Brian Powers on How Humana Understands Medicare Advantage Enrollees' Social Needs
05/03/22 • 24 min
Let us know what you think about Health Affairs podcasts at [email protected]. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.
More than 40 percent of Medicare enrollees are enrolled in Medicare Advantage (MA) plans, privately-sponsored health plans that provide Medicare benefits often along with other benefits not included in the standard Medicare package such as eye exams, hearing aids, and dental coverage.
Medicare Advantage is growing rapidly. On the current trajectory, it's likely that the majority of Medicare enrollees will be in MA plans within a year or two.
Since MA plans are paid on a capitated basis, insurers have a financial incentive to control health care costs. Recently, much attention has been focused on how addressing social needs can yield health benefits, which save MA plans money.
In order to address those needs, health plans need to know the social needs of their enrollees.
Brian Powers from Humana joins A Health Podyssey to discuss understanding the unmet social needs of Medicare enrollees.
Powers and colleagues published a paper in the April 2022 issue of Health Affairs assessing the health related social needs of enrollees in Humana's MA plans. They found significant needs including financial strain, food and utility insecurity, poor housing quality, and unreliable transportation. These needs were distributed unevenly across enrollees by race, socioeconomic status, and sex.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
Let us know what you think about Health Affairs podcasts at [email protected]. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.
More than 40 percent of Medicare enrollees are enrolled in Medicare Advantage (MA) plans, privately-sponsored health plans that provide Medicare benefits often along with other benefits not included in the standard Medicare package such as eye exams, hearing aids, and dental coverage.
Medicare Advantage is growing rapidly. On the current trajectory, it's likely that the majority of Medicare enrollees will be in MA plans within a year or two.
Since MA plans are paid on a capitated basis, insurers have a financial incentive to control health care costs. Recently, much attention has been focused on how addressing social needs can yield health benefits, which save MA plans money.
In order to address those needs, health plans need to know the social needs of their enrollees.
Brian Powers from Humana joins A Health Podyssey to discuss understanding the unmet social needs of Medicare enrollees.
Powers and colleagues published a paper in the April 2022 issue of Health Affairs assessing the health related social needs of enrollees in Humana's MA plans. They found significant needs including financial strain, food and utility insecurity, poor housing quality, and unreliable transportation. These needs were distributed unevenly across enrollees by race, socioeconomic status, and sex.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
Previous Episode
Alexandra Bhatti Assesses US Child Care Vaccination Laws
Let us know what you think about Health Affairs podcasts at [email protected]. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.
This episode is sponsored by the Rural Health Research Gateway at the University of North Dakota.
Vaccine requirements have been much in the news lately tied to the COVID-19 pandemic, but disputes over requiring vaccines have been with us for decades.
How to balance respecting individual autonomy with protecting public health is not a new issue. It's played out in particular force when it comes to children.
All states have vaccine requirements for children as they enter school and those requirements are often pretty widely known. Less well known are those requirements related to child care, which can affect children long before they reach school age.
Alexandra Bhatti from Merck joins A Health Podyssey to discuss vaccine requirements for child care in the United States.
Bhatti and coauthors published a paper in the April 2022 issue of Health Affairs assessing child care vaccination requirements in the United States. They found considerable variation across the 50 states and Washington, DC.
While all jurisdictions require children up through age five to meet certain requirements to attend school or child care programs, the states are uneven in their breadth, enforcement, and implementation of these requirements.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
Next Episode
Vilsa Curto on Vertical Integration's Effect on Health Care Prices
Let us know what you think about Health Affairs podcasts at [email protected]. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.
The health care sector has gone through various waves of consolidation with hospitals purchasing physician practices and hospitals, physicians, and health insurers merging with each other.
We're in the midst of a wave of consolidation.
Two years ago, Health Affairs published a paper that found more than half of US physicians and 72 percent of surveyed hospitals were affiliated with one of 637 health systems in 2018. More recently, some have estimated that the 10 largest health systems now control about a quarter of the health care market.
Consolidation brings with it various opportunities for savings and efficiency but it also concentrates market power and creates opportunities to raise prices.
Vilsa Curto from Harvard University joins A Health Podyssey to discuss the effects of consolidation and integration.
Curto and colleagues published a paper in the May 2022 issue of Health Affairs assessing trends in vertical integration and joint contracting between physicians and hospitals in Massachusetts and exploring the affects on prices for physician services.
They found notable price affects that varied according to system size and physician type.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
If you like this episode you’ll love
Episode Comments
Generate a badge
Get a badge for your website that links back to this episode
<a href="https://goodpods.com/podcasts/a-health-podyssey-203371/brian-powers-on-how-humana-understands-medicare-advantage-enrollees-so-20751521"> <img src="https://storage.googleapis.com/goodpods-images-bucket/badges/generic-badge-1.svg" alt="listen to brian powers on how humana understands medicare advantage enrollees' social needs on goodpods" style="width: 225px" /> </a>
Copy