Making Specialty Health Plans ‘Work’

We’ve seen an increase in Medicaid and Medicare consumers in specialty health plans during the last decade—"vertical” plans organized for consumers with specific needs. There are now more than 700,000 Medicaid beneficiaries in these plans (see The Medicaid Vertical Carve-Out Landscape: The 2019 OPEN MINDS Update). And in the Medicare market, there are 2.5 million Medicare beneficiaries served by SNPs, 12.3% of the total 20.4 million Medicare Advantage enrollees (see Medicare Specialty Vertical Carve-Out Plans: The 2018 OPEN MINDS Medicare SNP Market Share Report).

During the recent 2020 OPEN MINDS Performance Management . . .