November, 2008

SNP Quality Measurement for 2008

SNPs were created by Congress as part of the Medicare Modernization Act (MMA) of 2003 as a new type of Medicare managed care plan focused on certain vulnerable groups of Medicare beneficiaries: the dual eligible, the institutionalized and individuals with severe or disabling chronic conditions. A central goal of the SNP program is to promote using enhanced coordination and continuity of care models to improve care for Medicare beneficiaries with special needs.

There are three kinds of SNPs. Dual-eligible SNPs coordinate benefits and services by combining benefits and services available through Medicare and Medicaid. Institutional and Chronic Condition SNPs focus on the special needs of those populations.

SNPs may target enrollment, designing special clinical programs to accommodate groups with distinct health care needs. SNPs limit their enrollment to the particular population that they serve. SNPs are Medicare Advantage (MA) plans, and the organizations that offer SNPs must comply with all requirements of general market Medicare Advantage plans, except that general market MA plans must enroll all MA-eligible Medicare beneficiaries in their service area. Currently, there are approximately 1.2 million beneficiaries participating in SNPs, and more than 700 SNPs.