CMS, CMMI officials seek more data from Medicare Advantage plans on impact of health equity

nurse taking elderly patient's blood pressure
Biden administration officials have said they are hoping to examine how supplemental benefits in Medicare Advantage plans are helping underserved beneficiaries. (Dmytro Zinkevych/Shutterstock)

Biden administration officials want more information from Medicare Advantage (MA) plans on how key benefits are helping underserved patient populations.

Officials with the Centers for Medicare & Medicaid Services (CMS) discussed the need for greater collaboration during a conference this week sponsored by the Better Medicare Alliance. Officials said they want to better understand the impact of incentives in the MA program to address health equity and to spur more participation in the value-based insurance design (VBID) model.

“Having a better understanding of the experience of those beneficiaries enrolled in MA is crucially in determining how value-based care is delivered,” said Purva Rawal, Ph.D., chief strategy officer for the Center for Medicare and Medicaid Innovation (CMMI), during the conference Wednesday.

Rawal said CMMI is exploring how to increase participation in the VBID model, which enables MA plans to test changes to cost-sharing and other plan designs to entice enrollees to use targeted services.

She was heartened by the growth of the VBID model, which increased from 45 plans in 2017 to more than 1,000 for 2022.

“This number translates to [an] increase in the number and types of clinical needs and social interventions,” she said.

RELATED: Commonwealth Fund: MA, traditional Medicare beneficiaries face similar barriers in access to care

Next year, CMS is projecting that 3.7 million underserved enrollees in MA will see the benefits.

“The key flexibilities within the model that we want to continue where we see increased participation is target reductions in cost-sharing, health-related supplemental benefits to those that get low-income subsidies, meal deliveries, transportation and access to virtual community programs,” Rawal said.

Rawal’s comments come after a new analysis from Avalere Health that shows the number of MA plans offering such supplemental benefits increased in 2022.

She said CMMI wants to do a better job, though, of diffusing what types of benefits do work.

“In order to test other benefit, quality and payment inequities, CMMI plans to do analyses and partner with the Center for Medicare, other interested stakeholders to explore model testing on new areas,” she said.

CMS’ director of Medicare, Meena Seshamani, M.D., Ph.D., said in a separate session at the conference Thursday that there needs to be better data on integrating payers and providers to address health equity.

“This data must be actionable, relevant and timely,” she said.

Seshamani said that the agency is currently doing a breakdown of the performance of accountable care organizations by race, ethnicity, income level and geography to see where there are opportunities to address health equity.

“We need to look at specific interventions that can target these equity issues,” she said. “We want to partner with you on that. How are you using data to identify areas to improve?”

The remarks come a day after CMMI released a strategic redirection that made equity a major pillar.