Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
RAND Corporation, Pittsburgh, Pennsylvania, USA.
Health Serv Res. 2021 Jun;56(3):517-527. doi: 10.1111/1475-6773.13620. Epub 2021 Jan 13.
Dual Eligible Special Needs Plans (D-SNPs) were intended to provide better care for beneficiaries eligible for both Medicare and Medicaid through better coordination of these two programs.
671 913 dual eligible (DE) respondents to the 2009-2019 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
We compared the 2015-2019 experiences of DE beneficiaries in D-SNPs relative to fee-for-service Medicare (FFS) and non-SNP Medicare Advantage (MA) using propensity-score weighted linear regression. Comparisons were made to 2009-2014. 12 patient experience measures were considered.
Annual mail survey with telephone follow-up of non-respondents.
More than 65% of DE beneficiaries enrolled in FFS. Of 12 measures, D-SNP performance was higher than non-SNP MA on two (P < .05), lower than non-SNP MA on two (P < .05), and higher than FFS on four (P < .01). DE beneficiaries did not report better coordination of care in D-SNPs. D-SNP performance was often worse than other coverage types in prior periods.
Relative to FFS Medicare, DE beneficiaries report higher immunization rates in D-SNPs, but slight or no better performance on other dimensions of patient experience. New requirements in 2021 may help D-SNPs attain their goal of better care coordination.
双重资格特殊需求计划（D-SNPs）旨在通过更好地协调这两个计划，为同时符合医疗保险和医疗补助资格的受益人提供更好的护理。
2009 年至 2019 年医疗保险消费者评估医疗保健提供者和系统（CAHPS）调查中，671913 名双重合格（DE）受访者。
我们使用倾向评分加权线性回归，将 D-SNP 中 DE 受益人的 2015 年至 2019 年的经历与医疗保险按服务收费（FFS）和非 SNP 医疗保险优势（MA）进行比较。与 2009 年至 2014 年进行了比较。考虑了 12 项患者体验指标。
每年进行邮件调查，并对未回复者进行电话跟进。
超过 65%的 DE 受益人参加了 FFS。在 12 项措施中，D-SNP 的表现有两项优于非 SNP MA（P<0.05），两项劣于非 SNP MA（P<0.05），四项优于 FFS（P<0.01）。DE 受益人并未报告在 D-SNPs 中更好地协调护理。在之前的时期，D-SNP 的表现往往劣于其他覆盖类型。
与 FFS 医疗保险相比，DE 受益人在 D-SNPs 中报告的免疫接种率较高，但在患者体验的其他方面的表现仅略有改善或没有改善。2021 年的新要求可能有助于 D-SNPs 实现更好的护理协调目标。
