James Verdier

Melanie Au

Mathematica Policy Research, Inc.

600 Maryland Avenue, SW

Suite 550

Washington, DC 20024

MedPAC

601 New Jersey Avenue, NW

Suite 9000

Washington, DC 20001

(202) 220-3700

Fax: (202) 220-3759

www.medpac.gov

•

•

The views expressed in this report

are those of the authors.

No endorsement by MedPAC

is intended or should be inferred.

Medicare Advantage

Special Needs Plans

Site Visits

A study conducted by staff from 

Mathematica Policy Research, Inc. for the

Medicare Payment Advisory Commission

June 2006 • No. 06–3
	  




	 

	







	












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METHODOLOGY

 MedPAC staff chose four sites for this early snapshot of SNPs: Baltimore, Maryland; Boston, 

Massachusetts; Phoenix, Arizona; and Miami, Florida. The site visits were conducted in February 

and March 2006. MPR staff accompanied MedPAC staff on visits to the last three sites, which 

are the subject of this report. 

 MedPAC staff chose the sites based on the following criteria: 

• A large number of competing SNPs 

• The presence of existing special plans that converted to SNPs 

• Passive enrollment of Medicaid managed care enrollees in dual-eligible SNPs 

• The presence of organizations that offer several dual-eligible SNPs 

• The presence of two or more of the three types of SNPs: dual eligible, institutional, and 

chronic care 

 In advance of the site visits, MPR staff prepared (1) background information on each state and 

its Medicare and Medicaid programs, (2) profiles of each SNP operating in the marketplace we 

planned to visit, and (3) detailed interview protocols for the interviews with SNPs, state Medicaid 

agencies, and CMS regional offices. 

 MPR staff made some recommendations for SNPs to be visited, but the final decision rested 

with MedPAC staff, affected in some instances by the willingness of SNPs to be interviewed. 

Table 1 shows the number and types of SNPs in each of the three market areas and the number 

of plans offering SNPs that we visited in each market. As noted in the table, we visited 5 of 6 

plans offering SNPs in Boston, 6 of 10 in Phoenix, and 4 of 11 in Miami. Table 1 also provides 

background information on the metropolitan area markets and the states that we visited. 

 Table 2 shows, by SNP type, the names of all the plans operating SNPs in each of the market 

areas we visited and the geographic regions they cover. The information in Table 2 is taken from 

the January 2006 CMS report on SNPs, which is publicly available. Because we promised the 

interviewed SNPs that we would not link particular comments to specific SNPs, this summary 

report does not use plan names in the text. 

 Due to time and logistical constraints, we were able to conduct interviews with Medicaid 

agency officials only in Boston and Phoenix and with CMS regional office officials only in Boston. 

 We circulated a draft of this report to all the individuals we interviewed, and incorporated 

corrections and revisions as appropriate in response to their suggestions. 

 


 

  	



Table 1. SNP Site Visit Facts 

Boston Phoenix Miami 

Visit Date 2/15/06 – 2/16/06 2/22/06 – 2/23/06 3/16/06 

SNP Types in Metropolitan Area Market Dual Eligible, 

Institutional, Dual 

Demo 

Dual Eligible, 

Institutional, 

Chronic Conditions 

Dual Eligible, 

Institutional 

Number of SNPs in Metropolitan Area 

Market 

7 12 11 

 Number of Plans Offering SNPsa 6 10 11 

 Number of Plans Offering SNPs Visitedb

 5 6 4 

Total Metropolitan Area Population (2003) 4,579,137 3,593,408 2,341,167 

Total State Population (2003-2004) 6,360,110 5,642,350 17,148,330 

State MA Enrollment (2005) 159,034 207,435 574,426 

State Medicaid Capitated Managed Care 

(MC) Enrollment (2004) 908,174 881,741 1,597,215 

State Full Dual Eligible Enrollment in 

Medicaid (2003) 

192,000 70,000 380,000 

 As a % of Total Medicaid (2003) 21% 8% 17% 

 As a % of Total Medicare (2003) 20% 10% 13% 

 Percent Autoenrolled in Stand- 

 Alone PDPs (2006)c 97% 84% 93% 

State Total Dual Enrollment As a % of 

Total Medicaid MC (2004) 0.1% 8% 0.9% 

Sources: Kaiser Family Foundation State Health Facts, www.statehealthfacts.kff.org; HSC, Boston 

Community Report, December 2005; HSC, Phoenix Community Report, September 2005; HSC, 

Miami Community Report, December 2005; CMS Medicaid Data Sources and Medicare 

Enrollment Reports, 2003; CMS Special Needs Plan Report, January 4, 2006 

a

Plans with the same or similar contract names but different contract numbers in the CMS Special Needs 

Plan Report were counted as separate plans (e.g., the two Commonwealth Care Alliance plans); some plans 

operate multiple SNPs, which accounts for the difference between SNP numbers and plan numbers 

b

If two separate plans fell under the same parent company (e.g., United Healthcare of Florida and United 

Healthcare Insurance Company) and we spoke with representatives from the parent company, we counted it 

as if we spoke with both companies 

c

This calculates dual auto-enrollment in PDPs as of May 7, 2006 as a percentage of full dual eligibles in 

2003 (the most recent year for which those data are available) 
Table 2. SNP Plans in Sites 

Boston Phoenix Miami

SNP Type Plan Contract Name Region Covered Plan Contract Name Region Covered Plan Contract Name Region Covered Chronic Condition 

 Sun Health Medisun, 

Inc. 

Maricopa County 

Institutional United Healthcare 

Insurance Company (also offers a dual eligible plan) 

Boston, Springfield, Worcester Metro Areas 

United Healthcare Insurance Company (also offers a dual eligible plan) 

Maricopa, Pima, Pinal, and Yuma Counties 

CareOne Health Plan, Inc. 

Florida 

 United Healthcare 

Insurance Company 

Panhandle, Jax, Tampa, Orlando, Southern FL 

Dual Eligible Commonwealth 

Care Alliancea

Greater Boston and Springfield Areas 

Abrazo Advantage Health Plan 

Central Arizona American Pioneer 

Life Insurance Company 

Florida 

Commonwealth Care Alliance 

Greater Boston and Springfield Areas 

Arizona Physicians IPA, Inc. (offers 2 dual eligible plans) 

Cochise, Maricopa, Mohave, Pima, and Yuma Counties (first dual eligible plan) Cochise, Maricopa, Mohave and Related Counties (second dual eligible plan) 

Humana Medical Plan, Inc. 

Dade County 

Fallon Community Health Plan 

WORC, MSEX, FRK, HMD, HPS, NOF Counties 

Care 1st Health Plan Maricopa Counties Preferred Care 

Partners, Inc. 

Miami-Dade County 

Senior Whole Health, LLCa

Senior Whole Health Areas 

Cigna Healthcare of Arizona, Inc. 

Maricopa County and City of Apache Junction 

Summit Health Plan, Inc. 

Dade, Broward and Palm Beach Counties 

United Healthcare Insurance Companya

Boston, Springfield, and Worcester Metro Areas 

Health Choice Arizona, Inc. 

Apache, Coconino, Maricopa, Navajo, Pima and Pinal Counties 

United Healthcare Insurance Company 

Florida 
Table 2 (continued)

Boston Phoenix Miami

SNP Type Plan Contract Name Region Covered Plan Contract Name Region Covered Plan Contract Name Region Covered 

United Healthcare Insurance Company (also offers an institutional plan) 

Boston, Springfield, and Worcester Metro Areas 

Health Net of Arizona, Inc. 

Maricopa, Pinal, Pima, Santa Cruz Counties 

United Healthcare of Florida, Inc. 

Miami-Dade County 

Dual Eligible (continued)

PacifiCare of Arizona, Inc. 

Maricopa, Pima, and Apache Junction Counties 

Vista Healthplan, Inc. 

Dade, Broward and Palm Beach Counties 

 Southwest Catholic 

Health Network Corporation (Mercy Care) 

Maricopa, Pima, and Santa Cruz Counties 

Vista Healthplan of South Florida, Inc. 

Dade, Broward, Martin and St. Lucie Counties 

 United Healthcare 

Insurance Company (also offers an institutional plan) 

Maricopa and Pima Counties 

WellCare of Florida, Inc. 

Miami-Dade County 

Source: CMS Special Needs Plan Report, January 4, 2006 aSenior Care Options (SCO) Dual Demo Plan 




  	
 
	  	    	  			  

   	 		   	    	 	
 	 	  


	  

	 
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