Dual Eligible Special Needs Plans (D-SNP) are a special kind of Medicare Advantage Plan for people who qualify for both Medicare and Medicaid. This program takes members’ Medicare, Medicaid, and Part D needs and puts them all together into one package to provide an overall healthcare experience. D-SNP plans are unique in that they provide extra benefits. In addition to Medicare, Medicaid, and Part D coverage, they also help with additional healthcare coverage, including transportation (to doctor visits), dental or vision coverage, and credits to purchase OTC products.
Support for Highest-Need Populations
D-SNP members represent some of the most vulnerable populations in the United States. Health plans serving D-SNP programs need a holistic platform for end-to-end care management and population health that enables their unique Model of Care and keeps them compliant with state and federal regulations.
Best-in-class D-SNP care management platforms hinge on two critical factors: compliance and member satisfaction.
- Federal & state compliance
- Compliance reporting
- ODAG and CDAG Reporting
- User-friendly documentation management
- Complex Assessments
- STARS ratings
- HEDIS scores
- Coordination of care and collaboration
- Coordination of activities of daily living (ADL) needs identified via responses to assessment questionnaire which will generate service plan needs that can automatically feed authorization of such required services.
- Ongoing communication and engagement
- Member care plans with intelligent automation and evidence-based goals and opportunities
- Leverage social determinants of health (SDOH) connections to address nontraditional challenges for improved member outcomes
The right D-SNP managed care platform means better health outcomes and compliance with federal and state regulations.
HealthEdge’s GuidingCare: Next-gen care management platform for health plans with D-SNP
With strong expertise and experience in providing care management and population health services for government-funded payers and plans, HealthEdge is fluent in the needs of state-sponsored programs serving the most vulnerable and high-risk populations.
Nationally, 1 in 5 Medicaid members are managed on GuidingCare. GuidingCare is currently live in 35 states for Medicaid, 29 states for D-SNP, and 14 states for LTSS. Learn more about how GuidingCare supports D-SNP populations here.