As CMS expands FIDE-SNP integration requirements, prioritizing contracts with fully integrated plans offers SNFs a path to more stable payer relationships and more predictable reimbursement.
Enrollment in Dual-Eligible Special Needs Plans and Disenrollment Rates
In this cross-sectional study of 2.7 million dually eligible Medicare beneficiaries, dually eligible Medicare and Medicaid beneficiaries enrolled in fully integrated dual-eligible special needs plans had substantially lower disenrollment rates compared with beneficiaries enrolled in other Medicare Advantage plan types. Of dual-eligible beneficiaries enrolled in FIDE-SNPs in 2021, 19 001 (8.1%) disenrolled by 2022. Of those enrolled in coordination-only D-SNPs, D-SNP look-alikes, and standard MA plans in 2021, disenrollment rates were 18.3%, 30.5%, and 28.2%, respectively. Disenrollment rates were higher for Black beneficiaries and those who used more health services, including inpatient stays and more days of nursing home care.
— JAMA Health Forum, July 3, 2025
Meyers, David J. et al. “Enrollment in Dual-Eligible Special Needs Plans and Disenrollment Rates.” JAMA Health Forum, 3 Jul. 2025. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2835812.
Dual Eligibles More Likely to Stay in MA Plans Catered to Them, Research Reveals
A comprehensive study of dually eligible seniors enrolled in Medicare Advantage plans reveals striking differences in how often they switch or leave their health insurance plans. Fully integrated plans show the strongest retention rates.
The study found that seniors enrolled in fully integrated dual-eligible special needs plans (FIDE-SNPs) had the lowest disenrollment rates at 8%.
— McKnight’s Long-Term Care News, July 4, 2025
✔ Comply with every payer's rules
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✔ Monitor rates and payer trends
