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MANAGEMENT UPDATE.

A BIG NEW MEXICO INVESTMENT IN NEED OF DATA

New Mexico has invested over $2.4 billion in provider care increases for its Medicaid system since 2022 – a hefty sum which has led to some of the highest rates in the region.


“Yet, three years into the largest Medicaid rate investment in state history, the state does not have the data to determine whether access is improving, ”according to information released from the New Mexico Legislative Finance Committee on May 19, 2026. “Managed care network adequacy reports have now been revamped, and behavioral health spending per member grew significantly between 2021 and 2025 while the state cannot say whether more or fewer clients are receiving more or less care.”



Bottom line according to the Committee: “Whether the investment is working remains an open question, and the state currently lacks the tools to answer it. What data exists paints an incomplete picture, and it is still too early to draw conclusions.”


This isn’t the first time the Legislative Finance Committee has expressed concern about the state’s Medicaid program, with lots of questions raised but limited data providing performance information.  


Back in September of 2025, the Committee found that:


  • Per-member per-month costs for both behavioral health and long-term support services have increased significantly. 


  • Medicaid enrollees have less access than they did three years ago. 


  • Increases in utilization are apparent for both physical and behavioral health. Outcomes, however, have not kept pace. 


  • Administrative aspects of Medicaid—in particular, the implementation of the Medicaid management information system replacement—remain an issue.


Back then, Allegra Hernandez, senior fiscal analyst with the Legislative Finance Committee was quoted as saying in the New Mexico Political Report that “Despite significant investments that you all, as the legislature, have made in behavioral health and in Medicaid more broadly, the systems are not improving for users in the way that we would expect and hope with these investments, and moreover, spending has increased significantly, and these payoffs are not yet demonstrated to have shown up.”


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