Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Comparing Outcomes for Dual Eligible Beneficiaries in Integrated Care: Final Report

Publication Date
Zhanlian Feng, Joyce Wang, Angela Gadaska, Molly Knowles, Susan Haber, Melvin J. Ingber, Valentina Grouverman

Dual eligible beneficiaries are an important subset of the Medicare and Medicaid populations because they have a high prevalence of chronic conditions and disabilities, substantial care needs, and high health care and long-term services and supports (LTSS) utilization and costs. Integrated care models have the potential to coordinate the administration, financing, and delivery of primary, acute, and behavioral health care, as well as LTSS across the Medicare and Medicaid programs, providing significant opportunities to improve care delivery and experience of care for dual eligible beneficiaries. Examples of integrated care models include the Program of All-Inclusive Care for the Elderly (PACE), Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs), and D-SNPs, which have varying degrees of benefit integration and administrative alignment. For policymakers, the ability to compare the quality of care and outcomes across the different models and determine their effectiveness is hindered by the lack of timely and accurate utilization data submitted by the managed care plans, referred to as encounter data. In this study, we used Medicare encounter data from 2015 to analyze and compare selected measures of service utilization and outcomes for dual eligible beneficiaries enrolled in three types of integrated care models--D-SNPs, FIDE-SNPs, or PACE--relative to their counterparts enrolled in regular, non-integrated MA plans.

The report was prepared under contract #HHSP233201600021I between HHS/ASPE Office of Behavioral Health, Disability and Aging Policy and the Research Triangle Institute. For additional information about this subject, you can visit the BHDAP home page at or contact the ASPE Project Officer, at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201;

Related Products:

Product Type
High-Need, High-Cost Populations | Medicare-Medicaid Dual-Eligible
Medicaid | Medicare | Medicare Advantage | Medicare Advantage Special Needs Plan (SNP) | Medicare, Dual Eligible Special Needs Plan (D-SNP) | Medicare, Fully Integrated Dual Eligible Special Needs Plan (FIDE-SP) | Program of All-Inclusive Care for the Elderly (PACE)