Rebekah I Stein, Yanlei Ma, Jessica Phelan, Eric T Roberts, Kenton J Johnston, E John Orav, José F Figueroa
{"title":"2011-24年双重资格受益人中慢性病特殊需要计划的增长。","authors":"Rebekah I Stein, Yanlei Ma, Jessica Phelan, Eric T Roberts, Kenton J Johnston, E John Orav, José F Figueroa","doi":"10.1377/hlthaff.2024.00651","DOIUrl":null,"url":null,"abstract":"<p><p>Policy makers are actively investing in care programs that integrate Medicare and Medicaid benefits, with the goal of providing better-coordinated care for Medicare-Medicaid dual-eligible beneficiaries. However, nonintegrated plans have become increasingly popular among dual eligibles. One such plan type is the Chronic Condition Special Needs Plan (C-SNP)-a type of Medicare Advantage plan designed for people with specific chronic conditions. Using national Medicare data from the period 2011-24, we found that C-SNPs experienced modest enrollment growth among dual eligibles, with nearly 15 percent of C-SNP enrollees being full-benefit dual eligibles, who are eligible for Medicare and full Medicaid benefits. In 2024, among newly enrolled C-SNP full-benefit dual eligibles, 5.3 percent, 4.8 percent, and 14.9 percent were previously enrolled in plans with high, moderate, and low levels of Medicare-Medicaid integration, respectively. Among full-benefit dual eligibles qualifying for both C-SNPs and more integrated plans, those who were Black or Hispanic were more likely to enroll in C-SNPs rather than more integrated plans, which may have important implications for health equity. Policy makers should attend to these trends to ensure that both national- and state-level efforts to increase dual eligibles' enrollment in integrated plans are not significantly diluted.</p>","PeriodicalId":519943,"journal":{"name":"Health affairs (Project Hope)","volume":"44 3","pages":"304-312"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036663/pdf/","citationCount":"0","resultStr":"{\"title\":\"Growth Of Chronic Condition Special Needs Plans Among Dual-Eligible Beneficiaries, 2011-24.\",\"authors\":\"Rebekah I Stein, Yanlei Ma, Jessica Phelan, Eric T Roberts, Kenton J Johnston, E John Orav, José F Figueroa\",\"doi\":\"10.1377/hlthaff.2024.00651\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Policy makers are actively investing in care programs that integrate Medicare and Medicaid benefits, with the goal of providing better-coordinated care for Medicare-Medicaid dual-eligible beneficiaries. However, nonintegrated plans have become increasingly popular among dual eligibles. One such plan type is the Chronic Condition Special Needs Plan (C-SNP)-a type of Medicare Advantage plan designed for people with specific chronic conditions. Using national Medicare data from the period 2011-24, we found that C-SNPs experienced modest enrollment growth among dual eligibles, with nearly 15 percent of C-SNP enrollees being full-benefit dual eligibles, who are eligible for Medicare and full Medicaid benefits. In 2024, among newly enrolled C-SNP full-benefit dual eligibles, 5.3 percent, 4.8 percent, and 14.9 percent were previously enrolled in plans with high, moderate, and low levels of Medicare-Medicaid integration, respectively. Among full-benefit dual eligibles qualifying for both C-SNPs and more integrated plans, those who were Black or Hispanic were more likely to enroll in C-SNPs rather than more integrated plans, which may have important implications for health equity. Policy makers should attend to these trends to ensure that both national- and state-level efforts to increase dual eligibles' enrollment in integrated plans are not significantly diluted.</p>\",\"PeriodicalId\":519943,\"journal\":{\"name\":\"Health affairs (Project Hope)\",\"volume\":\"44 3\",\"pages\":\"304-312\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036663/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health affairs (Project Hope)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1377/hlthaff.2024.00651\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health affairs (Project Hope)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1377/hlthaff.2024.00651","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Growth Of Chronic Condition Special Needs Plans Among Dual-Eligible Beneficiaries, 2011-24.
Policy makers are actively investing in care programs that integrate Medicare and Medicaid benefits, with the goal of providing better-coordinated care for Medicare-Medicaid dual-eligible beneficiaries. However, nonintegrated plans have become increasingly popular among dual eligibles. One such plan type is the Chronic Condition Special Needs Plan (C-SNP)-a type of Medicare Advantage plan designed for people with specific chronic conditions. Using national Medicare data from the period 2011-24, we found that C-SNPs experienced modest enrollment growth among dual eligibles, with nearly 15 percent of C-SNP enrollees being full-benefit dual eligibles, who are eligible for Medicare and full Medicaid benefits. In 2024, among newly enrolled C-SNP full-benefit dual eligibles, 5.3 percent, 4.8 percent, and 14.9 percent were previously enrolled in plans with high, moderate, and low levels of Medicare-Medicaid integration, respectively. Among full-benefit dual eligibles qualifying for both C-SNPs and more integrated plans, those who were Black or Hispanic were more likely to enroll in C-SNPs rather than more integrated plans, which may have important implications for health equity. Policy makers should attend to these trends to ensure that both national- and state-level efforts to increase dual eligibles' enrollment in integrated plans are not significantly diluted.