NOTE: The abstract below is a shortened version of the RADAR on Medicare Advantage article “2021 Flex Benefits Show COVID Influence, Insurer Comfort.”
By Lauren Flynn Kelly
Last year, Medicare Advantage plans for the first time were able to extend a variety of non-primarily health-related items and services to their chronically ill beneficiaries, but insurer adoption of these benefits was relatively small. In 2021, the availability of such benefits has more than tripled, suggesting carriers are becoming more comfortable with a variety of new supplemental benefits and the idea of incorporating cost offsets into their bids.
In the Jan. 27 report, An Early Look at 2021 Medicare Advantage Benefits: Part II, Faegre Drinker reported that Special Supplemental Benefits for the Chronically Ill (SSBCI) are featured in 831 plans (out of approximately 5,200 total plans) this year. That’s compared with only 245 plans in 2020. Meals was the most common offering, followed by food and produce, and social needs benefits.
One likely reason for the increase is that CMS for 2021 allowed plans to offer SSBCI to individuals with conditions beyond the 15 diseases it originally outlined. But “the biggest single reason,” suggests Michael Adelberg, principal at Faegre Drinker and one of the report’s authors, is that “plans have an extra year to explore the opportunities, conduct the analysis and see what their competitors are doing.”
And with the ongoing COVID-19 pandemic that began in March 2020, MA insurers had a chance to test out some midyear benefit changes due to flexibility granted during the public health emergency. As a result, some benefits offered this year appear to be directly related to supporting seniors at home, such as virtual companion visits and grocery delivery coverage.
The firm also analyzed the landscape of condition-specific benefits. Diabetes remained the top condition tied to one of these benefits, followed by congestive heart failure and anxiety/depression/substance use disorder.
In a separate analysis from Avalere Health that excluded MA Employer Group Waiver Plans and incorporated January enrollment data from CMS, the firm estimated that more than 3 million MA beneficiaries are enrolled in plans providing SSBCI. Avalere’s totals included 787 MA plans offered by 44 parent organizations, compared with 239 plans offering SSBCI in 2020.
Although that represents just 16% of plans, the significant year-over-year increase “in the number of plans and enrollees in these plans indicates that plans are gaining more insight on the impact that SSBCI can have on beneficiary outcomes and costs,” wrote Avalere.