2024年医疗保险优势D-SNP格局的关键见解

11 CMS recently released information about CY 2024 MA planofferings, including D-SNPs.2The remainder of this paperdiscusses key takeaways from a review of CY 2024 D-SNP planoffering data and Milliman’s Medicare Advantage CompetitiveValue Added Tool (Milliman MACVAT®).1. The D-SNP market continues itshigh growth rateThe number of D-SNPs will increase by 8% in CY 2024. Figure 2shows the growth in D-SNPs over the past five years.FIGURE 2:NUMBER OF D-SNPS (CY 2019-CY 2024)In CY 2024, the pace of growth of offered D-SNPs (7.8%)remains high, though the majority of growth is attributable to newplans offered by national carriers (detailed further in the nextsection). While the growth rate in the number of MA generalenrollment plans has slowed in each of the past five years, withthis year being the first it went negative (-1.1%), the growth ratein the number of D-SNPs has remained high (8%-16%).However, growth in the number of D-SNPs has slowed in each ofthe past two years. Figure 3 shows the average annual growth inMA plans by year from 2019 through 2024 separately for D-SNPsand general enrollment plans.2CMS. Prescription Drug Coverage – General Information. Retrieved February 23,2024, fromhttps://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/index.5476047030100200300400500600700800900202020212022 February 202479285420232024 February 2024In 2024, five states had an increase in the number of MAOsoffering D-SNPs from 2023 while six states had reductions.Figure 4 shows the number of unique MAOs offering D-SNPs ineach state.Consistent with recent years, D-SNP availability at the local levelcontinues to be strong. Based on our analysis of the plan dataand CMS dual eligible beneficiary enrollment data,398% of fullbenefit dual eligible beneficiaries have access to a D-SNP orMedicare-Medicaid Plan (MMP) in 2024 and 95% have access toat least three D-SNP or MMP options. MMPs are plan typesdistinct from D-SNPs and are excluded from D-SNP totalsthroughout this paper, but they share many characteristics withD-SNPs, including enrolling only dual eligible beneficiaries.MMPs are discussed further below. These amounts bothincreased by less than 1% from 2023. By comparison, 95% of fullbenefit dual eligible beneficiaries had access to a D-SNP in 2020and 80% had access to at least three D-SNP or MMP options.coordination/medicare-and-medicaid-coordination/medicare-medicaid-coordination-office/analytics. February 2024Aetna (CVS Health) offers D-SNPs in 31 states (one morethan in CY 2023, entering Maryland).Other MAOs offering D-SNPs in at least 10 states includeElevance, Molina, and CIGNA. Figure 5 shows the four MAOsmentioned above with the largest D-SNP footprints.Despite relatively minimal expansion at the state level for thelargest D-SNP MAOs, these MAOs continue to increase thenumber of D-SNPs by offering D-SNPs in different service areaswithin a given state or differentiated D-SNP products within thesame service area, e.g., health maintenance organization (HMO)and preferred provider organization (PPO), separate plans for fulland partial duals, or plans with different benefit packages. Theaforementioned seven large MAOs make up over 90% of thetotal growth in D-SNP offerings. UnitedHealthcare, Humana,Aetna, and Centene all offer more than 100 unique D-SNP plansin 2024—an average of at least three unique D-SNPs per MAOper state. Key insights into 2024Medicare Advantage D-SNP landscape32. D-SNP enrollment and plan offeringscontinue to be concentrated in a fewnational MAOsUnitedHealthcare continues to offer D-SNPs in more states andcover more D-SNP beneficiaries than any other MAO. The fourMAOs with the largest D-SNP footprints are as follows:UnitedHealthcare offers D-SNPs in 42 states (one less thanCY 2023, exiting California) and covers 2.2 million D-SNPbeneficiaries (37% of nationwide D-SNP enrollment) as ofJanuary 2024.Humana offers D-SNPs in 35 states (one more than CY2023, entering Maryland) and covers 0.9 million D-SNPbeneficiaries (16% of nationwide D-SNP enrollment).Centene (Allwell) offers D-SNPs in 33 states (one more thanCY 2023, entering Delaware).FIGURE 5:NATIONAL MAO D-SNP FOOTPRINTS (CY 2024) February 2024Approximately 55% of D-SNPs achieved star ratings of 4.0 orgreater. Both of the largest two D-SNP MAOs—UnitedHealthcareand Humana—have at least 75% of D-SNPs achieving 4.0 starsor greater. However, both MAOs have a lower percentage of D-SNPs achieving 4.0 stars or greater in 2024 than 2023, withUnited decreasing by 15% to 75% and Humana decreasing by4% to 94%.Note that star ratings are assigned at the contract level and MAcontracts may contain other plans, including general enrollmentand other SNP types. Therefore, star ratings for D-SNPs may beinfluenced by performance of non-D-SNP plans within the samecontract.5. D-SNP integration requirementshave largely been met throughcoordination rather than integrationBeginning in CY 2021, D-SNPs are required to meet newminimum integration s