While MAOs Embrace ‘Flex Benefits,’ SSBCI Uptake Is Slow

After a relatively modest first year, the number of condition-specific supplemental benefits offered by Medicare Advantage plans more than doubled from approximately 820 in 2019 to 1,850 this year, according to a new report from Faegre Drinker Consulting. And, in the first analysis of new Special Supplemental Benefits for the Chronically Ill (SSBCI) for 2020, Faegre Drinker found that only 245 plans out of approximately 6,000 MA plans total offered them. But the firm observed that adoption of the new “flexible benefits” permitted by CMS may improve as plans see what works and what doesn’t and explore their potential to increase enrollment, improve outcomes and generate net cost savings.

“We see a big increase in condition-specific benefits in 2020, but the SSBCI uptake was pretty small,” remarks Michael Adelberg, a principal with Faegre Drinker and a former CMS MA official. Nevertheless, the industry is only at the start of a multiyear process to embrace flexible benefits, he points out.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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