More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

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In 2022, more Medicare Advantage plans will offer nonmedical supplemental benefits that address various social determinants of health such as meals, nutrition, transportation and in-home support services, finds a new analysis from Avalere.

Ahead of the annual election period, which began on October 15, the Centers for Medicare and Medicaid Services published information on MA and Part D plan (PDP) premiums, benefit offerings and star ratings. Avalere analyzed that data to assess changes in the number of MA plans offering select types of non-medical supplemental benefits, many of which have become newly available to enrollees in recent years due to regulatory and legislative changes.

Focusing primarily on the four key benefits, the most commonly offered is meals (68%), followed by transportation (39%), nutrition (30%), and in-home support services (11%). 

The percentage of plans offering these types of benefits will increase from 2021 to 2022, with the largest increases for nutrition and in-home support. Smaller increases will occur in the percentage of plans offering meals and transportation.

Avalere also examined the distribution of plan offerings at different premium levels. In 2022, the percentage of plans with a $0 premium will increase to 58% from 53% in 2021. In 2022, only 18% of plans will have a premium of more than $50, a slight decrease from 2021, in which 21% of plans had a premium of more than $50.

More plans will offer meals, nutrition, transportation or in-home support services at a $0 premium in 2022. The percentage of all plans that offer meals as a supplemental benefit at a $0 premium will increase from 30% in 2021 to 40% in 2022. Notably, in 2022, the percentage of all plans offering nutrition at a $0 premium will more than double from 2021 (9% to 19%).

The data also examined the extent to which Medicare beneficiaries have access to at least one plan at a $0 premium that offers at least one of these four supplemental benefits. The availability of $0 premium plans will increase for all four of these benefit types. This increase is greatest for $0 premium plans offering nutrition – where availability will increase from 67% in 2021 to 89% in 2022 – and in-home support services (up from 49% in 2021 to 62% in 2022).  

Nearly all beneficiaries will have access to at least 1 $0-premium plan offering meals as a supplemental benefit in 2022.

Finally, the analysis assessed the relationship between Star Ratings and supplemental benefit offerings. Because plans with four or more stars receive higher payments, they have more funding available to provide supplemental benefits or reduce cost-sharing, compared to plans with fewer stars.

In 2022, while plans with at least four stars are more likely to offer meals (70% vs. 62%) or transportation (40% vs. 32%), they are as likely to offer in-home support services (10%) and are less likely to offer nutrition (26% vs. 36%). A higher percentage of plans with at least four stars will offer these four benefits in 2022 than in 2021. The same trend holds true for plans with less than four stars for three of the four benefits, while the percentage of these plans offering in-home support services will decrease slightly from 12% in 2021 to 10% in 2022.

WHAT'S THE IMPACT?

As the AEP begins, beneficiaries will see a wide range of plans offering services. Open enrollment runs from October 15 to December 7.

This early look at the benefits shows that certain types of nonmedical benefits – most notably meals – are widely available at a $0 premium, whereas other types of benefits, such as in-home support services, are offered less widely. 

The AEP represents an opportunity for Medicare beneficiaries to make an informed choice based on the plans available to them. Should Congress make changes to either MA payment or fee-for-service benefits during the current or future legislative debates, the availability of these supplemental benefits may shift over time.

The analysis includes MA plans with drug coverage. Avalere excluded Special Needs Plans, since these plans are only available to enrollees with specific characteristics. They're typically dual eligible, require an institutional level of care, or have a specific type of chronic condition. Avalere also excluded employer plans, as these are not available to enrollees not covered by an employer group.

THE LARGER TREND

Insurers are expanding their Medicare Advantage offerings at a decent clip, with Humana announcing this month it would debut a new Medicare Advantage PPO plan in 37 rural counties in North Carolina in response to market demand in the eastern part of the state.

Around the same time, UnitedHealthcare, which already has significant market control with its MA plans, said it will strengthen its foothold in the space by expanding its MA plans in 2022, adding a potential 3.1 million members and reaching 94% of Medicare-eligible consumers in the U.S.

For the third straight year, health insurer Cigna is expanding its Medicare Advantage plans, growing into 108 new counties and three new states – Connecticut, Oregon and Washington – which will increase its geographic presence by nearly 30%.

Centene is also getting in on the act, expanding MA into 327 new counties and three new states: Massachusetts, Nebraska and Oklahoma. In all, this represents a 26% expansion of Centene's MA footprint, with the offering available to a potential 48 million beneficiaries across 36 states.

The Centers for Medicare and Medicaid Services said in late September that the average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared with $21.22 in 2021. However, Part D coverage is rising to $33 per month, compared with $31.47 in 2021.

Enrollment in MA continues to increase, CMS said. In 2022, it's projected to reach 29.5 million people, compared with 26.9 million enrolled in a Medicare Advantage plan in 2021.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com