This week’s In Focus highlights a recent HMA publication examining the drivers and barriers to Medicare Advantage plan adoption of newly available supplemental benefits intended to address unmet health and social needs. Unlike Traditional Medicare, Medicare Advantage plans, which provide coverage for 40 percent of all Medicare beneficiaries, may offer enrollees supplemental benefits which are not covered by the Medicare program. Until recently, the Medicare program has required that supplemental benefits be limited to those that are medical in nature. However, in recent years, Congress and CMS —through four different legislative and regulatory authorities — granted new flexibilities for Medicare Advantage plans to offer non-medical benefits that address social needs. Medicare Advantage plans may also now tailor supplemental benefits and make them available only to certain subpopulations based on chronic disease or health status.
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2021 Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access
The experts at Health Management Associates (HMA) have released Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access. The white paper examines the factors contributing to a Medicare Advantage plan’s decision to offer or not offer newly available supplemental benefits and opportunities and challenges with adoption and implementation. Newly available supplemental benefits are intended to address unmet health and social needs.
HMA further sought to understand the extent to which Medicare Advantage enrollees had access to these benefits when eligible, and the effectiveness of these benefits as a tool to contain costs, improve outcomes, and increase enrollee engagement and satisfaction.
The report outlines seven key insights and accompanying policy considerations aimed towards promoting evidence-based benefit designs; expanding Medicare Advantage organization willingness to adopt the flexible benefits; and enhancing beneficiary involvement, access, and usage of these benefits.
HMA colleagues Narda Ipakchi, Mary Hsieh, Sarah Barth, and Jonathan Blum contributed to the report which follows up on a previous report providing a snapshot of early adoption of these benefits.
This analysis was funded by a grant from Arnold Ventures, a philanthropy dedicated to tackling some of the most pressing problems in the United States.
Exploring Medicare Advantage supplemental benefits: HMA’s assessment of adoption, access, and policy opportunities
The experts at Health Management Associates (HMA) have released Medicare Advantage Supplemental Benefit Flexibilities: An Early Assessment of Adoption and Policy Opportunities for Expanded Access. The white paper examines the factors contributing to a Medicare Advantage plan’s decision to offer or not offer newly available supplemental benefits and opportunities and challenges with adoption and implementation. Newly available supplemental benefits are intended to address unmet health and social needs.
Three HMA clinicians author naltrexone formulations in correctional settings issue brief
HMA’s Donna Strugar-Fritsch, Shannon Robinson, MD and Scott Haga, PA-C, recently authored the issue brief, Naltrexone Formulations in Correctional Settings. This brief provides clinical, financial, and administrative information prisons and jails can use in deciding whether to keep detainees on extended release naltrexone (XR-NTX, or the brand Vivitrol) or switch them to oral naltrexone tablets in instances where detainees have been prescribed XR-NXT prior to incarceration.
HMA expert provides Medicaid funding insights
HMA Managing Principal Anne Winter joined the “Our American States” podcast, produced by the National Conference of State Legislatures, to discuss emerging gene therapies and the high costs associated with them. The episode, The Fiscal Challenge of Emerging Gene Therapies, originally aired Jan. 11, 2021.
States, Medicaid, and Economic Hard Times
Health Management Associates (HMA) and Wakely Consulting Group, Inc., collaborated to analyze, compile, and model data on Medicaid enrollment growth during the COVID-19 pandemic and develop projections under various recovery scenarios as well as analyze the potential impact of key variables on state Medicaid expenditures.
The analysis examined two key questions, how much strain will state Medicaid budgets be under over the next few years and what types of state characteristics and what types of policy options will allow states the ability address budgetary challenges.
HMA colleagues Eric Hammelman, Stephen Palmer, Matt Powers, and Kathy Gifford contributed to the report.
HMA and Wakely Consulting Group collaborate on states, Medicaid, and economic hard times report
In the wake of the COVID-19 pandemic and resulting economic crisis, public health, the economy, health coverage, and state budgets saw major impacts with state Medicaid programs at the intersection of these programs and challenges.
HI, MN Rerelease Medicaid Managed Care RFPs
This week, our In Focus section reviews the Hawaii Quest Integration (QI) Medicaid managed care request for proposals (RFP) released on December 8, 2020, and the Minnesota Families and Children Medical Assistance (MA) and MinnesotaCare programs RFP released on January 4, 2021.
2020 Highlights: Key Trends in Medicare-Medicaid Integration
This week, our In Focus section focuses on five critical policy and program trends to provide integrated care to dual-eligible individuals for Medicare and Medicaid. Both federal and state governments continue to look for ways to improve coordination and integration for this population. We anticipate the emphasis on innovative approaches to whole person, person-centered care, care management and coordination, care transitions, and regulatory oversight to persist. 2020 has been an active year of policymaking by the Centers for Medicare & Medicaid Services (CMS) and states. HMA distilled the themes and their strategic implications in this article. We continue to assist clients in tracking new policies and industry trends, developing innovative plans and strategies, and delivering high quality care and services to this population.