More MA Plans Offering Benefits for Members with Chronic Diseases

In 2021, the number of Medicare Advantage members who enrolled in plans with additional supplemental benefits for members who have chronic diseases spiked dramatically, Avalere researchers found in a recent report.

Avalere used Q2 2021 and 2020 Plan Benefit Package files from CMS as well as enrollment Public Use Files for the first month of 2021 and 2020. That data includes non-employer waiver group plans across the country with eleven enrollees or more.

Forty-four parent organizations provided special supplemental benefits for the chronically ill through 787 Medicare Advantage plans. Accordingly, 15 percent of non-employer Medicare Advantage plan members were in plans that offered special supplemental benefits for the chronically ill.

Sixteen percent of the plans that Avalere studied were offering supplemental benefits for members with chronic diseases. As a result, most Medicare beneficiaries had access to Medicare Advantage plans that offered at least one type of special supplemental benefits for the chronically ill in 2021.

The year prior, a little more than one million Medicare Advantage members were enrolled in plans that provided extra benefits for those suffering from a chronic disease. Six percent of enrollees in non-employer Medicare Advantage plans were enrolled in plans that had special supplemental benefits for the chronically ill. In 2020, 239 health plans offered these benefits.

The special supplemental benefit that payers offered the most frequently was meal benefits. Over 350 plans—or 45 percent of the plans studied—had this benefit as an option for those with chronic diseases. Close to five in ten Medicare Advantage enrollees (47 percent) were in a health plan that included a meal benefit for members engaged in chronic disease management.

The coronavirus pandemic increased the need for meal delivery benefits, particularly as Americans entered lockdown and as job loss escalated. Health plans responded quickly to support members facing food insecurity, both by donating towards nonprofits that supported local communities’ food-related needs and by bolstering their own meal-related programs.

This increase in meal benefit access is not solely due to the pandemic, however. A previous Avalere study that used Medicare Advantage benefits data from 2018 through 2021 found that the number of Medicare Advantage health plans offering meal delivery benefits had increased 34 percentage points over the past three years.

Another 1.9 million beneficiaries—or 43 percent of the health plans studied—offered food and produce benefits. This included options such as Cigna’s Healthy Benefits Plus program. Through this program, members could receive a $30 monthly produce card that aimed to help members afford fresh produce.

Approximately a quarter of Medicare Advantage health plans—or 200 health plans—offered pest control help. Approximately 1.4 million enrollees had access to such a benefit.

Other benefits that were less prevalent included transportation for non-medical needs, general supports for living, indoor air quality and equipment services, and service dog support.

CMS proposed allowing Medicare Advantage plans to offer special supplemental benefits for the chronically ill in 2019. This flexibility permitted health plans to cover services that were not directly related to health, expanding Medicare Advantage plans’ ability to tackle social determinants of health. The first year that plans could offer these benefits was 2020.

Given the short timeframe of this benefit’s availability, the triple-fold increase in enrollment in special supplemental benefits for the chronically ill is striking and could be seen as an indicator of what Medicare Advantage beneficiaries are seeking in their healthcare coverage.

The broader spectrum of utilization will also provide more data for health plans on patient outcomes, costs, and savings associated with this approach of using supplemental benefits to address social determinants of health.

“As plans test the impact of different benefits, new plans may decide to invest in providing SSBCI in future years,” the researchers concluded. “Stakeholders should consider engaging with the Biden administration around their early experiences with SSBCI and any policy change that could facilitate their wider adoption.”