Designing Member-Centric Benefits Leveraging Flexibilities and Pilots

  • December 02, 2020
  • 1:00 PM – 2:00 PM ET
  • Online
about

Thanks to Special Supplemental Benefits for the Chronically Ill (SSBCI), Medicare Advantage Organizations (MAOs) are no longer to limited to a “one-size-fits-all” approach to supplemental benefits. Many health insurance providers have used these special benefits to offer benefits and services tailored to each patient’s unique needs.

The year 2020 introduced many remarkable changes, and SSBCI is no exception. New guidance from CMS now extends SSBCI eligibility to members with “other chronic conditions”, and gives MAOs the freedom to introduce new benefits mid-year to enrollees affected by COVID-19. Medicaid waiver flexibility allows MCOs to address member needs now, when needed most.

While SSBCI is still a relatively new tool to MAOs, many health care leaders look to the new and expanded SSBCI and find opportunities to innovative with plan design, support member satisfaction, and establish new forms of “whole-person” preventive care that address Social Determinants of Health (SDOH). This innovation around SDOH was also amplified due to the COVID-19 pandemic.

This webinar discusses examples of innovative benefit design approaches, including SDOH-related SSBCI benefits and COVID-19 benefits. It also shares insights from a major health insurance provider on design, implementation and evaluation of SDOH pilot programs.

This presentation will provide a 2020 year-in-review for SSBCI, highlighting several new policy changes that will play an essential role in MAO 2022 benefit strategy and overall trends in this new landscape.

Presenters will also highlight success stories made possible by current SDOH benefits and pilot programs that demonstrate how these important programs support holistic care of members.

Attendees will learn about:

  • A review of new SSBCI policy changes in 2020 and beyond.
  • How a major health insurance provider is using benefits and pilot programs to support population health.
  • Opportunities for MAOs to use SSBCI, made possible by recent regulatory changes.

Speakers


Catherine Macpherson, MS, RDN
Vice President, Product Strategy and Development and Chief Nutrition Officer
Mom’s Meals

Catherine Macpherson, MS, RDN joined Mom’s Meals in 2017 as Vice President, Product Strategy and Development and Chief Nutrition Officer. She is responsible for ensuring the company’s nutrition solutions meet the needs of its partners by designing clinical programs that meet their strategic objectives. Previously, Macpherson served as Vice President of Medication Adherence and Immunizations at Walgreens, led Healthcare Product Strategy at WebMD, and managed health and wellness programs for Ceridian, the National Institute of Health and the American Institute for Cancer Research.

Catherine is a Registered Dietitian, a healthcare innovator, and a frequent speaker on the importance of nutrition to the aging population, care transitions and those managing chronic conditions. Macpherson earned her Masters of Science degree in Nutrition from the University of Minnesota and her BA from the University of Michigan.


Melissa Hildebrand, MSW
Director of Strategic Partnerships
Mom’s Meals

Melissa Hildebrand, MSW serves as Director of Strategic Partnerships with Mom’s Meals. She has worked in the healthcare and managed care industry for over 12 years. Her experience spans across supporting clinical programs, assessing trends and data for program adaptations, and product design. Currently she acts as account director for many of the health care accounts at Mom’s Meals. In this role, she supports current meals programs while also assisting with expansion and design.  Melissa has a Master’s degree in Social Work from Eastern Michigan University and a Bachelor’s degree in Dietetics from Western Michigan University.


Jennifer Spear, MBA
Population Health Strategy Lead, Office of Population Health
Humana

Jennifer Spear is a Population Health Strategy Lead with Humana’s population health team. Jennifer is in charge of executing interventions and programs that address food insecurity in Humana’s member population and the communities they serve.  Additionally, she works closely with community partners, the clinical community and other partners to address the health related social needs, particularly food insecurity, of people, where they are receiving care.  Spear previously led employee awareness strategies dedicated to raising awareness around the importance of social determinants of health and Healthy Days. Prior to her role working with food insecurity, Spear implemented member call programs that focused on Healthy Days assessments, which is how Humana is tracking progress toward its Bold Goal – that the communities it serves will be 20 percent healthier by 2020 and beyond.

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