OUR WORK
FEATURED CASE STUDY
Advancing Non-Medical Supplemental Benefits in Medicare Advantage
Many plans and providers are offering new, non-medical services in Medicare Advantage for the first time. We interviewed 20 plans and providers to get their take on the business opportunities, roadblocks…
Advancing Non-Medical Supplemental Benefits in Medicare Advantage
Our WorkAdvancing 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...
New Primarily Health-Related Benefits in 2021 Medicare Advantage Plans
Our WorkNew Primarily Health-Related Benefits in 2021 Medicare Advantage Plans THE ISSUE Medicare has long limited the types of benefits that could be reimbursed in Medicare Advantage to only medical and primarily health-related services. Recently, however, the...
Social Risk Factors Are High Among Low-Income Medicare Beneficiaries Enrolled in Medicare Advantage
Our WorkSocial Risk Factors Are High Among Low-Income Medicare Beneficiaries Enrolled in Medicare Advantage Medicare Advantage beneficiaries are Likely to experience social risk factors that negatively impact health THE ISSUE Research has found that social...
Telehealth During a Time of Crisis: Medicare Experiences Amid COVID-19
Our WorkTelehealth During a Time of Crisis: Medicare Experiences Amid COVID-19 THE ISSUE The COVID-19 public health emergency (PHE) has challenged health care payers and providers to address new and urgent demands, creating misalignment in supply, demand, and...
Considerations for Balancing Seniors Housing Residents’ Safety as Communities Reopen
Our WorkConsiderations for Balancing Seniors Housing Residents’ Safety as Communities Reopen A Strategic Approach to the COVID-19 Pandemic THE ISSUE Seniors housing operators face unparalleled challenges in our shared COVID-19 related public health crisis. With safety...
Protecting Consumers and Medicaid from Catastrophic Long-Term Care Costs
Our WorkProtecting consumers and medicaid from catastrophic long-term care costs How financial challenges in the long-term care industry may shift costs to policyholders and medicaid THE ISSUE Long-term care insurance (LTCi) is a financial product that promises over 7...
Medicare Advantage Provides Strong Financial Value to Beneficiaries as Compared to All Other Coverage Options
Our WorkMedicare advantage provides strong financial value to beneficiaries As compared to all other coverage options an important option for innovative, affordable access to care THE ISSUE Medicare beneficiaries have access to numerous coverage configurations...
Meeting Medicare Beneficiary Needs During COVID-19
Our WorkMeeting 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...
An Idea That’s Growing
Our WorkAn Idea That's Growing Long-Term Care Providers Taking Charge in Managed Care THE ISSUE While traditional insurance companies sponsor most Medicare Advantage (MA) plans, a growing number of hospitals, health systems, and physician groups also offer this...
POST-ACUTE PREPAREDNESS IN A COVID-19 WORLD
Our WorkPOST-ACUTE PREPAREDNESS IN A COVID-19 WORLD A FRAMEWORK FOR POST-ACUTE CARE RECOVERY AND REDESIGN THE ISSUE The supply of care provided after a hospital stay – commonly referred to as “post-acute care” – has also been disrupted by the pandemic. Under normal...
SPECIAL SUPPLEMENTAL BENEFITS FOR THE CHRONICALLY ILL (SSBCI) AND NEW PRIMARILY HEALTH RELATED BENEFITS
Our WorkSPECIAL SUPPLEMENTAL BENEFITS FOR THE CHRONICALLY ILL (SSBCI) AND NEW PRIMARILY HEALTH RELATED BENEFITS MEDICARE ADVANTAGE SSBCI AND NEW PRIMARILY HEALTH-RELATED SUPPLEMENTAL BENEFITS LANDSCAPE THE ISSUE Medicare Advantage plans can now offer a wide...
HEALTHCARE SERVICES IN SENIOR LIVING AND NURSING HOMES
Our WorkHEALTHCARE SERVICES IN SENIOR LIVING AND NURSING HOMES THE CASE FOR INTEGRATION THE ISSUE Residents of senior living and nursing home facilities have substantial health needs and use a great deal of high-cost healthcare services. At the same time, many...
A TURNING POINT IN MEDICARE POLICY
Our WorkA Turning Point in Medicare Policy Guiding Principles for New Flexibility Under Special Supplemental Benefits for the Chronically Ill THE ISSUE The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, signed into law on...
INVENTION BORN OF NECESSITY: THE PROVIDER-LED MEDICARE ADVANTAGE PLAN
Our WorkINVENTION BORN OF NECESSITY: THE PROVIDER-LED MEDICARE ADVANTAGE PLAN EVALUATING AN ORGANIZATION’S ABILITY TO PROVIDE INSURANCE TO ITS RESIDENTS THE ISSUE In today’s changing environment, post-acute and long-term care providers face big challenges—increasing...
CHRONIC CARE ACT: MAKING THE CASE FOR NON-MEDICAL SERVICES AND SUPPORTS IN MEDICARE ADVANTAGE SUPPLEMENTAL BENEFITS
Our WorkCHRONIC CARE ACT: MAKING THE CASE FOR NON-MEDICAL SERVICES AND SUPPORTS IN MEDICARE ADVANTAGE SUPPLEMENTAL BENEFITS ANALYZING DATA TO HELP PLANS IDENTIFY TARGET POPULATION FOR BENEFITS THE ISSUE With new flexibility in Medicare Advantage (MA) supplemental...
COMPARING THE CHARACTERISTICS AND EXPERIENCES OF MEDICARE BENEFICIARIES
Our WorkCOMPARING THE CHARACTERISTICS AND EXPERIENCES OF MEDICARE BENEFICIARIES ANALYZING DATA TO PREPARE FOR GROWING NUMBER OF HIGH-NEED MEDICARE BENEFICIARIES THE ISSUE Starting in 2020, the United States will experience extraordinary growth in the 75+ population....
THE HOT SPOT FOR MEDICARE SPENDING
Our WorkFUNCTIONAL IMPAIRMENT A KEY FACTOR IN HIGH MEDICAL SPENDING IDENTIFYING THE KEY SPENDING DRIVERS IN MEDICARE POPULATION THE ISSUE The discourse on major drivers of high medical spending for American seniors often focuses on the role of chronic conditions but...
BIPARTISAN CONSENSUS IN LONG-TERM CARE FINANCING
Our WorkBIPARTISAN CONSENSUS IN LONG-TERM CARE FINANCING EMERGING CONSENSUS ON A CHALLENGING PUBLIC POLICY PROBLEM THE ISSUE Half of all Americans turning 65 today will one day find themselves needing a high level of help with basic daily activities, such as walking,...
KEY COMPONENTS FOR SUCCESSFUL LTSS INTEGRATION
Our WorkKEY COMPONENTS FOR SUCCESSFUL LTSS INTEGRATION DEVELOPING THE BUSINESS CASE FOR LTSS INTEGRATION THE ISSUE A small share of the population with the most complex care needs accounts for a large portion of all healthcare spending. Healthcare payment and delivery...
REDUCING HOSPITALIZATIONS BY INTEGRATING HEALTH AND HOUSING
Our WorkREDUCING HOSPITALIZATIONS BY INTEGRATING HEALTH AND HOUSING QUANTIFYING THE VALUE OF HEALTHCARE INVESTMENTS BY SENIOR HOUSING OPERATORS THE ISSUE Over the next 15 years, 80 percent of the United States population will experience one or more chronic conditions,...
MEDICARE SPENDING ON OLDER ADULTS WHO NEED LONG-TERM SERVICES AND SUPPORTS
Our WorkMEDICARE SPENDING ON OLDER ADULTS WHO NEED LONG-TERM SERVICES AND SUPPORTS ESTABLISHING THE VALUE IN ADDRESSING NEEDS OF LTSS POPULATION THE ISSUE Experts may have overlooked a critical factor in understanding high Medicare spending and defining the high-cost,...