Tuesday, June 18, 2024

Medicare Advantage Plans See Modest Boost in Ratings with New Benefits

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Medicare Advantage (MA) plans have been given significant latitude to address the social needs of enrollees through Special Supplemental Benefits for the Chronically Ill (SSBCIs) since 2018. Despite this flexibility, uptake has been limited, largely due to a lack of supporting evidence. A new study, leveraging data from the MA Consumer Assessment of Health Care Providers and Systems (CAHPS) survey, has now shed light on the impact of these supplemental benefits on enrollee plan ratings.

Study Design and Participants

The research employed a cohort study design and utilized difference-in-differences estimators to compare the plan ratings of MA enrollees from 2017 to 2021. The study focused on those enrolled in plans that adopted expanded primarily health-related benefits (PHRBs), SSBCIs, or both. The analysis included 388,356 survey responses from 467 MA contracts and 2,558 plans, linked to Medicare administrative claims and enrollment data.

Participants in the study had a mean age of 74.6 years, with 57.2% being female. Among them, 8.9% were fully Medicare-Medicaid dual eligible, 74.6% had at least one chronic medical condition, and 15.6% were entitled to Medicare due to disability. The study also noted that 45.1% reported fair or poor physical health, and 13.7% had not graduated high school.

Key Findings and Implications

The study revealed that enrollees in plans that adopted both a new PHRB and SSBCI in 2021 saw a modest increase of 0.22 points in their plan ratings on a 0-10 scale. However, no significant association was found for plans adopting only one of these benefits. Specifically, adoption of solely a PHRB showed an adjusted difference of -0.12 points, and solely an SSBCI showed an adjusted difference of 0.09 points.

These findings suggest that while combined benefits can improve enrollee experiences, single interventions may not be as impactful. The modest rating increase indicates that further investment in supplemental benefits could enhance overall plan quality.

User-Usable Inferences

• Combining PHRB and SSBCI benefits can improve MA plan ratings.
• Single benefit adoption (either PHRB or SSBCI) shows negligible impact on ratings.
• Higher plan ratings may result in better enrollee satisfaction and plan quality.

The findings underscore the importance of comprehensive benefit strategies in enhancing MA plan experiences. By integrating both medical and nonmedical supplemental benefits, MA plans can better address the diverse needs of their enrollees, potentially leading to improved satisfaction and quality ratings.

Original Article: JAMA Netw Open. 2024 Jun 3;7(6):e2415058. doi: 10.1001/jamanetworkopen.2024.15058.

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