Medicare Advantage (MA) plans have grown steadily in enrollment and now cover more than one-third of all Medicare beneficiaries. By 2025, that number is expected to reach 40%. This changing payer mix presents a threat to post-acute provider revenue as MA plans often negotiate lower reimbursement rates, deploy strict utilization management, and exclude providers from their networks to control costs.

MA plans have long been allowed to offer extra benefits that traditional Medicare does not cover—called “supplemental benefits” (e.g., dental services, gym memberships, and vision benefits). CMS recently widened the scope of these benefits to include those that improve or maintain the beneficiary’s health. With these new flexibilities, MA plans have additional opportunities to control costs and manage utilization by addressing non-medical and long-term care related needs at home. The expansion also creates opportunities for post-acute providers to partner with MA Plans to care for chronically ill patients. By aligning with MA plans, providers can potentially generate new revenue or drive up referral volumes as a result of improved quality.

This white paper discusses some of the early trends in supplemental benefits offerings and provides strategic insights for post-acute providers exploring opportunities to launch or expand supplemental benefits in partnership with MA plans.

Download the research briefing