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.

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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.

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