Sept. 15, 2026
The Blue Cross Medicare Advantage Dual Care Plus (HMO 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:
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. 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% | 33% |
| How many members had a repeat HRA within a year of the first one | 100% | 16% |
| How many members had their ICT Meeting completed yearly | 100% | 71% |
| How many members had an individualized care plan completed/updated yearly | 100% | 75% |
| Medical Outcomes* | ||
| Percent of members who had a provider visit within 30 days of a hospital discharge | 80% | 78% |
| Percent of members who had a mental health follow-up service within 30 days of a mental health hospital discharge | 42% | No rate available |
| Percent of members with medication reconciliation on the day of discharge or within 30 days after hospital discharge | 75% | 56% |
| Observed/Expected ratio of members readmitted to the hospital within 30 days (for members less than 65 years of age) | <1.08 or lower | No rate available |
| Percent of members who continue taking their oral diabetes medications | 83% | 100% |
| Percent of members with blood pressure controlled | 72% | 78% |
| Percent of members 66 years and older who had a functional status assessment by their provider | 85% | 63% |
| Patient Experience | Top 3 Box Score | |
| A mailed survey was sent between November and December 2025. Members were asked to rate their level of satisfaction on a five-scale (1=Strongly Disagree to 5= Strongly Agree) regarding getting appointments and care quickly. Members also self- reported whether they have received the flu vaccine. A total of two survey responses were received, and both questions received a 100% positive response rate. |
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.
HMO Special Needs Plan provided by GHS Insurance Company (GHSIC). GHSIC is 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.