When Medicare Advantage (MA) plans began offering expanded supplemental benefits, it opened the door for more engagement with home care providers. Flashforward to 2023, and nearly a quarter of plans are offering some level of in-home support services.
That’s according to Tyler Overstreet Cromer, principal at the Washington, D.C.-based research and consulting firm ATI Advisory. She spoke about home care-related development within MA plans recently at Home Health Care News’ Capital + Strategy conference.
Broadly, MA enrollment has been on the rise and is set to outpace Medicare.
Specifically, MA has more than 28 million beneficiaries, or 45% of the Medicare population. This is expected to reach over 52% of total Medicare enrollment by 2030, according to data from the research and advocacy organization Better Medicare Alliance.
Over the past couple of years, in-home support services have become a popular supplemental benefit offering among MA plans.
Roughly 6 million people are enrolled in MA plans that offer in-home support services. Cromer noted that this doesn’t paint the full picture of how many people are actually receiving care.
“We have to be really careful because that doesn’t mean 6 million people are accessing services,” Cromer said. “It just means they’re enrolled in a plan that’s offering some level of in-home support.”
Additionally, the in-home support services that members have access to through MA plans don’t always measure up to the care delivered under Medicaid or private pay.
“[Under Medicaid, in-home support services] are generally quite comprehensive,” Cromer said. “With Medicare Advantage, we’re looking at limited benefits that might be to help with, say, keeping the house clean or preparing some meals on a very intermittent basis, perhaps following hospitalization or surgery.”
Still, in-home support services would not have become popular among MA plans if the offering wasn’t appealing to members, according to Cromer.
“What Medicare Advantage plans are really looking to do with these supplemental benefits is increase enrollment and retention,” she said. “They are also looking to improve clinical outcomes, so that is really important. If beneficiaries aren’t interested in these benefits, we wouldn’t have seen the growth that we see in plans offering these benefits, it just wouldn’t be happening. I absolutely think the consumer is driving it.”
While home care providers and MA plans are working together now more than ever, Cromer believes there are ways to strengthen the relationships between the latter and the former.
“I think being very thoughtful about how to design benefits that actually help members [will improve that relationship],” Cromer said. “There are some things that we see in benefit design that are a little troubling, like sometimes plans will offer a certain number of hours per month and those hours won’t roll over. Let the hours roll over and help members to really understand what the benefit is and how to use it.”
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