Pennsylvania Dual Eligibles Enrolled In An Integrated Medicare-Medicaid Plan Increased HCBS Use

After three years, Medicare-Medicaid dual-eligible beneficiaries enrolled in a fully integrated Medicare Advantage dual eligible special needs plan (FIDE-SNP) in Pennsylvania had greater increases in their use of home- and community-based services (HCBS) compared to a group of dual eligibles enrolled in a Medicaid managed LTSS plan not integrated with Medicare. In an integrated plan for dual eligibles, the state pays the special needs plan (SNP) a capitated rate to also manage enrollee Medicaid services.

The integration cohort included 7,967 individuals enrolled in the UPMC CHC plan who also enrolled in UPMC’s Medicare Advantage . . .