Care Delivery Integration

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.

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."

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.

The Rural Health Transformation Program offers a rare window for states, providers, and community partners to redesign rural healthcare around sustainability, access, and innovation. Success will hinge on strong partnerships, measurable outcomes, and the creativity to think beyond existing systems.

Explore ATI Advisory’s first look at Medicare Advantage in 2026. Our analysis reveals a stable market on the surface but shifting dynamics beneath, including the rapid rise of Special Needs Plans, changing benefit designs, and diverging strategies between national and regional carriers.

ATI Advisory, in collaboration with the LeadingAge LTSS Center at UMass Boston and The SCAN Foundation, has developed resources to inform policy discussions on financing and delivering long-term services and supports. These materials provide a consolidated reference for policymakers and stakeholders exploring sustainable approaches to LTSS.