projections the Centers for Medicare & Medicaid Services (CMS) released last month. Specifically, the Trump administration estimated that about 250 plans would offer newly allowed non-health related benefits in 2020, reaching about 1.2 million beneficiaries total.

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Those benefits, which will be allowed for the first time next year, can include anything that has a reasonable expectation of improving or maintaining the health or overall function of MA beneficiaries with chronic conditions — from carpet shampooing and pest control to ride-hailing and beyond.

On top of that, CMS projected 500 plans will offer supplemental benefits designed to help another 2.6 million beneficiaries maintain their health. While these flexibilities to cover non-medical benefits — such as home care — were first allowed in 2019, only 3% of plans offered such benefits during their inaugural year, according to AARP.

But now, hundreds of MA plans are set to take advantage of their freedoms to address social determinants of health and keep beneficiaries in the home.

Cigna

Take Cigna (NYSE: CI), for example.

In 2020, it’s giving select MA beneficiaries allowances for air conditioning and acupuncture, in addition to expanded transportation offerings to take select seniors to worship places and grocery stores.

For the first time, all Cigna MA beneficiaries will also have access to doctors via phone, computer or tablet for some routine care, according to a press release from the health services organization.

“This is an exciting year for Cigna as we roll out our biggest Medicare Advantage expansion to date with new geographies and new products,” Brian Evanko, Cigna’s president of government business, said in the release.

Humana

Meanwhile, Humana (NYSE: HUM) is also offering a virtual doctor visit benefit to all MA beneficiaries and a number of new allowances in 2020.

For example, select beneficiaries will have access to allowances for over-the-counter personal care items, as well as home support and resources for caregivers.

Humana has long expressed interest in providing home-based MA benefits in the past, even offering some seniors access to grandkids on demand to help address loneliness and other social factors.

In July, CEO Bruce Broussard alluded to the home as the care setting of the future.

“You have this holistic view of the customer, so you can create an intervention based on personal needs, clinical needs and [personal] preferences,” Broussard said at a Medicare Advantage conference. “All of those, I think, will make a great health care system a decade from now.”

SCAN Health Plan

SCAN Health Plan’s 2020 offerings will include no-cost telehealth, worldwide travel coverage, free Fitbits and acupuncture for select beneficiaries, in addition to other offerings.

SCAN was one of the few health plans to offer MA beneficiaries access to home care in 2019, teaming up with Los Angeles-based 24-hour Home Care to make it happen.

“It was probably in February 2018 when we first connected with [SCAN Health Plan],” Gavin Ward, regional director of strategy and partnership for 24 Hour Home Care, previously told Home Health Care News. “I’ve known the folks at SCAN for many years. I gave [them] a quick call, left a message that we had experience working with at-risk populations and thought there could be some synergy.”

Other home-based benefit offerings from SCAN include medical alert systems, respite care for caregivers, and a post-hospitalization initiative designed to keep people out of the hospital called “Returning to Home.”

While these are just a few anecdotal examples of the many new home- and community-based supplemental benefits set to be offered in 2020, they are a great indication of where the industry is headed and the future opportunities that exist for home-based care providers.

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