Editor’s note: The John A. Hartford Foundation, the Administration for Community Living and The SCAN Foundation fund the Aging and Disability Business Institute (www.aginganddis abilitybusinessinstitute.org), led by the National Association of Area Agencies on Aging (n4a). The mission of the Aging and Disability Business Institute is to build and strengthen partnerships between aging and disability community-based organizations (CBO) and the healthcare system. As a partner of the Aging and Disability Business Institute, ASA is collaborating with n4a on a series of articles and case studies in Aging Today that prepare, educate and support CBOs and healthcare payers to provide quality care and services.
Since April 2019, the National Council on Aging (NCOA) and the Aging and Disability Business Institute (the Business Institute) at the National Association for Area Agencies on Aging (n4a) have hosted the Medicare Advantage Learning Collaborative (MALC), a six-month webinar-based training program for community-based organizations (CBO) looking to acquire the necessary knowledge and skills to pursue partnerships and contracts with Medicare Advantage (MA) plans to provide home- and community-based services and supports.
“We created this curriculum in response to the 2018 call letter from CMS to MA plans that described broader opportunities for utilization of supplemental benefits,” said MALC lead faculty Sharon Williams, founder and CEO of Williams Jaxon Consulting.
“In early 2019, when CMS published standards for special supplemental benefits that provided a broader scope of expectations … we received lots of feedback from CBOs, with ongoing concerns around how well they would be prepared to take up this opportunity to work with MA plans.”
Collaborative’s Curriculum Reflects CBOs’ Concerns
What are the drivers for success, and what is the MA plan population—might it differ from the populations CBOs currently serve? And what could MA plans be looking for from CBOs? CBOs brought up these questions in early 2019 and, to address them, Williams, Kathleen Cameron, NCOA senior director, Center for Health Aging, Kathleen Zuke, NCOA senior program manager, Marisa Scala-Foley, the Business Institute’s executive director, and Karol Tapias, the Business Institute’s deputy director, initially identified eight months’ worth of training, in two-hour segments, for interested CBOs that applied for the MALC.
The training was then curated into a six-month curriculum consisting of a two-hour video conference call per month, plus homework and online communication between Collaborative members. Topics covered include a review of the policy landscape, with a focus on the CHRONIC Care Act; emerging opportunities for CBOs to partner with MA plans; impact of social determinants of health in Medicare; types of MA plans and profiles of plans’ members; key MA plan quality and performance standards (e.g., STAR ratings, accreditation, MA Special Needs Plans’ Model of Care); MA plan application process and operational overview; considerations for CBOs seeking contracts (e.g., network development, scaling interventions, firewalls for State Health Insurance Assistance Programs [SHIPs] contractors, etc.); financial modeling; and the building blocks of a strong value proposition.
Eleven organizations were chosen to become members of the Collaborative and to participate in the training, and attendance has been much greater than the curriculum planners had anticipated. At least 50 to 60 participants join in on each monthly call, which means that in addition to one representative from each of the 11 organizations, other staff from Collaborative members are participating as well.
Just prior to the establishment of the MALC, Cameron had commissioned Williams and Zuke to develop a series of MA webinars for the general CBO public. This initiative was based on concerns that some CBOs’ leaders only had rudimentary understanding of MA plans. They created three webinars, open to the general public, about Medicare and MA. MALC participants’ initial homework assignment was to review the webinars, to avoid repeating basic information in time-limited sessions.
“All [monthly] sessions are geared toward building the knowledge and information CBOs have on MA plans,” said Zuke. This focus ensures that CBOs will be best prepared to continue building their organizational readiness and initiate outreach to potential MA plan partners and be able to describe which services could be provided for getting supplemental benefits.
MALC instructors set up an online platform for completing homework (which is formatted as “progress reports” that can be viewed by all Collaborative members), and to record and archive lessons. For instance, in July, participants learned about Special Supplemental Benefits for the Chronically Ill, and the homework assignment was for CBOs to list what they considered offering to their communities under such benefits.
Other homework assigned during the sessions included reviewing resources focused on the basics of MA expanded supplemental benefits; Collaborative members identifying two to three MA plans in their regions, researching their STAR ratings and accreditation status and discussing which community-based services to market to these organizations and why; completing four sections of the n4a Readiness Assessment Tool, citing three to five strengths and opportunities for improvement within the CBO organization to enhance capacity to function as an MA Plan network partner; and developing a value proposition statement for a targeted MA Plan.
Instructors respond individually to program participants’ online queries, and MALC members can raise questions online and direct them to the greater Learning Collaborative community.
Guest Speakers Lend Additional Expertise
A crucial component of the Collaborative’s curriculum is the guest speakers, who lend experienced voices to the coursework’s monthly call sessions. In June, a representative from Humana spoke about why the health insurance giant believes social determinants of health are important to address as part of the services they provide to their members. Humana has the second largest MA plan enrollment in the country, according to Williams, and a Bold Goal initiative, which reaches out to their high-need members and emphasizes partnering with CBOs and “co-creating solutions at a local level.”
Another guest speaker, from United Healthcare, addressed the fundamental advantages of MA; and the Collaborative has also had representatives from CBOs speak to program participants, detailing successful partnerships that have been made with MA plans, and sharing extensive research.
MALC also hosted a representative from the Leavitt Partners consulting group, which works with MA and healthcare plans, to explain the setting of MA plan rates so MALC participants could understand the MA plan rate-setting process, including CMS approval of supplemental benefits funding. The speaker from United Healthcare and Mary Kaschak, executive director of the Long Term Care Quality Alliance, also talked about MA plan structure plan accreditation standards, STAR rating information and more. Both speakers addressed MA Special Needs Plans (SNP), which represent a significant opportunity for CBOs partnering, according to Williams.
Guest speakers from NCOA and n4a focused on policy and the Readiness Assessment Tool, as well as how consumers tend to shop for plans.
A Fringe Benefit Offers New Perspectives
An additional benefit, offered midway through the Collaborative’s 6-month timeframe, was an invitation for MALC participants to attend n4a’s July 2019 annual conference, in which there was a pre-conference session devoted solely to MA supplemental benefits. At least one representative from each Collaborative member attended.
The pre-conference session was composed of two half-day sessions of information on MA plans and guidance on how to develop value propositions in order to partner with them. These sessions offered varied perspectives, with different speakers, particularly from the MA plan side of the equation, who discussed how they approach benefits, and which value propositions might appeal to them.
Representatives from two Collaborative member CBOs were on a panel at the pre-conference with Williams, to share “where they are in the [development] process and what is resonating with them in terms of their experience in meeting with plans, and what goes into developing a value proposition,” said Tapias.
Following every two-hour conference call since May, Williams says that instructors have received emails lauding the Collaborative. As this MALC comes to a close in September there are no firm plans to hold another Collaborative, but considering how many CBOs applied to attend the 2019 training (more than 100), versus how many were accepted (11), Williams says conducting another Learning Collaborative around MA plans is under consideration.