Medicare Advantage (MA) plans have another new benefit to offer their members in 2020: telehealth services. The Centers for Medicare & Medicaid Services (CMS) recently announced it has finalized changes that would allow MA beneficiaries to access health care services from places like their homes, rather than require them to go to a health care facility for treatment.
The new policy, released in a final rule issued on April 5, is part of CMS’ efforts to modernize the MA and Part D programs, and promote innovation and competition to improve quality among private Medicare health and drug plans.
Although MA plans have been able to offer some telehealth services as part of their supplement benefits, the final rule allows them to include additional telehealth benefits and expand access to more providers and in more parts of the country than before. The CMS announcement follows the release of the Final Call Letter, which gives MA plans more flexibility to offer chronically ill patients supplemental benefits that address social determinants of health.
Approximately 81 percent of MA plans offered coverage of remote access technologies as part of supplemental telehealth benefits in 2018, an increase from 77 percent in 2017.
MA plan flexibility
The new telehealth and supplemental benefits will give MA plans the flexibility to provide a historic set of offerings to beneficiaries, CMS announced. It also means MA plans will be able to compete for patients based on their new offerings and overall cost.
“With these new telehealth benefits, Medicare Advantage enrollees will be able to access the latest technology and have greater access to telehealth,” CMS Administrator Seema Verma said in the announcement. “By providing greater flexibility to Medicare Advantage plans, beneficiaries can receive more benefits, at lower costs and better quality.”
For example, the final rule notes that an MA plan may offer as a supplemental telehealth benefit a videoconference dental visit to serve as a digital consultation.
Supplemental benefits motivate many MA members to switch plans. Deft Research’s 2019 Medicare Shopping and Switching Study found that 58% of the 1,637 MA members surveyed would switch to a different MA plan if telehealth services were offered as a supplemental benefit.
CMS estimates in the final rule that the additional telehealth benefits will generate $557 million in savings for enrollees over 10 years due to reduced travel time to and from providers.
In addition, a Medicare Payment Advisory Commission report to Congress in March 2018 noted that telehealth benefits will increase convenience for patients, improve communication between providers and patients, enhance care coordination, improve quality, and reduce costs related to in-person care.