Evidence map›Paper›PMID 39422888›Full record

ArticleJAMA health forum2024

Nationwide Availability of and Enrollment in Medicare and Medicaid Dual-Eligible Special Needs Plans With Exclusively Aligned Enrollment.

Kenton J Johnston, Michelle Hendricks, Megha Dabas, Eliza Macneal, Jeah Jung, David J Meyers, Jose F Figueroa, Eric T Roberts

Abstract read
In one paragraph

Article in JAMA health forum, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
    Article
  3. Article
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kenton J JohnstonGeneral Medical Sciences Division, School of Medicine, Washington University in St Louis, St Louis, Missouri.
Michelle HendricksGeneral Medical Sciences Division, School of Medicine, Washington University in St Louis, St Louis, Missouri.
Megha DabasGeneral Medical Sciences Division, School of Medicine, Washington University in St Louis, St Louis, Missouri.
Eliza MacnealLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.
Jeah JungCollege of Public Health, George Mason University, Fairfax, Virginia.
David J MeyersSchool of Public Health, Brown University, Providence, Rhode Island.
Jose F FigueroaT. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Eric T RobertsLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia.

Funding

Integrating Medicare and Medicaid coverage in managed care: effects on quality, utilization, and disparitiesR01HS029453 · AHRQ · UNIVERSITY OF PENNSYLVANIA · PI MEYERS, DAVID JOSEPH, ROBERTS, ERIC T · 2023 to 2024
$719k
AHRQ HHS R01 HS029453
6 · The paper itself

Abstract

Importance: In 2021, the Centers for Medicare & Medicaid Services designated a new category of dual-eligible special needs plans (D-SNPs) with exclusively aligned enrollment (receive Medicare and Medicaid benefits through the same plan or affiliated plans within the same organization). Objective: To assess the availability of and enrollment in D-SNPs with exclusively aligned enrollment and to compare the characteristics of beneficiaries enrolled in D-SNPs with exclusively aligned enrollment available vs beneficiaries without such enrollment available. Design, Setting, and Participants: Full-benefit beneficiaries enrolled in D-SNPs for 6 months or longer in 2021 or 2022. Availability of and beneficiary enrollment in D-SNPs were assessed by year and county for D-SNPs with exclusively aligned enrollment available vs D-SNPs without exclusively aligned enrollment available. The D-SNP enrollees residing in counties with aligned plans available were compared based on demographic, social, health, and area characteristics vs D-SNP enrollees in counties without such plans available. Comparisons were also made based on beneficiaries who enrolled in the aligned D-SNPs vs those who did not enroll (were enrolled in unaligned D-SNPs). The data analyses were conducted from October 1, 2023, to August 2, 2024. Main Outcomes and Measures: Availability of aligned D-SNPs and beneficiary residence by county; enrollment in exclusively aligned D-SNPs vs unaligned D-SNPs; and beneficiary demographic, social, health, and area characteristics. Results: Of 2 197 732 beneficiaries enrolled in D-SNPs in 2021, 881 736 (40.1%) were living in counties with aligned enrollment available and 251 305 (11.4%) enrolled. Of 2 689 045 beneficiaries enrolled in D-SNPs in 2022, 1 047 223 (38.9%) were living in counties with aligned enrollment available and 318 906 (11.9%) enrolled. Beneficiaries enrolled in D-SNPs residing in counties without aligned enrollment available were more likely to live in rural or micropolitan areas (21.9%) vs beneficiaries in counties with aligned enrollment available (8.1%) (standardized mean difference [SMD], 0.38 [95% CI, 0.38-0.38]), be entitled to disability (44.4% vs 27.3%, respectively; SMD, 0.36 [95% CI, 0.36-0.36]), or be Black individuals (27.4% vs 21.4%; SMD, 0.14 [95% CI, 0.14-0.14]); were less likely to be Hispanic individuals (15.4% vs 33.7%; SMD, 0.45 [95% CI, 0.45-0.45]) or Asian or Pacific Islander individuals (6.1% vs 12.2%; SMD, 0.22 [95% CI, 0.22-0.22]); and lived in zip codes with a higher area deprivation index (mean, 66.8 [SD, 26.4] vs mean, 43.2 [SD, 29.0]; SMD, 0.86 [95% CI, 0.86-0.86]). Beneficiaries enrolled in aligned D-SNPs were more likely to be receiving long-term institutionalized care vs beneficiaries in nonaligned D-SNPs (4.3% vs 1.0%, respectively; SMD, 0.24 [95% CI, 0.24-0.25]) or have dementia or Alzheimer disease (9.2% vs 5.9%; SMD, 0.13 [95% CI, 0.13-0.13]). Conclusions: This study found that availability of and enrollment in D-SNPs with exclusively aligned enrollment are increasing, but the overall proportion enrolled remains low. Further reforms are needed to promote aligned enrollment.

Indexed as

MedicaidAdultAgedAged, 80 and overDual Medicare Medicaid EligibilityEligibility DeterminationFemaleHumansMaleMedicareMiddle AgedUnited States

Identifiers

PMID39422888
PMCPMC11581671

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.