We need to bolster funding for patients and the providers who deliver care and services to the most vulnerable New Mexicans and help rebuild and protect New Mexico’s health care delivery network. This is particularly urgent in areas for providers of behavioral health and primary care, dental services and teleconsultation services for Medicaid clients.
Medicaid rates to physicians and others were not adjusted for inflation by the previous New Mexico administration, resulting in some rates falling to 70% of the Medicare fee schedule used to reimburse practitioners. This increase is also necessary to recruit and retain more providers, a goal we have been implementing at Rehoboth McKinley Christian Health Care Services in Gallup. Our Rural Residency Development Program includes a Family Medicine Residency program for medical students from this region to address the chronic shortage of primary care physicians in rural areas.
This type of initiative should also be considered by other hospitals statewide for the benefit of residents and to attract practitioners. Healthcare in rural areas like Gallup is important to the area’s development and growth. Businesses, education facilities and consumer enterprises all rely on community development, and one of the pillars of growth is good medical care.
Rural health benefits
In addition to attracting medical professionals, the governor’s Medicaid plan will also help rural communities’ behavioral health efforts. Many Medicaid-covered behavioral health services are not reimbursed by Medicare. The overall average percentage of the behavioral health outpatient rate increase is approximately 30%. By raising these payment rates, the state’s health services department will bolster its network of behavioral health providers across New Mexico. Outpatient behavioral health services that are currently above 90% of the 2019 Medicare fee schedule will remain unchanged.
Additional research will be conducted in consultation with providers to analyze Medicaid behavioral health rates and determine where further rate adjustments may be needed. The anticipated annual fiscal impact for this increase is estimated to be $58.6 million total in state and federal funds combined, with a state general fund impact of $12 million.
Another beneficiary to rural residents will be an increase in reimbursement rates paid under the Centennial Care program to New Mexico’s not-for-profit community hospitals, which are often located in rural areas. This increase will ensure that payments are adequate to help cover certain business and operating expenses, to account for lower economies of scale at these not-for-profit facilities, and to aid these hospitals in reinvesting in the health of their local communities.
Residents and medical professionals can review the governor’s Medicaid plan at https://www.hsd.state.nm.us.
David Conejo is president of the New Mexico Rural Hospital Network and a board member of the New Mexico Hospital Association.