Special Supplemental Benefits for the Chronically Ill in Plan Year 2021

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AUTHOR – ATI Advisory



Congress recently introduced new flexibility to allow plans to offer expanded supplemental benefits for chronically ill beneficiaries, known as Special Supplemental Benefits for the Chronically Ill, or SSBCI.  These benefits allow, for the first time in the Medicare program, for the payment of non-primarily health-related services. These new benefits can be offered non-uniformly, meaning they can be targeted and tailored to individual need. Now entering their second year, SSBCI are experiencing exponential growth.


We analyzed data from the Centers for Medicare and Medicaid Services (CMS) on plan benefit packages for Plan Year 2021, the second year these benefits are available. Our analysis revealed that the number of plans offering SSBCI has increased dramatically. The number of plans utilizing SSBCI authority has increased from 267 plans in 2020 to 942 plans in 2021. Key benefits, including Food and Produce, Meals, and Social Needs Benefits, are seeing more than a 200% increase since 2020.

While several large insurers are choosing to offer more SSBCI across their plans, other smaller and regional insurers are also choosing to offer SSBCI for the first time in 2021. In addition, SSBCI are being offered in greater percentages through Special Needs Plans (SNPs). While Non-SNPs offer SSBCI across 12% of their plans, 30% of all SNPs offer at least one SSBCI.


SSBCI are still early in their development and implementation, and yet we’re seeing certain benefits available in at least one plan in every county in the country. While Medicare Advantage organizations are still navigating how to best offer and target these new supplemental benefits, the rising availability of SSBCI demonstrates the value plans perceive in these benefits. As these benefits become more prominent, we hope to see stakeholders collaborate with one another to share learnings and, ultimately, enhance the availability of SSBCI to better meet the needs of chronically ill enrollees. For more information and the full portfolio of work on this topic, visit: https://atiadvisory.com/advancing-non-medical-supplemental-benefits-in-medicare-advantage/.

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