Differences in Healthcare Utilization Between Enrollees of Fully Integrated Dual Eligible Special Needs Plans Versus Non-Fully Integrated Plans

Authors
Hyunjee Kim, Angela Senders, Clint Sergi, Erika Simeon, Sean Shenghsiu Huang, Hiroko H. Dodge, K. John McConnell, Eric T. Roberts
Peer-Reviewed Article
April 2024
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Headline

Fully integrated dual eligible (FIDE) plans were associated with improved care outcomes for certain subpopulations of dually eligible older adults.

Background

FIDE plans are a type of Medicare Advantage dual eligible special needs plan (D-SNP) that offers enhanced service coordination across Medicaid and Medicare for people who are eligible for both programs, beyond what is traditionally offered by D-SNPs. Limited evidence is available on the effectiveness of these plans to improve outcomes related to hospitalizations, emergency department visits, discharges to home, and use of long-term nursing facility and home- and community-based services (HCBS). This study used encounter and claims data across six states to measure differences in FIDE and non-FIDE plan enrollee utilization.

Findings

This study found no significant overall health care utilization differences across FIDE and non-FIDE plan enrollees. Analyses of enrollee subpopulations revealed some differences, including that FIDE plan enrollees with Alzheimer’s disease and related dementias had greater rates of nursing facility and HCBS use and, among FIDE enrollees who used HCBS, there were fewer hospitalizations and a greater likelihood of discharges to their home. For FIDE plan enrollees with high needs living in the community, fewer hospitalizations were also observed.

Takeaways

Specific subpopulations of dually eligible individuals may experience greater care integration as a result of FIDE plan enrollment.

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