Our Work
Advancing Non-Medical Supplemental Benefits in Medicare Advantage
Many non-medical supplemental benefits are available in Medicare Advantage (MA) for the first time in 2019 and 2020. These benefits provide an unprecedented opportunity to deliver valuable non-medical services to Medicare beneficiaries to improve their health. ATI Advisory and the Long-Term Quality Alliance, with support from The SCAN Foundation, have developed a set of resources for plans, providers, and policymakers to advance the availability and implementation of these benefits and the Guiding Principles in practice. Learn more below.
We interviewed over 20 Medicare Advantage (MA) plans and providers to get their take on the business opportunities, roadblocks, and strategies to overcome these roadblocks, associated with providing new, non-medical benefits.
Our interviews pointed to a five-part process to develop supplemental benefit offerings, starting with building support within the MA Organization. We highlight opportunities for building a network of non-traditional providers, strategies for designing and targeting high-value benefits, approaches for educating members and providers, and for improving over time.
The number of plans offering these new benefits has grown precipitously. These benefits are here to stay. Our research highlights the potential for these benefits to improve or maintain Medicare beneficiary health, but this is not a given. Plans, providers, government, and consumers must collaborate to realize the potential of these benefits.
Resources:
- Executive Summary
- Background on Supplemental Benefits in Medicare Advantage (background on supplemental benefit authorities and context on the growth of supplemental benefits in MA)
- The Competitive Landscape for New, Non-Medical Benefits (a snapshot overview of plans offering new supplemental benefits in MA and examples of benefits)
- The Emerging Roadmap for Plans and Providers (actionable steps to overcome roadblocks and deliver new benefits to Medicare beneficiaries)
- Read the Full Report
Additional:
As new, non-medical supplemental benefits in Medicare Advantage (MA) continue to be offered by more plans over time, stakeholders must collaborate with policymakers to assure these benefits succeed. We interviewed 23 stakeholders, including Medicare Advantage Organizations (MAOs), providers, and beneficiary advocacy groups, to learn about their perspectives on these new benefits.
Our research identified five key areas where MA plans encountered barriers offering these benefits: lack of clarity on allowable benefits and eligibility, lack of consumer awareness, timing of guidance from the Centers for Medicare and Medicaid Services (CMS), sustainability concerns, and limited experience contracting with non-traditional providers.
This Policy Brief provides context on plan considerations and challenges around including non-medical supplemental benefits in their 2021 bids, and identifies short- and long-term policy opportunities to enhance the availability of these non-medical supplemental benefits.
Resources:
- Executive Summary
- Policy Context (key factors that may impede MA plans from offering new non-medical supplemental benefits)
- Policy Opportunities (short- and long-term policy opportunities to enhance the availability of non-medical supplemental benefits)
- Read the Full Report
- Two-Pager: Top 5 Policy Opportunities (overview of top policy opportunities to advance non-medical supplemental benefits in MA)
Additional:
- Blog in the Better Care Playbook (Part 1): Special Supplemental Benefits for the Chronically Ill: An Opportunity to Provide Comprehensive Supports for Medicare Beneficiaries with Complex Needs
- Blog in the Better Care Playbook (Part 2): A Roadmap for Health Plans to Provide Special Supplemental Benefits to Medicare Advantage Members
- Data Insight: Special Supplemental Benefits for the Chronically Ill in Plan Year 2021
- Chartbook: 2021 Special Supplemental Benefits for the Chronically Ill
- Data Insight: New Primarily Health-Related Benefits in 2021 Medicare Advantage Plans
- Chartbook: 2021 Expanded Primarily-Health Related Benefits
- Chartbook: 2020 SSBCI and New Primarily-Health Related Benefits
- Data Insight: Meeting Medicare Beneficiary Needs During COVID-19: Using Medicare Advantage Supplemental Benefits to Respond to the Pandemic
- A Turning Point in Medicare Policy
- Chronic Care Act: Making the Case for Non-Medical Services and Supports in Medicare Advantage Supplemental Benefits
