Modeling Medicare Long-Term Care Support Services Benefit Offerings
Background
Medicare Advantage (MA) plans have been allowed new flexibilities related to the types of supplemental benefits that could be offered to enrollees. As a result, Medicare Advantage plans began to offer long-term services and support (LTSS) benefits as supplemental benefit offerings. The SOA Research Institute is currently conducting a research project that focuses on consumer financial impacts of social insurance LTSS proposals, and we would like to also consider the impact on consumers of incorporating LTSS benefits into MA plans.
Research Objective and Deliverables
This research will develop an Excel-based model with a user’s guide that will be publicly available and address the following questions:
- What is the benefit value of current MA supplemental benefits (LTSS and non-LTSS)?
- What are potential LTSS benefits that could be offered given the existing benefit value of MA supplemental benefits?
- What is the impact of potential MA LTSS supplemental benefits in terms of:
- Changes to LTSS expenditure by other payors (Medicaid, private LTC insurers)?
- Changes in consumer out-of-pocket (OOP) spending on LTSS services?
- Impacts on informal caregiving?
The Excel workbook will allow users to define various MA supplemental LTSS benefit offerings, including benefit categories, benefit amounts, maximum benefits, and benefit cost sharing.
Target Audience and Impact
This model will help consumers, LTSS professionals and regulators better understand health care risks and the financial impact of LTSS proposals. This knowledge will also assist consumers to advocate for themselves in the public sphere.
Estimated Cost
$92,000
Estimated Timeline
Approximately 12 months