Patrick Foley, CEO of Belong Health, joins to discuss the growing opportunity in Medicare Advantage special needs plans and how Belong is helping community health plans compete in a market increasingly dominated by nationals.
Patrick walks through the three types of special needs plans — D-SNP for dually eligible members, C-SNP for chronic conditions, and I-SNP for institutional settings — and why C-SNP has become the highest growth segment over the past two to three years. The P&L dynamics are part of the story: C-SNP reimbursement reflects more accurate risk capture and higher member engagement, which makes it an attractive product for plans navigating a difficult MA environment.
The conversation also explores the strategic tension between nationals and community health plans. Nationals can take a portfolio approach — using C-SNPs to differentiate in specific markets and generate higher margins. Community plans don't have that option. They've been rooted in their communities for 50 years and can't walk away from Medicare lines of business even when the economics are tough. Belong's role is helping those plans make special needs products sustainable.
The episode closes on broker relationships and year-round enrollment, where C-SNPs and D-SNPs give community plans a tool to build multi-decade broker relationships rather than competing on benefits alone during open enrollment.
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