SENATE MEMORIAL 70

50th legislature - STATE OF NEW MEXICO - second session, 2012

INTRODUCED BY

John M. Sapien

A MEMORIAL

REQUESTING THE CHILDREN, YOUTH AND FAMILIES DEPARTMENT, THE AGING AND LONG-TERM SERVICES DEPARTMENT, THE DEPARTMENT OF HEALTH AND THE HUMAN SERVICES DEPARTMENT TO COLLABORATE IN CREATING A STATEWIDE PILOT PROJECT TO DEMONSTRATE CLINICAL AND TECHNOLOGICAL EFFICIENCIES IN THE DELIVERY OF HEALTH CARE TO MEDICAID RECIPIENTS LIVING WITH MULTIPLE HEALTH CONDITIONS.

     WHEREAS, New Mexico faces sharply increased medicaid enrollment in future years; and

     WHEREAS, the state's cost for supporting the medicaid program is expected to increase proportionately; and

     WHEREAS, the state cannot continue to support the cost of medicaid without finding ways to provide health care services more efficiently, with improved health outcomes; and

     WHEREAS, a relatively small percentage of medicaid recipients who are living with multiple health conditions account for a disproportionate percentage of the state's medicaid spending; and

     WHEREAS, medicaid recipients living with multiple health conditions receive health services from multiple agencies and often receive services that are not coordinated and involve wasteful duplication of services and inefficient health care delivery; and

     WHEREAS, the data that document medicaid recipients' health care services and their various health care providers often reside in "data silos" that make it all but impossible to identify the duplication, lack of coordination and inefficient delivery of services to particular recipients; and

     WHEREAS, there is a capability in the private health care technology sector to access data from all relevant "data silos" in any format and to consolidate that data by recipient and health care provider; and

     WHEREAS, this health care technology allows policymakers to analyze data for opportunities to improve health care outcomes, eliminate waste, fraud and abuse and provide for more efficient delivery, thus reducing per-recipient costs; and

     WHEREAS, there are professionals in the private health care clinical sector with experience in designing and implementing clinical interventions that are specifically aimed at addressing the issues identified in the integrated data analysis that health care technology produces; and

     WHEREAS, there are private companies that have achieved significant success in improving health outcomes and reducing costs for services to individuals with multiple health issues in other states; and

     WHEREAS, these private companies have based their models on integrated health data analytics and carefully designed clinical interventions; and

     WHEREAS, the experience of these companies' approaches in other states indicates the potential for New Mexico's medicaid program to save money and improve health outcomes for medicaid recipients; and

     WHEREAS, the children, youth and families department, the aging and long-term services department, the department of health and the human services department can find partners in the private sector that are willing and able to implement a pilot project that integrates data analysis with targeted clinical interventions to achieve these quality and efficiency outcomes; and

     WHEREAS, to finance the necessary technology and clinical interventions to achieve the quality and efficiency outcomes of the medicaid pilot, the children, youth and families department, the aging and long-term services department, the department of health and the human services department have the ability to enter into shared savings agreements with the private sector entities chosen to implement the pilot;

     NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that the children, youth and families department, the aging and long-term services department, the department of health and the human services department be requested to work together and enter into an interagency agreement to govern the implementation of a statewide, twelve-month pilot project to improve the quality and efficiency of health care delivery to medicaid recipients living with multiple health conditions through clinical and information technology interventions; and

     BE IT FURTHER RESOLVED that the children, youth and families department, the aging and long-term services department, the department of health and the human services department be requested to work with the private sector to undertake a statewide, twelve-month pilot project to reduce the per-recipient costs of delivering health care services to medicaid recipients living with multiple health conditions; and

     BE IT FURTHER RESOLVED that the results of the pilot project be documented and incorporated within the human services department's current effort to redesign the state's medicaid program in ways that will ensure the continuation of health services to the state's low-income and disabled residents; and

     BE IT FURTHER RESOLVED that the pilot project lay the groundwork for a request for proposals to procure the vendors most able to build integrated data analysis into a comprehensive pilot project; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the secretary of children, youth and families, the secretary of aging and long-term services, the secretary of health and the secretary of human services.

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