Home Health Revenue from MA on the Rise

Medicare Advantage (MA) plans accounted for an increasing percentage of total home health revenue throughout 2021, according to data from The Financial Monitor, SimiTree’s industry-leading data analytics and benchmarking tool.

By the third quarter, MA plans had grown to almost one-fourth of total revenue for agencies tracked, an increase of about 8 percent over the same time period a year ago.

SimiTree has not yet released its fourth quarter reports for 2021 to the public.

“This is right in line with growth projected by industry groups tracking MA plans and enrollment,” said Brian Martin, SimiTree’s Vice-President of The Financial Monitor. “The current expectation from the Better Medicare Alliance is that the Congressional Budget Office projections show that MA plans will cover over 50 percent of Medicare beneficiaries by 2030. The data shows we’re seeing the impact of this growth in home health.”

Both health-related and SSBCI plans increasing

The Better Medicare Alliance is an industry advocacy organization. In its most recent industry report, the Alliance reported that MA enrollment has nearly doubled over the last decade, with a total of 3,550 active Medicare Advantage plans in 2021. This represents a 13 percent increase over the previous year.

The volume of MA plans offering primarily health-related benefits has risen each year since 2019, surging from 102 plans in 2019 to 730 in 2021.

New to the market

In the last two years, plans offering non-skilled services have burst onto the scene as a new Medicare Advantage option. Between 2020 and 2021, the number of plans offering Special Supplemental Benefits for the Chronically Ill, or SSBCI benefits, jumped from 267 to 942, a 253 percent increase.

SSBCI benefits include a variety of in-home supportive services such as nutrition assistance, meal delivery, home cleaning services, transportation assistance, pest control, home modifications necessary for patient safety and other non-medical services that can help beneficiaries receive health care in their homes instead of facilities. These types of non-medical home care services are not covered by traditional Medicare and have only been approved for the MA market in the past few years.

Brian Martin VP, SimiTree

Brian Martin Vice-President, SimiTree Financial Monitor

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The report reflects data from both national and SimiTree client reports.

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