Do dual eligible beneficiaries experience better health care in special needs plans?

OBJECTIVE

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.

DATA SOURCES

671 913 dual eligible (DE) respondents to the 2009-2019 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

STUDY DESIGN

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.

DATA COLLECTION METHODS

Annual mail survey with telephone follow-up of non-respondents.

PRINCIPAL FINDINGS

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.

CONCLUSIONS

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.