Managed Healthcare Executive March 12, 2020
Healthcare experts agree that nonmedical, social factors such as housing, nutrition, and access to recreation can play a significant role in shaping people’s health. With that being said, Medicare Advantage (MA) plans can now cover benefits that address some of these social determinants of health (SDoH).
But last year, a relatively low percentage of plans offered the benefits permitted by CMS to address SDoH. A Milliman report identified only 102 plans as offering new SDoH services, cost, funding, and novelty are some of the impediments. MA plans can use their rebate money—the difference between their estimated costs (and profit) and county-level financial benchmark—to pay for SDoH and other “supplemental” benefits for their members (the rebate money can also be used...
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