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 

This idea has kept tens of thousands out of emergency rooms and saved one state millions of dollars

on Wed, 2015-02-25 00:00   lisabeth

If your infant has a high fever or you’re experiencing an unusual pain in your abdomen and you live in New Mexico, you may want to call the NurseAdvice line before you do anything else.

New Mexico is the only state with a 24/7 registered nurse call center that is free to all residents, whether insured or not. In operation since 2006, it has kept tens of thousands of New Mexicans out of emergency rooms and saved the state more than $68 million in health care expenses.

Story Date: 
February 25, 2015
News Author: 
Christine Vestal
Source Link: 
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Integrating Community Health Worker Models into Evolving State Health Care Systems

2015-02-23 13:30 to 15:00

As states transform their health systems, many are turning to CHWs to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health. As interest in CHWs continues to rise, so do challenges related to defining roles and scope of practice, training and certification, financing, and integrating CHWs into evolving health care systems.

Register
Announcement Type: 
Webinar

CMS State Innovation Model (SIM) Design Award - New Mexico

New Mexico will engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Health Care Innovation Plan. States receiving Model Design awards under the State Innovation Models initiative will have twelve months to submit their State Health Care Innovation Plans to CMS.

COME HOME Program Set to Save $33.5M Over 3 Years

on Mon, 2014-08-25 00:00   lisabeth

In 2012, the federal Centers for Medicare and Medicaid Innovation (CMMI) sought to support oncologists in addressing what CMMI considered to be among the failings in cancer care— namely, fragmented care, suboptimal outcomes, high costs, and patient dissatisffaction. To remedy these weaknesses, CMMI awarded $19.8 million to Innovative Oncology Business Solutions (IOBS), Inc, in Albuquerque, NM. Barbara L. McAneny, MD, an oncologist, is the CEO and chief medical officer for IOBS, the company she launched to manage the Community Oncology Medical Home (COME HOME) program.

Story Date: 
August 25, 2014
News Author: 
Joseph Burns
Source Link: 
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Will Health Reform Bring New Role, Respect To Primary Care Physicians?

on Thu, 2014-07-10 00:00   lisabeth

A few years ago it struck the D.C. region’s biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar. CareFirst BlueCross BlueShield spent billions on hospital procedures, drugs and specialty physicians to treat sick patients. Only one dollar in 20 went to the family-care doctors and other primary caregivers trained to keep people healthy.

The company’s move to shift that balance tells a lesser-known story of the Affordable Care Act and efforts to change the health system.

Story Date: 
July 10, 2014
News Author: 
Jay Hancock
Source Link: 
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Humana medical home program - Atrinea Health

This program is offered to practices that are either patient-centered medical home (PCMH) certified or in the certification process. These practices must meet HEDIS and clinical initiative targets and have made progress addressing some of the requirements necessary to transform their practice in order to become successful population health managers. For example PCMH program participants have implemented electronic medical records and likely use electronic prescribing systems. Additionally, they have made other infrastructure changes, including the use of a care coordinator in the practice.

IMPaCTing Meaningful Improvements in Primary Care Practice

2014-05-05 12:00 to 13:30

Primary care extension programs improve the quality of primary care services by educating providers on new and innovative practices in areas such as preventive medicine, health promotion, and chronic disease management. Section 5405 of the Affordable Care Act authorizes the establishment of a national primary care extension program.

Register Here
Announcement Type: 
Webinar

Centennial Care - New Mexico Medicaid Managed Care

New Mexico’s new Medicaid program, Centennial Care, is designed to enhance the state’s ability to deliver quality care in a more coordinated, patient-centered manner. The key goals of Centennial Care include:

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