New Mexico has been known for having a large population that uses Medicaid, with nearly 50% of its citizens in need of assistance for health insurance coverage. These services make health care attainable to those who would otherwise not have access to care at all.
However, like many state agencies, the Medicaid Assistance Division has very lean staffing and little time for policy analysis and programmatic planning to best serve our unique population.
In 2020, the Center for Health Policy – housed within The University of New Mexico’s College of Population Health – was formed to fill that gap. The Center’s design follows a tested template that has been deployed by 27 other universities in the U.S. to provide health policy recommendations to Medicaid agencies.
Right from the beginning, the Center for Health Policy was tasked with four projects:
- Health Care Access Survey
A survey was needed to look at the at the difference between people that received Medicaid, had private insurance coverage, or had no coverage in the state of New Mexico. Professor Gabe Sanchez, who holds the Robert Wood Johnson Endowed Chair in political science, agreed to work on the project with the Center for Health Policy. - Preferred Drug List
With only one pharmacist on staff, Medicaid needed help creating a preferred drug list to assure the best drug benefit at the best prices. The Center tapped into resources at the College of Pharmacy, asking Associate Dean Melanie Dodd and Professor Melissa Roberts, who has extensive experience in the drug industry, to work on the project. - Social Determinants of Health
Working with Shannon Sanchez-Youngman, PhD, the Center looks at how social determinants may influence medical service utilization and outcomes. Social determinants of health include external factors that impact health. For example, they could impact access to grocery stores, public transportation or quality housing. This can help to identify key factors that may be addressed to prevent reoccurring problems. - Parent Training
It has been found that many people seeking medical services for their children have issues that could be managed at home. Further, an overwhelming number of people simply do not know how to care for the complex problems their children presented and were asking for help. They also need an understanding of basic requirements, like feeding children, clothing them, making sure they get up and go to school, etc., in addition to addressing the complex problems. Home visitation was set up for these parents. Sanchez-Youngman has been tasked with examining home visiting models that are currently in use in New Mexico as well as considering the likelihood of success of other models in the context of New Mexico’s unique challenges.
I take great pride in contributing to the Center’s goal of supporting goal of supporting the Center for Health Policy in improving health outcomes for New Mexicans, I am committed to making a positive impact in the field of health policy.
More projects have already been identified for a phase two plan of the Center for Health Policy’s work. These projects were identified while working with new Medicaid Medical Director, Alanna Dancis, CNP, who came on board in late 2022.
“Dr. Dancis is passionate, and very high-energy,” said Robert Frank, MD, the Center’s director. “She opened the floodgates for our work.”
Dancis, a nurse practitioner who holds a doctorate in nursing administration, brings unique vision to her role, which has usually been filled by an MD. She is able to identify problems and needs from a very hands-on point of view, Frank said. The new projects she’s identified will look at workforce shortages, workforce compensation and lowering barriers to career entrance (such as potentially hiring technicians to supplement the workforce).
The Center then hired Amber Dukes, PhD, MPH, as senior program manager for the Center for Health Policy. Dukes was hired just in time to work with the new medical director, “like a firewoman with a hose” on the issues that poured in, Frank said.
“I take great pride in contributing to the Center’s goal of supporting goal of supporting the Center for Health Policy in improving health outcomes for New Mexicans,” Dukes said. “I am committed to making a positive impact in the field of health policy.”
Another new plan is the Behavioral Health Core project. Carli Bonham, MD, a psychiatrist and professor in the UNM Department of Psychiatry, has been working with the UNM School of Medicine Division of Community Behavioral Health on Medicaid issues. Bonham has assembled a talented team of data analysts and statisticians that can really get into the complicated Medicaid data and analyze what’s going on with people who are in contact with the behavioral health system.
The goal of this project is to build capacity towards eventually having a data warehouse where this data can be stored and treatment across state agencies can be followed. The short-term goal is to create a series of policy briefs, examining aspects of behavioral health in New Mexico, including its intersection with the criminal justice system.
As a policy analysis and recommendation provider, the Center is paid for by Medicaid. But health care compensation is tricky at best. Simply put, the federal government will pay on average $50 for every $100 of approved administrative fees (the policy services the Center provides), leaving a 50% shortfall to the University.
Frank said he’s been working to close that gap, along with the Center’s consulting partners, Sellers Dorsey, a national policy firm specializing in issues related to Medicaid.
With a focus on the future, the Center for Health Policy is beginning to impact the health care of almost half the New Mexicans in the state. Many significant challenges remain to be addressed. The Center needs more staff to assist Dukes to help support these projects.