Figure 1. Availability of Exclusively Aligned Fully Integrated or Highly Integrated Dual-Eligible Special Needs Plans (D-SNPs) in US Counties in 2021 and 2022.

The maps were created by linking annual (2021 and 2022) D-SNP contract and plan identifiers from the Centers for Medicare & Medicaid Services integration status file, which contains D-SNP integration and alignment status, to the National Bureau of Economic Research landscape files, which identify the counties where the D-SNPs were offered by year, and by linking to the US county map reprojection using SAS (SAS Institute Inc).