Model of Care

Every Special Needs Plan is required to have a model of care (MOC) approved by the National Committee for Quality Assurance (NCQA). The SNP MOC provides the basic framework under which a SNP will meet the needs of each of SNP members. The MOC is a vital quality improvement tool and an integral component for ensuring that the unique needs of each member enrolled in a SNP are identified and addressed. The MOC adheres to the CMS clinical and nonclinical standards and elements. The MOC identifies a target population and identifies specific specialties needs so resources and services are available to those who need them. The effectiveness of the MOC is evaluated through specific measurable goals and population specific quality indicators. Indicator data is collected on a routine and ad hoc basis, outcomes analyzed, interventions implemented for goal attainment and reports generated. Data collection follows protocols established in approved polices on program design. The MOC document outlines the specific program requirements and process that is approved and implemented for Alignment SNP members.