I-SNPs, or Institutional Special Needs Plans, are a type of Medicare Advantage plan designed specifically for individuals who require an institutional level of care, including those who reside in nursing homes. These plans offer a range of benefits tailored to the unique needs of this population, including on-site nurse practitioners employed by the plan who work with existing nursing home staff to provide primary care, care coordination, and assist in care planning.

In a recent Health Affairs study by Professor of Health Care Policy, David Grabowski and Health Policy PhD Candidates Amanda Chen and Joseph Hnath, they conducted a nationwide analysis of the I-SNP market. They examined the availability, growth, and characteristics of these plans. 

Findings:

• Significant Growth: The number of long-stay nursing home residents enrolled in I-SNPs quadrupled between 2006 and 2021. This indicates a growing recognition of the value these plans can provide to individuals in need of extensive care who reside in nursing homes.
• Uneven Availability: Despite this growth, a significant portion of nursing homes still do not have any residents enrolled in I-SNPs. Moreover, many geographic areas lack access to these plans, limiting their availability to a subset of the population.
• Dual Eligibility: The majority of long-stay nursing home residents enrolled in I-SNPs are eligible for both Medicare and Medicaid, highlighting the importance of I-SNPs to provide for their care needs during the nursing home, relative to other plans, including dual-eligible SNPs.

To expand access to I-SNPs, understanding the factors influencing their availability in different markets is crucial. Additionally, examining the reasons why long-stay nursing home residents choose to enroll in I-SNPs can provide insights into their preferences and needs. Identifying and addressing barriers to enrollment can help ensure that individuals who could benefit from these plans have access to them. Finally, comparing hospital admission rates and other quality outcomes between long-stay nursing home residents enrolled in I-SNPs and those who are not can help evaluate the effectiveness of these plans.

By gaining a deeper understanding of I-SNPs, policymakers and healthcare providers can work to address the challenges faced by long-stay nursing home residents and improve the quality of care they receive.