MA Insurers Embrace Supplementary Benefits, But Barriers Remain

By Leslie Small

Despite being able to offer an expanded array of supplemental benefits to Medicare Advantage (MA) customers for the first time in 2019, few insurers took advantage of that opportunity. One year later, health plans appear to be increasingly embracing the new flexibilities.

CMS recently revealed that in 2020 about 300 plans will offer reduced cost-sharing and additional benefits to MA enrollees with conditions like diabetes and congestive heart failure. And about 500 plans will give enrollees access to expanded health-related supplemental benefits. Combined, 800 out of 4,300 MA plans will offer such benefits in 2020, or 18.6%, compared with 7.3% of plans — or 270 out of a total 3,700 — that did so in 2019.

In addition, about 250 MA plans in 2020 will give certain chronically ill enrollees access to a "broader range of supplemental benefits that are not necessarily health related but may help to improve or maintain their health."

However, recent research from the Urban Institute points out that supplemental benefits must be funded by existing rebate dollars that the government pays to MA plans when their bids are lower than the county-level benchmark — and there is "substantial geographic variation" in rebate amounts.

Other barriers identified by MA insurers and other stakeholders include "the lack of additional funding for new benefits, MA plans' lack of experience addressing social needs, and plans' concerns about investing in benefits that reach a small number of enrollees and therefore have limited appeal to a broad group of beneficiaries," according to the study.

Laura Skopec, one of the study's authors and a senior research associate in the Urban Institute's Health Policy Center, says that she's not surprised there are more plans offering supplementary benefits for 2020, as insurers had more time to develop them than they did for 2019.

However, "I still remain skeptical that this will be like a nationwide, available-in-every-plan sort of thing, just because there's no additional funding; in some areas rebates are very small or nonexistent, so it will always be inherently limited by that," Skopec says.

From Health Plan Weekly