Integration Requirements for Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) Annual Program Review, CY 2021

Abstract

This is the first annual review of the integration requirements for Medicare Advantage dual eligible special needs plans (D-SNPs), completed for the Maryland Department of Health. The goal of D-SNP integration, which became effective in calendar year (CY) 2021, is to improve coordination of care transitions for individuals who are dually eligible for Medicare and Medicaid. To meet this goal, D-SNPs are required to notify the state designees (e.g., supports planners) of Medicare hospital and skilled nursing facility (SNF) admissions when members receive long-term services and supports (LTSS) through a home and community-based services (HCBS) waiver or state plan program. This review describes key findings from the first year of implementation, focusing on aggregate trends.