Medicare Advantage (MA) plans have seen a 35% upswing in supplemental benefits nationwide – most notably for in-home services. Regulatory changes now enable MA plans to offer members expanded non-medical supplemental benefits, including those that address health-related social needs and social determinants of health.
As care continues to shift to the home and community, there is a clear opportunity for MA plans to provide home-centered services that are high quality and easy to access – and data shows that many plans are leaning in. Members have no shortage of options available to them and many plans are designing benefits tailored to specific communities or condition-specific populations, where they believe they can make the biggest impact.
As a result, MA plans have seen a steady increase in enrollment since 2007, with 28.4 million beneficiaries now enrolled, accounting for 48% of the eligible Medicare population and 55% of total federal Medicare spending. The Congressional Budget Office projects that the share of all Medicare beneficiaries enrolled in MA plans will jump to 61% by 2032.
In-Home Supplemental Benefits: Opportunities and Challenges
A competitive MA landscape means members can shop around for lower costs, more choices, and a better experience. For smaller, regional health plans, enhanced supplemental benefits can help them stand out in their markets, driving coveted member acquisition.
But as plans expand service offerings and acquire members, many face challenges activating, coordinating, and measuring delivery and satisfaction. Benefits and care coordination often are held up by time-consuming tasks such as phone calls, faxes, multiple emails, and disjointed technology platforms. In addition, health plans and providers across the country are facing worsening staffing shortages, translating into fewer people to coordinate and deliver care.
Faster Access = Better Outcomes
To support in-home supplemental services (and navigate the challenges that come with them), investments in the right technology dramatically improve productivity, staff and provider satisfaction and total cost of care. Benefits and care coordination technology can improve efficiencies and deliver faster access to home and community services.
Other technologies, like member engagement tools and remote monitoring systems, can streamline in-home care management and help identify members who did not receive service as expected or satisfaction challenges allowing plans to proactively address in real time. Still others allow members to self-direct services, which offers more flexibility in caring for their health needs.
When considering technology, health plans should look for platforms that clearly save staff time, scale as membership grows, provide a great experience for all parties – the plan, network, and member – and integrate deeply into the existing systems in the marketplace.
Supplemental benefits can help plans differentiate themselves from the competition and improve Medicare Advantage member acquisition and retention. But it takes a proper investment in technology to efficiently organize and deliver home and community services. And a better experience leads to more healthy days at home and happier members.