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特殊需求计划以及双重资格者的福利与服务协调。

Special Needs Plans and the coordination of benefits and services for dual eligibles.

作者信息

Grabowski David C

机构信息

Department of Health Care Policy at Harvard Medical School in Boston, Massachusetts, USA.

出版信息

Health Aff (Millwood). 2009 Jan-Feb;28(1):136-46. doi: 10.1377/hlthaff.28.1.136.

Abstract

Special Needs Plans (SNPs) are a new type of Medicare Advantage (MA) plan with the potential to coordinate Medicare and Medicaid benefits and services for dually eligible beneficiaries. However, experience to date suggests that SNPs have not greatly expanded the number of people enrolled in joint Medicare-Medicaid products. SNPs need to have some contractual relationship with state Medicaid plans to add value for dually eligible beneficiaries beyond traditional MA plans. Although SNP enrollment is higher in states with such a relationship than in other states, several steps are identified to further expand this market and improve coordination between SNPs and state Medicaid programs.

摘要

特殊需求计划(SNPs)是一种新型的医疗保险优势(MA)计划,有潜力为双重资格受益人协调医疗保险和医疗补助福利及服务。然而,迄今为止的经验表明,特殊需求计划并未大幅增加参加医疗保险与医疗补助联合产品的人数。特殊需求计划需要与州医疗补助计划建立某种合同关系,以便为双重资格受益人提供超越传统医疗保险优势计划的价值。尽管在有这种关系的州,特殊需求计划的参保人数高于其他州,但仍确定了几个步骤来进一步扩大这个市场,并改善特殊需求计划与州医疗补助计划之间的协调。

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