ABOUT THE DEPARTMENT
We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Medicaid Primary Care Payment Reform
Eligibility screening and registration for New Mexico’s Medicaid Primary Care Payment Reform VBP Program has launched! Please visit this page to complete the eligibility screen: https://nmpcpr.nethealth.com/screening-eligibility. Read all instructions carefully; the option you select from the initial drop-down menu should reflect your Medicaid billing provider type. Supported browsers for eligibility screening and registration are Microsoft Edge and Google Chrome.
Eligible practices will be directed to next steps for registration (you may review here prior to beginning registration).
It is expected that all primary care practices in the state participate. The registration deadline to participate in Q1 and Q2 of the PCPR VBP Program (July-Dec 2024) was October 14th. Practices that register between now and December 31st at 9:59pm will be considered participating, and eligible for the incentive bonus payments, as of January 1st, 2025.
This is a great opportunity for practices to receive additional payments for serving your Medicaid patients!
Join the New Mexico PCPR Contact List
New Mexico PCPR VBP Program – Provider One-Pager
PCPR VBP Program Eligibility Screening
Contact Joshua Nelson (joshua.nelson@hca.nm.gov) Strategic Operations Manager, or Health Management Associates (NewMexicoPCPR@healthmanagement.com) if you have questions regarding the Medicaid PCPR VBP Program that are specific to your primary care practice, including questions related to quality reporting and data submission.
Submit feedback or questions related to the design of the Primary Care Payment Reform HERE
Primary Care Payment Reform Trainings and Events
UPCOMING EVENTS:
Second Quarter Virtual Structural Measure Planning Meetings:
As part of the criteria to qualify for the second quarter bonus payment, a representative from each primary care practice must attend ONE Structural Measure Planning Meeting.
These are focus group-style convenings to solicit provider feedback as we design the Patient Experience of Care and SBIRT measures to be applicable to primary care practices in New Mexico.
All sessions will cover the same material and practices only need to attend one virtual session.
Register Now! Second Quarter Virtual Structural Measure Planning Meetings:
December 2, 2024, 11:00 a.m. -12:30 p.m. – Register Here
December 5, 2024, 9:00 a.m.- 10:30 p.m. – Register Here
OFFICE HOURS:
We concluded the calendar year 2024 Office Hours series on 11/20/2024. We intend to restart Office Hours sessions in calendar year 2025.
NM PCPR Information and Resources for Data Collection and Reporting
Please note: Materials in this section contain the most current guidance for PCPR VBP Program data collection, submission, and analysis. As the program continues to evolve, documents in this section will be updated and should be considered your source of truth for the payment model. Information shared in previous presentations and materials was considered preliminary and subject to change.
- Requirements for PCPR VBP Program Registration
- Defining Primary Care Practice: Criteria for Inclusion in the Payment Model
- PC Checklist Redesigning Workflows for VBP
- NM PCPR Roadshow Report, June 2024
- New Mexico PCPR Provider Guidebook – coming soon
- New Mexico PCPR MCO Guidebook – coming soon
Video: Overview of the NM Primary Care Payment Model
Presented by HCA and hosted by the New Mexico Medical Society
Please note: The PCPR VBP Program has evolved over the past two years as a result of provider input, legislative and regulatory requirements and changes, and implementation logistics. As a result, information included the recording below may be outdated. Please refer to materials in the “NM PCPR New Resources for Data Collection and Reporting in SFY2025, Q1″ section for the most current information on data submission.
Materials, Recordings & Resources
Please note: The PCPR VBP Program has evolved over the past two years as a result of provider input, legislative and regulatory requirements and changes, and implementation logistics. As a result, information included in some of the recordings and materials below may be outdated. Please refer to materials in the “NM PCPR New Resources for Data Collection and Reporting in SFY2025, Q1″ section for the most current information on data submission.
Office Hours, November 20, 2024- New SBIRT Structural Measure Update!
Slide Deck – coming soon
Office Hours, November 6, 2024- Data Reporting Reminders
Office Hours, October 23, 2024- Overview of Q2 Structural Planning Meetings
Office Hours, October 30, 2024- Recap of data received during Q1 PE & SBIRT Planning Meetings
Office Hours, October 2, 2024- Eligibility Screening & Registration Demonstration
Office Hours, October 16, 2024- Q1 & Q2 Reporting
Office Hours, October 9, 2024- Eligibility & Registration Process
Office Hours, September 25, 2024- Registration and FAQs
Office Hours, September 11, 2024
Office Hours, September 4, 2024
Office Hours, September 18, 2024- Registration Launch
Office Hours, August 21, 2024 – Payment Calculation Plan Overview
Office Hours, August 28, 2024 – Frequently Asked Questions
Office Hours, July 31, 2024 – Patient Visits Data Collection
Office Hours, August 14, 2024 – Q1 Data Collection & Submission
Net Health Portal Demonstration and Q&A Session- July 26, 2024
Office Hours, July 24, 2024 – Patient Experience Planning Meetings
Report: New Mexico PCPR Provider Workshops Summary
Updated Eligibility, Intake, and Onboarding Process & Patient Experience Measure Update
Office Hours, July 17, 2024 - SBIRT
New Mexico PCPR: Virtual Provider Readiness Workshop
Report: New Mexico Primary Care Payment Reform Provider and Clinician Readiness Assessment
Office Hours, June 12, 2024 Slide Deck
Provider Readiness Webinar: Preparing your Practice for Redesigning Your Workflows for Value-Based Care
Primary Care Practice: Criteria for Inclusion in the PCPR
Primary Care Practice- Criteria for Inclusion in the Primary Care Model for Incentive Payments
Primary Care Provider Webinar: PCPR - Collecting and Reporting Quality Data Part 2 (5.1.24)
Office Hours, August 7, 2024 – Readiness Checklist & PCC Website Guide
Primary Care Provider Webinar: PCPR - Collecting and Reporting Quality Data Part 1 (3.20.24)
Primary Care Provider Webinar: PCPR - Internal Reporting Infrastructure (2.21.24)
- Recording of 2/21/24 webinar: Internal Reporting Infrastructure
Primary Care Provider Webinar: PCPR - Measurement Framework in Depth (1.18.24)
- Recording of 1/18/24 webinar titled Measurement Framework in Depth: Measurement Framework in Depth
Webinar Recording: - Data Collection, Analysis, and Reporting (7.2.23)
Recording of 7/20/23 webinar titled Data Collection, Analysis, and Reporting: Data Collection, Analysis, and Reporting Capabilities