MVP Health Care, University of Vermont Health Network to co-create MA plan focused on elder care

By | April 11, 2021

(Photo by Westend61/Getty Images)(Photo by Westend61/Getty Images)

Nonprofit MVP Health Care, a health plan based in Vermont and New York, and the University of Vermont Health Network are teaming up to launch a joint Medicare Advantage plan, the organizations announced this week.

The entities are currently focused on adhering to regulatory requirements, and because of that offered few details about the benefit design. But a tentative start date has been announced: January 1, 2022.

MVP and UVM plan to announce further details of their Medicare Advantage insurance plan during this fall’s annual enrollment period.

WHAT’S THE IMPACT?

Medicare Advantage plans can offer coverage for services that original Medicare does not, such as vision, hearing, dental and wellbeing benefits. These plans are rapidly growing in popularity, with enrollment in Medicare Advantage doubling over the past decade, according to the Kaiser Family Foundation.

The new partnership and the resulting Medicare Advantage plan are expected to align with existing healthcare reform efforts that shift the focus to wellness as much as illness while controlling costs. By complementing and amplifying those efforts, including the work of the All Payer Model in Vermont and payment reform in New York, the hope is that the plan will benefit Medicare-eligible residents.

The Centers for Medicare and Medicaid Services approved Vermont’s All Payer model in 2016.

“We’ve been doing business in Vermont for over 20 years, and have had a relationship with University of Vermont that whole time,” said MVP Health Care President and CEO Christopher Del Vecchio. “We’re aligned on truly being patient-centric for our members. And we overlap our footprint. We look forward to what we feel is a compelling solution.”

Strategically, the partnership made sense because Medicare Advantage plans have not yet heavily penetrated the target market, said Del Vecchio. But that’s not the only reason for pursuing the move.

Medicare Advantage plans, said Del Vecchio, “demonstrated they’re cost effective for members. They also provide more benefit than the traditional Medicare plans provide – things like vision and hearing and transportation benefits. And I think the service is better.”

MVP Health Care is a nonprofit health insurer caring for members in New York and Vermont. The University of Vermont Health Network is an academic health system comprising of six affiliate hospitals, a multi-specialty medical group, and a home health agency serving the residents of Vermont and northern New York.

“We have this on-the-ground knowledge we’re using to co-create a product for people in the region where they live,” said Del Vecchio.

“So it won’t be disconnected from the market, which should ultimately improve the tenor of the landscape for members of the plan and providers providing services for the plan. It’s important to transform care through the marketplace, using an evidence-based approach to what’s happening in the market … and really putting our arms around our members.”

THE LARGER TREND

At the end of the open enrollment period in December, data showed that more consumers are choosing Medicare Advantage plans for 2021 due to the plans’ supplemental benefits.

This is no surprise, as private plans have pushed the supplemental benefits of their MA plans through television and other advertising, including numerous mailings, in a way the Centers for Medicare and Medicaid Services does not do for traditional Medicare.

While enrollment numbers are not yet available, a Medicare Advantage study found that, for 2021, consumers are choosing MA, not only for the telehealth benefits, but for COVID-19 supplemental benefits offered by the private plans.

Of those who decided on an MA plan because of supplemental benefits, 35% cited COVID-19 supplemental benefits specifically, while 27% cited telehealth benefits, the report said.

In a Morning Consult poll, beneficiaries reported near universal satisfaction with Medicare Advantage’s coverage and provider networks, the latter being the oft-cited drawback of the plans, which have been compared to the narrow-network HMO plans of the 1980s.

Despite the apparent advantages, though, North Shore Insurance Brokers managing partner Ina Goldberg told Healthcare Finance News in January that people pay more in MA plans as they age and become sicker, and made an argument for original Medicare over Medicare Advantage.

Meanwhile, a February data brief, examining offerings of both traditional supplemental benefits and Special Supplemental Benefits for the Chronically Ill (SSBCI) in Medicare Advantage from 2020 to 2021, shows that the number of health plans offering supplemental benefits is growing.

The brief, prepared by the actuarial consulting firm Milliman in conjunction with advocacy group Better Medicare Alliance, found that over the last year, the number of health plans offering supplemental benefits grew in 36 out of 41 categories measured, including 15 out of 17 traditional supplemental benefit categories, four out of five expanded supplemental benefit categories and 17 out of 19 SSBCI categories. 

Benefits that are most widely offered in Medicare Advantage include vision (provided by 96% of plans), hearing (93%), fitness (92%) and dental care (87%).
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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