A new brief commissioned by Better Medicare Alliance (BMA), and prepared by the actuarial consulting firm Milliman, finds 2022 offers more availability of home-based palliative care, in-home support services, caregiver support, and therapeutic massage.
The findings show that under the Centers for Medicare & Medicaid Services’ (CMS) reinterpretation of “primarily health-related” benefits, supplemental benefit offerings in Medicare Advantage (MA) increased for the upcoming year.
Overall, the number of MA plans to offer at least one of the five recently expanded supplemental benefits jumped 43 percent (575 to 824) from 2021 to 2022, while the number of plans offering more than one benefit increased 15 percent (175 to 202).
“When CMS first expanded primarily health-related benefits such as these allowable in Medicare Advantage, many wondered what the uptake by health plans would be. Remarkably, these benefit offerings have grown 43 percent year-over-year and 134 percent since 2020,” Mary Beth Donahue, president and CEO of the BMA, said in the study announcement.
Under CMS guidelines issued in spring 2018, plans were given more flexibility regarding the benefits they were permitted to offer. Milliman analyzed CMS reports since 2019 to identify MA plans that offered benefits through this new flexibility, which expanded the types of supplemental benefits that could be provided to all enrollees (called “‘primarily health related’ for supplemental benefits”) and also allowed plans to offer different cost-sharing or additional benefits to specific subsets of their enrollees (called the reinterpretation of “uniformity requirement”). In spring 2019, CMS further expanded the flexibility of these benefits by allowing MA plans to offer special supplemental benefits for the chronically ill (SSBCI).
The study found:
- In-home support services had the largest growth in plan prevalence among these benefits, most notably from 2020 to 2022
- Support for caregivers of enrollees almost doubled from 2020 to 2022
- Home-based palliative care and therapeutic massage had small increases from 2021 and 2022
- Except for therapeutic massage from 2020 to 2021 and adult day health services from 2021 to 2022, all the identified benefits have increased in plan prevalence each year
To learn more, click here to access the full brief.