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. Registration is mandatory by October 14th at 9:59pm MDT to be eligible for the Q1 and Q2 (July-Dec 2024) incentive bonus payments. This is a great opportunity for practices to receive additional payments for serving your Medicaid patients. Take advantage of this opportunity by meeting the registration deadline of October 14th at 9:59pm MDT!
- Practices that register by October 14th will be eligible for the Q1 (July-Sept 2024) and Q2 (Oct-Dec 2024) bonus payments.
- Practices that register after October 14th will not be considered participating, and therefore not eligible for quality bonus payments, until Q3 (Jan-Mar 2025).
Join the New Mexico PCPR Contact List
New Mexico PCPR VBP Program – Provider One-Pager
PCPR VBP Program Eligibility Screening
Submit feedback or questions related to the Primary Care Payment Reform HERE
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.
Primary Care Payment Reform Trainings and Events
Submit feedback or questions related to the Primary Care Payment Reform HERE
UPCOMING EVENTS:
First Quarter Virtual Structural Measure Planning Meetings:
As part of the criteria to qualify for the first quarter bonus payment, a representative from each primary care practice must attend ONE Patient Experience and Screening, Brief Intervention, and Referral to Treatment (SBIRT) 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.
Last Chance! October 24, 2024, 12:30-2:00 p.m. – Register Here
To review the additional criteria that must be met to qualify for a first quarter bonus payment, please see the data submission documents in the “NM PCPR New Resources for Data Collection and Reporting in SFY2025, Q1” section.
Save the date! Second Quarter Virtual Structural Measure Planning Meetings:
November 14, 2024, 1:00 p.m.- 2:30 p.m. – Register Here
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:
Office Hours are hosted every Wednesday at 12:00 p.m. This is an opportunity for stakeholders to ask questions about the PCPR VBP Program. You may drop in as your schedule allows, but please note that the first few minutes of each session typically include recent updates.
Weekly, July 10th – November 27th 12:00-12:30 PM – Register Here*
*Please note that we have extended Office Hours sessions through November! Please ensure they were added to your calendar accordingly.
NM PCPR Information and Resources for Data Collection and Reporting in SFY2025, Q1
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.
The Q1 reporting period is October 1st-October 31st (previously Oct 1st-14th). We are extending the first data submission and attestation period to allow practices sufficient time for registration, onboarding, and training.
All practices that register by October 14th will meet Q1 data submission requirements for Third Next Available Appointment (TNAA) and patient visits through completion of their onboarding test data submission task:
- For TNAA, practices will use the TNAA Data Collection Template (below) and may submit data collected throughout the quarter or complete a point in time collection (i.e., follow the steps under “How to Measure and Record the Data” in the TNAA data submission document (below) at any time the practice chooses).
- For patient visits, practices will use the Patient Visits Data Collection Template (below) and may submit data collected throughout the quarter or for the most recently completed month.
To meet Q1 data submission requirements for the Screening, Brief Intervention, and Referral to Treatment (SBIRT) and patient experience of care measures, practices must submit answers to questions about their current practices during onboarding, attend one Structural Measure Planning meeting, and complete attestation to these activities during the October 1st– 31st data submission period.
- NEW! 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 Patient Visits Data Collection Template
- NM PCPR TNAA Data Collection Template
- Net Health NM PCPR Provider Data Collection TNAA
- Net Health NM PCPR Provider Data Collection Patient experience
- Net Health NM PCPR Provider Data Collection Patient Visits_
- Net Health NM PCPR Provider Data Collection_SBIRT Measure
- Net Health NM PCPR MCO Data Collection Data Reporting Standards Measures
- Net Health Encounter Acceptance Rate File Technical Specifications
- NM PCPR Roadshow Report, June 2024
- New Mexico PCPR Provider Guidebook, Summer 2024 Update – coming soon
- New Mexico PCPR MCO Guidebook, Summer 2024 – coming soon
- New Mexico PCPR Provider Video, Summer 2024 – 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, October 16, 2024
Office Hours, October 9, 2024
Office Hours, October 2, 2024
Office Hours, September 25, 2024
Office Hours, September 18, 2024
Office Hours, September 11, 2024
Office Hours, September 4, 2024
Office Hours, August 28, 2024 – Frequently Asked Questions
Office Hours, August 21, 2024 – Payment Calculation Plan Overview
Office Hours, August 14, 2024 – Q1 Data Collection & Submission
Office Hours, July 31, 2024 – Patient Visits Data Collection
Office Hours, July 24, 2024 – Patient Experience Planning Meetings
Net Health Portal Demonstration and Q&A Session- July 26, 2024
Office Hours, July 17, 2024 - SBIRT
Report: New Mexico PCPR Provider Workshops Summary
Report: New Mexico Primary Care Payment Reform Provider and Clinician Readiness Assessment
Updated Eligibility, Intake, and Onboarding Process & Patient Experience Measure Update
New Mexico PCPR: Virtual Provider Readiness Workshop
Provider Readiness Webinar: Preparing your Practice for Redesigning Your Workflows for Value-Based Care
Office Hours, June 12, 2024 Slide Deck
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