Medicare Advantage health plans are wary of investing heavily into addressing social health determinants, even though the federal government has given them the flexibility to offer related benefits, according to new research released Thursday.
In interviews with five major Medicare Advantage insurers, the Urban Institute and the Robert Wood Johnson Foundation found they added few new benefits that addressed social needs in 2019.
The five insurers represent a third of the Medicare Advantage market. While the new benefit flexibility to offer supplemental benefits to chronically ill patients is a positive step, it still wasn't enough to encourage them to provide more non-medical services.
In April, the CMS released new policies allowing MA plans to cover meal deliveries, transportation and home cleaning services if it helps patients to better manage their health conditions. However, the agency didn't provide new funding to cover the costs of the benefits, which may have hampered adoption.
Study co-author Laura Skopec, senior research associate at the Urban Institute's Health Policy Center, said MA plans didn't have time or experience offering supplemental benefits to update their 2019 plans.
Insurers also expressed concerns about investing in benefits that only impact a few members and felt they could not identify what would reach the most beneficiaries.
Medicare Advantage plans are required to use a part of the rebate they receive for bidding lower than benchmark amounts to provide supplemental benefits. But that rebate amounts to $107 per member per month in 2019, according to researchers. The amount varies considerably between states. While the average rebate in 2015 in Florida was $159 a month per member, the average rebate in North Dakota that same year was just $2.
"Addressing these issues is very much still in its infancy," Skopec said. "I think there is a long way to go in terms of providing insurers with information about program might actually work."
Hospitals and insurers have struggled to identify the most effective social determinants programs and their upfront costs.
Medicare Advantage plans have become more popular over the last decade, rising from 11.1 million enrollees in 2010 to 22 million in 2019, according to the Kaiser Family Foundation.
