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. 

Primary Care Innovations and PCMH Activity

Dual Eligible 2703 SPA CPC CPC+ PCMH QHP PCMH Legislation Private Payer

Private Payer Programs

Program Name Payer Type Coverage Area Parent Program Outcomes
Humana medical home program - Atrinea Health Commercial Albuquerque Humana Medical Home Program
Intel Connected Care Commercial Rio Rancho

State Legislation

Legislation Status Year
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.

Enacted 2009
HB 67 - 2021

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

Enacted 2021
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.
- Review national and state models of optimal primary care investment to increase access to and improve the quality of primary care services. 

 

Enacted 2024

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 

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