Questions Congressional Budget Office is asking about adding a benefit to Medicare
Your clients often have to decide whether adding a new benefit is worth it. Here's some of what Medicare managers consider.
Are clients trying to figure out if a health benefits investment is worth it? Medicare program managers do that all the time.
Officials in Washington are now trying to figure out whether permanently expanding Medicare telehealth benefits makes sense.
Medicare managers used emergency powers to add telehealth coverage during the early days of the pandemic, when seeing a doctor in person was difficult. Now, telehealth services providers are asking Congress to keep the extra telehealth coverage in place.
The process the Congressional Budget Office is using to look at the idea could give employers and their benefits advisors ideas about how to size up the employers’ own health benefits options.
Michael Cohen, an analyst in the COB’s health analysis division, talked about the process last week at a research meeting.
Here are five questions Cohen and his colleagues are asking to evaluate the idea of telehealth benefits expansion, drawn from his presentation slidedeck.
1. Do the new services replace old services, or are patients using the new services in addition to traditional services?
2. Does use of telehealth services change the odds that beneficiaries will end up getting additional care later?
3. How do providers respond when payment rates for services change?
4. Are the effects of coverage for telehealth mental health services different from the effects of coverage for other types of telehealth services?
5. Would care providers respond differently to a permanent benefits change than they would to a temporary benefits change?
Versions of these same questions could apply to other new benefits under consideration, such as decisions to add alternative care benefits, critical illness insurance or pet insurance.