Organization and Planning Grant Requirements

Phase One National Press Release

COMMUNITIES in CHARGE in CENTRAL NEW MEXICO

Albuquerque, NM

April 2000

               Background

New Mexico ranks last in the nation in the percentage of its population between 19-64 that is uninsured.  New Mexico has limited resources for new taxes for public services and an increase in taxes for health care is not a realistic strategy in the current political environment.  In the central New Mexico area, much of the care for the uninsured is delivered by the safety net of the University of New Mexico Health Sciences Center (UNMHSC--a public academic health center) in coordination with the Albuquerque FQHCs.  However a significant among of indigent care is also provided by the private health care systems.  Total indigent care costs for the region is estimated at between $100-200 million financed through disproportionate share funding, county indigent funds, special grant-financed programs, and a substantial amount of cost-shifting.

The central New Mexico region has four major vertically-integrated hospitals which also own or are closely affiliated with one or more managed-care plans.  The region has an extremely high rate of managed care penetration, estimated at over 60 percent.  In 1997, the state implemented mandatory managed care for approximately 200,000 beneficiaries.

Communities in Charge in Central New Mexico is a collaborative initiative for a four-county region including and surrounding Albuquerque. The Coalition represents all the major health care providers and systems in the area, the state health and human service departments, and a wide range of community grassroots organizations. The program will design a financing system for care for approximately 125,000 uninsured adults. (The program concentrates on adults, as virtually all of New Mexico's low-income children are eligible for Medicaid.)

The program design recognizes the special circumstances in the state-a political reality that new taxes for health care are not an option at this time, a very low-income population with little current access to employer-provided health care coverage, and significant opportunity to build a system of coverage for working families.  From the outset, the Coalition has included the key players to make the project work.  This includes the provider community--public and private--which includes the majority of the health care dollars, and the state Medicaid agency which controls the other major portion of the financing system, and the business community whose support is essential for project success.

The Coalition was formed in the spring of 1999, but includes many of the same members as the coalition formed in New Mexico for the Covering Kids project. The Coalition is led by a Steering Committee which includes representatives from the New Mexico Hospitals and Health Systems Association, the University of New Mexico Health Sciences Center, the state's health and human services departments, the New Mexico Health Policy Commission, the New Mexico Primary Care Association, the New Mexico Advocates for Children and Families, county government, and the business sector.

→Back to Top

       Guiding Principles

The project plans to utilize a financial strategy that reorients existing health care dollars so that they are used more efficiently while leveraging other resources.  Various financial options will be reviewed and approaches developed to improve the health care delivery system to free up funding to finance care for the uninsured, work with the business community to explore potential incentive systems for employer-provided coverage, and work with the state to leverage federal funds.  

The project will dovetail with tow other major initiatives - the UNM Care Plan and Kellogg Community Voices project of NNMHSC, a state project that addresses the uninsured.  The first uses a "health commons" approach to address coverage issues to the uninsured.  The second is directed by a legislative memorial and sponsored by the New Mexico Health Policy Commission

The Communities in Charge Coalition will serve as a critical consensus-building group in developing the financial strategies; the lead organization for the Coalition is the New Mexico Hospitals and Health Systems Association.

→Back to Top

       Initial Project Objectives

→Back to Top

        Financing & Outreach Strategy

Financing Strategy

Rather than constructing a single financing solution for the uninsured, a variety of mechanisms will be pieced together.  The project will seek to reallocate existing health care dollars being spent on behalf of the uninsured and will also explore options for leveraging additional federal and state resources, including cost-neural Medicaid waiver options.  The project will also investigate potential business/employer incentives that could be designed to improve employer-subsidized coverage.

Outreach Strategy

The membership of the Coalition includes the state's major health care advocacy groups.  These groups will take the lead in designing strategies to communicate with and involve the uninsured in the development of outreach strategies.  The Coalition plans particular targeting efforts through church organizations, labor organizations, and other existing grassroots organizations.  New Mexico has been creative and successful in its outreach strategies for Medicaid and SCHIP.

Delivery System

The anticipated network and delivery system design will build off the experiences of the UNM Care Plan which has developed linkages between UNMHSC the FQHSs, dental providers, public health services, social services, and case management services.  This project will allow expansion of this model to the private provider system to create a more seamless and integrated system between the public and private sectors.

→Back to Top

       Challenges

→Back to Top

       Demographics

Geographic Area: Four counties in central New Mexico including the Albuquerque area; a mix of urban, suburban, and rural counties

Total Population: About 700,000; over 1/3 of the state's population

Uninsured Population: 125,000 adults

Target Segment: Uninsured adults below 235 percent of the federal poverty level (Virtually all uninsured children in New Mexico are eligible for Medicaid or SCHIPS, which covers children in families with incomes up to 235 percent of the FPL).

       →Back to Top

        Contact Us

Maureen Boshier
President & CEO
New Mexico Hospitals & Health Systems, Inc.
2121 Osuna Road NE
Albuquerque, NM 87113
Phone: (505) 343-0010
Fax: (505) 343-0012
E-mail:  mboshier@nmhhsa.org

        →Back to Top  

 Communities In Charge 2002 is a program of The Robert Wood Johnson Foundation.
E-mail Webmaster with comments: Webmaster@mx.com Last Modified:10/2002