2021 Outlook: Duals Plans Double Down on SDOH, Telehealth Investments

Amid the changes brought about by the COVID-19 pandemic, Medicare Advantage Special Needs Plans (SNPs) and others serving low-income dually eligible members are looking at ways to promote the use of telehealth and other technologies more broadly across their populations while taking a targeted approach to addressing social determinants of health (SDOH), experts tell AIS Health. At the same time, state efforts to advance the integration of Medicare and Medicaid benefits have been somewhat stymied by the pandemic and will face challenges such as aligning enrollment and measuring quality in an equitable way.

Cheryl Phillips, M.D., president and CEO of The SNP Alliance, says the association of SNPs and Medicare-Medicaid Plans (MMPs) expects the Biden administration to support improvements to the delivery of long-term services and supports — particularly with the federal Home and Community-Based Services model — and explore ways to support caregivers. “I think the next question will be [do] both sides understand the needs of those who are dually eligible? And I think a new administration will do some work in helping them better understand how MA and particularly SNPs can be the best vehicle to align and serve high-risk, high-cost individuals, particularly those who are dually eligible. So, there’s some work for us to do in engaging the administration early on, but I’m certainly optimistic,” she tells AIS Health.

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