Improving Integration for Dual Eligible Beneficiaries: The Role of D-SNPs

August 2020
Full report

Dual Eligible Special Needs Plans (D-SNPs) offer states a flexible path to advance whole person health and improve health outcomes for individuals who are eligible for both Medicare and Medicaid benefits (dual eligibles).

Dual eligible beneficiaries have limited economic resources and they are more likely to have complex health conditions, yet they must navigate two fragmented insurance programs. As states seek ways to improve outcomes for dual eligibles, D-SNPs can be a valuable partner. D-SNPs improve the beneficiary experience through better care coordination, greater use of primary care services, and access to additional benefits. D-SNPs also enhance the delivery system by creating administrative efficiencies for providers serving dual eligible beneficiaries and facilitating opportunities to better integrate long-term services and supports.

This paper describes how state partnerships with D-SNPs can achieve these outcomes and increase integration of services for dual eligible beneficiaries.

Topics

  • State efforts to integrate care
  • Challenges faced by dual eligible beneficiaries
  • Flexible options for states to partner with D-SNPs
  • Improvements in beneficiary care and experience

Related Public Policy Research

The Unique Needs of Partial Dual Eligible Beneficiaries
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Partial duals have medical, social, and functional needs that are similar to those of full duals and are likely to experience changes in their Medicaid eligibility status during the year.
Understanding the Medicare Advantage Program
October 2017
MA plans provide enrollees a valuable alternative to FFS by offering out-of-pocket cost protections, additional benefits, and innovative strategies for care management and coordination.
Effect of C-SNP Enrollment on Outcomes for Beneficiaries with Diabetes
October 2017
Beneficiaries with diabetes enrolled in C-SNPs have better outcomes across several areas—primary care, inpatient use, and diabetes management—than they would in non-specialized MA plans.

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