New Mexico Medical Review Association

This report conveys the findings of the Independent Assessment of the quality, access, and cost-effectiveness of health care services delivered under the New Mexico Medicaid Managed Care program, Salud! This report fulfills the requirement of the Centers for Medicare and Medicaid Services (CMS) that state Medicaid authorities arrange for an independent assessment of a state’s 1915(b) waiver programs. The Lewin Group has reviewed the quality- and access-related state contractual requirements, each Salud! health plan’s quality improvement program, member and provider survey activities, HEDIS® and CAHPS® performance, provider network, and member materials, and various financial reports. The State of New Mexico has created a favorable environment for quality, access, and cost-effectiveness to occur in each of the three MCOs. Thus, the program clearly meets CMS guidelines and requirements in terms of quality, access, and cost-effectiveness.

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