Publicly Reported Quality Performance for Dual-eligible Special Needs Plans, 2010-2019.

IF 2.1 3区社会学 Q2 GERONTOLOGY

Journal of Aging & Social Policy Pub Date : 2025-01-01 Epub Date: 2023-06-22 DOI:10.1080/08959420.2023.2226309

Laura M Keohane, Srivarun Tummarakota

引用次数: 0

Abstract

As enrollment increases in Dual-eligible Special Needs Plans (D-SNPs) that exclusively enroll low-income Medicare beneficiaries with Medicaid coverage, better evidence is needed about quality of care in these managed care plans. Using 2010-2019 publicly reported Healthcare Effectiveness Data and Information Set (HEDIS) measures, we found that median HEDIS performance scores were usually slightly worse for D-SNPs than the overall MA program with some reductions in quality performance gaps between 2010 and 2019. D-SNPs had more incomplete performance reporting than MA contracts, especially for measures focused on clinical conditions. Medicare Advantage reporting requirements should require greater transparency about performance in D-SNPs.

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2010-2019 年公开报告的符合双重资格的特殊需求计划的质量绩效。

随着专门为低收入医疗保险受益人提供医疗补助（Medicaid）的双资格特殊需求计划（D-SNPs）注册人数的增加，我们需要更好的证据来证明这些管理性护理计划的护理质量。通过使用 2010-2019 年公开报告的医疗保健效果数据和信息集 (HEDIS) 指标，我们发现 D-SNPs 的 HEDIS 性能得分中位数通常略低于整体 MA 计划，但 2010 年至 2019 年期间的质量性能差距有所缩小。与 MA 合同相比，D-SNP 的绩效报告更不完整，特别是在侧重于临床条件的措施方面。医疗保险优势计划的报告要求应要求 D-SNPs 的绩效具有更大的透明度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Aging & Social Policy GERONTOLOGY-

CiteScore

13.00

自引率

3.90%

发文量

期刊介绍： The Journal of Aging & Social Policy offers a platform for insightful contributions from an international and interdisciplinary group of policy analysts and scholars. It provides an in-depth examination and analysis of critical phenomena that impact aging and the development and implementation of programs for the elderly from a global perspective, with a broad scope that encompasses not only the United States but also regions including Europe, the Middle East, Australia, Latin America, Asia, and the Asia-Pacific rim. The journal regularly addresses a wide array of issues such as long-term services and supports, home- and community-based care, nursing-home care, assisted living, long-term care financing, financial security, employment and training, public and private pension coverage, housing, transportation, health care access, financing, and quality, family dynamics, and retirement. These topics are of significant importance to the field of aging and social policy, reflecting the journal's commitment to presenting a comprehensive view of the challenges and solutions related to aging populations around the world.