Medicare Advantage plans have reacted to industry criticism of their limited coverage expansion of SdoH.
I expected a buzz over our recent Monitor Mondays report and RACmonitor article about the limited coverage expansion of the social determinants of health (SDoH) by Medicare Advantage (MA) plans. Actually, there have been a constant series of announcements in recent days.
Direct Response by the Major Players
Two weeks ago, the Urban Institute and Robert Wood Johnson Foundation (RWJF) identified how the five major MA plans were not doing enough to address the SDoH. Ironically, several of these entities have bolstered their offerings, with major press releases to announce their programs. Both Cigna and Humana affirmed their priority to assure appropriate coverage for any social needs impacting their members’ health. Each entity also promised to grow their SDoH programs:
Both plans also expressed a staunch commitment to offer dental and vision options, as well as increase case management for their MA populations.
Not to be outdone, Anthem plans to also broaden service options for members, offering a wide range of benefits targeted to those at risk for the SDoH:
Telehealth Expansion: What about Consumer Confidence?
Cigna, Humana, and Anthem also plan to expand their telehealth access options, to capture expanded reimbursement available through the Centers for Medicare & Medicaid Services (CMS). However, a recent survey by The National Poll on Healthy Aging could have the potential to impact the plan. The study revealed that:
These numbers do not reveal high levels of consumer confidence for the use of telehealth among this segment of the population.
Smaller MA Plans Meeting the Challenge
Not only are the largest MA plans stepping up, but Alignment Health Plan, out of Southern California, is expanding services for their MA beneficiaries, including:
I anticipate that the industry will see most (if not all) MA plans put their best foot forward to ensure coverage for the SDoH, especially if they want to continue to enhance their health outcomes for members. Their financial sustainability is at stake.
Programming Note:
Follow this continuing story weekly on Monitor Mondays, 10-10:30 a.m. EST, for the State of the Social Determinants report.
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