Medicare Advantage (MA) plans are using supplemental benefits, such as transportation, companionship and food allowances, to address whole-body wellness.
- William Shrank, M.D.Chief Medical & Corporate Affairs Officer at Humana
- Matt Parker VP, Product at HealthSparq
- Andrew Parker Founder & CEO of Papa
- Megan Callahan VP of Lyft Healthcare
- Martin Esquivel Vice President of Medicare Product Management Anthem, Inc.
- Andrew Renda Associate Vice President, Bold Goal, Office of Health Affairs and Advocacy at Humana
Medicare Advantage (MA) plans are starting to realize that social determinants of health (SDOH) and health outcomes are closely intertwined. During Fierce Health Payer’s virtual webinar series, entitled “Medicare Advantage’s Evolution”, plans showcased how they address these disparities by introducing new and innovative supplemental benefits.
MA Beneficiaries Embrace Technology
New technology is a driver behind this change. In fact, a large share of MA beneficiaries showed increased interest in virtual connection before and during the pandemic. The beginning of the webinar introduced some of the following numbers, which is important for payers to note when building or adapting their plans:
- 79% say these tools help them make more informed decisions
- 50% of MA beneficiaries more likely to use telehealth post COVID-19
- 45% likely to use online appointment scheduling
- 44% used online transparency tools in the last year
- 38% likely to use online chat (e.g. symptoms guidance)
- 31% likely to use online cost estimates
CMS Administrator Seema Verma said that because of this technological era dominating the market, she believes that more MA supplemental benefits will begin to be introduced, some of which plans may have never thought of. A recently used example she gave was plans giving away technology, such as cell phones and computers as a benefit for those who needed to partake in telehealth visits or just stay connected. This was allowable in part by flexibilities given by CMS, which Verma sees continuing at least in the near future.
“But I think there’s a lot more out there, whether it’s remote monitoring of patients. I think those types of things should be–and will be–more available as technology becomes more available, and I think our plans are going to try to take advantage of that and offer it to our Medicare beneficiaries.”
Humana Addresses SDOH
William Shrank said the pandemic was a big learning curve for the health plan Humana.
“[The pandemic] forced us to rethink how we do our work and how we interact with our members, how we reach out and ask questions, how care is delivered and our role in supporting our members,” Shrank said.
Humana had to get creative. They developed a network of partnerships to collaboratively “identify gaps in the health system and meet the needs of a population where we didn’t have all the answers,” Shrank said.
Meals for America and Meals on Wheels both aided Humana in delivering more than 900,000 meals to beneficiaries. Humana was also able to deliver millions of kits with masks and pertinent health-related information to plan members with the help of others.
Other initiatives included ensuring behavioral health services were available through telehealth and creating localized teams who helped vulnerable seniors secure needed resources.
Social isolation was one of the biggest hurdles these seniors faced during the pandemic. So, Humana gave senior plan members the option to opt into a virtual “popup pal” program, where participants offer members companionship when they might be lacking it.
Now, Humana is focused on tackling health equity and is currently hiring a chief equity officer whose duty will be to identify and address health disparities in member populations. Shrank describes this move as “critical to assessing their own performance.”
“It’s all a part of a broadening recognition that we need to not only provide the right orientation, but also the right resources to the problem of health equity. We need to be much more thoughtful about rewarding providers who care for the most vulnerable populations, more thoughtful about some of the more structural, financial influences that impact our ability to deliver equitable outcomes. We increasingly have to be really discrete and thoughtful around measurement so we can really track and improve our performance consistently. The more we’re focused on understanding implicit bias, the more we’re focused on bringing that lens of being more thoughtful from a cultural competency standpoint.” Shrank said.
Plans Integrate Social Benefits
The handful of plans in the second part of Fierce Health Payer’s webinar series went on to elaborate on how they respond to their plan members’ changing needs.
“To really drive adoption of social determinants of health benefits, you have to normalize social determinants,” Andrew Parker of Papa said.
Papa is an organization similar to Humana’s companionship program as mentioned above. Papa’s “companion providers” supply seniors with different levels of support and services and contribute to a whole-person approach to care. The program was born out of the idea that with a shortage of home care professionals, there needed to be new services invented.
With the introduction of the pandemic, the program has momentarily moved online.
“Telehealth has always been a part of our roadmap, we just didn’t know if it would be adopted.”
For Papa beneficiaries, the desire for connection outweighed the hesitation about technology. Forty percent of members requested that they were taught how to use video and a significant portion of visits are being conducted virtually.
A bit unconventional, Lyft has entered the healthcare space, teaming with plans to give patients 20-25 rides a year that they can then use to visit the doctor or to visit family members and run errands.
Megan Callahan, the VP of Lyft Healthcare, cited a study of a senior population that was given unlimited Lyft rides for three months. After the study, 35 percent reported increased physical activity and 90 percent reported increased quality of life, as a result of increased independence.
Callahan said more plans are starting to adopt transportation as a benefit and cited 35 percent of plans doing so already.
However, one size does not fit all when it comes to these MA supplemental benefits. What one benefit might do for one plan member might need to be adapted for another.
“I think it’s also really important to have an omnichannel approach. If you’re 65 and above, you’re a senior. Well my step-dad is 65, and he rides a motorcycle, and my grandma is 87, but she bowls. But there’s a lot of different people in between. So thinking about people as a nuance to their different needs and approaches and how to engage them in things is really how you win in this market. But it’s very difficult to do that because that can mean 10 different formats,” Parker said.
Martin Esquivel from Anthem said it’s also important to note that all SDOH aren’t necessarily tied to a patient’s income.
Now, leaders of these organizations say the challenge is to fight for these benefits to stay past their trial periods.
“It’s up to our organizations to generate proof points and demonstrate there’s a return on health and investment,” Parker said.