On September 24, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that the average premium for a Medicare Advantage (MA) plan in 2021 would drop by an average of 34% compared to the 2017 premium. CMS also revealed that record number of MA plans would be offering in-home benefits.
Medicare enrollment is growing quickly. By 2030, one in five US citizens will be 65 years old or older. Seniors currently receive benefits through Medicare in two ways. One referred to as “traditional Medicare”, the other, Medicare Advantage (MA), also known as “Medicare Part C.” Parts A and B cover hospitalizations and outpatient care and doctor visits, respectively; Part D covers prescription drugs.
Expanded MA supplemental benefits are largely tied to CMS’s updated guidance allowing plans to cover anything that has “a reasonable expectation” of improving or maintaining the well-being of beneficiaries with chronic conditions.
As the healthcare climate pivots from fee-for-service to value-based payment models, Medicare Advantage benefits are expanding to include a broader scope of offerings. Insurers are slowly realizing that the value of offering these benefits is far greater than paying for treatment costs, including time spent in high-cost, acute care facilities, once a patient’s illness becomes more severe.
In January 2019, the Centers for Medicare and Medicaid Services (CMS) announced an expansion of its “value-based insurance design” (VBID) model for Medicare Advantage (MA) plans. With the industry moving away from fee-for-service models and towards fee-for-value arrangements, the Medicare Payment Advisory Commission (MedPAC) has advocated for the addition of carved-in hospice benefits to Medicare Advantage plans, including a test of this offering, starting in 2021.
How the expansion of Medicare Advantage supplemental benefits emphasizes home healthcare.
An increasing amount of health plans are turning their sights to the social determinants of health. But why?
The costs of post-acute care have been rising faster on average than those of all other sectors of the healthcare market, with a 70% increase in a decade. As much as 40% of the total costs of a hospitalizable event is spent on post-acute care.
The Medicare Advantage program is a way for seniors to obtain Medicare Parts A and B benefits and often Part D as well from a Medicare-approved commercial insurance carrier instead of directly from the government. Medicare Advantage plans are growing rapidly, and there are good reasons for their popularity.
Healing at home is a trend that’s been quickly gaining speed in developed countries around the world. In the United States, however, health systems that encourage patients who don’t need intensive 24/7 hospital care to opt for home care instead, is being adopted at a slower pace.