New Mexico

In 2009, New Mexico passed HB 710 "Medical Home-Based Care Program and Insurance" directing the Human Services Department to apply for a Medicaid waiver or State Plan Amendment (SPA) to implement a medical home program and convene an insurance task force to explore incentives for a medical home-based managed care model. In 2013, CMS approved New Mexcio's 1115 waiver known as Centennial Care. This program is built on PCMH principles including care coordination, paying for quality care and outcomes and integrated behavioral health services.  Full implementation began January 1, 2014, and is being executed through Managed Care Organization (MCO) programs. New Mexico is also working to develop a model for Behavioral Health Homes (BHH) with a comprehensive primary care model through the MCO's under Centennial Care. The state has plans to expand the health home model for other chronic conditions.

New Mexico is also a leader in the movement to integrate primary care and community-based organizations. The Health Extension Rural Offices (HEROs) work to link community priority health needs with University of New Mexico Health Science Center resources to achieve measurable improvement in health status. 

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
2,100,000
Uninsured Population:
16%
Total Medicaid Spending FY 2012: 
$3.3 Billion 
Overweight/Obese Adults:
62.7%
Poor Mental Health among Adults: 
33.0%
Medicaid Expansion: 
Yes 

New Mexico Senate Bill 14

The bill establishes the New Mexico Health Care Authority in July 2024. Also amends the Primary Care Council's duties to:
- Analyze the proportion of health care delivery expenditures allocated to primary care statewide annually.
- Develop a five-year plan to determine how primary care investment could increase access to primary care and improve the quality of primary care services while also lowering the costs of primary care delivery.

HB 67 - 2021- Primary Care Council Act

Establishes a primary care council, charged with analyzing primary care spend as a proportion of health care spending yearly, making recommendations for policy to recommend policies, regulations and legislation to increase access to primary care, improving the quality of primary care services and lowering the cost of primary care delivery while reducing overall health care costs;  Council must present a 5 year plan to the Secretary

CareLink NM Health Homes

In April of 2016 the New Mexico Human Services Department (HSD), with CMS approval, initiated the CareLink New Mexico Health Home Program (CLNM HH). The first stage of this statewide program engaged agencies to provide coordinated care in two rural counties.

How Primary Care Docs Are Learning To Treat Mental Illness

The patient, pleading for pills, set off alarm bells in the doctor’s head.

When abused, the anti-seizure drug the patient was seeking can produce a euphoric high. Was the patient battling an addiction?

On a computer, the doctor searched a database for the patient’s electronic record, including any recently prescribed narcotics.

News Author: 
Brittany Lyte

Advancing Primary Care Innovation through Medicaid Managed Care

As the health care system moves toward more sophisticated value-based payment (VBP) models, those seeking to improve efficiency continue to look to primary care as the key to prevention and better health management. And for good reason: greater use of primary care is associated with lower costs, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality.

News Author: 
Rachael Matulis, MPH
Diana Crumley, JD, MPAff

Young Children’s Health Center

Practice Type: 
Multispecialty practice
Practice Setting: 
Urban
Practice Address: 
306-A San Pablo SE
Albuquerque, NM 87108

Young Children's Health Center (YCHC) is a community-based pediatric clinic that provides comprehensive health services to families with children from birth to young adulthood residing in the southeast heights of Albuquerque.  Staff is bilingual Spanish/English in order to better serve the community.  Special components of this clinic include home visitation to families with babies 0-36 months, behavioral health services, case management, and outreach activities to local schools and the community center, which includes gang prevention and intervention and other neighboring activities.

A State-Based Strategy For Expanding Primary Care Residency

As the health care system looks to improve overall health and reduce unnecessary spending, primary care physicians become increasingly critical. The Affordable Care Act (ACA) recognizes that primary care clinicians have the potential to “bend the cost curve” through care coordination and preventive health care for our increasingly diverse and aging population. However, there aren’t enough primary care physicians to meet this need — especially in rural or poor urban areas.

News Author: 
Arthur Kaufman
Charlie Alfero

Medicaid Health Plans are Improving Access and Quality of Care

As states look at how to provide high-quality, affordable care to Medicaid beneficiaries, more are turning to Medicaid managed care for the care coordination and support Medicaid health plans provide for millions. Nearly two-thirds of all Medicaid beneficiaries rely on Medicaid health plans for their coverage.

News Author: 
Alicia Caramenico

Lofty Goals Being Set For Reimbursement Reform

Those seeking to reform oncology reimbursement for physicians have set lofty goals: create an equitable method for reimbursing oncologists for the entire continuum of care of these complex patients, and provide better care for patients— reducing adverse events, emergency department (ED) visits and hospitalizations, while lowering the overall cost of cancer treatment in America.

News Author: 
Marie Rosenthal

New Mexico House Bill 710

New Mexico passed HB 710 "Medical Home-Based Care Program and Insurance" directing the Human Services Department to apply for a Medicaid waiver or State Plan Amendment (SPA) to implement a medical home program and convene an insurance task force to explore incentives for a medical home-based managed care model.

Pagine

Subscribe to RSS - New Mexico
Go to top