Since the Centers for Medicare & Medicaid Services (CMS) began allowing Medicare Advantage (MA) plans to offer supplemental benefits, those benefits’ popularity has skyrocketed.
Those benefits, broadly, fall into two categories: Expanded Primarily-Health Related Benefits (EPHRB) and Special Supplemental Benefits for the Chronically Ill (SSBCI). Their existence alone has changed how home care providers interact with MA plans.
But, some providers were wary of wading into MA waters. After all, EPHRB and SSBCI were new, and not every plan offered them. Even if they did, they may not offer enough hours of in-home support services (IHSS) – a popular supplemental benefit – for it to make sense from the provider side.
But the growth has been stark, according to analysis from ATI Advisory. So stark, in fact, that nearly every home care provider is at least considering what MA business may look like for them down the line.
ATI Advisory is a Washington, D.C.-based research and advisory firm that studies supplemental benefit developments closely.
There has been a 364% increase in plans offering IHSS since 2020, from 283 plans then to 1,314 in 2023. There has been a 320% increase in caregiver support service offerings, from 134 plans to 563 plans.
There has also been a 1,215% increase in plans offering social needs benefits, from 34 plans in 2020 to 563 now. All of these aforementioned supplemental benefits are ones that home care providers could theoretically fulfill.
“In-home support services are a really popular offering,” ATI Advisory Principal Tyler Cromer told Home Health Care News in January. “Nearly a quarter of all the plans are offering in-home support services this year.”
More importantly, perhaps, is that more plans are seeing the need for these benefits and allowing beneficiaries to use them more often. That makes it a more financially viable option for home care providers.
“We continue to see a movement toward providing beneficiaries flexibility in how they use these benefits,” Cromer said. “It is a more person-centered approach. And what I mean by that is, we see plans offering – particularly within SSBCI options – anywhere from $1,000 to $2,000 per year to spend on any assortment of available supplemental benefits.”
Outside of the raw numbers, ATI Advisory has also found that plans view these benefits as key for the satisfaction and retention of members.
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