Maintaining a healthy and balanced diet is essential for the elderly, young children, physically disabled, and chronically ill patients. Around 54 million people will face food insecurity by 2020. Since the onset of the pandemic, millions of Americans lost their jobs, remittances, and other vital sources of income, jeopardizing the livelihoods of many. This resulted in a negative socio-economic impact, gripping on individuals’ health and well-being.
Moderate or severe food insecurity adversely affects the health outcomes of an individual, no matter the age. People with multiple chronic conditions have special dietary needs recommended by their dietitians who design an appropriate meal plan for each patient.
For some seniors with low income or access challenges to fulfill their various medical and non-medical needs, the question is “Should I take a meal today or medications? Who would look after them during isolation or provide meals post-hospitalization?
Specially tailored meals based on the medical conditions of chronic patients help them to better manage their care and avoid unnecessary healthcare costs. Members with chronic conditions such as congestive heart failure, diabetes, and end stage renal disease may be eligible for a Medicare Advantage Plan that may cover up to 10 meals, specially tailored for the condition.
Meal Delivery Offerings by Medicare Advantage Health Plans for Chronically Ill
The Original Medicare Part A and Part B doesn’t pay for meal delivery services of the patients. The Medicare, Medicaid and commercial plans have announced to offer meal delivery services to meet the nutritional needs of patients. As per the new CMS rules 2020, home-delivered meals and other services are now part of Special Supplemental Benefits for the Chronically Ill (SSBCI). Medicare Advantage plans can successfully expand the special supplemental benefits to meet the unique and evolving needs of the vulnerable population in the USA. They focus on providing meals addressing the specific health conditions of the seniors who struggle with hunger, isolation, or chronic illness. MA plans with expanded supplemental meal delivery services play an important role in addressing the social determinants of health.
With SSBCI, various health plans can design a customized nutrition program and deliver nutritional and condition-specific meal services to eligible members, as recommended by physicians. Furthermore, they can also design a home-delivered meal plan as a supportive service, which helps members (homebound and chronically ill) to remain independent and active. Plus for those who need food assistance as a part of their recovery post-discharge, can also avail meal delivery services or grocery delivery services and avoid readmissions to hospitals, reduce transportation costs, and other social determinants of health.
What else should members know about these MA offered home-meal services ?
- Medicare Advantage plans are the only health plans that typically offer this service.
- Members must have a certain health condition to qualify for this service. (for example, situations like post-surgery discharge) The meal delivery service is generally covered for a limited time and depends from plan to plan.
- Must be ‘Chronically ill”, meeting the definition of having a chronic illness laid by CMS such as diabetes, cardiovascular disorders, stroke, chronic lung disorders, chronic and disabling mental health disorders, and others.
- Need intensive care coordination.
- Be at high risk of hospitalization.
- Have a reasonable expectation of improving health or overall health function.
- Must be completed individualized assessment.
These new supplemental benefits for enrollees include:
1 Food and Produce
- Meets the nutritional needs of the members
- Includes food & produce, canned goods, frozen foods, food gift cards covered as SSBCI. (Tobacco, as well as alcohol, are not allowed), based on physicians’ recommendations
- Beneficial for chronically ill members with limited mobility or unable to leave their homes, can access healthy foods including grocery delivery
- Offered as a limited basis
- Includes home-delivered meals and congregate-setting meals
- Beneficial for the chronically ill – for those who have recovered from surgery or hospitalization and for vulnerable individuals who can not leave their homes, living in isolation
How MA plans can leverage technology and benefit members?
MA plans can adapt digital solutions that focus on catering to better care coordination and utilization management of the SSBCI to ensure best practices are followed by the care team in helping their members with scenarios such as post-discharge meal needs and educating them for making better food choices.
Members can view their SSBCI details under this one platform that includes meal service providers, view menu, customize dishes, schedule meals, place an order, and track the delivery at the comfort of their homes. On the other hand, care providers can view and track members’ requests, analyze members’ plans, check the nutritional intake of their members, solve members’ queries online, send notifications, order meals for them and much more. With our integrated meal delivery platform, providing nutritious tailor home-delivered meals, MA members and care team becomes easier with actionable insights for better decision making.
Healthcare providers can e-prescribe or do virtual consultations to extend care coordination. This allows direct communication to members, virtual monitoring of health conditions, track nutrient intake, and recommend members so eat wholesome meals based on their health condition. In addition, plans can also manage to provide nutrition education, cooking classes, and offer food programs to maintain the health and well-being of their members.
Collectively, technology-focused SSBCI services can help medical and community service providers to address important health-related social issues of seniors such as hunger, isolation, independence, and chronic care coordination.
MA plans have a positive impact on the health outcomes of the members, as home-delivered meal programs help members to avail customized meals at their home or in congregate settings. It ultimately reduces readmissions in hospitals, ED visits and overall costs. Implementing digital healthcare solutions can help all the key stakeholders to manage and improve health outcomes. Technology helps MA plans to deliver flexible and personalized care to beneficiaries. Address healthcare needs related to food insecurity and improve lives leveraging SSBCI. For more information about SSBCI benefits management portal, connect with our healthcare services team, and contribute towards improving the health outcomes of members in the communities.
Ayushi Patel is the Director of Strategy & Innovation at Mobisoft Infotech. She leads the strategic partnerships and initiatives in the healthcare division. Her experience includes healthcare administration, business development and sales, and customer success management.