Nov. 13, 2025
The Blue Cross Medicare Advantage Dual Care Plus Preferred (PPO 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 3,089 members.
Every year we measure how we are doing with meeting the program goals. We also measure our progress in helping members access quality care in partnership with you. Here are our 2024 results:
| Our goal | 2024 results | |
| Program measures | ||
| 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% | 67% |
| How many members had an ICP completed/updated yearly | 100% | 73% |
| Medical outcomes | ||
| Hospitalizations per 1000 members per year | 229.0 or less | Acute hospital 219.5 |
| Observed/expected ratio of members readmitted to the hospital within 30 days (goal is number listed or lower) | Under age 65: 0.75 Age 65 & over: 0.71 |
Under age 65: 1.01 Age 65 & over: 0.87 |
| Percent of members with medication reconciliation after hospital discharge | 63% | 52% |
| Percent of members who continue taking their oral diabetes medications | 80% | 82% |
| Percent of members who continue taking their blood pressure medications (ACE/ARBs) | 84% | 85% |
| Percent of members who continue taking their statin medications | 83% | 81% |
| Percent of members who continue taking their antidepressant medication | 57% | 62% |
| Percent of members with blood pressure controlled | 71% | 66% |
| Percent of members with annual flu vaccine* | 70% | 66% |
| Program measures | Our goal | 2024 results |
| Percent of members 66 and older who had the following services: | ||
| Functional assessment | 71% | 73% |
| Pain assessment | 81% | 86% |
| Medication review | 77% | 99.7% |
| Patient experience* | Top 3 box score | |
| Member satisfaction with their providers | 75% | 95% |
| Member satisfaction with their care coordination | 75% | 90% |
| Member satisfaction with their health care quality | 75% | 93% |
| Member satisfaction with overall Plan | 75% | 95% |
Members were very satisfied with their providers and the overall SNP plan itself. We continue to work 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 a mail survey conducted October through December 2024. Overall response rate was 14%. Respondents were asked to rate on a scale of 1 to 5; 1=Strongly Disagree and 5=Strongly Agree and to self-report if the flu vaccine was obtained.
PPO 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.