We are excited for our providers to participate in our new line of business, TotalCare (HMO-D-SNP), which will go into effect Jan. 1, 2026!
To participate in the D-SNP network, please return your signed amendment before Feb. 3, 2025, if you have not already done so. Receipt of your signed amendment by February 3rd will ensure that together, we can continue to provide accessible, quality health care, guided by local innovation.
About D-SNPs
A D-SNP is a type of Medicare Advantage plan, specifically designed for individuals who are eligible for both Medicare and Medi-Cal. D-SNPs can provide significant value to providers by:
- Increasing revenue through assigned care managers who will help reduce administrative burden on staff and providers.
- Using care coordination to help manage the complex needs of dual-eligibles more effectively.
- Providing a coordinated system that reduces the number of avoidable hospital readmissions that negatively impact revenue under traditional Fee-For-Service (FFS) Medicare.
- Providing a unified framework for billing and care management.
- Working with only one insurance entity (the Alliance’s TotalCare plan), as opposed to Medicare and Medi-Cal separately.
D-SNPs address social determinants of health (SDOH), which can have a significant impact on a patient’s overall well-being. TotalCare will reduce the need for providers to address non-medical services by possibly offering supplemental benefits that address housing needs, food insecurity and transportation.
D-SNPs also reduce out-of-pocket costs for dual-eligible beneficiaries, which improves adherence to treatment plans and increases patient satisfaction. When patients are more engaged and compliant, it leads to improved health, reduced need for costly interventions and promotes a more stable provider revenue.
We are excited for our provider partners to participate in this significant new line of business!
For questions, please contact your Provider Relations Representative, or visit our webpage.
