Figure 2. Prior-Year Medicare Plan for Full Benefit Dual-Eligible Beneficiaries Living in Counties With Available Aligned Dual-Eligible Special Needs Plans (D-SNPs).

Includes Medicare beneficiaries with (1) at least 1 calendar year (2020 or 2021) of continuous baseline enrollment in Medicare Parts A and B (traditional Medicare or Medicare Advantage), (2) a following year (2021 or 2022) of at least 6 months of full benefit D-SNP enrollment, and (3) residence in a county where an aligned D-SNP was available. PACE indicates Programs of All-Inclusive Care for the Elderly. Beneficiaries were excluded if they had end-stage kidney disease, were living outside the 50 US states and the District of Columbia, and the penetration rate of Medicare Advantage by county or Rural-Urban Continuum Codes was missing. Individuals who died during the first 6 months of the study year were included if they met the criteria up to the month of their death. Beneficiaries were assigned to the plan that they had for the most months during the study year. If 2 plans had the same number of months, then beneficiaries were assigned to the last plan they had during the study year. For the prior year, beneficiaries were assigned to the plan they had in December. The aligned D-SNPs were identified using the Applicable Integrated Plan indicator data published by the Centers for Medicare & Medicaid Services and linked by unique 5-digit contract and 3-digit SNP identifiers using the contract and plan benefit package numbers for Medicare Part C in the Master Beneficiary Summary File. For beneficiaries with a single combination contract number and plan benefit package number operating in 2 states with 2 separate D-SNP types (eg, 1 coordination-only D-SNP and 1 highly integrated D-SNP), the D-SNPs were treated as 2 separate plans.