Starting in 2019, Medicare Advantage (MA) plans have increasingly offered new nonmedical supplemental benefits like transportation to medical appointments, in-home caregiver visits, and debit cards to help pay for groceries, gas, and utilities. Many older adult beneficiaries say that these kinds of services are helpful and would help support their ability to age well in home and community, and research on non-medical supports outside of the MA system has shown that access to services like transportation y comidas a domicilio can improve care and quality of life.
At The SCAN Foundation, we believe policy and programs should address what older adults say they need to age well at home and in community.
As plans and policymakers look to the future of MA non-medical benefits, understanding the experiences of MA enrollees is critical to ensuring these benefits add real value.
And yet, when listening to older adults with MA coverage, it is clear there remain major gaps in understanding of how to utilize these benefits and whether they are delivering on their promise to improve the health and well-being of the people they are designed for. This is particularly important as MA plans rethink non-medical benefits due to rising costs and regulatory changes due to rising costs and regulatory changes.
Here are important considerations as policymakers explore ways to ensure MA plans provide the supports needed to improve the health and well-being of older adults:
Older adults need clear information and transparency
While older adult beneficiaries have generally positive opinions about their MA plan’s nonmedical benefits, they say it’s often difficult to find information about their details, limitations, and how to access them. For example, flexible debit cards (“flex cards”) offer beneficiaries a choice of how to spend allotted funds, but they may lack clear parameters on what products or services are covered, or even how to use the card.
Recent federal policy actions have sent mixed signals on increasing transparency around information about these benefits for older adults. On one hand, the government-run Medicare Plan Finder website was recently updated to add more information about the specific supplemental benefits that unique MA plans offer, which could support more informed plan choices. However, CMS also recently paused enforcement of requirements that would have required MA plans to alert their members mid-year that they have unused supplemental benefits they can tap into. This proactive step could help older adults better access these services they say are important to them, but which often go unused because of lack of awareness. Enforcement of requirements would require MA plans to alert their members mid-year that they have unused supplemental benefits they can tap into. This proactive step could help older adults better access these services they say are important to them, but which often go unused because of lack of awareness.
This disconnect points to a larger need: hearing directly from older adults about what works and what does not. The SCAN Foundation provides support for La gente dice, a national database chronicling the diverse healthcare and long-term care experiences and observations of older adults, and other resources. The People Say includes interviews that discuss experiences navigating and using MA nonmedical supplement benefits.
Health needs are unique
Older adults want flexibility in their plans so they can utilize the nonmedical benefits that help them the most. Older adults in rural areas, for example, may find more use in benefits such as transportation to health appointments or in-home care than those in more densely populated areas. It’s crucial that benefits offered help advance health and well-being. To ensure offerings have a meaningful impact on older adults’ health and work in ways that matter most to real people, MA plans need more input from beneficiaries who have experience with the benefits.
Policymakers and researchers need quantitative and qualitative data to make informed choices
There is limited data on how supplemental benefits are used and what impact they have on beneficiaries’ lives. More input is needed to offer services that improve the health of older adults. Medicare Advantage plans are only required to submit limited data on utilization and cost of supplemental benefits. These figures must be made more widely available to others to better understand the supplemental benefits landscape. Access to data must be paired with qualitative learnings to ensure policy solutions address what matters most to older adults.
Listen to older adults
As Medicare Advantage confronts new challenges, older adults’ experiences must help drive policy development and program innovation. Older adults say supplemental benefits can help them lead healthier lives while simultaneously citing frustrations about accessing and choosing benefits, noting discrepancies in how the benefits were marketed to them and how they actually play out within the context of their coverage. Qualitative learnings from older adults can guide program reforms to ensure efficient and impactful changes to Medicare Advantage.