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Diane Publishing Books
Medicare Special Needs Plans: CMS Should Improve Information Available about Dual-Eligible plansńˇ╗ Performance
James C. Cosgrove (au)
About 9 million of Medicareńˇ╗s over 48 million beneficiaries are also eligible for Medicaid because they meet income and other criteria. These dual-eligible beneficiaries have greater health care challenges than other Medicare beneficiaries, increasing their need for care coordination across the two programs. In addition to meeting all the requirements of other Medicare Advantage (MA) plans, dual-eligible special needs plans (D-SNPs) are required by the Centers for Medicare & Medicaid Services (CMS) to provide specialized services targeted to the needs of dual-eligible beneficiaries as well as integrate benefits or coordinate care with Medicaid services. This report (1) analyzed the characteristics of dual-eligible beneficiaries in D-SNPs and other MA plans; (2) reviewed differences in specialized services between D-SNPs and other MA plans; and (3) reviewed how D-SNPs work with state Medicaid agencies to enhance benefit integration and care coordination. Tables and figures. This is a print on demand report.
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