Medicare Advantage lacking for mental health coverage
Just 38% of MA plan members say they have enough coverage for mental health treatment, down from 39% a year ago.
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Overall customer satisfaction with Medicare Advantage plans has increased this year, thanks largely to improvements in billing and payments, cost and provider choice. But according to the new J.D. Power 2022 U.S. Medicare Advantage Study, some concerning trends are brewing beneath the surface of those positive numbers.
Most notably, a majority of Medicare Advantage plan members are saying they don't have enough coverage for mental health and substance use disorder services.
Data from the Commonwealth Fund and the National Library of Medicine shows an estimated 1.7 million Medicare beneficiaries living with a diagnosed substance use disorder, and about one in four beneficiaries living with a mental health condition.
Older adults in particular, the study found, have been affected by the loneliness and isolation that have only increased throughout the COVID-19 pandemic. For some health plans, coverage can be improved, while others may have an opportunity to educate customers about mental health benefits, because many beneficiaries may be unaware of the coverage and medications that are available.
WHAT'S THE IMPACT?
Overall, member satisfaction with Medicare Advantage plans is on the rise. Customer satisfaction clocked in at 809 on a 1,000-point scale, which is up three points from 2021 and up 15 points during the past five years.
Despite that, just 38% of MA plan members say they have enough coverage for mental health treatment, down from 39% a year ago. Just 27% of members say they have enough coverage for substance use disorder services.
These numbers compare with 91% of members who say they have enough coverage for routine diagnostics and 89% who say they have enough coverage for preventive and wellness services.
Telehealth usage, meanwhile, is on the decline. Just 24% of MA plan members used telehealth during the past year, down from 35% in 2021. Among those who have used the technology, however, 48% say they are very likely to use it again, an increase of five percentage points from last year.
Health plan portals still show some promise, but breaking inertia is proving difficult. A strong majority (82%) of MA members are registered for their health plan's member portal – up four percentage points from a year ago – but 14% have registered for the portal and never logged in. Overall customer satisfaction scores are 72 points higher (823) when customers register and log in to the portal than when they do neither (751).
Kaiser Foundation Health Plan ranks highest in Medicare Advantage plan overall satisfaction, with a score of 844. Humana (824) ranks second and Highmark (811) ranks third.
THE LARGER TREND
The Centers for Medicare and Medicaid Services is looking for ways to make Medicare Advantage better. The agency released a Request for Information in July seeking public comment on the popular offering, and is seeking input on ways to make it more equitable, affordable and sustainable.
As enrollment in the Medicare Advantage program grows, so do concerns and uncertainty over the profits providers are reaping and whether "overpayment" is an issue. A report from the Brookings Institution indicates the five major insurers – UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Elevance Health (formerly Anthem) – are padding their bottom lines by disguising profits as costs.
The report points out that insurers are able to do this because profits accrued through related businesses are not regulated by medical loss ratio requirements.
Medicare Advantage plan payments are expected to get an 8.5% revenue increase for 2023. This is an increase over the 7.98% proposed in the February advance notice. The 2023 growth rate is set at 4.88%.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
