SPECIAL SUPPLEMENTAL BENEFITS FOR THE CHRONICALLY ILL (SSBCI) AND NEW PRIMARILY HEALTH RELATED BENEFITS

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ATIWork
04/22/2020
AUTHOR – ATI Advisory

MEDICARE ADVANTAGE SSBCI AND NEW PRIMARILY HEALTH-RELATED SUPPLEMENTAL BENEFITS LANDSCAPE

THE ISSUE

Medicare Advantage plans can now offer a wide range of benefits to address the needs of the aging population, through newly expanded supplemental benefits. This expansion gives plans more flexibility to meet member needs for non-medical supports and services and to address social determinants of health. This year (2020) marks the first time that SSBCI are available – and the first time that non-primarily health related benefits can be offered in Medicare Advantage – and the second year that plans can offer expanded primarily health-related benefits. For more information on these benefits, see our primer.

We’re interested in understanding what benefits are being offered, by which carriers, and in which locations. We’re also interested in how many Medicare beneficiaries are enrolled in these plans.

OUR WORK

We analyzed the data to identify which insurance providers and organizations are offering SSBCI, what new benefits are most popular, and what areas of the country are more likely to have some SSBCI coverage.

Pest control, food and produce, and non-medical transportation are the most popular new SSBCI benefit offerings. Anthem is a leading offeror of SSBCI, with 20% of their plans offering some type of SSBCI. SSBCI offerings are also popular with some smaller, regional plans, such as Geisinger Health and SCAN Health Plan. Coverage of these benefits is not available throughout the country and is clustered geographically. In total, about 1.7 million people are enrolled in plans offering SSBCI, and 3.5 million people are enrolled in a plan that offers SSBCI or one of the new primarily health related benefits, though being enrolled does not mean an individual has access to the benefit.

OUR VIEW

2020 is just the beginning. As plans, and consumers, try out new benefits for the first time in 2020, we expect a lot of learning, and maybe some mistakes. We also expect some benefits to become more popular over time as plans demonstrate their impact on improving health and reducing unnecessary healthcare costs.

In 2019, ATI Advisory and the Long-Term Quality Alliance convened a group of leading stakeholders and developed principles to guide the implementation of SSBCI. The core principal identified through this work is that SSBCI be designed to meet individual need.

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