5 Reasons D-SNP Advisory Committees Are Good For Health Insurers
Last year, the Centers for Medicare and Medicaid Services (CMS) released their Contract Year 2023 Medicare Advantage and Part D Final Rule — and with it, new provisions for health plan members who are most in need of complex care.
At Belong Health, we anticipate this set of policy changes— geared towards improving consumer protections, managing cost-sharing, and strengthening coordination between healthcare providers and recipients— will yield powerful benefits not only for a broad spectrum of underserved communities, but also for insurers nationwide.
Frankly, we couldn’t be more excited to help chart a path across that new landscape.
As part of CMS’s new rule, Medicare Advantage plans offering Dual Special Needs Plans must establish member advisory committees in each state. By design, these committees— which have historically been successful for Medicaid plans— will serve to gather direct input on enrollee experiences. Maintenance of enrollee advisory committees will ensure that enrollee feedback is heard by the plans to help identify and address barriers to high-quality, coordinated care.
Curated with an eye towards specific demographic and geographic characteristics, the CMS advisory committees are required, by law, to be composed in such a way that reflects the unique makeup of the D-SNP population being served.
Here are five reasons why the development of these culturally specific advisory committees is great news for health insurers:
1. Greater enrollee involvement means better quality of care.
Healthcare decisions need not — and should not — amount to a “black box” that alienates the recipient of care from the details of the care they deserve. The existence of an enrollee advisory committee naturally increases the quality of communication between the insurer and the insured — a fact that only strengthens both ends of that ongoing relationship.
By closely involving D-SNP enrollees in healthcare decision-making processes, insurers will gain intimate insights into the needs and preferences of their target populations. How do they get to work? What is their daily diet? Where do they get their news? How do they feel about themselves? With whom do they live?
Once armed with this valuable data, insurers can design and implement stronger and more acutely targeted programs — ones that consider, for example, community-specific needs and social determinants of health, including food insecurity, housing, transportation, and communication barriers.
This socially conscious and targeted approach to healthcare will no doubt strengthen health outcomes for D-SNP members, whose needs and lives are often more complex than most.
- 2. Insurers who demonstrate trust are naturally more trusted.
More often than not, members of the D-SNP population are hampered by low health literacy and by lack of access to trusted health experts. In a culture that renders the nuances of healthcare as unknowable to most Americans, it’s a safe bet D-SNP individuals with complex needs will rush to embrace an insurer that actively involves them in the design and delivery of their own health plans.
According to a 2022 report from Trilliant Health (which drew from Public Opinion Strategies survey data), patients’ trust in doctors and hospitals has steadily declined throughout the COVID-19 pandemic. That same study found insurance companies “consistently rank as the least trustworthy among all healthcare stakeholders” and “consumer’s trust in most healthcare companies eroded between April 2020 and December 2021.”
But as they include members in the care design decisions — lending credibility, candor, and clear communication to a system that too often leaves D-SNP members in the dark — CMS’s new advisory committees may just help the healthcare industry reverse this unfortunate trend.