Homecare & Drug Treatment in 2020 MA Plans

Last month, the Centers for Medicare & Medicaid Services (CMS) released proposed changes for supplement benefits within Medicare Advantage (MA) plans in 2020. According to CMS, the changes will increase plan choices, as well as offer additional benefits for the critically ill.  It will also address issues related to the national opioid crisis.

In 2020, CMS expects approximately 10% of MA plans to offer non-health related, in-home care for help with acts of daily living, such as dressing, feeding, and bathing. Additional benefits include transportation to doctors and healthcare appointments. Some plans are expected to offer coverage for limited home modifications for the installation of grab bars and wheelchair ramps to allow beneficiaries to “age in place” within their own environments.

To address the opioid epidemic, supplemental benefits will be extended to those members receiving treatment for drug addictions. In addition, proposed changes could add flexibility to Medicare Part D prescription drug plans with a goal of lower cost-sharing for people in addiction therapies. CMS also expects more interoperability between agencies to make the healthcare system more seamless for its members.

Interoperability was a buzz word in 2016, with the passage of the 21^st Century Cures Act, signed by Obama and hailed as miracle by Republican Senator Lamar Alexander. Interoperability – the seamless flow of a patient’s health information between providers and their patient’s – remains an unrealized expectation, largely due to administrative delays and bottlenecking. In 2017, President Trump signed the Executive Order Promoting Healthcare Choice and Competition, commonly known as Trumpcare, and it too seeks to address issues such as inoperability and better communication between healthcare providers.