More than one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, and many high-need MA enrollees may benefit from new flexibilities for plans to provide supplemental benefits that can address functional and health-related social needs. In 2019, the Centers for Medicare & Medicaid Services (CMS) expanded the definition of primary health-related supplemental benefits that MA plans were allowed to offer to include services that support physical impairments, improve functional or psychological status, or reduce avoidable emergency and health care utilization. Beginning in 2020, CMS allowed MA plans to offer Special Supplemental Benefits for the Chronically Ill (SSBCI) to provide expanded benefit options for enrollees with certain chronic health conditions. Examples of “special” expanded supplemental benefits include in-home supports, home-delivered meals, non-medical transportation, and housing. While relatively few MA plans offered these benefits in 2020, new data show that many more plans will offer expanded supplemental benefits for 2021. Addressing functional and social needs may lead to improved health and cost outcomes for older adults with complex needs.
This webinar, coordinated by the Better Care Playbook and made possible through the Seven Foundation Collaborative, explored considerations for health plan adoption and implementation of expanded supplemental benefits. Featured speakers described recent research on the adoption of these benefits, as well as discussed related opportunities and challenges on expanded supplemental benefits, including SSBCI implementation from the perspective of health plans, providers, and beneficiaries.
I. Welcome and Introduction
Speaker: Michelle Herman Soper, MHS, Vice President for Integrated Care, Center for Health Care Strategies (CHCS)
M. Soper welcomed participants, introduced the speakers, and provide a brief overview of the Better Care Playbook and recent flexibilities for expanded supplemental benefits.
II. Current Benefit Landscape and Initial Health Plan Adoption
Speaker: Narda Ipakchi, MBA, Senior Consultant, Health Management Associates
N. Ipakchi provided a landscape of the types of benefits offered in 2020, describe the opportunities and barriers to health plans adopting new supplemental benefits, and provided insights about how beneficiaries understand these benefits.
III. Analysis of Supplemental Benefit Offerings and Beneficiary Impact
Speaker: Matt Kazan, MPP, Principal, Avalere
M. Kazan shared research findings on factors that have driven plan adoption of MA supplemental benefit offerings across all benefits options from 2018-2020, as well as the potential impact that these new, expanded benefit offerings could have on Medicare beneficiaries with high-risk factors.
IV. Looking to the Future: Expanded Supplemental Benefits and Adoption in 2021
Speaker: Tyler Cromer, MPA, Principal, ATI Advisory
T. Cromer shared new data about the expanded supplemental benefits that MA plans will offer in 2021. She also presented insights from market research on how plans make strategic decisions about design and implementation of new benefits as well as their operational challenges. She shared core implementing principles for non-medical benefits that were developed by a diverse panel of stakeholders.
V. Reflections on Opportunities for Health Plans and Partners to Implement New Supplemental Benefits
Speaker: Sachin Jain, MD, MBA, President and Chief Executive Officer of SCAN Group and Health Plan
S. Jain reflected on the presentations and findings, and share thoughts on how the SCAN Health Plan developed its strategy to adopt and implement expanded supplemental benefits for high-need Medicare beneficiaries.
VI. Moderated Q&A
Moderator: Michelle Herman Soper, CHCS