The number of Medicare Advantage health plans that are offering palliative care as a supplemental benefit more than doubled between 2020 and 2021. This represents a larger trend of plans offering an increasing number primarily health-related supplemental benefits.
Analysis by the consulting firm ATI Advisory found that the number of health plans offering home-based palliative care coverage jump to 134 in 2021, up from 61 last year. In-home support services, food services and social needs benefits also saw a substantial rise. All told, more than 1,350 plans are offering primarily health-related supplemental benefits this year. In 2020, the total was 635.
“There are considerable increases in [supplemental benefits] from Plan Year 2020 to Plan Year 2021,” ATI indicated. “Certain benefits that can help fill critical needs for a chronically ill population – particularly during the COVID-19 pandemic – such as food & produce, meals (beyond a limited basis), and social needs benefits, saw some of the largest increases.”
Through Medicare Advantage, the U.S. Centers for Medicare & Medicaid Services (CMS) contracts with private insurance companies to provide coverage for Medicare beneficiaries. Law requires Medicare Advantage plans to cover all of the services offered by traditional Medicare, but also allows for certain supplemental benefits.
Historically these benefits were very limited, but the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act (CHRONIC), passed by Congress in 2018, expanded the range of those benefits to include programs to address some social determinants of health as well as home-based palliative care.
Hospices provide about 50% of home-based palliative care in the United States according to the Center to Advance Palliative Care, and the number of providers that are diversifying their services lines to include palliative care continues to increase.
Law permits Medicare Advantage plans to target specific populations among their enrollees to receive supplemental benefits — such as those with serious illness or high-health care utilization — rather than offering the same benefits to all enrollees.
Payers are attracted in part to the cost savings that could be realized from expanded access to palliative care, particularly in terms of reduced hospitalizations, readmissions and emergency department visits. Home-based palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch said in a 2019 report.
In addition to the number of plans offering palliative care, geographic scale also expanded this year. That benefit will be available in 293 counties in 11 states during 2021. Last year, that number was 175 counties in seven states, Elexa Rallos, analyst for ATI Advisory, told Hospice News.
“During a time where the health care ecosystem has been placed under considerable strain due to the COVID-19 public health emergency, increased uptake of [supplemental benefits by Medicare Advantage] plans demonstrates the value plans perceive from these benefits,” ATI indicated in its analysis.