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). 

It is expected that all primary care practices in the state participate. Practices that register by June 30, 2025 at 9:59pm are considered participating, and eligible for the incentive bonus payments, as of July 1, 2025.

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

Helpful Resources:

• 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, MD, 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 that are specific to your primary care practice, including questions related to quality reporting and data submission.

Submit feedback or questions related to the design of the Primary Care Payment Reform HERE.

UPCOMING EVENTS:

NEW! In-Person Workshops

WE ARE COMING TO A CITY NEAR YOU! JOIN US!

Register now for upcoming in-person workshops:

• June 16 in Las Cruces, La Clinica de Familia Administrative Building
• Location: 385 Calle de Alegra, Las Cruces, NM 88005
• REGISTER HERE
• June 17 in Albuquerque, New Mexico Health Care Authority ABQ Office
• Location: 5700 Pasadena Ave., Albuquerque, NM 87113
• REGISTER HERE
• June 18 in Santa Fe, New Mexico Health Care Authority Headquarters
• Location: 33 Plaza La Prensa Santa Fe, NM 87507
• REGISTER HERE

NEW! Patient Experience of Care Webinar

REGISTER HERE

The patient experience of care measures for the Primary Care Payment Reform Value-Based Payment Program have been announced. The program will be using a Net Promoter Score-like measure for adult and pediatric patients. Attend this webinar to learn more about the measure, how the data will be collected and reported, the timeline for implementation, and how you can use the data to improve your patient satisfaction scores. Attending this webinar live or watching a recording will serve as the performance measure requirement for the second quarter.

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!