Our Work

Meeting medicare beneficiary needs during covid-19

Using Medicare Advantage supplemental benefits to respond to the pandemic

THE ISSUE

The COVID-19 pandemic is placing an extraordinary toll on the healthcare system and restricting Medicare beneficiaries to their homes, often without access to critical needs. Medicare Advantage (MA) plans have the opportunity to meet these needs through new and expanded supplemental benefit authority, including recent guidance from CMS allowing mid-year supplemental benefit changes. New non-medical benefits support beneficiaries, especially those at higher risk for severe illness from COVID-19, remaining safely in their homes through home-based care and social services.

OUR WORK

ATI Advisory analyzed the Centers for Medicare & Medicaid Services’ (CMS) publicly available data on Medicare Advantage plan benefit packages to determine which plans and geographies are offering supplemental benefits with the greatest opportunity to address beneficiary needs disrupted by the pandemic.

We also interviewed Medicare Advantage plans and service providers to learn how these stakeholders are responding to the growing demands induced by the pandemic and what barriers these stakeholders continue to experience.

Interviews revealed the greatest challenges Medicare beneficiaries face are in food insecurity and social isolation, exacerbated by the pandemic’s impact on caregivers. MA plans report new non-medical supplemental benefits have been essential in meeting evolving needs during the pandemic, but there remains concern and confusion around implementing mid-year benefit changes.

Based on these findings, we present a series of recommendations to Medicare Advantage plans and CMS for how to best offer services that meet the evolving needs of Medicare beneficiaries.

OUR VIEW

As the country continues to navigate the COVID-19 pandemic over the next several months, and potentially into 2021, Medicare beneficiaries will require home-based services and supports to meet their evolving needs. Medicare Advantage plans have unprecedented flexibility to offer necessary social supports to their beneficiaries and should evaluate plan benefit designs in light of this flexibility. Medicare Advantage plans also should partner with community-based organizations to determine opportunities to address unmet need.

CMS should continue to facilitate an environment that promotes this flexibility and supports innovation, for example providing education and implementing policies that encourage Medicare Advantage plans to provide non-medical benefits.

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