Netherlands Institute of Mental Health and Addiction Reports Findings in Insurance (How Medicare Advantage plans use data for supplemental benefits decision-making): Insurance

2022 APR 21 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Insurance is the subject of a report. According to news reporting out of Utrecht, Netherlands, by NewsRx editors, research stated, “Health care payers are increasingly experimenting with interventions to address social risk factors. With enactment of the 2018 Bipartisan Budget Act, Medicare Advantage (MA) plans have new opportunities to offer supplemental benefits that are not ‘primarily health-related.’ This article presents findings from interviews conducted with executives from MA plans regarding plan decision-making processes related to new social risk factor benefits.”

Our news journalists obtained a quote from the research from the Netherlands Institute of Mental Health and Addiction, “Semistructured qualitative interviews with MA plan leadership. A total of 63 plan representatives from 29 unique MA plans were interviewed about the rationale for social risk-related interventions and how data are used to inform benefits expansion decisions. This paper combines qualitative interview data from 2 separate studies with similar target groups and interview guides. Interview transcripts were qualitatively analyzed to examine underlying themes. Three main themes emerged: (1) Plans use multiple data sources to determine how to target benefits; (2) evidence gaps hinder decision-making to expand or offer new supplemental benefits; and (3) in the absence of sufficient evidence, some plans have their own research and quality improvement processes to maximize effectiveness. Findings provide insights about opportunities and challenges that MA plans face in making decisions related to supplemental benefits designed to address members’ social risk factors. Barriers include collecting, generating, and analyzing data critical to informing investments.”

According to the news editors, the research concluded: “Results highlight the need to ensure interoperability of new and existing data sources, foster shared learning opportunities, and narrow evidence gaps about specific social care interventions to inform the design and implementation of effective supplemental benefits.”

This research has been peer-reviewed.

For more information on this research see: How Medicare Advantage plans use data for supplemental benefits decision-making. The American Journal of Managed Care, 2022;28(4). The American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

Our news journalists report that additional information may be obtained by contacting Laura S. Shields-Zeeman, Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, Netherlands. Additional authors for this research include Emily A. Gadbois, Michelle Tong, Joan F. Brazier, Laura M. Gottlieb and Kali S. Thomas.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.37765/ajmc.2022.88866. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the The American Journal of Managed Care is: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

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