PDF(Pubmed)
Abstract：
UNASSIGNED: Dual Eligible Special Needs Plans (D-SNPs) are private managed care plans designed to promote Medicare and Medicaid integration for full-benefit, dually eligible beneficiaries. Currently, the highest level of D-SNP integration occurs in plans with exclusively aligned enrollment (EAE).
UNASSIGNED: To compare patient experience of care, out-of-pocket spending, and satisfaction among dually enrolled Medicaid beneficiaries in D-SNPs with EAE, those in D-SNPs without EAE, and those with traditional Medicare.
UNASSIGNED: This cross-sectional study included respondents to a mail survey fielded to a stratified random sample of full-benefit, community-dwelling, dual-eligible Medicaid beneficiaries who qualified for receipt of home and community-based services in the Virginia Medicaid Commonwealth Coordinated Care Plus program between March and October 2022.
UNASSIGNED: Enrollment in a D-SNP with EAE or a D-SNP without EAE vs traditional Medicare.
UNASSIGNED: The main outcomes were self-reported measures of access and delays in receiving plan approvals, out-of-pocket spending, and satisfaction with health plans\' customer service and choice of primary care and specialist physicians.
UNASSIGNED: Of 7200 surveys sent, 2226 were completed (response rate, 30.9%). The analytic sample consisted of 1913 Medicaid beneficiaries with nonmissing data on covariates (mean [SD] age, 70.8 [15.6] years; 1367 [71.5%] female). Of these, 583 (30.5%) were enrolled in D-SNPs with EAE, 757 (39.6%) in D-SNPs without EAE, and 573 (30.0%) in traditional Medicare. Compared with respondents enrolled in D-SNPs without EAE, those in D-SNPs with the highest level of integration (EAE) were 6.77 percentage points (95% CI, 8.81-12.66 percentage points) more likely to report being treated with courtesy and respect and 5.83 percentage points (95% CI, 0.21-11.46 percentage points) more likely to know who to call when they had a health problem. No statistically significant differences were found between members in either type of D-SNP and between those in D-SNPs and traditional Medicare in terms of their difficulty accessing care, delays in care, and satisfaction with care coordination and physician choice.
UNASSIGNED: This cross-sectional study found some benefits of integrating administrative processes under Medicare and Medicaid but suggests that care coordination and access improvements under full integration require additional time and/or efforts to achieve.
UNASSIGNED: To compare patient experience of care, out-of-pocket spending, and satisfaction among dually enrolled Medicaid beneficiaries in D-SNPs with EAE, those in D-SNPs without EAE, and those with traditional Medicare.
UNASSIGNED: This cross-sectional study included respondents to a mail survey fielded to a stratified random sample of full-benefit, community-dwelling, dual-eligible Medicaid beneficiaries who qualified for receipt of home and community-based services in the Virginia Medicaid Commonwealth Coordinated Care Plus program between March and October 2022.
UNASSIGNED: Enrollment in a D-SNP with EAE or a D-SNP without EAE vs traditional Medicare.
UNASSIGNED: The main outcomes were self-reported measures of access and delays in receiving plan approvals, out-of-pocket spending, and satisfaction with health plans\' customer service and choice of primary care and specialist physicians.
UNASSIGNED: Of 7200 surveys sent, 2226 were completed (response rate, 30.9%). The analytic sample consisted of 1913 Medicaid beneficiaries with nonmissing data on covariates (mean [SD] age, 70.8 [15.6] years; 1367 [71.5%] female). Of these, 583 (30.5%) were enrolled in D-SNPs with EAE, 757 (39.6%) in D-SNPs without EAE, and 573 (30.0%) in traditional Medicare. Compared with respondents enrolled in D-SNPs without EAE, those in D-SNPs with the highest level of integration (EAE) were 6.77 percentage points (95% CI, 8.81-12.66 percentage points) more likely to report being treated with courtesy and respect and 5.83 percentage points (95% CI, 0.21-11.46 percentage points) more likely to know who to call when they had a health problem. No statistically significant differences were found between members in either type of D-SNP and between those in D-SNPs and traditional Medicare in terms of their difficulty accessing care, delays in care, and satisfaction with care coordination and physician choice.
UNASSIGNED: This cross-sectional study found some benefits of integrating administrative processes under Medicare and Medicaid but suggests that care coordination and access improvements under full integration require additional time and/or efforts to achieve.
摘要：
■双重合格特殊需求计划（D-SNP）是私人管理式医疗计划，旨在促进Medicare和Medicaid整合，以实现全面受益，双重资格受益人。目前,最高水平的D-SNP整合发生在具有完全一致纳入(EAE)的计划中.
■为了比较患者的护理体验，自付开支,与EAE的D-SNP双重登记的医疗补助受益人的满意度，没有EAE的D-SNP，和那些传统的医疗保险。
■这项横断面研究包括了一项邮件调查的受访者，这些调查是针对全面受益的分层随机样本，社区住宅，双重资格的医疗补助受益人，他们有资格在2022年3月至10月之间在弗吉尼亚医疗补助联邦协调护理加计划中接受家庭和基于社区的服务。
■与传统医疗保险相比，参加有EAE的D-SNP或无EAE的D-SNP。
■主要结果是自我报告的访问措施和接收计划批准的延迟，自付开支,以及对健康计划的满意度，客户服务以及初级保健和专科医生的选择。
■在发送的7200份调查中，2226人完成（反应率，30.9%）。分析样本由1913名医疗补助受益人组成，这些受益人的协变量数据不缺失(平均[SD]年龄，70.8[15.6]岁；1367[71.5%]女性）。其中,583例（30.5%）被纳入有EAE的D-SNPs，没有EAE的D-SNPs中有757（39.6%），和573（30.0％）在传统的医疗保险。与没有EAE的D-SNP的受访者相比，整合水平(EAE)最高的D-SNP患者报告受到礼貌和尊重的可能性为6.77个百分点(95%CI,8.81-12.66个百分点),而5.83个百分点(95%CI,0.21-11.46个百分点)更有可能知道健康问题时应该给谁打电话.在D-SNP两种类型的成员之间以及D-SNP和传统Medicare的成员之间，在难以获得护理方面均未发现统计学上的显着差异，延迟护理，以及对护理协调和医生选择的满意度。
■这项横断面研究发现，在Medicare和Medicaid下整合行政流程的一些好处，但表明在完全整合下的护理协调和获取改善需要额外的时间和/或努力才能实现。
■为了比较患者的护理体验，自付开支,与EAE的D-SNP双重登记的医疗补助受益人的满意度，没有EAE的D-SNP，和那些传统的医疗保险。
■这项横断面研究包括了一项邮件调查的受访者，这些调查是针对全面受益的分层随机样本，社区住宅，双重资格的医疗补助受益人，他们有资格在2022年3月至10月之间在弗吉尼亚医疗补助联邦协调护理加计划中接受家庭和基于社区的服务。
■与传统医疗保险相比，参加有EAE的D-SNP或无EAE的D-SNP。
■主要结果是自我报告的访问措施和接收计划批准的延迟，自付开支,以及对健康计划的满意度，客户服务以及初级保健和专科医生的选择。
■在发送的7200份调查中，2226人完成（反应率，30.9%）。分析样本由1913名医疗补助受益人组成，这些受益人的协变量数据不缺失(平均[SD]年龄，70.8[15.6]岁；1367[71.5%]女性）。其中,583例（30.5%）被纳入有EAE的D-SNPs，没有EAE的D-SNPs中有757（39.6%），和573（30.0％）在传统的医疗保险。与没有EAE的D-SNP的受访者相比，整合水平(EAE)最高的D-SNP患者报告受到礼貌和尊重的可能性为6.77个百分点(95%CI,8.81-12.66个百分点),而5.83个百分点(95%CI,0.21-11.46个百分点)更有可能知道健康问题时应该给谁打电话.在D-SNP两种类型的成员之间以及D-SNP和传统Medicare的成员之间，在难以获得护理方面均未发现统计学上的显着差异，延迟护理，以及对护理协调和医生选择的满意度。
■这项横断面研究发现，在Medicare和Medicaid下整合行政流程的一些好处，但表明在完全整合下的护理协调和获取改善需要额外的时间和/或努力才能实现。
