Meyers David J, Macneal Eliza, Offiaeli Kendra, Roberts Eric T
Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
JAMA Health Forum. 2025 Jul 3;6(7):e251748. doi: 10.1001/jamahealthforum.2025.1748.
Medicare beneficiaries dually enrolled in Medicare and Medicaid have some of the highest care needs. Finding ways to support dually eligible beneficiaries in the Medicare Advantage (MA) program has become a policy goal.
To determine if enrollment in different MA plan types is associated with differences in disenrollment.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included Medicare enrollment data from dually eligible Medicare beneficiaries in 2021. Analyses were conducted between March 2024 and February 2025. Data were analyzed from January through March 2025.
Enrollment in different MA plan types, including those that exclusively serve dual-eligible beneficiaries (coordination-only, dual-eligible special needs plans [D-SNPs] and fully integrated D-SNPs [FIDE-SNPs]), standard MA plans that serve dual-eligible and non-dual-eligible beneficiaries, and D-SNP look-alike plans, defined as standard MA plans that primarily enroll dual-eligible beneficiaries.
One-year disenrollment from one plan to another or to traditional Medicare.
Among 2 698 434 dually eligible beneficiaries in 2021, the mean (SD) age was 66.9 (14.1) years, and 62.5% were female individuals. Of dual-eligible beneficiaries enrolled in FIDE-SNPs in 2021, 19 001 (8.1%) disenrolled by 2022. Of those enrolled in coordination-only D-SNPs, D-SNP look-alikes, and standard MA plans in 2021, disenrollment rates were 18.3%, 30.5%, and 28.2%, respectively. Disenrollment rates were higher for Black beneficiaries and those who used more health services, including inpatient stays and more days of nursing home care.
The results of this cross-sectional study suggest that FIDE-SNPs retained their members at higher rates, which could be a sign of improved care experiences. Understanding how FIDE-SNPs may be affecting patient care will be important moving forward.
同时参加医疗保险和医疗补助计划的医疗保险受益人有一些最高的护理需求。找到支持医疗保险优势（MA）计划中双重资格受益人的方法已成为一项政策目标。
确定参加不同类型的MA计划是否与退保差异相关。
设计、设置和参与者：这项横断面研究纳入了2021年双重资格医疗保险受益人的医疗保险参保数据。分析于2024年3月至2025年2月进行。数据于2025年1月至3月进行分析。
参加不同类型的MA计划，包括专门为双重资格受益人服务的计划（仅协调、双重资格特殊需求计划 [D-SNP] 和完全整合的D-SNP [FIDE-SNP]）、为双重资格和非双重资格受益人服务的标准MA计划，以及D-SNP类似计划，定义为主要招收双重资格受益人的标准MA计划。
从一个计划转至另一个计划或转至传统医疗保险的一年退保情况。
在2021年的2698434名双重资格受益人中，平均（标准差）年龄为66.9（14.1）岁，62.5%为女性。2021年参加FIDE-SNP的双重资格受益人中，到2022年有19001人（8.1%）退保。2021年参加仅协调D-SNP、D-SNP类似计划和标准MA计划的受益人，退保率分别为18.3%、30.5%和28.2%。黑人受益人和使用更多医疗服务的人，包括住院和更多天数的疗养院护理，退保率更高。
这项横断面研究的结果表明，FIDE-SNP以更高的比率留住了其成员，这可能是护理体验改善的一个迹象。了解FIDE-SNP如何影响患者护理对于未来发展很重要。
