Medicare Advantage Plans Pulling Back On In-Home Care Supplemental Benefits
Home Health Care News | By Robert Holly
Insurance companies selling Medicare Advantage (MA) plans have been facing increased scrutiny from members of Congress and regulators, with critics of the private version of Medicare claiming carriers are profiting far too much.
In light of those sentiments and expected constraints, some believed MA plans could begin trimming their supplemental-benefits packages, which could lead to fewer home-based care offerings delivered under the Expanded Primarily Health-Related Benefits (EPHRB) and Special Supplemental Benefits for the Chronically Ill (SSBCI) options.
MA plans began touting their benefits to Medicare beneficiaries at the beginning of October – and early signs suggest a pullback is, indeed, taking place.
“Fewer plans are using SSBCI to offer benefits, with decreases in Social Needs Benefits (128 fewer plans than in 2023) and Meals (99 fewer plans),” Washington, D.C.-based research and advisory firm ATI Advisory wrote in a LinkedIn post.
Specifically, across EPHRB, SSBCI and VBID authorities in 2024, 867 plans will offer in-home support services (IHSS) as a supplemental benefit, according to ATI. This is a decrease from the 1,308 plans offering this benefit in 2023.
It’s not exclusively due to the brighter spotlight on plans, however.
“We suspect the main reason behind the decrease is that IHSS is a more administratively complex benefit to offer, especially compared to something like a grocery card,” Bill Winfrey, director of Medicare innovation at ATI Advisory, told Home Health Care News in an email. “To offer the benefit, plans must identify providers in a crowded marketplace, build a provider network to ensure market coverage and manage increasing labor costs that are driving up the cost of the benefit itself.”
Before heading into the 2024 plan year, IHSS had been one of the most popular benefits. There was a 364% increase in plans offering the benefit since 2020…
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