Federal Look-Alike Plan Termination Policy and Dual-Eligible Enrollment in Integrated Care Programs.

ABSTRACT:

Importance

In 2023, the Centers for Medicare & Medicaid Services terminated dual-eligible special needs plan look-alikes-Medicare Advantage plans with beneficiary panels composed of more than 80% dual-eligible individuals but lacking Medicaid integration. Understanding whether this policy promoted dual-eligible enrollment in integrated care plans, particularly those attaining high-level integration, is critical.

Objective

To describe dual-eligible enrollment transitions after the look-alike plan termination and evaluate whether the policy was associated with increased enrollment in highly integrated plans.

Design, setting, and participants

This repeated cross-sectional study analyzed US Medicare administrative data from January 2017 to January 2023. Samples were limit

SUBMITTER: Ma Y 

PROVIDER: S-EPMC12811809 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature