SANTA FE, N.M. (AP) – Spending on federally subsidized Medicaid health care across New Mexico has surged to an all-time high as the coronavirus pandemic throws more people of all ages into poverty, state program analysts and health officials said Wednesday.
An independent evaluation of the state’s flagship managed care program for Medicaid insurance found that enrollment is surging to new heights, adding more than 52,000 people to the state’s “Centennial Care” program that serves about 80% of New Mexico’s Medicaid patients.
It’s the largest surge in enrollment since New Mexico expanded Medicaid in 2014 to include more people on the cusp of poverty under the Affordable Care Act.
“Medicaid enrollment increases as the economy is worsening — so not surprising,” said Jacob Rowberry, a program evaluator for the budget and accountability office of the Legislature.
He added: “There are typically 665,000 people that were part of the Centennial Care program before the pandemic. As of last month, there were 741,000 members.”
Utilization of medical services has decreased since the start of the pandemic in March. That could spur the state to try to recover some costs from managed care organizations over the next two years, though state officials at the Human Services Department say their cost recovery options are limited.
“This is not unique to New Mexico by any means,” Rowberry said. “Nationally, we also saw significant health care decreases during the pandemic era. And I think all Medicaid offices as well as commercial carriers are all trying to really understand how the pandemic is currently impacting health care utilization.”
Costs of the state’s principal Medicaid program are expected to climb to $5.8 billion during the current fiscal year that started in July 2020 and ends next June, up from $5.2 billion during the previous fiscal year.
Those expenses are largely underwritten by the federal government, though New Mexico’s general fund is likely to pay out $1 billion.
Human Services Secretary David Scrase, attending Wednesday’s hearing of the Legislative Finance Committee by webcast, said that recent increases in the state’s per-person Medicaid payment rates to medical providers is a “small part of cost trends in Medicaid” and that his agency is focused on obtaining more federal money amid the pandemic.
“We see our role in Medicaid is to leverage every federal dollar we possibly can. And we’ve been busy at that,” he said.
The new evaluation also found that the state’s main Medicaid program spends more than $100 million on so-called care coordination, though results are unclear. Coordinated care involves personal interviews, assessments and referrals of patients to specific medical services aimed reduce health risks.
“Significant resources have been dedicated to these efforts without tracking associated health outcomes,” the report stated.
State Medicaid Director Nicole Comeaux defended the state’s approach to care coordination.
Since 2018, she said a focus has been placed on patients with acute needs, such as high risk pregnancies, at crucial times — such as when patients move home from hospitalization. Assessments of health conditions with fewer risks have been scaled back.
“We should zero in on those individuals with higher acuity issues,” Comeaux said. “And that is where we will truly find savings as a state.”
New Mexico’s rates of poverty and Medicaid enrollment rank among the highest in the nation.
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