AJMC April 13, 2022
Laura S. Shields-Zeeman, PhD, MS, Emily A. Gadbois, PhD, MS, MA, Michelle Tong, BA, Joan F. Brazier, MS, Laura M. Gottlieb, MD, MPH, Kali S. Thomas, PhD, MA

This article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.

ABSTRACT

Objectives: Health care payers are increasingly experimenting with interventions to address social risk factors. With enactment of the 2018 Bipartisan Budget Act, Medicare Advantage (MA) plans have new opportunities to offer supplemental benefits that are not “primarily health-related.” This article presents findings from interviews conducted with executives from MA plans regarding plan decision-making processes related to new social risk factor benefits.

Study Design: Semistructured qualitative interviews with MA plan leadership.

Methods: A total of 63 plan representatives from 29 unique MA plans were interviewed about the rationale for social risk–related interventions and how data...

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Topics: Equity/SDOH, Healthcare System, Insurance, Medicare Advantage, Patient / Consumer, Survey / Study, Trends
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