Medicare Specialty Vertical Carve-Out Plans: The 2018 OPEN MINDS Medicare SNP Market Share Report

Created as part of the Medicare Modernization Act of 2003, Medicare Advantage special needs plans (SNPs) have been in operation since 2006. Medicare Advantage SNPs serve Medicare beneficiaries with complex conditions and needs. Plans must offer the full-continuum of Medicare benefits, including Part A, Part B, and Part D. In addition, plans must offer supplemental benefits and develop a model of care specific to the beneficiaries being served. There are three main types of SNPs:

• Dual Eligible Special Needs Plans (D-SNPs)
• Chronic Condition Special Needs Plans (C-SNPs)
• Institutional Special Needs Plan (I-SNP)

The number of consumers enrolled in SNPs has increased steadily over the last five years with 2.5 million beneficiaries enrolled as of December 2017. While the enrollment in SNP plans has increased, the number of available SNP plans has fluctuated from year to year, suggesting fewer plans are serving more members. On February 9, 2018, Congress authorized permanent continuation of the SNP program, with additional care management requirements that will go into effect in 2020. This report examines the current SNP landscape, including:

• Trends in Medicare Advantage SNP enrollment by plan type year over year
• Analysis of the number of plans operating in the SNP market year over year
• Comparison of the top SNP insurers in 2016 and 2017, including enrollment and type of plans offered
• The number of enrollees in each type of SNP by state
• The number of plans and insurers available in each state

Medicare Advantage SNPs offer a unique opportunity to tailor services and supports for individuals with specific conditions and characteristics. As the health and human services market moves towards providing increased services and care coordination for high needs and complex consumers, the Medicare Advantage SNP model will be an important part of that goal.