(Reuters Health)—Most Medicare Advantage plans are not offering chronically ill enrollees supplemental benefits to address social needs, which were added to the government health program in 2018 in an effort to improve health outcomes and achieve cost savings, a U.S. study suggests.1
Researchers examined publicly available data on benefits and plan design for Medicare Advantage plans to see which ones offered new benefits under the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2018.
In 2020, 139 of 3,052 plans (4.6%) offered benefits for social needs under the CHRONIC Care Act. The most commonly offered benefit was pest control, provided by 2.2% of plans, followed by produce at 2.1%, and meal delivery at 1.8%.
“For Medicare beneficiaries who need assistance, ability to access benefits for things like meals, transportation, pest control, and air quality control matter because it could prevent health exacerbations and unnecessary healthcare utilization,” says co-author Kali Thomas, an associate professor at the Brown University School of Public Health, Providence.
“For example, research suggests receiving meals is associated with reductions in the likelihood of hospitalization and nursing home placement among Medicare beneficiaries who are food insecure,” Ms. Thomas says by email.
A growing number of research studies are also finding that social determinants of health may have a stronger impact on patients’ health and wellbeing than medical care, Ms. Thomas adds.
“Medical entities, including Medicare Advantage plans, have recognized this and are looking for ways to address individuals’ social needs as a way to improve their quality of life and health, and reduce potentially unnecessary, and often costly, healthcare utilization,” Ms. Thomas says.
Plans with higher ratings, as well as health maintenance organizations (HMOs) and older, more established insurers were more likely to offer these social needs benefits than other Medicare Advantage plans, Ms. Thomas and colleagues report in JAMA Network Open.
The study found that 6.2% of HMOs offered these benefits, compared with just 1.1% of preferred provider organization (PPO) plans.
Although only 2.7% of plans established between 2014 and 2020 offered social needs benefits, the benefits were offered by 5.7% of plans established between 2006 and 2013 and 4.3% of plans established before 2006.
None of the plans with quality ratings of two to two and a half stars offered these benefits. However, 5.3% of plans with 3 to 3.5 stars offered social needs benefits, as did 5.4% of plans rated from 4 to 4.5 stars and 4% of plans with top ratings of five stars.