Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health in Response to the CHRONIC Care Act

JAMA Network July 12, 2019
Kali S. Thomas, PhD, MA; Shayla N. M. Durfey, BS; Emily A. Gadbois, PhD; David J. Meyers, MPH; Joan F. Brazier, MS; Ellen M. McCreedy, PhD; Shekinah Fashaw, MSPH; Terrie Wetle, PhD

Question How are Medicare Advantage (MA) plan representatives responding to new flexibility granted by the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act to address members’ social determinants of health through supplemental benefits?

Findings This qualitative study with participants from 17 MA plans (representing >65% of the MA market) revealed that addressing members’ social determinants of health was important but reported 2 distinct approaches: creating supplemental benefits or supporting community-based organizations. Participants described complex decision-making concerning how to provide supplemental benefits, including a need for evidence, return on investment, strong community partnerships, and US Centers for Medicare & Medicaid Services guidance.

Meaning Enrollees in MA may have differential access to supplemental benefit offerings that address social determinants...

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