Over the past decade, Medicare Advantage plans have become a dominant force in providing healthcare coverage for older Americans. Whereas traditional Medicare has long served as the federal standard, private Medicare Advantage plans now cover more than half of older beneficiaries. In 2020, a pivotal policy change expanded the scope of these plans beyond conventional medical care, permitting the inclusion of supplemental benefits targeting social determinants of health. This landmark shift allowed Medicare Advantage providers to offer benefits such as grocery assistance, meal delivery services, utility support, accessible transportation, pest control, and even air filtration systems—interventions far removed from typical clinical care yet crucial for holistic health maintenance.
This innovative expansion is grounded in the growing recognition that health outcomes are deeply intertwined with social and environmental factors. Food insecurity, unstable housing, unreliable transportation, and lack of social support have all been linked to exacerbated medical conditions and poorer overall health trajectories among older adults. Despite the intuitive promise of addressing these social needs, empirical evidence remains scarce regarding the extent to which Medicare Advantage beneficiaries utilize these new benefits, and more critically, whether these provisions translate into tangible improvements in healthcare utilization patterns and functional status.
Entering this critical knowledge gap, George Mason University health economist Jeah Jung has embarked on a rigorous five-year investigation funded by a substantial $3 million R01 grant from the National Institute on Aging. Her study aims to methodically evaluate the impact of these non-medical supplemental benefits on health outcomes across the nation. Utilizing secure Medicare administrative data, the research will explore whether access to services such as meal delivery or transportation correlates with reductions in emergency department visits and hospitalizations, as well as whether these benefits contribute to enabling beneficiaries to maintain independent living within their communities rather than transitioning prematurely into nursing home care.
A noteworthy component of the study is its emphasis on equity and differential uptake. Roughly 55% of Medicare beneficiaries, approximately 34.4 million Americans, are enrolled in Medicare Advantage plans as of 2025. Despite their widespread adoption, only about 30% of these plans have integrated non-medical supplemental benefits, whereas over 90% of dual-eligible special needs plans—targeting low-income seniors eligible for both Medicare and Medicaid—have implemented these features. Jung’s analytical framework will dissect these disparities in benefit adoption and usage, stratifying results by demographic variables including race, ethnicity, sex, health risk profiles, and socioeconomic status at the community level. This nuanced approach aims to shed light on whether these programs are reaching the populations most vulnerable to social determinants of poor health.
The implications of this inquiry extend beyond academic interest; the research outcomes have the potential to reshape federal policy and healthcare delivery. Medicare Advantage represents a massive federally supported initiative, with billions of dollars flowing annually into private insurers administering care for a significant portion of the aging U.S. population. Validating the effectiveness of social supports within this model is paramount to justifying ongoing investment and guiding future resource allocation. If these social interventions demonstrably reduce costly acute care episodes or delay institutionalization, federal agencies and insurers may prioritize scaling and refining benefit designs to maximize impact and value.
Furthermore, the interdisciplinary nature of the research team amplifies its potential contributions. Alongside Jung, Emily Ihara, professor and chair of the Department of Social Work at George Mason University’s College of Public Health, brings expertise in social determinants and community health dynamics. Collaborators from Oregon Health & Science University and Dartmouth College enrich the study with diverse methodological perspectives and strengthen the generalizability of findings. This collective effort embraces a comprehensive view spanning healthcare economics, social work, epidemiology, and health services research.
Methodologically, the study leverages the robustness of Medicare administrative claims data, which encompasses detailed records on healthcare utilization, diagnoses, and demographics. By coupling this information with plan-level data on supplemental benefit offerings, the researchers will employ sophisticated statistical models to infer causal relationships while controlling for confounding factors. The longitudinal design enables dynamic analysis over multiple years, observing trends in health service use both prior to and following benefit adoption. Importantly, the focus on emergency department visits, hospital admissions, and nursing home placements targets high-cost, high-burden events that are of interest to payers, policymakers, and clinicians alike.
One critical technical challenge lies in accurately capturing beneficiary engagement with supplemental benefits. Utilization metrics may not always be straightforward, especially for services such as transportation or pest control that might fall outside traditional claims frameworks. To address this, the research team plans to integrate additional data sources and potentially collaborate with Medicare Advantage plans to obtain usage logs. This data triangulation will enhance validity and provide a clearer picture of how beneficiaries interact with these novel offerings.
Preliminary observations underscore a policy landscape increasingly attentive to social determinants as integral components of health. The Centers for Medicare and Medicaid Services (CMS) have endorsed initiatives supporting beneficiary access to non-medical services, and the Medicare Advantage program’s policy flexibility since 2020 embodies this shift. Yet, systematic evaluation remains nascent, making Jung’s study both timely and essential. Its forthcoming findings promise to inform whether health policy should more aggressively integrate social interventions as routine components of chronic disease management and elder care.
In summary, the expanding role of Medicare Advantage plans in addressing social determinants represents a paradigm shift with profound implications. George Mason University’s research endeavor, supported by the NIH’s National Institute on Aging, pioneers an empirical assessment of these innovative benefit expansions at a national scale. The project’s comprehensive approach balancing economic analysis, social work insight, and rigorous epidemiological methods aspires to clarify the real-world impact of social supports on health outcomes. As the U.S. grapples with an aging population and escalating healthcare costs, evidence generated from this work will be critical to crafting policies that not only extend life but enhance the quality and dignity of those lives.
Subject of Research: Evaluation of Medicare Advantage plans’ supplemental social benefit programs and their impact on healthcare utilization and functional outcomes among older Americans.
Article Title: Transforming Medicare Advantage: Investigating the Impact of Social Determinant Benefits on Health Outcomes
News Publication Date: Not specified
Web References:
- https://publichealth.gmu.edu/profiles/jjung41
- https://medpac.gov/wp-content/uploads/2025/07/July2025_MedPAC_DataBook_Sec9_SEC.pdf
References: Not explicitly provided
Image Credits: Not provided
Keywords: Medicare Advantage, social determinants of health, supplemental benefits, health economics, emergency department visits, hospitalizations, nursing home care, health policy, health outcomes, older adults, health disparities
