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Fulfilling the Promise of the CHRONIC Care Act: The Future of New Supplemental Benefits in Medicare Advantage - Shared screen with speaker view
Christina Wu - LTQA
Please find the program here: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Briefing-Program.pdf
Christina Wu - LTQA
Please find our new policy report here: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Policy-Recommendations.pdf
Christina Wu - LTQA
All other resources from LTQA and ATI Advisory can be found on our landing page here: https://atiadvisory.com/Advancing-Non-Medical-Supplemental-Benefits-in-Medicare-Advantage/
Christina Wu - LTQA
Christina Wu - LTQA
For those of you joining late:• Today's Event Program: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Briefing-Program.pdf• New Policy Report: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Policy-Recommendations.pdf• All other resources from LTQA and ATI Advisory can be found on our landing page here: https://atiadvisory.com/Advancing-Non-Medical-Supplemental-Benefits-in-Medicare-Advantage/
Renae Walton
Provide us the funding for home based programs.
Renae Walton
for further research
Nicole Howell
It strikes me that we need to consider how to measure some of the non tangibles ie quality of life and improved engagement don't always lend themselves to easily digestible metrics
Joanne Lynn
You might mention the limitations or concerns with any biases in the MCBS
Sara Raju
im curious to hear more about why you recommend to expand the qualification for functional challenges
Sara Raju
since they overlap highly with those that already qualify for SSBCI
Judy Frieder
Home modifications have been proven to have a 10 to 1 savings in medical costs through the PACE program and there are virtually no MA programs that do much in the home mods area. Do you see that changing?
Tyler Cromer - ATI Advisory
Sara, we agree there is a high degree of overlap but that clarifying that functional limitations alone could qualify someone to receive SSBCI would be an incremental improvement to access for beneficiaries who could benefit from services like delivered food and produce or non-medical transportation
Joanne Lynn
The overblown prose of the TV ads from insurance brokers is really troubling. Shouldn't CMS or Congress should rein them in.
Nicole Howell
Well said, Joanne
Sara Raju
Thank you Tyler!
Judy Frieder
Thank you Joanne. That is a huge "issue" in my opinion.
tim s
As a Home mods provider, I would like to strongly agree with Judy Frieder's comment. There is very little to no interest in a proven cost saver like home mods from the MA plans.
Christina Wu - LTQA
Thanks, Doug! I just responded to Eileen's comment in the Q&A: As part of the newly instated MLR reporting requirement, the CY2023 MAPD Final Rule requires plans to report on expenditures on supplemental benefits in aggregate, including non-primarily health-related SSBCI. This reporting will begin in 2023 and data will be available no sooner than 18 months after the end of the contract year. This will provide some line of sight into expenditures, though not by PMPM. Please see Rec 2 (pg. 12) here: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Policy-Recommendations.pdf
Judy Frieder
Thanks, Tim
Doug Robertson
Thank you for the thorough response Christina - that helps.
Doug Burr
Do you believe that Medicare FFS beneficiaries should be allowed to use funds from their HSAs (without tax implications) to pay for a similar menu of non-medical supplemental benefits as are available to Medicare Advantage beneficiaries? Why or why not? Should there be income or functional limitation such as eligibility thresholds for such similar use of funds from HSAs to cover non-medical supplemental costs?
Christina Wu - LTQA
Please keep your questions and comments coming! If we don't get to them during this event, we will develop a Q&A document to respond to them in our follow-up materials.
Sara Raju
do you anticipate that clarity of SSBCI would be an issue if the qualification standards were expanded?
Christina Wu - LTQA
Joanne, thank you for that comment. TV ads and other advertisements potentially misrepresenting availability of, or eligibility for, these benefits are of critical concern to us and have been flagged through our research and interviews. Most recently, in CMS' MA-PD Final Rule for CY 2023, CMS has implemented regulations towards third-party marketing organizations (TPMOs) so that plans must monitor what is being displayed by these parties. Our new policy report does not focus on marketing, but this is definitely an important area to continue to explore.
Mark Miller
Could you address the complexities in picking an MA plan that offers these benefits? First the enrollee needs to find plans that offer them, but then there is no certainty that they'll be available, depending on needs analysis.
Mark Miller
And a second question - is it even a good idea to pick a plan primarily for these benefits?
Joanne Lynn
How could these supplemental benefits begin to support more adequate financing of supportive care, rather than seeming to the public to be meeting the need and thus one more element that reduces the attention to the oncoming calamity of inadequate availability of supportive care (whether in the community or facility)?
Christina Wu - LTQA
@Nicole and Annette, thanks for your comments earlier! We discuss the importance of measuring the "non-tangibles" in recommendation 3 starting on pg. 16: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Policy-Recommendations.pdf
Leslie May-Chibani
Is there work to leverage the work that has been done for decades by community based organizations like meals on wheels, transportation via the senior centers?
Doug Robertson
Very helpful insights, thank you.
Christina Wu - LTQA
@Mark, thanks for your questions. I think they were partly addressed by the panelists. There are certainly other important factors that go into the process of selecting a plan first, and these benefits should definitely not be viewed as substitutes for LTSS, given their limited scope and volume. We didn't focus on marketing and education in this latest report, but have discussed it a lot in prior reports, including in the 2020 Roadmap for Plans and Providers, 2021 Progress Report, and the 2021 policy recommendations for the Administration, which includes recs for improving resources for SHIP counselors and Medicare Plan Finder (all can be found on our landing page: https://atiadvisory.com/Advancing-Non-Medical-Supplemental-Benefits-in-Medicare-Advantage/). While our research included perspectives from beneficiary advocacy organizations, there is more room for digging into the beneficiary experience and ways to solution for the painpoints they face.
Christina Wu - LTQA
@Joanne, excellent question, as Tyler and Marc (and others) have highlighted, total plan dollars for these supplemental benefits are limited, particularly as financing is limited to rebate dollars. However, many of these new benefits, things like Caregiver Supports or In-Home Support Services, are the first time plans have begun providing these types of services. While only a piece to the puzzle right now, we view this as an important step for MA plans in beginning to augment, as much as they are currently able, the supportive care and long-term services and supports infrastructure that we desperately need. As plans gain more experience and as the evidence base grows, there is an opportunity to consider more sustainable financing mechanisms for provision of these services.
Nicole Howell
Great conversation, thank you
Christina Wu - LTQA
• Today's Event Program: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Briefing-Program.pdf• New Policy Report: https://atiadvisory.com/wp-content/uploads/2022/05/Fulfilling-the-Promise-of-the-CHRONIC-Care-Act-Policy-Recommendations.pdfAll other resources from LTQA and ATI Advisory can be found on our landing page here: https://atiadvisory.com/Advancing-Non-Medical-Supplemental-Benefits-in-Medicare-Advantage/
Christina Wu - LTQA
Thanks to everyone for your participation in the event and thoughtful questions and comments! We will follow up with the slides, recording, and a Q&A document as a follow-up. Please email mkaschak@ltqa.org with any questions!