Supplemental Benefits are Worth Fighting for to Support Senior Health

According to the Better Medicare Alliance, Medicare Advantage (MA) continues to grow in popularity with more than 50% of seniors now enrolled in an MA plan (vs. fee-for-service). This popularity is due in part to supplemental benefits offered through MA including vision, dental and fitness benefits. However, the Centers for Medicare & Medicaid Services (CMS) released guidelines earlier this year that require more data collection to assess the utilization of supplemental benefits and whether they drive better outcomes and address health disparities. These requirements, along with changes in payment methodology, have created a new environment for payers and supplemental benefits providers. 

With Congress and CMS tightening guidelines and scrutiny, the spotlight on supplemental benefits is more intense than ever. This presents a significant opportunity for supplemental benefits providers to demonstrate accountability and showcase how they drive engagement and utilization, as well as positive health outcomes and lower costs. Although the CMS changes present challenges for some, they also highlight a path forward for robust, outcomes-driven supplemental benefits programs. Those who place beneficiaries at the center of what they do with strong value propositions and proven outcomes will not only survive but thrive, bringing needed services to keep seniors healthy, independent and active. 

Take physical activity, for example. Studies, including one from the National Institute on Aging, have proven that seniors who regularly engage in physical activity report better health outcomes. Movement is especially important for those 65 and up, who are entering a period in their lives when healthcare utilization may increase. Physical activity strengthens the immune system, improves cardiovascular health, supports mental and brain health, and can benefit those struggling with chronic conditions. In addition, physical activity programs designed specifically for seniors can improve balance and prevent falls. However, the effectiveness of fitness programs for older adults gets to the heart of the issue with supplemental benefits – they only move the needle if they are being used. 

To be good stewards of taxpayer dollars and to support health plans in meeting CMS requirements around utilization and health outcomes, there are three things that supplemental benefits providers can do:

1. Adopt a utilization-based approach that incorporates a robust engagement and reporting platform to motivate beneficiaries to take steps toward better health. This includes investing in technology-driven tools like predictive analytics to provide each member with a personalized experience that best fits their health status and preferences. 
2. Clearly demonstrate the relationship between the benefit and health outcomes and reduced healthcare costs. A third-party analysis of claims related to SilverSneakers outcomes found that participants incur 16% lower healthcare costs than non-participants. 
3. Maintain a continuous commitment to health equity. The Medicare Advantage population includes a growing and diverse segment of beneficiaries who are low-income, reside in rural areas and who are part of a racial or ethnic minority group. It is critical that supplemental benefits are not only accessible to these members but include opportunities tailored to them. 

Supplemental benefits providers who already prioritize utilization-based approaches are well positioned to align with these new guidelines. By continuing to focus on reducing healthcare costs while enhancing member satisfaction and well-being, we can seize this opportunity to be a catalyst for healthy, active aging while using taxpayer dollars responsibly. When seniors thrive both physically and emotionally, the benefits extend to everyone involved.

The new CMS guidelines represent a transformative moment for Medicare Advantage. By embracing utilization, engagement and health outcomes, supplemental benefits providers can lead the way in creating a sustainable program and a healthier future for seniors. 

Photo: kate_sept2004, Getty Images

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