On October 19, we were honored to have Superintendent of Insurance Russell Toal as our featured speaker for the second installment of our fall Health Security Plan Design Series.
The Office of the Superintendent of Insurance is overseeing this first year of the Health Security Plan design process, and Supt. Toal updated us on what his office has been doing and what we can expect for the remainder of the year. We had 50 people from all over the state join us for the meeting, including four legislators.
Supt. Toal outlined the issues being researched this year, and he noted that the goal is to be able to share the results of that research before the 2022 legislative session begins.
You’ll be hearing more about the legislature in the coming months—our goal for this session is to make sure that funding to continue this important process is included in next year’s state budget. And, of course, we’ll need your help!
The Superintendent described three of this year’s four priority research areas. The fourth, an analysis of key research needed in the future, is being undertaken by an expert from New Mexico State University.
Research Issue #1
Research on federal laws and waivers applicable to the Health Security Plan is being completed by experts at George Washington University. Their analysis will explore what the laws say, what waivers are available and how they could be used, and how these federal laws and waivers might shape the Health Security Plan’s design.
Research Issue #2
Research on provider payment options is being undertaken by experts from Columbia University and Rutgers University. They are analyzing payment models and methodologies used in other countries and states and will also be gathering input from health care providers. Their report will encompass such areas as policies and models for pricing health care services, utilizing US and international models; integrating lessons from US and international experiences; and proposed benchmarks.
Research Issue #3
Research on hospital global budgets is being done by New Mexico and national experts. They will provide an overview of global budgeting, examples from other countries/states, opportunities and challenges, and other key topics. Their report will address feasibility and implementation barriers and also provide recommendations.
New Mexico has an opportunity to receive multi-year funding from the Centers for Medicare & Medicaid Services (CMS) to develop a global budget system, an approach that has been very successful in Maryland. (For more on Maryland’s system, take a look at last week's New York Times article “A $1,775 Doctor’s Visit Cost About $350 in Maryland. Here’s Why.”)
Much of the meeting was spent answering participants’ questions. One issue that was raised was getting additional funding to continue the design process. Supt. Toal noted that the two main Health Security sponsors (Rep. Debbie Armstrong and Sen. Jerry Ortiz y Pino) “seem optimistic that the legislature will continue to fund research that’s going to be necessary, and that really is critical to be able to answer the questions that have been posed over the years.”
There were also very encouraging comments from attending legislators:
“It’s really great to see folks looking at innovative ways to solve problems in a poor state in the area of health care.” – Rep. Marian Matthews
“This discussion just points up the need we have to keep going; we can’t stop. . . . We have a lot of money this year. So if money is needed for a piece of this, this is the year to ask in the 30-day session.” – Sen. Liz Stefanics
“If there are some opportunities to take advantage of some of this one-time money, we need to do that.” – Sen. Harold Pope Jr.
We want to thank Supt. Toal and his staff (particularly project manager Colin Baillio) for the significant time and energy they are devoting to the Health Security Plan design phase.
For more details, watch the recording of the meeting.
The first meeting in this series, with Rep. Armstrong and Sen. Ortiz y Pino, is also available online.
Up Next: Paying Our Health Care Professionals
The next topic in our fall Health Security Plan Design Series is provider payments. This issue will be divided into two sessions, with the first session focusing on how health care professionals get paid now, and the second session presenting a variety of other payment options, drawn from other countries and systems.
Welcome!
A big welcome to our newest member organizations, the New Mexico Psychological Association and the State Psychologist Association of New Mexico!
If your organization is interested in becoming a member of our coalition or would like a presentation to their board or membership, please email us.