New research from ATI shows that in 2023, Institutional Special Needs Plan (I-SNP) enrollees had lower mortality risk and fewer emergency department visits, hospitalizations, and hospital readmissions than non-I-SNP MA beneficiaries. This brief investigates the association between I-SNP enrollment and mortality, healthcare utilization, spending, and quality outcomes for long-term care residents enrolled in Medicare who had one or more nursing facility stays of 90 days or longer during the year.
These findings build on a previous analysis conducted by ATI, which shows a similar association between I-SNP enrollment and favorable long-term care outcomes in 2022.
Recent Work
PACE Growth by the Numbers: October 2026
Program of All-Inclusive Care for the Elderly (PACE) is a capitated health plan that provides comprehensive Medicare and Medicaid covered services to frail, older adults in the community who are eligible for nursing home care. New research from ATI explores the latest enrollment trends and highlights latest opportunities for PACE growth.
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A Practical Option for States: One-Time Medicaid Reassignment to Support D-SNP Alignment
Beginning January 1, 2030, Dual Eligible Special Needs Plan (D-SNP) enrollment must be fully aligned with Medicaid plan enrollment, and beneficiaries will no longer be able to stay in their current D-SNP. Building on a previous ATI resource, this brief outlines a transitional strategy for states subject to the impending D-SNP enrollment alignment requirements to consider.
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The Kim Frailty Index and Implications for LEAD ACOs
The Kim Frailty Index (KFI) is a validated, peer-reviewed measure of frailty that uses only healthcare claims data to measure frailty with sufficient accuracy for population-level decision making. The CMS Innovation Center is embedding KFI data into its Long-term Enhanced ACO Design (LEAD) Model as one of the factors used to assess whether a beneficiary qualifies as "High Needs."
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