Medicare Advantage

“Medicare Advantage Special Needs Plans Site Visits.” James Verdier and Melanie Au, June 2006. Medicare Advantage Special Needs Plans (SNPs) specialize in serving Medicare beneficiaries who are dually eligible for Medicare and Medicaid, are eligible to be in nursing facilities or other long-term-care institutions, or have chronic conditions. This report provides an early descriptive snapshot of how SNPs are developing in Boston, Phoenix, and Miami. The authors provide findings from site visits and describe why plans decided to become SNPs; outline plans’ outreach, marketing, network development, care coordination, and quality improvement strategies; discuss implementation challenges; and review suggestions for improvement. The authors also describe SNP relations with state Medicaid programs, including current or planned inclusion of Medicaid-funded services in the SNP benefit package.

Working with Disability

“Working with Disability: How Much Are Medicaid Participants Earning?” William E. Black, Su Liu, and Henry T. Ireys, June 2006. Promoting employment for people with disabilities is an important policy objective for the nation. The first brief in a new series on the Medicaid Buy-In program, which extends Medicaid coverage to people with disabilities who go to work so they do not lose health care, examines participant earnings. We found that 66 percent worked, with average annual earnings of over $7,000 in 2004.

Read more about the study, which is based on linked data files Mathematica created from state enrollment records and the Social Security Administration’s Master Earnings File. Forthcoming briefs will look at participant enrollment, characteristics, Medicaid service use and costs, and other issues.

Mental Health Parity

"National Estimates of Mental Health Insurance Benefits." Myles Maxfield, Lori Achman, Jeffrey Buck, and Judith Teich. Journal of Behavioral Health Services & Research, May 2006. This article presents estimates of the proportion of the U.S. population that had mental health benefits in 1999, the extent of their coverage, and the proportion enrolled in health plans subject to the Mental Health Parity Act of 1996 (MHPA). Over three-quarters (76 percent) had mental health benefits as part of their health insurance. Approximately 18 percent had no such benefits; for the remaining 6 percent, mental health benefits could not be determined. Of the 18 percent with no mental health benefits, 84 percent also had no health insurance; the remainder (16 percent) had health insurance that did not cover mental health benefits. Estimates of the generosity of coverage indicate that for 44 percent of the population, benefits included prescription drugs as well as at least 30 inpatient days and 20 outpatient visits for psychiatric care. For 12 percent of the population, benefit generosity could not be determined. Finally, study results suggest that the MHPA affected only 42 percent of the U.S. population.

Developing Improved Disability Data

On July 12 to 13, our disability experts will be presenting at the Interagency Subcommittee on Disability Statistics State of the Art Conference: Developing Improved Disability Data, in Washington, DC. The conference will explore characteristics of an ideal national disability data collection effort across agencies, and how such an effort might be implemented. One approach is the development of a separate national disability survey; another involves systematic collection of disability data, including improved disability questions within existing national surveys. A combined approach might also be possible. For a list of conference presenters, who will discuss best practices and perspectives on existing national data, click here.

To read more about the conference, click here.