More Medicare Advantage Plans Offer SDOH Benefits With $0 Premium

More Medicare Advantage health plans will deliver social determinants of health and non-medical supplemental benefits in 2022 and the existence of $0 premium plans continues to grow, an Avalere study found.

“The AEP represents an opportunity for Medicare beneficiaries to make an informed choice based on the plans available to them and with their individual needs in mind,” the study explained. “Should Congress make changes to either MA payment or fee-for-service benefits during the current or future legislative debates, availability of these supplemental benefits may shift over time.”

The researchers compared Medicare Advantage plan benefit package files from CMS for the first quarters of 2021 and 2022, along with Medicare Advantage plan premium data for both years, excluding data on special needs plans. The study involved Medicare beneficiary data from the CMS September 2021 Penetration File as well.

The study assessed the prevalence of four non-medical supplemental benefits that addressed various social determinants of health needs. Those four benefits included meal delivery, nutritional counseling and education, transportation, and in-home support services.

Meal deliveries remain the most common benefit that Medicare Advantage plans offer, with nearly seven in ten Medicare Advantage plans reporting that they would make this benefit available to seniors in 2022. While the share of plans offering this benefit was already high in 2021, the percentage rose from 55 percent in 2021 to 68 percent for the next year.

Transportation was the second benefit that Medicare Advantage plans were most likely to deliver. Thirty-nine percent of Medicare Advantage plans disclosed that they would make this benefit available to seniors in 2022, a slight increase from 2021 when 36 percent of plans could say the same.

Although fewer health plans intended to offer nutritional benefits and in-home support benefits, these social determinants of health benefits saw the biggest increases in adoption. In 2021, 17 percent of plans offered nutritional counseling but, in 2022, 30 percent of plans will offer this benefit.

These nutritional counseling benefits could become essential factors in payers’ chronic disease prevention strategies. Particularly for common chronic conditions such as diabetes, payers have found that nutritional counseling can help address comorbidities such as obesity and lower the risk of chronic disease development or improve members’ outcomes.

Meanwhile, the prevalence of health plans offering in-home support benefits jumped from six percent in 2021 to eleven percent the following year. While uptake of this benefit remains the lowest out of the four benefits that Avalere studied, the marked increase may reflect a growing interest as health plans invest more heavily in the home healthcare and in-home support space.

Avalere also noted that 58 percent of Medicare Advantage plans will have no premium in 2022, compared to 53 percent in 2022. Additionally, the number of plans with a premium higher than $50 dropped from 21 percent in 2021 to 18 percent in 2022. 

Some plans with $0 premiums will still offer the supplemental benefits that Avalere analyzed. The study found that almost every Medicare beneficiary will have access to at least one Medicare Advantage plan with no premium that offers meal delivery supplemental benefits in 2022.

In 2022, four out of ten health plans with $0 premiums will offer meal delivery as a supplemental benefit. Nearly one out five of these plans will offer nutrition benefits, double the share of $0 premium health plans that offered nutrition benefits in 2021.

Plans with higher star ratings were more likely to offer meal delivery benefits and transportation benefits in both 2021 and 2022. However, plans with less than four stars were more likely to offer nutritional benefits in 2021 and 2022 and more likely to offer in-home support services in 2021.

During the 2022 open enrollment season, Medicare Advantage beneficiaries will have greater access to non-medical supplemental benefits and will be more likely to have access to some of these benefits without a premium.