What type of service will a high-risk C-SNP or D-SNP member receive?

High-risk Chronic Special Needs Plans (C-SNP) and Dual Eligible Special Needs Plans (D-SNP) are designed specifically to meet the complex needs of their members. Members enrolled in these plans typically have significant health issues or receive both Medicare and Medicaid benefits. Therefore, they require more targeted support to manage their health conditions effectively.

The provision of Case Management tailored to individual needs is particularly crucial for high-risk members. This personalized approach ensures that their unique health care requirements are prioritized and managed in an efficient manner. Case management may involve coordinating care among multiple providers, assisting with medication management, and fostering communication between the member and their healthcare team. This is essential for improving health outcomes and facilitating access to necessary services, reflecting the holistic support model that C-SNPs or D-SNPs strive to provide.

Other services like in-home visits from physicians, free transportation, or monthly check-ins may also be beneficial for certain members, but they do not encompass the comprehensive, individualized approach that case management represents. The latter gets to the heart of supporting high-risk members by addressing their specific challenges and resources, ensuring they receive the necessary care and services to maintain their health effectively.