The program runs from 2026 to 2030 with annual funding tied to performance, supports providers, communities, and statewide infrastructure, and distributes funding through competitive procurements and community-based awards. Key initiatives include enhancing data systems, expanding access to specialty and behavioral health services, building the rural health workforce, and funding community-designed solutions. Technical assistance and shared services also help stabilize rural providers.
New Mexico's Rural Health Transformation Program is actively implementing with federal funding awarded and multiple state-level procurement opportunities (RFAs, RFPs) already issued. Submission deadlines for administrative and innovation centers are scheduled for late May and early June 2026, and initial webinars and public engagement have begun. This reflects the transition from program launch into full operational activity, including competitive awards to organizations and integration of technical support structures. State opportunities: 2 active (1 open, 1 closing soon, 1 past/closed), $56.0M listed funding. Key opportunities: Center for Rural Health Sustainability & Innovation (CRHSI) RFP; ASO Services for Rural and Behavioral Health Program Administration; New Mexico Rural Health Care Delivery Fund Stabilization Grant FY27-29.
RHTP Strategy
Coordinate investments across data enhancement, workforce development, service expansion, innovation funding, and technical assistance to stabilize and improve rural health systems.
Key Initiatives
1Rural Health Data Hub
2Healthy Horizons
3Rooted in New Mexico
4Rural Health Innovation Fund
5Bridge to Resilience
Timeline: 2026–2030
Health Priority
Access to Specialty and Behavioral Health Services: The program seeks to expand access to specialty, maternal, behavioral health, and chronic disease services in rural, frontier, and tribal communities. (Regions: rural, frontier, tribal)
May 30, 2026
Health Priority
Rural Health Workforce: Focus on building and sustaining the rural health workforce through targeted training, education, and retention strategies. (Regions: rural, frontier, tribal)
May 30, 2026
Health Priority
Data and Technology: Enhancing data systems, analytics, and technology to improve care delivery and decision-making processes. (Regions: statewide)
May 30, 2026
Supporting
PDF
2025-2026
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NM - 2025 - RFI 26-630-0900-0011 RHTP(PDF)
Migrated from duplicate federal row
SupportingHTML2025No amount extracted
NM - 2025 - Primary Care Council – New Mexico Health Care Authority
Auto-grouped context match (38%)
ReferencePDF2025-2030Award: $1.0B
NM - 2025 - New Mexico State Of New Mexico RHT 2025 Application
NM - 2026 - Center for Rural Health Sustainability & Innovation (CRHSI) RFP
Primary source
SupportingHTML2026-2027No amount extracted
NM - 2026 - Request for Proposal (RFP) #27-630-1000-0003: Center for Rural Health Sustainability Innovation (CRHSI)
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SupportingPDF2026Award: $211.5M
NM - 2026 - Revised Budget Narrative
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PrimaryPDF2026-2027No amount extracted
NM - 2026 - Administrative Service Organization (ASO) Support RFP
Primary source
SupportingPDF2019Award: $60.0M
NM - 2019 - New Mexico FOR IMMEDIATE RELEASE: $60 million boost to Medicaid provider rates
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SupportingPDF2025Award: $10.6B
NM - 2025 - HCA FY’25 Budget Request Submission
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ReferencePDF2027-2029Award: $50.0M
NM - 2027 - New Mexico Rural Health Care Delivery Fund Stabilization Grant FY27-29 RHTP Guidance
Consolidated support doc
PrimaryPDF2027-2029Award: $50.0M
NM - 2027 - RHCDF Request for Applications (RFA)
Auto-linked process guidance fallback (23%)
SupportingHTML2025-2026Award: $211.5M
NM - 2025 - Newsroom – New Mexico Health Care Authority
Consolidated support doc
PrimaryHTMLNo amount extracted
NM - 2026 - RHTP (RHT) – New Mexico Health Care Authority
Primary source
Announcement Documents (1)
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AnnouncementHTMLEvent2026
New Mexico's RHCDF is launching a FY27-29 application cycle, with a $50M investment planned to support rural Medicaid providers across the state. The FY26-27 award cycle distributed $20M to 30 rural providers and facilities, including tribal, hospital, and behavioral health recipients. The funding aims to stabilize health care service operations in rural and high-need regions. Key contacts: hca.rhcdf@hca.nm.gov
Event schedule:
- RHCDF Application Opens - 03/16/2026 - Online
- Technical Assistance Webinar: Overview and Application Guidance - 03/17/2026 - Online
- Technical Assistance Webinar: Building a Strong Budget and Workplan - 03/20/2026 - Online
Budget: $20.0MFINANCE
Contacts
<hca.rhcdf@hca.nm.gov> - Program contact - New Mexico statewide
Core Initiatives
Stabilize operational funding for rural Medicaid providers.
Maintain quality and accessibility of health care in rural high-need areas.
Support sustainability for tribal and rural health facilities.
Award Announcement Documents (1)
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Award AnnouncementPDFEvent2023-2024
New Mexico's PCC developed a multi-year primary care transformation plan prioritizing Medicaid/rural workforce, health IT, payment reform, and health equity with an explicit budget proposed for SFY23-24. Key projects include a statewide community provider hub, a Semillas health workforce pipeline and mentoring program, and statewide data system improvements to monitor health equity and provider supply. Funding requests are tied to new Medicaid payment models, performance improvement infrastructure, and rural access initiatives directly supporting RHTP goals.
Award: $3.6M
Core Initiatives
Improve health equity statewide
Invest in primary care workforce sustainability
Advance provider payment models for quality and value
Show all initiatives (9)
Improve health equity statewide
Invest in primary care workforce sustainability
Advance provider payment models for quality and value
Expand health information infrastructure
Enhance rural primary care access
Health Equity
Payment Strategies
Health Technology
Workforce Sustainability
Application Documents (15)
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ApplicationNEWHTML2026
New Mexico HCA issued an RFP for Administrative Services Organization (ASO) services to support rural and behavioral health program administration including Rural Health Transformation Program domains. The proposals are due June 5, 2026, and submissions must be electronic via Submittable. Key contacts: Elisa Wrede Elisa.wrede@hca.nm.gov
Event schedule:
- proposal submission deadline - 06/05/2026 - 5:00 PM MT - electronic submission via Submittable
OTHER
Contacts
Elisa Wrede - <Elisa.wrede@hca.nm.gov> - Procurement Manager, HCA Strategic Planning Director - New Mexico
New Mexico HCA issues an RFP to competitively select an operator for the Center for Rural Health Sustainability Innovation (CRHSI) under the Rural Health Transformation Program, starting August 2026. The RFP emphasizes electronic submissions and strict deadline compliance. Key contacts: Nikki Swope nikki.swope@hca.nm.gov
Event schedule:
- Proposal Submission Deadline - 06/04/2026 - 5:00 PM MT - Electronic via Submittable
Guidance Documents (5)
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GuidancePDF2025-2026
New Mexico received approximately $211M in federal funding for the Rural Health Transformation Program. Five core initiatives target specialty care access, workforce development, community innovation, provider stability, and improved data infrastructure. Stakeholder input drove program design, and implementation is underway with cross-agency collaboration and regional partnerships.
Event schedule:
- Application Released (CMS NOFO) - September 2025
- Submission Deadline - December 2025
- Award Decisions Announced - December 31, 2025
- Year 1 Reporting Due - August 30, 2026
- Fund Obligation Deadline - October 30, 2026
- Healthy Horizons ASO RFP Submission Due - May 28, 2026 - 5:00 PM MST
- CRHSI Submission Due - June 4, 2026 - 5:00 PM MST
- Stakeholder Advisory Committee Application Opens - Mid-June 2026
New Mexico is offering a $50 million Rural Health Care Delivery Fund Stabilization Grant program for FY27-29. The initiative seeks to financially stabilize rural clinics, hospitals, and healthcare providers by reimbursing eligible operating losses and protecting existing rural Medicaid services. Applications must be submitted by April 19, 2026 for one, two, or three years of support; all funds are reimbursement-only, not advance grants.
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GuidancePDF2022-2023
Strategy Documents (1)
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StrategyPDF2025
New Mexico's Turquoise Care Medicaid MCO procurement outlines a comprehensive strategy to improve quality, access, and equity for Medicaid members, focusing on population health streams and addressing cultural, behavioral, and social determinants. Children in State Custody will be served by a dedicated contractor with specialized care coordination and provider network requirements. Proposed initiatives include continuous enrollment for young children, expanded home visiting, supportive housing, and traditional healing benefits for Native Americans, pending 1115 waiver renewal.
QUALITY_IMPROVEMENT · POPULATION_HEALTH · FINANCE · OTHER
Core Initiatives
Every Medicaid member has high-quality, person-centered care.
Build a New Mexico health care delivery system accessible for preventive and emergency care, supporting the whole person.
Strengthen delivery system through innovative payment reforms and value-based initiatives.
Show all initiatives (4)
Every Medicaid member has high-quality, person-centered care.
Build a New Mexico health care delivery system accessible for preventive and emergency care, supporting the whole person.
Strengthen delivery system through innovative payment reforms and value-based initiatives.
Address health disparities through strategic program changes for equity.
This document is a CMS summary of FY26 Rural Health Transformation Program state applications. States propose initiatives targeting maternal health, chronic disease, workforce development, and digital/telehealth innovation. The summaries emphasize significant rural health disparities and outline diverse state approaches to improve access, quality, and sustainability.
Core Initiatives
Expand access to care in rural communities
Strengthen rural healthcare infrastructure
Workforce development and retention
Show all initiatives (46)
Expand access to care in rural communities
Strengthen rural healthcare infrastructure
Workforce development and retention
Advance value-based care and care coordination
Support maternal, behavioral, and chronic disease health
Empower rural Mainers to achieve their own healthy living goals through expanded population health solutions
Expand the supply of care by growing a rural workforce and spreading technologies that connect every community to advanced care
Ensure care will be available and affordable long into Maine’s future by pairing affordability measures with strategies that advance quality, efficiency, and fiscal durability such as value-based payments
Transform the rural health workforce through new apprenticeships, improved IT, and expansion of Area Health Education Centers, and pipeline programs (Maryland)
Promote sustainable access and innovative care through new and expanded capacity for primary care, specialty practices, school-based health centers, and behavioral health (Maryland)
Improve healthcare access and quality in rural areas through technology and community-centered care (New Mexico)
Build a statewide network of rural healthcare hubs to expand access to care, improve healthcare outcomes, strengthen coordinating networks and provider sustainability, and empower rural communities to design and lead tailored healthcare solutions (Missouri)
Strengthen the foundation of rural health systems through integrated, community-driven solutions that expand access, modernize health information exchange, build workforce capacity, and address key community supports (Michigan)
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SummaryPDF2023-2027
This 5-year strategic plan outlines New Mexico’s roadmap to transform rural and statewide primary care, launching Medicaid payment reforms in 2024 and building primary care workforce capacity, especially in rural areas. Strategic priorities include health equity investment, primary care/behavioral health integration, EHR/data modernization, and expanded social supports and residency programs. The work is coordinated with the state’s Medicaid 1115 waiver demonstration and ongoing legislative and technical assistance activities.
The New Mexico Health Care Authority is soliciting applications for the $50 million Rural Healthcare Delivery Fund to stabilize essential rural healthcare services. Applications open March 16, 2026, with awards beginning August 1, 2026.
Award: $50.0M
Data Documents (5)
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DataPDF
New Mexico HSD partners with CHESS Health to provide the Connections App, a digital recovery tool supporting SUD treatment adherence and peer support at no cost to providers or patients. The initiative includes training providers to implement the app and engage patients in ongoing recovery support.
Core Initiatives
Engage behavioral health providers in innovative digital recovery support
Increase treatment adherence for substance use disorder
Provide peer support and technology-enabled recovery services
📊
DataXLSX2023-2027
This document outlines strategic goals for New Mexico Medicaid and primary care transformation aligned with health equity, payment reform, HIT investment, and workforce sustainability. Major initiatives include designing new Medicaid alternative payment models and investing in HIT for improved care. Implementation spans FY2023-FY2027 with recommendations for policy and fiscal change.
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DataPDFEvent2022-2023
Reference Documents (5)
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ReferenceNEWPDFEvent2026
This Q&A provides clarifications for the ASO Services RFP, especially concerning the Rural Health Transformation Program (RHTP), including domain mapping, federal compliance requirements, and applicable business preferences. It emphasizes that RHTP (Service Domain 3) is federally funded and does not apply New Mexico resident business preferences. The guidance also details requirements on system interfaces, reporting, monitoring, technology platforms, and approach expectations for scaling and oversight.
Event schedule:
- Proposal Reference Questionnaire Due Date - 05/20/2026 - 5:00 PM MST - Submittable
- Cost Proposal Submission Deadline - 05/15/2026 - Submittable
- year 1 RHTP funds obligation deadline - 2026-10-30
- proposal submission due date - 2026-06-11
QUALITY_IMPROVEMENT · FINANCE · NETWORK_DEVELOPMENT · OTHER · HEALTH_INFORMATION_TECHNOLOGY
Core Initiatives
Build scalable administrative infrastructure for the Rural Health Transformation Program
Support federal compliance and oversight of rural health delivery
Enable effective funding administration for rural Medicaid and behavioral health
Show all initiatives (4)
Build scalable administrative infrastructure for the Rural Health Transformation Program
Support federal compliance and oversight of rural health delivery
Enable effective funding administration for rural Medicaid and behavioral health
Develop reporting and monitoring tools for program oversight
📄
ReferencePDF2025
📄
ReferencePDF
New Mexico passed legislation to expand graduate medical education residency slots with priority for rural, underserved, and specialty shortage areas. An initial appropriation of $300,000 was made for the first funding round, supporting hospitals and health centers to create or expand GME programs.
Budget: $300K
Core Initiatives
Other Documents (3)
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OtherPDF2024-2025
The New Mexico Health Care Authority (HCA) will launch on July 1, 2024, consolidating several state health and safety-net programs to improve service delivery and health outcomes statewide. Special emphasis is placed on rural health: increasing provider payments, establishing a Rural Health Care Delivery Fund, and expanding rural workforce training. HCA will continue key social programs and study expanded health coverage as mandated by state law.
Core Initiatives
Ensure every New Mexican has access to health coverage and safety-net services
Increase transparency and quality in the health system
Enhance cost-effectiveness and purchasing power for health care services
Show all initiatives (4)
Ensure every New Mexican has access to health coverage and safety-net services
Increase transparency and quality in the health system
Enhance cost-effectiveness and purchasing power for health care services
Implement unified policy and strategy for health care delivery
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OtherPDF2024-2025
The document announces the launch of the New Mexico Health Care Authority on July 1, 2024, consolidating several health-related state functions for improved coordination. It also introduces the transition to the Turquoise Care Managed Care Medicaid program, aiming for enhanced access, quality, and accountability.
Core Initiatives
📄
OtherPDF2024-2026
The plan prioritizes health transformation for rural and underserved communities with new financial support mechanisms for rural health authorities and hospitals. Multiple initiatives support rural hospital viability, rural workforce, primary care access, and behavioral health infrastructure. Expands value-based care, payment models, technology upgrades, and Medicaid improvements targeting rural NM counties.
Documents predating or adjacent to the RHTP program — useful background, excluded from main activity feed.
NM - 2025 - Office of Inspector General – New Mexico Health Care Authority
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NM - 2025 - Contact Us – New Mexico Health Care Authority
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NM - 2025 - Public Information and Communications Overview – New Mexico Health Care Authority
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Source Checks
Last checked
Last changed
This document is an administrative amendment to a New Mexico RFP for ASO services covering the Rural Health Transformation Program (RHTP) and other rural/behavioral health domains. It corrects references, clarifies procurement domain numbering, updates links and submission instructions, and details evaluation, scoring, and compliance expectations for applicants. Service Domain 3 specifically governs the federal RHTP component, setting out requirements for administration, monitoring, reporting, and operational support consistent with CMS federal guidelines. Key contacts: New Mexico Health Care Authority Office of the Secretary
Event schedule:
- Issue RFP - 04/30/2026
- Acknowledgement of Receipt Form Due - 05/11/2026
- Pre-Proposal Conference - 05/11/2026
- Deadline to Submit Written Questions - 05/13/2026
- Response to Written Questions Released - 05/15/2026
- Proposal Evaluation - 2026-06-05 - 17:00 MST/MDT - New Mexico
QUALITY_IMPROVEMENT · OTHER
Contacts
New Mexico Health Care Authority Office of the Secretary - Contact Office - New Mexico
Core Initiatives
Ensure compliant administration of rural health transformation and behavioral health programs.
Support HCA in monitoring, reporting, compliance and program oversight for federal RHTP funds.
Enable operational support for payment administration, contracting, and technical assistance within the RHTP domain.
OTHER
Contacts
Nikki Swope - <nikki.swope@hca.nm.gov> - Procurement Manager - New Mexico
Award: $50.0M
Core Initiatives
Support stabilization of rural health care services by offsetting documented operating losses.
Maintain essential health care services in rural communities.
Preserve workforce and core operational functions.
The New Mexico Primary Care Clinician & Provider Transformation Collaborative aims to transform primary care payment and delivery via a statewide alternative payment model (APM), focusing on moving away from fee-for-service, improving outcomes, and supporting workforce needs. The Collaborative involves a range of primary care, policy, and advocacy stakeholders, and will provide guidance, feedback, and technical assistance during APM development and implementation. The strategy prioritizes health equity, workforce sustainability, sustainable financing, and technology improvements.
Core Initiatives
Develop and drive investments in health equity to improve the health of New Mexicans.
Develop and recommend sustainable payment models and strategies for equitable primary care.
Develop and implement health information technology improvements for seamless primary care.
Show all initiatives (4)
Develop and drive investments in health equity to improve the health of New Mexicans.
Develop and recommend sustainable payment models and strategies for equitable primary care.
Develop and implement health information technology improvements for seamless primary care.
Create a sustainable workforce, financial model, and budget to support primary care transformation.
Improve cardiometabolic health outcomes and sustain healthcare workforce expansion including recruitment and retention strategies (Minnesota)
Conduct statewide assessment of rural health needs and develop Coordinated Regional Integrated Systems (CRIS) to create a connected and data-driven network (Mississippi)
Strengthen healthcare workforce, secure financial solvency for rural providers, embed prevention and community health at the center of care, and expand technology use (Montana)
Improve access to primary and specialty care to reduce preventable ER visits and improve maternal and child health (New York)
Catalyze innovative care models, transform the rural care experience, and create a sustainable rural healthcare delivery system via coordinated hubs (North Carolina)
Rebuild and retain rural health workforce through new residencies, technology tools, and nutrition/behavioral health initiatives (North Dakota)
Make Rural Nevada Healthy Again by implementing value-based care models that prevent and manage chronic diseases and invest in workforce recruitment and infrastructure (Nevada)
Improve healthcare availability in rural New Jersey by investing in primary and specialty provider expansion, supporting CCBHCs, and fostering flexible healthcare systems through technology and mobile care (New Jersey)
Improve quality of life through access to primary and preventive care, chronic disease management, maternal health, behavioral health, and oral health with strong partnerships and technology use (New Hampshire)
Reduce chronic disease risk factors and improve access to specialty care with community-centered chronic disease and behavioral wellness initiatives (New Mexico)
Improve access to care through clinically integrated networks (CINs), community-based clinics in K-12 schools and college campuses, and mobile health care services, rural hospital improvements, and home visits.
Improve health outcomes through expansions of behavioral health services.
Improve chronic disease health outcomes such as reduced A1C and increased levels of hypertension management.
Expand technology to build remote monitoring and telehealth, expand electronic medical record (EMR) usage for pharmacists, and pilot innovative screening technologies for chronic conditions.
Build a future where every community – no matter how small or remote – has access to high-quality, locally grounded care.
Reduce preventable hospitalizations and emergency department visits year over year.
Build a resilient, digitally connected, community-anchored provider network to deliver flexible care across rural regions.
Design data-driven solutions tailored to the unique needs of rural residents.
Advance whole-person health through connected care technologies and coordinated pathways for behavioral health, chronic disease, maternal health, and social needs.
Promote sustainable access by focusing on the integration and comprehensive delivery of services leveraging technology and supporting the workforce.
Strengthen the workforce through rural clinical placements and policies that allow top-of-license practice.
Increase healthcare access and quality for improved chronic disease management and health outcomes for rural communities.
Prioritize direct investment in provider capacity over creating new programs.
Address health-related barriers to workforce participation, establishing West Virginia as a center for rural healthcare access.
Increase healthcare workforce pipeline capacity.
Make Rural Texans Healthy Again by reducing ability barriers to receive appropriate care with choice and competition.
Making Rural Utahns Healthy by promoting wellness, nutrition, physical activity, and preventative care.
Build robust rural networks through enhanced primary care and long-term care support.
Empower rural communities through food as medicine, maternal care, workforce development, technology adoption, and improving access and preventive health.
Address the state’s higher rates of substance use disorder, high hospital clinician and administrative staff turnover, and emergency room strain by expanding rural health networks and value-based payment models.
Improve the workforce, leverage technology, and improve healthcare system sustainability in rural West Virginia.
Improve care coordination, mental health support, leveraging technology, and workforce development.
Increase access to care by focusing on rural clinical workforce, leveraging technology, and right-sizing the delivery system.
Core Initiatives
Develop and drive investments in health equity across New Mexico to improve the health of New Mexicans.
Develop and recommend sustainable payment models and strategies to achieve high quality and equitable primary care for all New Mexicans.
Develop and drive health information technology improvements and investments that make high quality primary care seamless and easy for care teams and patients.
Show all initiatives (17)
Develop and drive investments in health equity across New Mexico to improve the health of New Mexicans.
Develop and recommend sustainable payment models and strategies to achieve high quality and equitable primary care for all New Mexicans.
Develop and drive health information technology improvements and investments that make high quality primary care seamless and easy for care teams and patients.
Create a sustainable workforce, financial model, and budget to support the mission and secure necessary state and federal funding.
Expansion of primary care physician residency programs to increase workforce capacity
Refinement and implementation of a new primary care payment model
Support workforce sustainability, health equity, and health technology
Enhance integrated behavioral health services within primary care
Develop leadership and governance structures to advance value-based care
Improve quality of care through value-based payment programs
achievement of structural measures and patient-centered medical home (PCMH) recognition
increase participation in advanced APMs and allow for physician alignment with hospitals under the TCOC Model
continue restructuring and re-affirm accountable, value-based care
reform and invest in primary care, health, and pediatric care that expands access and moves delivery system away from FFS health care
advance health equity, addressing health-related social needs and disparities
use data and analytics to improve performance measurement and monitoring
foster conditions needed for communities to engage in data justice and identify strengths and inequities related to structural racism and discrimination
The New Mexico RHT Plan is a comprehensive state application to CMS proposing over $1 billion in rural Medicaid hospital transformation funding with five main initiatives supporting rural access, workforce, provider stability, technology, and community partnerships. About one-third of New Mexicans are rural with high poverty, chronic illness, maternal health challenges, and many hospitals at risk of closure. Implementation will use subawards and competitive procurement, with targeting and accountability overseen by HCA and a Stakeholder Advisory Committee.
Expand access to care for rural, frontier, and tribal communities
Improve health outcomes and health equity
Advance rural provider financial stability
Show all initiatives (30)
Expand access to care for rural, frontier, and tribal communities
Improve health outcomes and health equity
Advance rural provider financial stability
Strengthen the rural health workforce
Support data-driven innovation and transparency
Make Rural America Healthy Again
Workforce Development
Sustainable Access
Tech Innovation
Access and Care Delivery Innovations
Workforce Development and Training
Data Infrastructure and Interoperability
Telehealth and Digital Health
Behavioral Health and Chronic Disease Management
Rural and Frontier Provider Stability and Sustainability
Ensuring all initiatives are implemented in alignment with New Mexico’s transformation goals and CMS requirements.
Driving measurable improvements in rural health access, outcomes, and sustainability.
Maximizing impact and avoiding duplication of existing funding streams through effective financial management.
Supporting effective implementation of rural health initiatives through coordinated operations, staffing, and resource deployment.
Building local rural health workforce sustainability through recruitment, training, and retention programs.
Enhancing specialty care access and remote care solutions to reduce travel burdens and improve chronic disease management.
Facilitating collaboration and shared services to strengthen rural provider sustainability and program impact.
Developing secure statewide analytics platforms and supporting data transparency and cross-sector collaboration.
Maintaining program integrity, facilitating collaboration, and supporting the successful implementation of the RHT Program through administrative oversight.
Administer effective and non-duplicative rural health programs
Prevent duplication, supplantation, or misuse of RHT Program funds
Expand and complement existing rural health funding streams
Provide clear funding guidance and guardrails for RHT funds
Coordinate across agencies to monitor and prevent duplication
Replicate successful programs and curricula statewide
Core Initiatives
Drive investments in health equity for New Mexicans
Develop sustainable Medicaid alternative payment models
Improve and invest in health information technology
Show all initiatives (4)
Drive investments in health equity for New Mexicans
Develop sustainable Medicaid alternative payment models
Improve and invest in health information technology
Create a sustainable workforce and financial model
New Mexico's Human Services Department and Primary Care Council are advancing an ambitious Medicaid Primary Care Alternative Payment Model (APM) to promote health equity, workforce sustainability, and health information technology. Since 2019, significant investments in Graduate Medical Education expansion have brought dozens of new and expanded primary care residencies, especially in rural and high-need areas. Strategic planning emphasizes payment reform, team-based care, and population health, aiming to reduce inequities and improve outcomes for all New Mexicans through robust partnerships and data-driven approaches.
Core Initiatives
Develop and drive investments in health equity to improve the health of New Mexicans.
Implement Medicaid investment and payment strategies aligned with PCC Mission and Vision.
Develop and drive health information technology improvements for accessible, high-quality primary care.
Show all initiatives (7)
Develop and drive investments in health equity to improve the health of New Mexicans.
Implement Medicaid investment and payment strategies aligned with PCC Mission and Vision.
Develop and drive health information technology improvements for accessible, high-quality primary care.
Sustain, diversify, and empower the primary care workforce in New Mexico.
Develop and recommend sustainable payment models and strategies to achieve high quality and equitable primary care for all New Mexicans.
Develop and drive health information technology improvements and investments that make high quality primary care seamless and easy for Interprofessional Primary Care Teams, patients, families, and communities.
Create a sustainable workforce, financial model, and budget to support our mission and secure necessary state and federal funding.
This agreement establishes New Mexico's managed care program for Medicaid eligible populations, including rural areas. It integrates value-based purchasing, quality improvement, network development, and population health management, with explicit goals to reduce cost and improve access. The contract outlines requirements for care coordination, provider payments, information systems, and supports milestones such as the D-SNP integration by January 2025. Key contacts: Lorelei Kellogg; Jon Emery
Event schedule:
- D-SNP agreement required by - 01/01/2025 - MT - State of New Mexico
- Go-Live - 2024-07-01
- Readiness review period ends - 2024-06-30
- Must obtain prior written approval of all readiness elements by - 2024-07-01
- Deadline to declare intent and timeline to achieve LTSS/HE accreditation - 2026-12-31
- Annual submission of Cultural Humility Plan (CHP) and evaluation - April 30 - New Mexico
- Contract execution with UNM Health Sciences Center – Center for Development & Disability (UNM/CDD) - September 30 - New Mexico
- Opportunity for current Medicaid Recipients to select a Turquoise Care MCO - April 2024 - New Mexico
Lorelei Kellogg - Acting Director, Medical Assistance Division, New Mexico Health Care Authority - New Mexico
Jon Emery - Acting Chief Legal Counsel, Office of General Counsel, New Mexico Health Care Authority - New Mexico
Core Initiatives
Reduce health care costs for Medicaid-eligible individuals
Improve quality of care
Improve access to care, especially for rural and vulnerable populations
Show all initiatives (66)
Reduce health care costs for Medicaid-eligible individuals
Improve quality of care
Improve access to care, especially for rural and vulnerable populations
Implement value-based purchasing and performance targets
Transition more Care Coordination functions to local resources
Advance Value-Based Payment (VBP) arrangements
Ensure timely and effective Care Coordination for Members
Promote compliance with Behavioral Health parity requirements
Provide comprehensive and integrated health care benefits
Create a statewide program for quality improvement in Nursing Facilities to measurably improve quality ratings over the term of the contract
Create a program for reduction of readmissions from Nursing Facilities to hospitals, and measurably lower readmission rates over the course of the contract
Develop Care Coordination models designed to improve maternal and child health outcomes for prenatal and Postpartum Members
Create a training program for care coordinators and Providers on appropriate Care Coordination for pregnant women who may be experiencing a high risk pregnancy or during their Postpartum period
Participate in Behavioral Health emergency planning and response to address disaster-related emotional needs
Maximize Value Based Purchasing (VBP) initiatives and advance initiatives in Turquoise Care
Ensure timely payments to all providers and maintain claims processing compliance with ICD-10
Comply with Pharmacy Preferred Drug List (PDL) requirements and ensure appropriate pharmacy benefits management
Develop reimbursement strategies to support Population Health Management.
Focus reimbursement strategies on improvements in maternal and child health outcomes.
Implement Value-Based Purchasing (VBP) to improve Member health care outcomes and quality scores.
Execute and facilitate the Primary Care Payment Reform (PCPR) payment model.
Increase the percentage of primary care spending as a proportion of total healthcare spending.
Develop and implement a Population Health Management plan to improve well-being and health outcomes through person-centered care and addressing disparities
Comply with State and federal standards for quality management and quality improvement (QM/QI)
Support Native American and Member Advisory Boards to advise on service delivery and quality
Conduct annual Member and Provider Satisfaction Surveys to assess quality, availability, and accessibility of care
Adopt and disseminate practice guidelines based on valid clinical evidence
Collect, track, trend, and report performance measures (PMs) and tracking measures (TMs) quarterly as directed by HCA
Manage Critical Incident reporting, analysis, and follow-up to improve care quality and safety
Participate fully in External Quality Review Organization audits and initiatives
Support and promote Patient-Centered Medical Home (PCMH) programs and Health Homes initiatives
Expand Provider adoption and use of Health Information Technology (HIT)
Accelerate statewide Health Information Exchange (HIE) participation
Improve Care Coordination and health outcomes for high-needs/high-cost Members
Sustain and develop capacity for the Maternal Home Visiting (MHV) program
Ensure Members receive clear, accessible, and approved Member Materials
Provide timely payments to Health Home Providers and HIE operators
Ensure nondiscrimination and accessibility in Member communications and services
Ensure compliance with Medicaid program integrity and Fraud, Waste, and Abuse prevention
Maintain financial stability and solvency of the CONTRACTOR
Protect Medicaid funds through effective oversight of overpayments and recoveries
Ensure proper reporting and prevention of fraud, waste, and abuse in Medicaid services
Maintain adequate insurance, bonds, and insolvency protection as required by law
Ensure continuity of care and minimize disruptions for CISC Members
Expand provider network and shape provider expertise to meet unique and complex needs of CISC Members
Advance evidence-based practices and standards within the Provider network
Include CISC-specific Population Health Management strategies and activities
Implement CISC-specific quality goals, practice guidelines, and Performance Improvement Projects
Include CISC program information in member materials
Design and implement Value-Based Purchasing models focused on CISC Members
Increase the number of unique Members receiving outpatient Behavioral Health Services by 25% in CY25.
Implement a Value-Based Purchasing (VBP) Strategy meeting three component areas with quarterly reporting.
Increase Telemedicine visits by 20% in Rural, Frontier, and Urban areas for Physical and Behavioral Health Specialists.
Increase the percentage of agency-based authorized personal care services delivery progressively from 88% in CY24 to 96% in CY28.
Submit biannual reports on Hepatitis C treatment, stratified by race and ethnicity, and increase pharmacy counseling claims annually.
Complete 90% of eligible Non-Emergency Medical Transportation (NEMT) trips annually.
Increase value-based payments across multiple years for Levels 1, 2, and 3
Build provider readiness and development of VBP models, especially for LTC and Behavioral Health Providers
Reduce avoidable hospital readmissions by engaging high-volume hospitals
Ensure effective member transitions from inpatient stays to home/community
Develop and implement full delegation of care coordination in Level 3 VBP arrangements
Ensure accurate payment and reimbursement for COVID-19 vaccine administration
Comply with federal billing guidelines and regulations for COVID-19 vaccines
Implement robust reporting and operational requirements for vaccine administration claims
Maintain privacy and security of health information in compliance with HIPAA and HITECH
Improve healthcare quality through measurement of defined preventive, mental health, and chronic disease care metrics
Expand graduate medical education residency positions in New Mexico
Increase rural physician training and retention
Address physician shortages in primary care and psychiatry in underserved regions
Transparency and clarity in health system performance
Oversight and accountability to enhance quality of care and health outcomes
Cost-effectiveness and proactive management of state health care funds
Show all initiatives (5)
Transparency and clarity in health system performance
Oversight and accountability to enhance quality of care and health outcomes
Cost-effectiveness and proactive management of state health care funds
Customer service through a no-wrong door approach to health care and safety-net services
Unified vision and strategy for health care service delivery and coverage
Core Initiatives
Leverage purchasing and partnerships to improve comprehensive healthcare models.
Achieve health equity by addressing social determinants and barriers.
Implement technology and data-driven decision making.
Show all initiatives (16)
Leverage purchasing and partnerships to improve comprehensive healthcare models.
Achieve health equity by addressing social determinants and barriers.
Implement technology and data-driven decision making.
Build a culture of empowerment and growth in state government.
Develop and implement a department‐wide employee training program
Provide guidance and support to employees regarding HSD policy options in order to support in‐office work
Assess Division Organizational Health Indicators and prioritize interventions needed for improved health
Complete Business Transformation Council (BTC) process redesign effort and Organizational Change Management effort
Resolve Personnel Issues and complete personnel investigations more quickly to better support employees and management
Position the IT workforce for success
Update and create bureau training materials to document required tasks and to ensure institutional knowledge is shared and retained
Realign and reclassify positions to foster internal growth, promotion and expertise while retaining institutional knowledge
Decrease Income Support Division vacancy rate to 3.5% in two years
Provide current, accessible, and fillable electronic human resources forms on TheWire (HSD employee intranet)
Develop and implement electronic tracking mechanisms to ensure timeliness and effectiveness of employee relations actions for all staff
Create a secure, comprehensive and customizable electronic hiring and onboarding process available to applicants, new employees, hiring managers, and OHR
NM - 2020 - #38 – Provider Training and Outreach Plan and Eval Instructions
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