Assessing D-SNP Enrollment Value for Dually Eligible Individuals

This technical report evaluates the impact of enrollment in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) on outcomes for partial-benefit dually eligible (PBDE) individuals who transition to full-benefit dually eligible (FBDE) status. The study focuses on individuals who switched from PBDE to FBDE status between 2018 and 2019. It presents findings indicating that D-SNP enrollees experienced lower rates of acute hospitalization and skilled nursing facility use prior to their transition, alongside increased utilization of home- and community-based services following the switch. The report highlights the limitations of the findings, noting that they do not account for other factors influencing health outcomes and are not generalizable to the broader PBDE population. The results suggest potential benefits of D-SNP enrollment for the small percentage of dually eligible individuals who switch status annually, particularly in reducing institutional care usage. The report also discusses ongoing debates regarding D-SNP enrollment policies for PBDE individuals.