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

Public Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
CareLink NM Health Homes	Medicaid	Bernalillo, Curry, De Baca, Grant, Hidalgo, Lea, Quay, Roosevelt, San Juan, and Sandoval Counties	ACA Section 2703 Health Homes
Centennial Care - New Mexico Medicaid Managed Care	Medicaid	Statewide	Medicaid Section 1115 Waiver
CMS State Innovation Model (SIM) Design Award - New Mexico	Grant	Statewide	CMS State Innovation Model (SIM)
Home Visitation Program - Ben Archer Health Center	Grant	Dona Ana County	CMS Health Care Innovation Award (Round 1)
Oncology Medical Homes - COME HOME Program	Grant	Florida, Georgia, Maine, New Mexico, Ohio, Pennsylvania, Tennessee	CMS Health Care Innovation Award (Round 1)
Project ECHO- University of New Mexico Health Sciences Center	Grant	New Mexico, Washington	CMS Health Care Innovation Award (Round 1)
School-based Health Center Improvement Partnership - New Mexico	Grant	Colorado, New Mexico	CHIPRA Quality Demonstration Grant

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

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

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