Medicare Advantage grocery supplemental benefit use is associated with increased outpatient care, suggesting that policy changes allowing for nonmedical supplemental benefits could improve beneficiaries’ health, especially for dual-eligible beneficiaries.
Objective: To examine the association between the use of the grocery card supplemental benefit offered by Medicare Advantage (MA) plans and health care utilization.
Study Design: Observational study utilizing 2021-2022 MA claims data.
Methods: This observational cohort study examined eligible adults who were continuously enrolled between January 1, 2021, and December 31, 2022, in MA dual-eligible special needs plans that offered a grocery card benefit from January 1, 2022, through December 31, 2022. We performed difference-in-differences analyses comparing health care utilization among dual-eligible members who opted to use grocery card supplemental benefits vs those who did not, before and after the benefit’s introduction.
Results: Grocery card use was associated with an increase in the likelihood of annual wellness, primary care provider (PCP), and specialist visits (6.6%, 4.9%, and 6.6%, respectively) and increased number of office and specialist visits (2.3% and 2.8%, respectively). Frequent use (more than half of the available grocery card dollars) was analyzed separately and was associated with slightly greater increases in the likelihood and number of visits (all P < .05).
Conclusions: This observational study of dual-eligible beneficiaries found a modest relative increase in office visits, including annual wellness, PCP, and specialist visits, among beneficiaries who opted to use the grocery card supplemental benefits after they were offered compared with beneficiaries who did not. These findings suggest that policy changes that allow for nonmedical supplemental benefits have had favorable results, especially for dual-eligible beneficiaries.
We evaluated the association between the use of grocery dollars offered through Medicare Advantage supplemental benefits and health care utilization among dual-eligible beneficiaries enrolled in Medicare Advantage plans that offered grocery supplemental benefits.
Medicare Advantage (MA) plans, covering more than half of eligible Medicare beneficiaries, can offer supplemental benefits not included under traditional fee-for-service Medicare. Regulatory and legislative changes effective in 2019 and 2020 expanded the scope of allowed supplemental benefits to address health-related social needs (HRSNs),1,2 including newly permitted nonmedical services, such as grocery cards, which can help address food insecurity. Dual-eligible members, who are eligible for both Medicare and Medicaid, often have access to a wider array of these nonmedical supplemental benefits through specialized plans such as dual-eligible special needs plans (D-SNPs) and plans participating in the MA value-based insurance design model.
Since these benefits were implemented, there has been interest in understanding the extent to which individuals are using the benefits and how they impact health and well-being. Previous analysis has shown that most MA members are using at least 1 supplemental benefit and that beneficiaries in underserved areas are more likely to use these benefits.3 Although there is evidence that supplemental benefit use is associated with improved health care utilization,4 evidence on the value of specific services such as grocery cards and their relationship to the health care of individuals is limited.5,6
Food insecurity can play a large role in a person’s health. It is associated with more health conditions7-11 and costly health care utilization patterns, including increased emergency department (ED) visits, hospitalizations, and nursing home stays.12,13 At the same time, individuals who experience food insecurity are less likely to have a usual source of health care and more likely to have fewer office visits.14,15 This potential delayed care, in turn, can exacerbate the individual’s health conditions and continue their reliance on higher-cost health care.16,17