Editor's note: A previous version of this article incorrectly named CareMore as a participant in Anthem's "flex benefits."
The federal government has allowed for greater flexibility to provide supplemental benefits in Medicare Advantage (MA), but experts warn that health plans looking to take the plunge must be planning for the long term.
Scott Rinefort, senior director for product design at Anthem’s CareMore subsidiary, said insurers must be “really mindful” of how they implement supplemental benefits and look past the immediate operational concerns to really make them work.
“It’s really tempting to grab this and go,” Rinefort said on a panel at the Medicare Advantage Product Design Innovations conference Tuesday. “I think this is a long play, and the last thing anyone wants to do with their health plan is … get into a roller coaster ride.”
Despite the risks, health plans are intrigued by the opportunities offered in supplemental benefits for MA members, said Stacey Muller, principal and consulting actuary at Milliman.
The Centers for Medicare & Medicaid Services (CMS) first relaxed the rules for supplemental benefits for the 2019 plan year but limited the eligible services to options such as transportation and home healthcare. For 2020, CMS expanded those flexibilities to allow for additional benefits such as meal services and air quality devices for asthma patients.
Uptake for 2019 was slow, however—a recent study estimated that just 21% of MA beneficiaries were offered these benefits this year.
Anthem offers a "flex benefits" approach for some of its MA plans, which Rinefort called a “sales dynamic” for the supplemental benefits. CareMore, an integrated health system and health plan for Medicare and Medicaid patients, does not participate in the approach.
In that model, Anthem enrollees are allowed to pick the supplemental benefits that they’d value most and design a plan that fits them, he said. For example, a beneficiary may be more likely to use or want coverage for transportation and can then choose that over coverage for something they value less, such as adult daycare.
“Play with us in our sandbox,” Rinefort said. “Design the plan that you want—and you get that when you sign up for an Anthem Medicare plan.”
Despite that opportunity, however, he noted that uptake of these benefits has been slow among members, and that boils down in part to more effective education.
A health plan can’t expect beneficiaries to flock to an alternative benefit if the only notification they receive is through a flier or if it’s buried in a pamphlet. The supplemental options that take off the most are the ones beneficiaries immediately recognize, he said; a senior who is familiar with Uber is more likely to take advantage of transportation coverage.
Supplemental benefits should also be designed in a way that fits them into a beneficiary’s life in more than one way, ensuring a more long-term payoff, he said. A nutrition class that informs a patient about diabetes and teaches them to cook is going to provide more lasting changes, for example, he said.
“It’s not a panacea, but we’re making inroads,” Rinefort said.