Dual-Eligible Special Needs Plans (D-SNPs) are a lifeline for individuals eligible for both Medicare and Medicaid, offering tailored care for those with complex health needs. In 2023, 5.2 million dual-eligible individuals were enrolled in D-SNPs, reflecting the critical role these plans play in providing specialized care. However, the challenge for D-SNPs lies in retaining these members, whose eligibility can fluctuate, and who often face barriers in understanding and navigating their benefits.

Take, for example, a new member enrolling in a D-SNP. Their first interactions can set the tone for their long-term engagement. By streamlining enrollment, simplifying healthcare access, and providing a seamless, personalized experience, D-SNPs can build trust and keep members connected. When members feel supported, not only does retention improve, but so do health outcomes. These strategies, such as providing clearer communication and expanding care options, help ensure that D-SNPs meet the immediate needs of members. They also establish lasting relationships that keep them engaged for the long haul. In this blog, we will discuss what D-SNPs are and effective strategies for improving retention.

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What is D-SNP?

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A D-SNP, or Dual Eligible Special Needs Plan, is a Medicare Advantage plan tailored for individuals eligible for both Medicare and Medicaid. These plans offer specialized benefits and services to address the unique needs of this population, such as managing severe or chronic conditions. Also, state programs often help cover Medicare-related costs based on eligibility, ensuring comprehensive and cost-effective care for enrollees.

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Medicaid Eligibility Categories

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• Full Medicaid: Covers all eligible low-income individuals.
• Qualified Medicare Beneficiary (QMB): Helps with Medicare costs like premiums and deductibles.
• Specified Low-Income Medicare Beneficiary (SLMB): Supports Medicare Part B premiums for slightly higher-income individuals.
• Qualifying Individuals: Offers limited assistance with Part B premiums.

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Cost-Sharing Indicators

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• Zero-Dollar Sharing Plans: Covers all Medicare costs.
• Non-Zero Sharing Plans: Includes minimal cost-sharing.

Careful planning ensures D-SNPs meet specific member needs effectively.

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6 Ways to Retain D-SNP Members 

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Retaining D-SNP Medicare members is challenging due to their unique healthcare needs, difficulties in understanding benefits, communication barriers, and lack of trust further complicating engagement. Here are 6 ways to retain members:

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1. Simplify the Enrollment Process

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Building meaningful relationships with members starts with trust. When new members join, it's crucial to provide a clear introduction to their benefits and integrate them into the care team. Engaging with them through personalized meetings or conversations helps enhance their experience and provides valuable insights at both individual and population levels. This approach boosts member satisfaction and retention, ensuring they feel valued and supported.

Moreover, SNP members receive additional benefits not covered by Medicare, such as hearing, dental, vision, over-the-counter items, food benefits, transportation, and caregiver support. Raising awareness and encouraging the use of these benefits can drive engagement. However, connecting with members, especially those with restrictions or accessibility challenges, can be difficult. Using an omnichannel approach—incorporating SMS, email, IVR, mobile, web, and print—facilitates personalized outreach, helping to overcome barriers at scale and improving interactions between members and plans.

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2. Addressing Barriers to D-SNP Retention

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D-SNP members often face barriers that hinder retention, such as health literacy, transportation difficulties, and language barriers. Many struggle to comprehend their benefits, so simplifying communications and offering resources to improve health literacy is crucial. For those facing transportation challenges, particularly in rural areas, providing access to services like telehealth or mobile clinics can help. Offering multilingual support ensures that non-English speakers can navigate their healthcare more effectively. Addressing these issues enhances retention by making care more accessible and understandable.

Example

If a D-SNP member is not fluent in English and has trouble understanding their benefits, the plan offers video tutorials and written materials in multiple languages. Additionally, apps can also enable members to view their benefits, appointments, and other key details in languages such as Spanish, Chinese, or Arabic, helping them navigate the system with ease.

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3. Simplify Healthcare Access

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Healthcare can be complex, especially for members with chronic conditions or disabilities. Simplifying the process can improve understanding and navigation, leading to better retention for SNP members. One effective method is using VCF contact cards, which can be shared via SMS or links. When clicked, these cards automatically save the plan number and contact details to the member's address book, making it easier to reach out for queries and improving accessibility.

Seamless communication is key to coordinating care. 1:1 messaging through engagement channels helps clarify member queries. A tool that allows members to transition from automated messages to live conversations with keyword prompts is especially beneficial. This ensures care managers can provide immediate support at crucial moments.

Example

To make navigation and communication even simpler for SNP members, imagine a scenario where a member named Maria receives a personalized text with a link to her VCF contact card. Clicking it instantly saves her plan’s contact details on her phone. One day, Maria faces a billing question. Instead of searching through emails, she uses the saved contact to call her care manager directly. When automated prompts can’t resolve her query, typing "speak to agent" seamlessly connects her to live support, ensuring swift assistance and satisfaction.

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4. Expand Care Accessibility

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The CMS announced the Health Equity Index accreditation reward factor for 2027, designed to reduce health disparities, particularly for SNP populations. Plans that focus on increasing access and providing additional support will benefit. To remove barriers, it’s crucial for plans to identify and address members' unique needs throughout their health journey.

HealthFeed’s programs leverage omnichannel outreach to engage members on key health topics. By incorporating behavioral science and advanced Natural Language Understanding (NLU), our conversational AI adapts to member responses, delivering personalized messages at crucial moments to overcome obstacles and maintain engagement.

Using strategies like refill reminders or medication adherence prompts can effectively reinforce positive behaviors and enhance member engagement.

Example

HealthFeed’s omnichannel tools make it easier for healthcare providers to reach diverse patient groups and improve care accessibility. For example, clinics can automate text reminders for appointments in underserved communities, send secure telehealth links to remote patients, or run flu shot campaigns with multilingual automated calls. By streamlining all interactions, providers ensure patients—regardless of location or technology access—can easily connect with the care they need, effectively bridging critical gaps.

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5. Continuously Improve Member Experience

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To retain members in D-SNP Medicare plans, health plans should leverage predictive data to personalize outreach and timing, ensuring that members receive support when needed. This approach helps build trust, improve satisfaction, and strengthen relationships, which ultimately enhances retention. By reducing unnecessary contact and offering relevant interventions, plans can foster loyalty. HealthFeed’s data-driven strategy exemplifies this by using technology to deliver tailored, effective communications that boost member retention in D-SNP Medicare programs.

Example

A health plan uses predictive data to identify D-SNP members like Sarsh who may miss medication refills. Personalized SMS reminders are sent, and if further assistance is needed, a care manager reaches out to offer support, such as transportation or benefit details. This focused approach enhances satisfaction and retention while reducing excess communication.

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6. Member Education & Empowerment

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Educating D-SNP Medicare members is key to improving retention. Providing resources like instructional guides, video tutorials, and clear FAQs can help members better understand their benefits and services, which enhances their ability to navigate the healthcare system confidently. Organizing webinars and community outreach activities creates opportunities for members to ask questions and receive tailored advice. Using simple, understandable language in communications, particularly for older adults, ensures members grasp complex healthcare concepts. By focusing on education, health plans can empower members to make informed decisions, leading to higher satisfaction and stronger loyalty.

Example

HealthFeed’s personalized patient journey illustrates how education and empowerment go hand in hand. For example, when a person named Sally is newly diagnosed with diabetes, she receives timely, relevant resources starting with a text message linking to an article about Type 2 diabetes. This is followed by a video on healthy eating and later, a TikTok-style clip highlighting exercises to lower blood sugar.  

By providing step-by-step, medically validated content through accessible channels, HealthFeed equips Sally with the knowledge and tools she needs to confidently manage her condition, fostering better health outcomes and ongoing support.

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Conclusion

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In conclusion, retaining members in D-SNP Medicare plans is crucial for both the health of individuals and the long-term sustainability of these programs. By implementing strategies such as streamlining enrollment, enhancing healthcare access, broadening care options, and continually improving the member experience, healthcare providers can build trust, increase satisfaction, and foster loyalty. Moreover, leveraging data and personalized engagement ensures that members receive the support they need at the right time, which not only improves outcomes but also boosts retention over the long term.