CMS Pub. 100-16, ch. 5, § 20.2.4

In 2007, CMS contracted with the National Committee for Quality Assurance (NCQA) to

develop a strategy to evaluate the quality of care provided by SNPs. That strategy

resulted in development of a tool to collect information that is meant to provide CMS

with a better understanding of how SNPs perform on a set of standardized national

performance measures that assess internal SNP processes and operations that affect the

enrolled Medicare beneficiaries’ quality of care (see Section 30.1 of this chapter for

information regarding SNP-specific HEDIS measures). S&P measures address the SNP

structures, systems and processes in place to address quality of care in the following 6

areas:

1. Care Management;

2. Improving member satisfaction;

3. Clinical quality improvements;

4. Care transitions;

5. I-SNP relationships with facility; and

6. Coordination of Medicare and Medicaid coverage.

The S&P measures rely on a review of plan policies and procedures, data reports,

prepared materials and other documentation the plans use to implement their programs,

analyze internal data, document processes and convey information to members and

practitioners.

NCQA collects S&P measure data from SNPs annually and provides an overview of

performance results in a report submitted to CMS. For additional information regarding

S&P measures, please see the NCQA Web site at:

http://www.ncqa.org/Programs/OtherPrograms/SpecialNeedsPlans.aspx.