MARKET RESEARCH - Executive Summary
The Evolving Landscape of Medicare Advantage Benefits: Trend Analysis
July 21, 2023 Summary
🏥 In the vast landscape of the Medicare Advantage market, a realm where beneficiaries seek high-quality healthcare options, an abundance of benefit trends emerge. These trends have the power to shape plan selection and ultimately impact the lives of millions. In this 📑 whitepaper summary, we embark on an exploratory journey through a multitude of benefits including Supplemental, Enhanced, SSBCI (Special Supplemental Benefits for the Chronically Ill), Optional, and Combined benefits. Join us as we unravel the prevalence of these benefits and uncover their hidden potential.
📊 To truly comprehend the magnitude of these benefit trends, we must delve into statistical data derived from Non-SNP plans listed in CMS’ Landscape files. These invaluable resources allow us to trace benefit offerings over a span of more than five years—painting a vivid picture of how plans have adapted to cater to beneficiaries’ needs.
💎 Supplemental benefits form the bedrock upon which our understanding of Medicare Advantage plans is built. Within this realm lies a treasure trove of varying benefits that have evolved over time to meet the ever-changing needs of beneficiaries. Enhanced benefits dominate the market for a third consecutive year among 20 different Supplemental benefits. With 22 sub-benefits within this Enhanced category, the ‘Fitness Benefit’ stands tall with an astounding 98% plan coverage. On the other hand, among the 10 sub-benefits of SSBCI, ‘Food Produce’ experiences significant growth, capturing 13% of the market compared to a mere 2% in 2020. Interestingly, Combined benefits display an upward trajectory with a remarkable 71% plan coverage in the market this year. It’s becoming prominent by increasing the plan coverage year-over-year. In contrast to all these benefits, Optional benefits have experienced a slight decline in plan coverage over time – dropping from 34% in 2022 to 30% in 2023.
💪 Let us first shine a spotlight on Supplemental benefits—a cornerstone for those seeking comprehensive coverage beyond what traditional Medicare offers. Approximately 12 benefits within this category are considered table stakes, highlighting their essential role in maintaining competitiveness within the market. Astonishingly, most states now offer Supplemental benefits at rates exceeding 70%. This means that beneficiaries can access an array of additional services such as Over-The-Counter (OTC) benefits that enhance their well-being.
🌍 To further illuminate the landscape, we turn to the Medicare Plan Finder (MPF) listed benefits index, an invaluable tool that provides an index of benefit availability across states. It reveals that twenty states boast a perfect index score of 1 for Worldwide Emergency benefits, while fifteen states earn the same distinction for Fitness benefits indicating the highest coverage of these benefits, along with Hearing, Vision, Dental, and OTC benefits. These findings emphasize the commitment of Medicare Advantage plans to ensure beneficiaries have access to emergency services regardless of their location.
🏆 As we dive deeper into this intricate web of benefits, we cannot ignore the differences between HMOs and PPOs—the two pillars upon which many plans stand. Dental, Vision, and Hearing benefits are generously covered by both HMOs and PPOs at rates exceeding 90% nationwide. However, it is worth noting that PPOs exhibit a higher average year-over-year (YoY) growth rate in coverage with 21% in Supplemental benefits and 36% in Enhanced compared to HMOs by 4% in both benefits.
📈 Now, let us explore year-over-year benefit coverage trends—a lens through which we can witness the evolution of offerings over time. Our statistical analysis uncovers remarkable growth in enrollment share of specific benefits such as OTC benefits reaching nearly 90%, while Meal benefits experience a notable 7% rise hitting 77%, and Dental benefits reach 95%. Within Enhanced benefit offerings, Fitness, and Remote Access Technology have the highest coverage. Food Produce hiked its enrollment share from 9% to 15% in 2023, while the share of Combined and Optional benefits is 33% and 75% respectively.
🧮 Through segmented analysis of Optional and Combined benefits, we discover a rising trend in the number of plans offering multiple Optional benefit packages, while the proportion of plans offering at least one package is decreasing. Combined benefits, however, have seen increases across single and multi-package plans. Noticeable growth was seen in Comprehensive Dental, Eyewear, and POS (Point of Service) which are offered as Optional benefits. However, Preventive Dental is the leading Combined benefit in the market.
🔍 Discover the Full Insights: Dive Deep into Benefit Trends in the Medicare Advantage Market.