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D-SNPOhio

A first-time D-SNP builder

First D-SNP build, with NCD requirements built in

Illustrative scenario based on a common network-build situation — not an actual customer. Blueprint is a new product.

Executive Summary

Consider a plan launching its first Dual Eligible Special Needs Plan in Ohio — a LOB with distinct NCD-aligned specialty requirements and CMS model of care documentation that a Medicare Advantage team has never navigated. Blueprint's D-SNP-specific configuration applies Ohio's dual-eligible provider type requirements automatically, flags NCD specialty gaps the team hadn't anticipated, and structures the documentation needed for the CMS model of care review.

The Challenge

  • 1

    A first D-SNP build means navigating NCD-aligned specialty requirements and dual-eligible network standards that MA experience never covered.

  • 2

    NCD specialty categories are often poorly mapped in existing provider data, making it hard to know which providers actually meet D-SNP requirements.

  • 3

    CMS model of care review requires documentation of care coordination network standards the team has no prior process for producing.

The Solution

  • Blueprint's D-SNP configuration auto-applies NCD specialty categories and dual-eligible provider type requirements specific to Ohio.

  • Provider records are remapped against NCD specialty definitions — surfacing contracted providers that don't actually count toward D-SNP adequacy.

  • Blueprint's adequacy scoring surfaces exactly which NCD categories have gaps, giving the team a prioritized recruitment list well before submission.

Key Results

Auto-loaded

Ohio NCD specialty requirements

Remapped

Providers to correct NCD categories

Early

Gap visibility before deadline

Without an NCD-aware tool, it's easy to assume providers count toward D-SNP adequacy when they don't. Blueprint maps them — turning a hidden gap into an early, fixable one.

How the workflow helps — illustrative scenario

Build Timeline

How the build unfolded

Week 1

D-SNP workspace configured; Ohio NCD requirements loaded automatically

Week 2

Contracted providers remapped against NCD categories — gaps identified

Week 4

Targeted outreach to NCD-eligible behavioral health and LTSS providers

Week 7

NCD category gaps filled; care coordination documentation started

Week 12

Submit to CMS with model of care documentation structured and complete

Ready to see results?

Your build could look like this.

Schedule a 30-minute demo and we'll walk through Blueprint on a real network build for your state and LOB.