60: Psychiatrist and Nonpsychiatrist Physician Network Breadth in Dual Eligible Special Needs Plans

Eric P. Slade, Ph.D., joins Dr. Dixon and Dr. Berezin to discuss the complex and often confusing world of dual eligibility for Medicare and Medicaid coverage when it comes to mental health services, in particular Dual Eligible Special Needs Plans (D-SNPs), a type of Medicare Advantage plan designed around those eligible for both programs.

 

• Slade interview [00:59]
• Medicare and Medicaid [02:24]
• Eligibility for each, and both [06:36]
• Dual eligibility [08:09]
• Who pays for care? [09:51]
• Managed care [11:13]
• Trade offs between traditional insurance and HMO plans [15:47]
• Medicare Advantage [18:17]
• Dual Eligible Special Needs Plans (D-SNPs) [19:06]
• D-SNPs from the perspective of consumers [21:34]
• Provider networks [24:50]
• Findings [27:07]
• Why do D-SNPs not have larger psychiatrist networks than traditional Medicare? [30:02]
• Mental health care and insurance coverage [33:47]
• What should policymakers take from this? [36:37]
• What should clinicians take from this? [39:56]

 

Transcript

 

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