by Tina Reed | Nov 14, 2018 1:27pm
Starting next year,
Medicare Advantage plans will be allowed to pay for a wider array of
health-related benefits including transportation and home health
visits, Health and Human Services Secretary Alex Azar said on Wednesday.
And by 2020, HHS
will extend the range of benefits even further to allow MA plans to cover
benefits such as home modifications and home-delivered meals, he
said.
Why?
"These
interventions can keep seniors out of the hospital, which we are increasingly
realizing is not just a cost saver but actually an important way to protect
their health, too," Azar said. "If seniors do end up going to the
hospital, making sure they can get out as soon as possible with the appropriate
rehab services is crucial to good outcomes and low cost as well. If a senior
can be accommodated at home rather than an inpatient rehab facility or a
[skilled nursing facility], they should be."
Azar was speaking in
D.C. at a healthcare policy symposium focused on social determinants of
health hosted by Utah-based Intermountain Healthcare and the Orrin G.
Hatch Foundation's Hatch Center.
He was focusing on the
agency's approach to social determinants a day after it was announced that CMS would begin allowing states to cover a
broader range of mental health services under Medicaid.
Specifically, CMS would consider Medicaid demonstration waivers
covering short-term stays for acute care provided in psychiatric hospitals
or residential treatment centers in return for states expanding access to
community-based mental health services.
As he spoke, Azar also
teased new focus areas coming from CMS' Center for Medicare and Medicaid
Innovation (CMMI) for helping vulnerable populations.
“What if we provided
more than connections and referrals? What if we provided solutions for the
whole person including addressing housing, nutrition and other social needs all
together?" Azar said. "What if we gave organizations who work with us
more flexibility so they can pay beneficiaries' rent if they are in
unstable housing or make sure that a diabetic has access to and can afford
nutritious food? If that sounds like an exciting idea, then stay tuned to what
CMMI is up to.”
Azar said the moves
are part of a broader push under the Trump administration to better harness the
flexibility of existing programs to address social determinants that drive up
health costs and hurt patient outcomes.
“It probably won’t surprise you to hear that
this administration is thinking about how to improve healthcare and social
services while preserving what is unique about our American system: its
decentralized nature and the key role played by the private sector and civil
society," Azar said. “But it may surprise you that we are thinking
about this very specifically in the context of social determinants of
health. We are deeply interested in this question, and thinking about how
to improve health and human services through greater integration has been a
priority throughout all of our work."
Medicare Advantage
(MA) plans are offered by private companies approved by Medicare and paid
by Medicare to cover patients' benefits including hospital and medical
insurance.
While the idea has
been lauded by health experts, Kaiser Health News reported few
seniors will actually be able to access these changes. Medicare officials
estimate about 7 percent of Advantage members — 1.5 million people — will have
access, KHN reported.
Companies
offering MA plans both compete for patients and hold the risk for them,
Azar said. "They've got incentives to offer benefits that are both
appealing to their members and that will bring down healthcare costs whether
those benefits are traditionally thought of as health services or not,"
Azar said. "The key is just that we need to give them the flexibility to
do this, which we generally don't do."
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