Differences In Care Between Special Needs Plans And Other Medicare Coverage For Dual Eligibles

Policy makers are pursuing strategies to integrate Medicare and Medicaid coverage for people enrolled in both programs, who are known as dual eligibles. Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans that exclusively serve this population, with several features intended to enhance care and facilitate integration with Medicaid. This study compared access to, use of, and satisfaction with care among dual eligibles enrolled in D-SNPs versus those enrolled in two other forms of Medicare coverage: other Medicare Advantage (MA) plans not exclusively serving dual eligibles and traditional Medicare. Compared with those in traditional Medicare, dual eligibles generally reported greater access to care, preventive service use, and satisfaction with care in D-SNPs. However, we found fewer differences in these outcomes among dual eligibles in D-SNPs versus other MA plans. Compared with non -Hispanic White dual eligibles, dual eligibles of color (for example, those identifying as Black or Hispanic) were less likely to report receiving better care in D-SNPs versus other Medicare coverage. These findings suggest that D-SNPs altogether have not provided consistently superior or more equitable care, and they highlight areas where federal and state policy could strengthen incentives for D-SNPs to improve care.

Automated summary

Policy makers are exploring strategies to integrate Medicare and Medicaid coverage for dual eligibles, with Dual Eligible Special Needs Plans (D-SNPs) serving as Medicare Advantage plans exclusively for this population. This study found that, compared to traditional Medicare, dual eligibles generally reported better access to care, higher use of preventive services, and greater satisfaction with care in D-SNPs. However, there were fewer differences in these outcomes between dual eligibles in D-SNPs and those in other Medicare Advantage plans. Additionally, dual eligibles of color were less likely to report receiving better care in D-SNPs compared to other forms of Medicare coverage.