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Additional Guidance on CY 2021 Medicare-Medicaid Integration Requirements for Dual Eligible Special Needs Plans (D-SNPs)

Among the factors contributing to imprecision in the overall estimate: Medicare Advantage encounter data can be incomplete, which means the estimate may be too low if data are lacking on enrollees who would meet the clinical criteria for use

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However, clinical outcomes are complicated by behavioral factors, including lower adherence rates reported among women, which may obscure the true extent of sex-related efficacy differences [52]