More Medicare Advantage (MA) plans are offering in-home support services as supplemental benefits.
That’s according to a new report from Washington, D.C.-based research and advisory firm ATI Advisory. The report included interviews with health plans, providers and advocates to gauge the progress on uptake for primarily health-related benefits and Special Supplemental Benefits for the Chronically Ill (SSBCI) among MA plans.
In-home support services specifically, which are often carried out by home-based care providers, saw a boon in adoption from 2020 to 2021. Those are defined as “services to assist individuals with disabilities and/or medical conditions in performing activities of daily living (ADLs) within the home.”
According to the report, that trend is likely to continue.
In 2022, 14% of all plans will offer in-home support services – the most popular benefit by far. Comparatively, 3% of plans are offering services such as home-based palliative care, for instance.
The in-home support services benefit is a primarily health-related benefit available to all members, as opposed to SSBCIs, which are designated for the chronically ill. Some plans, however – 59, according to ATI – offer in-home support services through the SSBCI pathway.
“We were really impressed by the fact that – even throughout another year of the pandemic – plans have shown more desire to offer these benefits,” Elexa Rallos, an analyst at ATI Advisory, told Home Health Care News. “And we’ve even actually seen the generosity of the in-home support service benefit increase over time, … which we hope will continue.”
Home care providers did have trouble staffing some of the MA benefit cases over the last year, according to ATI Principal Tyler Overstreet Cromer and Rallos. But that hasn’t noticeably stopped more plans from offering home-based benefits in 2022 and beyond, they said.
Overall, MA plans offering supplemental benefits maintained a steady increase over the past year, according to the report. There was a 240% increase in the number of plans offering SSBCI from 2020 to 2021 and a 111% increase in the number of plans offering primarily health-related benefits from 2020 to 2022.
Data on plans offering SSBCIs in 2022 is expected to be released in the first quarter of next year.
“One thing that I found really promising through the conversations we had was the amount of progress that has been made since we talked to plans and providers a year ago,” Cromer told HHCN. “A year ago, we were hearing about the difficulties in connecting to plans, especially for home care providers. There were contracting difficulties. You heard a lot about the payment per hour. But this year, we heard a lot less of that. There’s been a lot of progress in figuring out some of these issues.”
There remains room for substantial improvement, however.
Specifically, the three things that have been blocking more widespread success of the MA supplemental benefits are: unclear eligibility requirements, particularly for SSBCI; a lack of understanding of the benefits on all ends of the spectrum; and missing data due to the lack of standardized reporting requirements.
“Say someone enrolls for the first time in their plan, and part of why they do that is because they really want one of the benefits that’s available as SSBCI. Maybe it’s help with groceries,” Cromer said. “But before they can get help with groceries, the plan has to have a provider see them to document that they have a [qualifying] condition, and that process might take two or three months. … So, this takes time, attention and resources, but meanwhile, that person can’t access the benefits.”
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