Neil Steffens – The Virginian-Pilot https://www.pilotonline.com The Virginian-Pilot: Your source for Virginia breaking news, sports, business, entertainment, weather and traffic Tue, 17 Sep 2024 22:07:32 +0000 en-US hourly 30 https://wordpress.org/?v=6.6.2 https://www.pilotonline.com/wp-content/uploads/2023/05/POfavicon.png?w=32 Neil Steffens – The Virginian-Pilot https://www.pilotonline.com 32 32 219665222 Column: Advantage plans address gaps in traditional Medicare https://www.pilotonline.com/2024/09/17/column-advantage-plans-address-gaps-in-traditional-medicare/ Tue, 17 Sep 2024 22:05:28 +0000 https://www.pilotonline.com/?p=7371104 Medicare Advantage (MA), also known as Medicare Part C, is a managed care alternative to traditional Medicare coverage offered by health plans. In recent years, MA membership has grown substantially and MA plans have been permitted to add new benefits to better address members’ needs.

In particular, changes in regulation and legislation have allowed MA health plans, such as Anthem Blue Cross and Blue Shield in Virginia, more flexibility in designing specially tailored benefits that support a person’s overall health and wellbeing. These supplemental benefits are unique to MA and can help address gaps in traditional Medicare. Supplemental benefits historically included “primarily health related” benefits such as dental, vision and hearing services, and more recently include services that support health-related needs, such as help purchasing nutritious food and transportation to access plan benefits.

According to the National Academy of Medicine, what’s typically considered “medical care” only accounts for 10-20% of contributors to health outcomes. Other factors that have an impact on health include a person’s access to grocery stores, relationships with friends and family, and home and workplace environments. These are known as social drivers of health, and they account for the remaining 80-90%. Recognizing the profound impact of social drivers on a person’s health, it’s important to shift the lens through which we view health care. Addressing these aspects will help us transition toward a more holistic view, one that takes into account our whole health.

Whole health is an approach to health care that recognizes health must be evaluated as a bigger picture, one that includes physical, behavioral and social drivers. We must move beyond the traditional scope of simply addressing physical health and find ways to positively influence behavioral and social drivers of health. This involves a focus on health equity and using data to tailor our efforts to individuals, taking a big picture view of their health needs. Only by understanding this big picture can people start to view their own health as something that is both influenced by the world around them and within their control to shape and change.

Thanks to the expansion of MA supplemental benefits, plan members are now better able to get the help they need to improve their whole health. For example, while medically tailored meals have been offered as a conventional supplemental benefit for a while, some MA plans are now able to offer additional nutrition benefits such as grocery cards, which provide a monthly allowance that give members the ability to purchase produce and other food items at participating grocery stores.

A study published last year found that a vast majority of a MA health plan’s members used at least one supplemental benefit in 2022, with many accessing more than one benefit. In addition, members who used at least one supplemental benefit were more likely to live in areas with fewer resources, such as food deserts and areas with lower socioeconomic status, suggesting that these benefits are helping to address social drivers of health.

Another recent study suggested that use of supplemental benefits is associated with an increased likelihood of having a preventative screening or annual wellness visit and a decreased likelihood of having a hospitalization or emergency room visit for a non-emergent issue.

Today, more than 32 million people have chosen to enroll in a MA plan. That’s more than half of all eligible Medicare members, showcasing the critical value that MA plans, including supplemental benefits, provide for older adults and people with disabilities.

With the Medicare Annual Enrollment Period fast approaching, from Oct. 15 to Dec. 7, it’s a crucial time for all Medicare-eligible individuals. Take this opportunity to review your options carefully to ensure that your MA plan is working for you. Don’t overlook the supplemental benefits, as these can significantly contribute to overall health and wellbeing.

Neil Steffens is Medicare president of Anthem Blue Cross and Blue Shield’s East Region, which includes Virginia.

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Information critical to Medicare choices https://www.pilotonline.com/2013/11/02/information-critical-to-medicare-choices/ https://www.pilotonline.com/2013/11/02/information-critical-to-medicare-choices/#respond Sat, 02 Nov 2013 04:00:00 +0000 https://www.pilotonline.com?p=1189116&preview_id=1189116 If you have Medicare Parts A and B, choosing a Medicare plan can sometimes prove confusing, challenging and time-consuming. But the Centers for Medicare & Medicaid Services makes it easier for beneficiaries to navigate the Medicare landscape by rating the health plans.

Much like the ratings used by some movie reviewers, Medicare’s five-star assessment grades the excellence of Medicare Advantage and prescription drug plans nationally. A 5-star rating represents an excellent plan and a 1-star a poor performer.

The system helps people compare Medicare Advantage and prescription drug plans so they have information they need to choose a higher quality plan and better health care. It’s especially useful now as the Medicare annual open enrollment period approaches. This year, from Oct. 15 – Dec. 7, and generally only during this period , Medicare-eligible individuals can choose a Medicare plan for the first time or change their current plan for the coming year.

The rating system uses more than 50 different quality measures in five categories. They include staying healthy via preventive services; managing chronic conditions such as diabetes and high blood pressure; evaluating a plan’s responsiveness and service; considering complaints, appeals and voluntary disenrollment; and assessing the quality of customer service.

Medicare is tough when issuing its top ratings. For 2013, only four Medicare Advantage-only plans are five-star performers. People should use the star ratings in several ways. First, they should acknowledge that each plan is different – with different pricing, benefits, and health care provider networks. Second, they should determine if the plans performed better in 2013 than 2012 and compare them to original Medicare. Here are four considerations to look at when choosing a Medicare plan:

1.Review all of your options. In 2013, beneficiaries in nearly every U.S. county are able to select from an average of 26 plans.

2.Decide what benefits you want based on your health care needs. There is a wide range of plans so determine your specific wants and needs. Do you require a certain type of specialty care? Do you want to keep a favorite doctor?

3.Determine which plans you can afford since cost is usually a major factor in deciding which health care plan will best suit your needs. Don’t just consider the plan with the lowest monthly premium. Find out if a plan requires a copayment or has a high annual deductible to meet before it pays any of your health care expenses.

4.Enroll in the plan that best fits your needs and budget.

So before you enroll in a Medicare plan, check the star ratings at the Medicare Plan finder website at https://www.medicare.gov/find-a-plan/questions/home.aspx.

Steffens is Humana’s vice president of senior markets in Virginia.

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