Health Plan Weekly

Last year, Medicare Advantage plans for the first time were able to extend a variety of non-primarily health-related items and services to their chronically ill beneficiaries, but insurer adoption of these benefits was relatively small. In 2021, the availability of such benefits has more than tripled, suggesting carriers are becoming more comfortable with a variety of new supplemental benefits and the idea of incorporating cost offsets into their bids.

At the same time, an examination of 2021 Plan Benefit Package (PBP) data illustrates the heavy influence of the COVID-19 pandemic on benefit design, as more insurers are offering grocery delivery, virtual companionship and other services aimed at supporting isolated seniors.

Health care organizations, eager for innovative ways to engage members in the midst of the pandemic, ramped up their use of email and texts in 2020, and found they were highly effective in prompting consumer action, a recent survey on health care consumer engagement found.

The survey, conducted annually for the past five years by consulting and research firm Engagys, found when it polled around 100 health care entities in November that 2020 had been a “breakout year” for use of more efficient digital channels and personalized messages, says Kathleen Ellmore, the firm’s co-founder and managing director.

An earlier version of this story incorrectly stated that Psych Hub is creating “provider ratings.” A Psych Hub representative tells AIS Health that the company is instead “working to identify universal quality outcome measures.” This version has been corrected to clarify that distinction.

With unmeasurable stress and trauma caused by the pandemic, the U.S.’s longstanding shortage of behavioral health care has become an acute crisis — making improvements to the way treatment is paid for a more urgent issue than ever. Fortunately, new trends in quality measures, network design and reimbursement could help the health insurance industry improve access and affordability for behavioral health care to members.

If Chiquita Brooks-LaSure is confirmed as the next CMS administrator, the managed care industry can expect to see a thoughtful and experienced leader helming an agency that wields vast regulatory power over some of insurers’ most lucrative business lines, industry experts say. However, that doesn’t necessarily mean that every move taken by Brooks-LaSure, HHS secretary nominee Xavier Becerra or the Biden administration at large will be completely industry-friendly.

Dan Mendelson, founder of the consulting firm Avalere Health, suggests that “the health insurance industry can expect her to look carefully at the issues before acting; she’s not an impetuous person in any respect. That thoughtfulness is pretty much a hallmark of her operating style.”