Nov. 13, 2025
The Blue Cross Medicare Advantage Dual Care Plus (HMO SNP) program serves older adults and people with disabilities. The following is a program summary and 2024 results.
The SNP program includes:
- A care manager is assigned to coordinate benefits and services.
- Individual care plans and care teams are there to support member needs.
Quality and performance improvement measures include:
1. An initial health risk assessment is completed within 90 days of SNP enrollment. The HRA includes an assessment of medical, social, functional and behavioral health needs.
2. Another HRA is completed within a year of the most recent HRA. This helps us stay updated with the member’s progress.
3. An interdisciplinary care team is created for the member. This team is made up of the primary care provider, other medical staff and those who offer services for the member’s care. An ICT meeting takes place every year.
4. An individualized care plan is completed for each member in the SNP every year.
Results of the SNP program last year:
At the end of 2024, the SNP program had 3,120 members.
Every year we measure how we’re doing with meeting the goals of the program. We also measure our progress in helping members access quality care in partnership with you. Here are our 2024 results:
| Things we are measuring | Our goal | 2024 results |
| Program measure | ||
| How many members had their initial HRA completed within 90 days of enrollment (result includes all members even those who refused or were unable to be reached) | 100% | 47% |
| How many members had a repeat HRA within a year of the first one | 100% | 41% |
| How many members had their ICT meeting completed yearly | 100% | 63% |
| How many members had an ICP completed/updated yearly | 100% | 73% |
| Medical outcomes | ||
| Hospitalizations per 1000 members per year | 234 or less | Acute hospital 204 |
| Observed/expected ratio of members readmitted to the hospital within 30 days (members less than age 65) | <1.08 (or lower) | 0.689 |
| Percent of members who had a provider visit within 30 days of a hospital discharge | 93% | 81% |
| Percent of members who had a follow-up visit with a mental health provider within 30 days of a mental health hospital discharge | 57% | 30% |
| Percent of members with medication reconciliation on the day of discharge or within 30 days after hospital discharge | 68% | 58% |
| Percent of members who continue taking their oral diabetes medications | 84% | 79% |
| Percent of members who continue taking their blood pressure medications (ACE/ARBs) | 86% | 82% |
| Percent of members who continue taking their statin medications | 84% | 80% |
| Percent of members who continue taking their anti-depressant medication | 75% | 61% |
| Percent of members with blood pressure controlled | 72% | 68% |
| Percent of members with annual flu vaccine* | 72% | 69% |
| Percent of members 66 years and older who had a Functional Status Assessment | 83% | 66% |
| Patient experience | ||
| Percent of members surveyed who are satisfied or very satisfied that they can get appointments and care quickly* | 75% | 80% |
We continue to work together with members to improve measured health outcomes and help with management of conditions, taking medications, and preventing unnecessary admissions to the hospital. Many of these measures are tracked in the provider’s record of care and action plans may be developed to address these items.
*From an experience of care survey conducted March-June 2024. Respondents were asked regarding experience of care and to self-report if the annual flu vaccine was obtained.
HMO Special Needs Plan provided by Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. Enrollment in HCSC’s plan depends on contract renewal.