Sept. 15, 2026
The Blue Cross Medicare Advantage Dual Care Plus Preferred (PPO SNP) program serves older adults and people with disabilities.
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:
- An initial health risk assessment is completed within 90 days of SNP enrollment. The HRA includes assessment of medical, social, functional, and behavioral health needs.
- Another HRA is completed within a year of the Initial (or most recent) HRA. This helps us keep up to date with the member’s progress.
- 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.
- 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 2025, the SNP program had 4,177 members.
We hold ourselves to high standards. Every year we measure how we are doing with meeting the goals of the program. We also measure our progress in helping members stay healthy and making sure your experience is a good one. Here are our 2025 results:
Things We Are Measuring | Our Goal | 2025 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% | 48% |
| How many members had a repeat HRA within a year of the first one | 100% | 48% |
| How many members had their ICT meeting completed yearly | 100% | 81% |
| How many members had an individualized care plan completed/updated yearly | 100% | 88% |
| Medical Outcomes | ||
| Hospitalizations per 1,000 members per year | 226.0 or less | Acute Hospital 211 |
| Observed/Expected ratio of members readmitted to the hospital within 30 days (goal is number listed or lower) | Under age 65: 0.91 | Under age 65: 0.90 |
| Percent of members who had a provider visit within 30 days of a hospital discharge | 84% | 83% |
| Percent of members who had a mental health follow-up service within 30 days of a mental health hospital discharge | 71% | 71% |
| Percent of members with medication reconciliation on the day of discharge or within 30 days after hospital discharge | 54% | 46% |
| Percent of members who continue taking their oral diabetes medications | 84% | 83% |
| Percent of members who continue taking their blood pressure medications (ACE/ARBs) | 83% | 84% |
| Percent of members who continue taking their statin medications | 83% | 82% |
| Percent of members with blood pressure controlled | 60% | 69% |
| Percent of members with annual flu vaccine* | 60% | 66% |
| Percent of members 66 years and older who had a functional status assessment | 83% | 50% |
| Patient Experience | ||
| Percent of members surveyed who are satisfied or very satisfied that they can get appointments and care quickly* | 77% | 97% |
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 a mail survey conducted November-December 2025. Overall response rate was 13%. 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 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.