The Value Triangle: How Your Medicare Advantage Plan Can Ensure Every Supplemental Benefit Offers Strategic Upside

In 2024, the average Medicare beneficiary has access to more than 40 Medicare Advantage (MA) plans. This is approximately twice as many choices as individuals had in 2018. As competition has stiffened, many MA plans have pumped up supplemental benefits as a way of attracting new enrollees and retaining existing members.

The median number of supplemental benefits provided by MA plans is currently 23, according to CMS. That number has been growing in recent years, but we may have reached an inflection point. As plans face increasing revenue pressure, rising healthcare costs and intensifying scrutiny from CMS, it appears a change is in the air. As such, McKinsey expects benefit designs will evolve from “a buffet to a curated menu.” With a more focused approach, plans will need to evaluate each supplemental benefit for its ability to provide strategic upside.

We’re already seeing this come to fruition. Both Humana and CVS recently stated they would be reducing the overall benefits they offer. This is becoming a necessary practice for plans who want to stay financially viable as they compete in the market.

In addition to commonly offered supplemental benefits such as vision, dental and hearing, plans have presented a wide range of options, including acupuncture, chiropractic services, wigs for chemotherapy-related hair loss and non-emergency transportation, to name a few.

In this new environment, the strategy must change. Every supplemental benefit you offer has to be evaluated through a different lens.

Look for the Value Triangle 

In the past, plans have mostly used supplemental benefits as a strategy for member recruitment and retention. They weren’t as likely to scrutinize the clinical and financial impact of these offerings. The priority was making the plan more attractive to enrollees. The time has come for supplemental benefits to bring more to the table.

As an example, several larger MA plans have been the victim of their own success in recent years. Attractive supplemental benefits led to more robust membership. That was a good outcome, in theory. But the spike in enrollees brought higher medical costs along for the ride, which put additional financial pressure on these plans.

The best supplemental benefits will help your plan generate revenue, save costs and improve the quality of care you provide to members, in addition to being an attractive service for individuals.

As such, when your MA plan is evaluating your lineup of supplemental benefits, you should choose solutions that check all the boxes and offer the full triangle of value: clinical impact, a financial return and an advantage in recruitment/retention.

When It Comes to Supplemental Benefits for the Chronically Ill (SSBCI), Be Ready for New CMS Regulations

With supplemental benefits that are specifically designed to support individuals with chronic conditions, CMS is pushing plans toward viewing supplemental benefits more strategically. In CY2025, CMS began denying any plan’s bid if it fails to demonstrate how proposed benefits will improve or maintain the health and overall function of chronically ill enrollees. These new requirements include establishing a body of evidence that demonstrates the efficacy of each benefit; using written, objective criteria for determining an enrollee’s eligibility for SSBCI; ensuring equitable access to such benefits and establishing a process for notifying enrollees annually to remind them of unused supplemental benefits.

Offer Benefits Your Members Actually Want, and You Actually Want Them to Use

The Commonwealth Fund estimates roughly 30% of MA members didn’t use any of their supplemental benefits in the previous year. Industry experts suggest several reasons for low engagement.

One theory is that plans are offering benefits that are too skimpy to be worth a member’s interest, while a second is that members simply aren’t aware of certain benefits and/or how to take advantage of them. Yet another theory offered is that in some cases plans might be advertising benefits to attract enrollees but not aggressively encouraging members to use them.

The best strategy for any plan is to offer only the benefits you can stand behind, the ones that offer real value to both the member and the plan. There shouldn’t be misaligned incentives at play, where increased member engagement in a given benefit actually creates negative financial or operational consequences for your plan. For every benefit you consider, ask yourself a few honest questions. Do your members really want and need this benefit? Do you really want members actively engaging with this benefit? If the answer is no to one or both of these questions, you should continue your search.

Not All Benefits Are Created Equally – Get a Guarantee 

You have almost unlimited choices as an MA plan when it comes to potential benefits to offer your population. Lots of the services you evaluate may promise the value triangle we discussed earlier. But in the challenging and competitive environment you’re facing, you need a sure thing. Any vendor partner who isn’t willing to put their fees at risk and offer a meaningful performance guarantee should instantly raise a red flag for your organization. Moving forward, every benefit has to drive value. You can’t afford to take chances on vendor partners who won’t bet on themselves.

At Belle, we’ve intentionally designed a solution that is highly valued by members while creating significant financial and clinical value for MA plans. Our research shows that we are able to positively impact total cost of care, engagement in other valuable health plan services and reduce member churn. We’ve specifically mapped our solution against the new CMS guidelines for SSBCI. We anticipate being part of a bigger trend where supplemental benefits that clearly deliver on the value triangle are viewed more as a clinical solution than an optional offering that is a “nice to have.” Based on our interactions with MA plans across the country, this shift is well underway.

Want to hear more thoughts from our team about the value shift for supplemental benefits? Want to learn more about the solution we’ve designed to achieve the value triangle and check all boxes for new CMS regulations? Contact us today for a personal consultation.