Medicare Advantage (MA) supplemental benefits adoption has been slow by some measures and rapid by others.
A new report from the consulting firm Milliman offers a look into that dynamic and shows exactly where each of those benefits stands in 2022. The report was commissioned by the Better Medicare Alliance (BMA).
Among the primarily-health related benefits, in-home support services (IHSS) remains the most popular benefit by a large margin. Meanwhile, adult day service offerings have actually fallen off from 2021.
As for the Special Supplemental Benefits for the Chronically Ill (SSBCI), the services that home care agencies can provide also remain the most popular. Those include the food and produce, meals beyond a limited basis, non-medical transportation and general supports for living offerings.
IHSS can be offered through both the primarily-health related and SSBCI pathways. The benefit has seen significant uptick over the last couple years. Now, 544 plans are offering it, a 268% increase from the 148 plans that offered IHSS in 2020.
“That’s really significant growth from when this was first available as a benefit,” Tyler Cromer, a principal for ATI Advisory, told Home Health Care News when initial MA benefits data for 2022 was first released. “There’s a lot of good news here for home care providers.”
As for adult day services, it’s drop in popularity among plans could be due to a few reasons. In 2021, 88 plans offered the benefit, up from 63 in 2020. But in 2022, just 42 plans are on board with the benefit.
Adult day services were hit hard by COVID-19 over the past two years. For long periods of time, operators in a lot of states were not even allowed to open and struggled to stay afloat.
Additionally, because MA plans are still experimenting with supplemental benefits, the amount of hours they pay for – for any given service – is sometimes meager. With that in mind, the benefit may not be worth it right now for either side – provider or MA plan.
The SSBCI are a newer set of benefits than the primarily-health related ones, and their adoption has been intriguing from home-based care operators’ perspective.
“I think we expected to see growth in the number of plans offering SSBCI, and the data has confirmed that,” Elexa Rallos, an analyst at ATI, told HHCN. “We were expecting to see big growth in the benefits that a lot of members are asking about – things like food and produce and meals. But we’re also seeing a lot of growth in newer, more non-medical benefits – things like transportation and the general supports for living benefit, which is really interesting.”
Overall, close to 1,300 MA plans will be offering some sort of SSBCI this year.
Another interesting aspect of the Milliman report was the kind of conditions that MA plans are targeting with these flexible offerings.
The top four targeted conditions are diabetes, congestive heart failure, COPD and hypertension, according to the report. Behind those was cellulitis, dementia, stroke and urinary tract infection.
Specifically, 56 more plans are targeting diabetes through these supplemental benefits in 2022 compared to the year prior.
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