Nov. 14, 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:
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:
| Things we are measuring | 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% | 17% |
| How many members had a repeat HRA within a year of the first one | 100% | 0% |
| How many members had their ICT meeting completed yearly | 100% | 67% |
| How many members had an ICP completed/updated yearly | 100% | 83% |
| Medical outcomes* | ||
| Percent of members who had a provider visit within 30 days of a hospital discharge | 82% | 83% |
| Percent of members who had a follow-up visit with a mental health provider within 30 days of a mental health hospital discharge | 40% | 0% |
| Percent of members with medication reconciliation on the day of discharge or within 30 days after hospital discharge | 73% | 33% |
| Observed/expected ratio of members readmitted to the hospital within 30 days (for members less than 65 years of age) | <1.08 or lower | 0 |
| Percent of members who continue taking their oral diabetes medications | 82% | 75% |
| Percent of members who continue taking their antidepressant medication | 73% | 0% |
| Percent of members with blood pressure controlled | 72% | 50% |
| Percent of members surveyed who responded to having an annual flu vaccine (from a mail survey conducted October through December 2024) | 74% | 33% |
| Percent of members 66 years and older who had a Functional Status Assessment by their provider | 83% | 33% |
| Patient experience* | Top 3 box score | |
| Percent of members who are satisfied or very satisfied that they can get appointments and care quickly (from a mail survey conducted October through December 2024) | 80% | 100% |
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.
*The 2024 results are based on a small number of members. In some measures, only one member met the requirements to be included. A mailed survey was conducted October through December 2024 with only three responses. 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.
HMO Special Needs Plan provided by Blue Cross and Blue Shield of Oklahoma, which refers to GHS Insurance Company (GHSIC), an Independent Licensee of the Blue Cross and Blue Shield Association. GHSIC is a Medicare Advantage organization with a Medicare contract and a contract with the Oklahoma Medicaid program. Enrollment depends on contract renewal.