Fostering Flexibility
How Medicare Advantage Potentially Accelerated Telehealth Benefits
Bibliographic Data
| ID | 13775321 |
|---|---|
| Authors | Lisa M Grabert (0000-0002-0823-0172, Marquette University College of Nursing, Milwaukee, WI, USA, corresponding author), Grace Mccormack (0000-0002-6939-6758, University of Southern California Schaffer Center for Health Policy & Economics, Los Angeles, CA, USA), Grace P McCormack (0000-0003-4960-5185, University of Southern California), Erin Trish (0000-0002-8736-7862, University of Southern California Schaffer Center for Health Policy & Economics, Los Angeles, CA, USA), Kathryn L Wagner (Marquette University College of Business Administration, Milwaukee, WI, USA) |
| Year | 2024 |
| Volume | 61 |
| Pages | 469580241238671-469580241238671 |
| Publication date | 2024-01-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | INQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL) |
| Journal identifiers | ISSN: 0046-9580 • E-ISSN: 1945-7243 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/00469580241238671 |
| PMID | 38450625 |
| OpenAlex | W4392566405 |
| Language | EN |
| References cited | 14 |
In 2018, the US Congress enacted a policy permitting Medicare Advantage (MA) plans to cover telehealth services in a beneficiary's home and through audio-only means as part of the basic benefit package of services, where prior to the policy change such benefits were only allowed to be covered as a supplemental benefit. MA plans were afforded 2 years of lead time for strategizing, negotiating, and capital investment prior to the start date (January 1, 2020) of the new coverage option. Our data analysis found basic benefit telehealth was offered by plans comprising 71% of enrollment in 2020 and increased to 95% in 2021. At the same time, remote access telehealth was offered as a supplemental benefit for 69% of enrollees in 2020, a decrease of 23% compared to 2019. These efforts by MA plans may have enabled traditional Medicare (TM) to leverage an existing telehealth infrastructure as a solution to the access issues created by public health policies requiring sheltering in place and social distancing during the COVID-19 pandemic. The success of this MA policy prompts consideration of additional flexibility beyond the standard basic benefit package, and whether such benefits reduce costs while improving access and/or outcomes in the context of a managed care environment like MA. Subject to oversight, such flexibility could potentially improve value in MA, and facilitate future changes in TM, as appropriate
Beneficiary · Business · Context (archaeology · Economic growth · Economics · Flexibility (engineering · Health care · Leverage (statistics · Telehealth · Telemedicine · Computer Science · COVID-19 and healthcare impacts · Finance · Medicine · Patient Satisfaction in Healthcare · Telemedicine and Telehealth Implementation
Trends in the Use of Telehealth During the Emergence of the Covid-19 Pandemic — United States, January–March 2020
Medicare Must Provide Additional Cost and Access Information to Enhance Decision Making Around Trade Offs Between Medicare Advantage and Medigap
Telehealth Benefits Offered by Medicare Advantage Plans in 2020
| Citation velocity | historical |
|---|---|
| Highly cited | No |