{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:13:38Z","timestamp":1789881218213,"version":"4.0.1"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Medicare Advantage (MA) plans have had the ability to offer long-term services and supports (LTSS) supplemental benefits (eg, in-home support services, adult day health services, caregiver support, home-based palliative care, and nonopioid pain management) since 2019. However, it is largely unknown how available these benefits currently are among MA plans.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the prevalence of LTSS supplemental benefits among MA plans and enrollment within these plans.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This longitudinal cohort study used publicly available Centers for Medicare &amp;amp; Medicaid Services data on MA plan benefits and enrollment from January 2019 to April 2025 to examine changes in the offering of and access to LTSS supplemental benefits among MA plans as well as the enrollment within such plans. The analysis was limited to those MA plans that were identified as health maintenance organization or preferred provider organization plans. Data analyses were performed from November 2024 to March 2025.21.4<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>MA plans offering LTSS supplemental benefits, the share of MA beneficiaries enrolled in a MA plan with LTSS benefits at the county level, and benefit generosity between newer and older MA plans.<\/jats:p><\/jats:sec>Results<\/jats:title>In this study of 4521 MA plans in 2019 and 6614 MA plans in 2025, the number of MA plans offering any LTSS benefits increased from 581 to 814 from 2019 to 2025; however, the share of such plans slightly decreased from 12.9% to 12.3%. A mean (SD) of 21.4% (20.9%) of MA beneficiaries at the county level were enrolled in plans offering supplemental benefits in 2019, which decreased to 7.9% (12.7%) in 2025. The share of plans offering in-home support services, adult day services, home-based palliative care, and nonopioid pain management increased by 4.6, 0.02, 1.1, and 1.9 percentage points, respectively, whereas caregiver support services decreased by 5.6 percentage points. Lastly, when comparing newer and older MA plans offering LTSS benefits, newer MA plans offered 0.59 (95% CI, 0.48-0.70) more benefits than older MA plans.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, the availability of LTSS benefits within MA plans in 2025 was essentially no different than it was when benefits were first offered. The share of MA beneficiaries enrolled in a plan offering LTSS decreased during the same time frame, suggesting that there is still untapped potential for MA plans to offer LTSS supplemental benefits.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.26406","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T15:00:37Z","timestamp":1754924437000},"page":"e2526406","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Services and Supports in Supplemental Benefits in Medicare Advantage Plans"],"prefix":"10.1001","volume":"8","author":[{"given":"Deepon","family":"Bhaumik","sequence":"first","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Grabowski","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"issue":"2","key":"zoi250744r4","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1177\/10848223221135576","article-title":"\u201cWhat were they thinking?\u201d: the exclusion of Medicare home health from providing supplemental social needs benefits.","volume":"36","author":"Cabin","year":"2024","journal-title":"Home Health Care Manag Pract"},{"issue":"3","key":"zoi250744r6","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1377\/hlthaff.2012.0170","article-title":"Strong social support services, such as transportation and help for caregivers, can lead to lower health care use and costs.","volume":"32","author":"Shier","year":"2013","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"zoi250744r9","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.14359","article-title":"Analysis of Medicare Advantage plans\u2019 supplemental benefits and variation by county.","volume":"4","author":"Crook","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"22","key":"zoi250744r10","doi-asserted-by":"publisher","first-page":"2238","DOI":"10.1001\/jama.2019.4709","article-title":"Early Adoption of new supplemental benefits by Medicare Advantage plans.","volume":"321","author":"Meyers","year":"2019","journal-title":"JAMA"},{"issue":"6","key":"zoi250744r11","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15058","article-title":"New supplemental benefits and plan ratings among Medicare Advantage enrollees.","volume":"7","author":"Tucher","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi250744r12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.33972","article-title":"County-level enrollment in Medicare Advantage plans offering expanded supplemental benefits.","volume":"7","author":"Yang","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi250744r15","doi-asserted-by":"publisher","DOI":"10.1086\/711951","article-title":"Can health insurance competition work? evidence from Medicare Advantage.","volume":"129","author":"Curto","year":"2021","journal-title":"J Polit Econ"},{"key":"zoi250744r16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.jhealeco.2018.07.002","article-title":"Paying more for less? Insurer competition and health plan generosity in the Medicare Advantage program.","volume":"61","author":"Pelech","year":"2018","journal-title":"J Health Econ"},{"issue":"4","key":"zoi250744r17","doi-asserted-by":"publisher","first-page":"e132","DOI":"10.37765\/ajmc.2022.88866","article-title":"How Medicare Advantage plans use data for supplemental benefits decision-making.","volume":"28","author":"Shields-Zeeman","year":"2022","journal-title":"Am J Manag Care"},{"issue":"7","key":"zoi250744r18","doi-asserted-by":"publisher","first-page":"e210","DOI":"10.37765\/ajmc.2024.89583","article-title":"The impacts of supplemental benefits on Medicare Advantage plan composition.","volume":"30","author":"Tucher","year":"2024","journal-title":"Am J Manag Care"},{"issue":"suppl 3","key":"zoi250744r19","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14460","article-title":"Examining trends in Medicare Advantage plan disenrollment associated with expanded supplemental benefit adoption.","volume":"60","author":"Tucher","year":"2025","journal-title":"Health Serv Res"},{"issue":"10","key":"zoi250744r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.35164","article-title":"Addressing Social needs through Medicare Advantage plans\u2019 supplemental benefits: a potential not yet realized.","volume":"5","author":"Meyers","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi250744r21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.33020","article-title":"Evaluation of supplemental benefits across Medicare Advantage plans and beneficiary demographic characteristics, 2019 to 2022.","volume":"5","author":"Rowen","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi250744r22","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1377\/hlthaff.2022.01031","article-title":"Reducing Medicare Advantage benchmarks will decrease plan generosity, but those effects will likely be modest.","volume":"42","author":"Chernew","year":"2023","journal-title":"Health Aff (Millwood)"},{"issue":"10","key":"zoi250744r23","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.35161","article-title":"Examination of differences in nonmedical supplemental benefit coverage for dual-eligible enrollees in Medicare Advantage plans in 2021.","volume":"5","author":"Jin","year":"2022","journal-title":"JAMA Netw Open"},{"key":"zoi250744r1","author":"Centers for Medicare & Medicaid Services","year":"2018"},{"key":"zoi250744r2","doi-asserted-by":"crossref","unstructured":"Roberts? ET, Burke? R, Haddad? K. Medicare Advantage supplemental benefits: origins, evolution, and issues for policy making. Health Affairs Forefront. Published online September 19, 2024. doi:10.1377\/forefront.20240913.836055","DOI":"10.1377\/forefront.20240913.836055"},{"key":"zoi250744r3","unstructured":"Freed? M, Biniek? JF, Damico? A, Neuman? T. Medicare Advantage in 2024: Enrollment Update and Key Trends. 2024. Accessed June 23, 2025. https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-advantage-in-2024-enrollment-update-and-key-trends\/"},{"key":"zoi250744r5","unstructured":"Dey? J, Marton? W, Anderson? L. Most older adults are likely to need and use long-term services and supports. 2021. Accessed June 23, 2025. https:\/\/aspe.hhs.gov\/reports\/most-older-adults-are-likely-need-use-long-term-services-supports-issue-brief-0"},{"key":"zoi250744r7","unstructured":"Kornfield? T, Fix? A, Donthi? S, Frieder? M, Duddy-Tenbrunsel? R, Kazan? M. Medicare Advantage plans offering expanded supplemental benefits: a look at availability and enrollment. 2021. Accessed June 23, 2025. https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2021\/feb\/medicare-advantage-plans-supplemental-benefits"},{"key":"zoi250744r8","unstructured":"Skopec? L, Ramos? C, Aarons? C. Are Medicare Advantage plans using new supplemental benefit flexibility to address enrollees\u2019 health-related social needs? Accessed June 23, 2025. https:\/\/www.urban.org\/research\/publication\/are-medicare-advantage-plans-using-new-supplemental-benefit-flexibility-address-enrollees-health-related-social-needs-0"},{"key":"zoi250744r13","unstructured":"Rizer? A, Benzing? L. Filling the gaps: the role and value of supplemental benefits in Medicare advantage. Health Affairs Forefront. Published online August 5, 2022."},{"key":"zoi250744r14","unstructured":"ATI Advisory. A deep dive on in-home, caregiver, and social supports in Medicare advantage: can these benefits meaningfully meet member needs and support independence? March 13, 2023. Accessed June 23, 2025. https:\/\/atiadvisory.com\/resources\/a-deep-dive-on-in-home-caregiver-and-social-supports-in-medicare-advantage-can-these-benefits-meaningfully-meet-member-needs-and-support-independence\/."},{"key":"zoi250744r24","unstructured":"Centers for Medicare & Medicaid Services. Medicare Advantage General Supplemental Services Submission Guide. Centers for Medicare & Medicaid Services. February 2024. Accessed July 17, 2025. https:\/\/www.csscoperations.com\/internet\/csscw3_files.nsf\/F2\/Medicare%20Advantage%20General%20Supplemental%20Services%20Submission%20Guide_508.pdf\/$FILE\/Medicare%20Advantage%20General%20Supplemental%20Services%20Submission%20Guide_508.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2837375\/bhaumik_2025_oi_250744_1753982850.33589.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T15:00:38Z","timestamp":1754924438000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2837375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.26406","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]}}}