Aetna, a subsidiary of CVS Health (NYSE: CVS), is leveraging a series of new benefits that, coupled with existing palliative care programs and ongoing hospice payment demonstrations, promise to keep patients in their homes and out of facilities.
The new benefits are heavily focused on making medications affordable and addressing social determinants of health. Beneficiaries in dual-eligible special needs plans (D-SNP), for example, will have access to an “Extra Benefits Card” that includes a monthly allowance that can be used for food, utilities, transportation, rent and other essentials.
“Aetna remains focused on providing benefits and services to help our members age in the place that is best for them – whether that is with caregivers or without, in a family home or in a senior living community,” Terri Swanson, president of Medicare for Aetna, told Hospice News in an email. “We have long offered benefits such as post-discharge meals to make sure our members are able to eat healthy food following a hospitalization, transportation to ensure they can access important medical appointments, and care management programs to help our members navigate their unique medical needs.”
The Aetna Medicare Extra Benefits Card will be available on all D-SNPs and most of the company’s Value Plus plans in 2024. In addition, an Aetna Assist Program provides further benefits for some beneficiaries, including $0 Part D drugs and an Extra Benefits Card. Many plans offer enhanced allowances in 2024 and more ways to help members with expenses, according to Swanson.
Aetna will continue to provide meals, but beginning in 2024, they will offer fresh foods rather than frozen, to patients that were recently discharged from a hospital or skilled nursing facility.
Some Aetna health plans will now offer a certain number of hours of personal care assistance for activities of daily living, she indicated. Depending on the individual plan, beneficiaries would receive these services in the 30 days following an inpatient discharge or a monthly allotment of hours throughout the year.
“To ensure important services are affordable, we continue to expand services available at no additional cost to the member,” Swanson said. “In 2024, we have plans that offer $0 copay for primary care visits and labs. New for 2024, all plans will provide $0 copay for preventive and diagnostic colonoscopies at in-network providers.”
The company is also leveraging palliative care services to further reduce hospitalizations and allow seniors to age in place for as long as possible.
Patients can access palliative care through a number of inroads. Among them is Signify Health, CVS Health’s home-based care arm, which the insurance company acquired in 2022 for $8 billion.
The subsidiary is a value-based care enablement company that concentrates on care in the home, including home health and palliative care. CVS indicated that the transaction will lay the foundation for further expansion in home-based health care.
“Signify clinicians in the home can refer members to Aetna for continued support,” Swanson said. “[Aetna’s] Medicare Advantage plans cover palliative care services as part of our medical benefits and our network includes a robust offering of palliative care providers, including community-based palliative care providers.”
Aetna also offers a Compassionate Care Program, an advanced illness care management service that also offers direct referrals to community-based palliative care providers, according to Swanson.
The company is also a participant in the hospice component of the value-based insurance design (VBID) demonstration, designed to test coverage of those services within Medicare Advantage plans. Aetna is now in its second year of participation in the program.
“Under this model we are able to provide care coordination for our members all the way through their advanced illness and end-of-life journey,” Swanson said. “We partner with their families and caregivers to ensure they have the support they need and provide additional benefits to help them in this difficult time.”