The Health Care Authority has partnered and collaborated with New Mexicans to create a payment reform specific to the needs of New Mexico. Our aim is to provide High Quality, Equitable Primary Care to all New Mexicans.

Eligibility screening and registration for New Mexico’s Medicaid Primary Care Payment Reform Value-Based Payment (PCPR VBP) Program is open! 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). 

In-state and Border primary care clinicians and practices (PCP) providing services that are rendered within 100 miles of the New Mexico state border (Mexico excluded) are eligible to participate in the NM PCPR VBP Program.  Out-of-state PCP services that are rendered in an area more than 100 miles from the New Mexico border (Mexico excluded) are not eligible to participate.

It is expected that all primary care practices in the state participate. Practices that register by March 31, 2026 at 9:59pm are considered participating, and eligible for the incentive bonus payments, as of April 1, 2026.

This is a great opportunity for practices to receive additional reimbursement for serving your Medicaid patients!

Helpful Resources:

• PCPR VBP Program Provider Guidebook
• PCPR VBP Program MCO Guidebook
• Join the New Mexico PCPR Contact List
• New Mexico PCPR Provider FAQ
• New Mexico PCPR MCO FAQ
• New Mexico PCPR VBP Program – Provider One-Pager
• PCPR VBP Program Eligibility Criteria
• PCPR Implementation Checklist

Contact Trisstin Maroney, M.D., Innovation Program Manager (trisstin.maroney@hca.nm.gov)  or Health Management Associates (NewMexicoPCPR@healthmanagement.com) if you have questions regarding the Medicaid PCPR VBP Program, 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:

Helping Primary Care Practices Succeed: PCPR VBP Program Winter Conference

We are excited to announce a Winter Conference that will support practices in understanding and implementing value-based care models, connect you with resources that can support population health efforts, and celebrate your contributions to Medicaid transformation in New Mexico. This is a great opportunity to learn how your practice can succeed, whether you are already registered or considering signing up.

• When: Thursday, March 5 from 8:00 a.m. to 5:00 p.m.
• Where: Embassy Suites by Hilton Albuquerque, 1000 Woodward Place Northeast, Albuquerque, NM 87102
• Who: Primary care clinicians, clinic administrators, care coordinators, and health system leaders who are currently participating in, considering participation in, or seeking a deeper understanding of the NM PCPR VBP Program are all encouraged to attend!
• Register Here!

Office Hours:

Virtual Office Hours take place every other Wednesday at noon. This is a great opportunity to get your questions answered by the PCPR VBP Program team Register Here!