Policy Solutions

The New Mexico Health Care Association takes a very active role on behalf of all its members to represent, protect and further the interests of long term care providers and the residents and family members they serve.

With the knowledge of long term and post-acute care professionals participating in the Association's member-driven committee policy development process, NMHCA is offering solutions to the state legislature and governor's office that can advance the profession and further enhance the lives of our residents.  

Ranging from legislative initiatives, to regulatory reforms, to innovative new programs, NMHCA and its members strive to improve lives by delivering solutions for quality care.

Payment & Managed Care

Introduction

Medicaid accounts for 65.7% of the payer breakdown in New Mexico nursing home facilities, which is higher than the national average. A 2016 Legislative Finance Committee Program Evaluation report stated “as the cost of nursing home care rises, Medicaid and other patient revenues are not keeping up.” Additionally, nursing facilities have suffered in recent years from heightened regulatory burden, low reimbursement rates, and low census, all of which are resulting in dangerously thin margins. MedPAC reported that in 2016, skilled nursing facilities had a razor-thin all-in margin of 0.7% down from 1.6% in 2015.

As a result, the New Mexico Health Care Association supports measures that help ensure access to healthcare and health care coverage for New Mexicans, maximize federal funds, are sustainable, transparent,provide system and efficiencies, and which promote a strong and high-quality health care provider system and workforce.

Priority Policy Solutions

NMHCA supports increased base reimbursement rates that consider the rising cost of labor, as well as local, state, and federal mandates;

NMHCA supports enactment and implementation of a provider fee mechanism to access and leverage additional federal funds for long term care providers; and

NMHCA supports meaningful involvement of nursing facilities in the design and implementation of any Medicaid value-based purchasing system;

NMHCA supports a system whereby Medicaid applicants for long term care whose applications are beyond the 90-day deadline, will be given a presumptive eligibility, including for payment.

Legal & Liability