The nation’s largest health insurers are increasingly modifying their supplemental benefit offerings in response to CMS expanding its coverage of in-home health care. The fact that Medicare Advantage carriers are offering more plans covering home health services reflects the growing realization of the value of such models of care. Contact Sena Health today to find out more about receiving patient-centric, hospital-level care in the comfort of your home.
By Robert Holly
A number of major Medicare Advantage (MA) carriers are expanding their supplemental benefit offerings shaped around in-home care next year. UnitedHealthcare, the insurance arm of UnitedHealth Group (NYSE: UNH), is among them.
Overall, UnitedHealthcare partners with more than 1.3 million physicians and care professionals across the U.S., plus another 6,500 or so hospitals and other care facilities. In 2020, UnitedHealthcare had more MA enrollees than any other group.
“We know the majority of older adults want to stay in their homes and communities as they age, and UnitedHealthcare continues to design plans that place the home at the center of health care support and delivery,” Steve Warner, senior vice president of Medicare Advantage in UnitedHealthcare’s Medicare & Retirement division, told Home Health Care News.
America’s largest health insurers — UnitedHealthcare, Humana Inc. (NYSE: HUM), Aetna, Blue Cross Blue Shield plans and others — have built out their home strategies in a variety of ways.
In some cases, that has meant the launch of internal in-home primary care and remote monitoring programs to better track members’ social determinants of health. In others, it has meant partnering with in-home care providers to offer the types of new supplemental benefits that the U.S. Centers for Medicare & Medicaid Services (CMS) has increasingly signed off on over the past few years.
“The interconnectedness of the health care system means that every touchpoint along a consumer’s health care journey is important,” Warner said. “Particularly for high-risk individuals and others who depend on a variety of needs being addressed from home, the people who provide these services are an integral piece of a shared community of support.”
On its end, UnitedHealthcare says it’s doing more than ever to support health and wellness from the comfort, safety and convenience of the home.
In 2021, most of its plans, for example, will include HouseCalls, a program that offers Medicare and Medicaid members a yearly in-home visit with a licensed clinician. The company expects to complete nearly 1.7 million HouseCalls visits for members in 2020.
HouseCalls has been particularly valuable during the COVID-19 pandemic, too, with the number of home visits in the third quarter growing by nearly 30% year over year, according to UnitedHealth Group CFO John Rex, who addressed the topic during an Oct. 14 earrings call.
“We continue to deepen our engagement with those seniors most in need, increasing the distribution of remote digital sensor kits to collect and monitor vital health data and address gaps in care generated by the pandemic,” Rex said at the time.
‘Health is more than medical care’
Apart from its HouseCalls program, at least six UnitedHealthcare plans are offering in-home support services under the “primarily health-related” supplemental benefit pathway in 2021, according to state-level data compiled by Washington, D.C.-based research and consulting firm ATI Advisory.
In comparison, only two UnitedHealthcare plans offered in-home support services supplemental benefits this year.
Geographically, the two UnitedHealthcare plans offering in-home support services in 2020 covered slightly more than two dozen counties. Next year, the six plans doing so will cover more than 250 counties, according to ATI Advisory’s data.
“They have made a very significant, clear increase in the coverage,” ATI Advisory CEO Anne Tumlinson told HHCN. “I think it speaks a lot to the power of these benefits.”
Overall, 429 MA plans will offer in-home support services across 36 states and Puerto Rico next year. Many more will also likely offer home-focused supplemental benefits through the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway in 2021.
These trends in supplemental-benefit design are, in part, linked to the realization that a large chunk of a person’s health is ultimately impacted by functional ability and social factors, including access to food, friends and transportation.
“We know that health is more than medical care, and that factors outside a doctor’s office play a significant role in influencing a person’s health and well-being,” Warner said. “This reality factors into how we design our plans and support older adults.”
UnitedHealthcare isn’t just coordinating and covering services that take place within its members’ homes.
At times, it’s even helping to provide the home in the first place.
“At an enterprise level, UnitedHealthcare continues to make significant investments in affordable housing as part of the company’s ongoing efforts to remove social barriers to better health for people in underserved communities,” Warner said. Since its affordable housing initiative kicked off in 2011, the company has worked with a range of advocates to invest more than $500 million in developments that increase access to housing, health care and social services.
Telehealth is ‘here to stay’
The U.S. tallied 91,530 new COVID-19 infections on Election Day, adding to the skyrocketing cases numbers reported in the past week.
The COVID-19 pandemic is changing the health care landscape, Warner recognized, but it isn’t altering UnitedHealthcare’s commitment to helping members access the care they need. That’s true whether they reside in a clinical setting or at home, he added.
To maintain that commitment, UnitedHealthcare has turned to more telehealth solutions.
“In just one month earlier this year, for example, more than 12% of our UnitedHealthcare Medicare members had a telehealth visit with their doctor – up from just a fraction of a percent last year,” Warner told HHCN.
In 2021, all standard MA plans from UnitedHealthcare will offer telehealth visits with a $0 copay.
“As in-person visits resume, telehealth utilization is moderating, but remains significantly higher than the pre-COVID baseline,” Warner said. “We believe higher utilization and increased comfort level in embracing telehealth is here to stay.”