Policy & Practice | Fall 2024

Amidst a complex, multivendor envi ronment, the blueprints guiding the program remain clear in their purpose and vision: helping New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and support services. Guided by those blueprints, New Mexico has successfully laid a solid foundation for the MMISR program, selecting, procuring, and onboarding module vendors, technologies, and a System Integration Platform (SIP), the KPMG Resource Integration Suite (KRIS) Connected Platform. Four of the eight functional MMISR modules—the Consolidated Customer Service Center, Unified Portal, Quality Assurance, and Data Services modules—are live, along with the SIP. Four are in develop ment, including the Internal Portal, Financial Services, and Care and Case

Figure 1: New Mexico “Casa Medicaid”

Management System modules, as well as the Benefits Management Services module, which is going live this fall. The Data Services module went live this summer, enabling a new era of robust data analytics and reporting. It is building on the groundwork of the Data Governance Council and enabling stakeholders to make more informed decisions via a single, authoritative source of data. With the blueprint laid out before us and the materials at our disposal, our task now shifts to meticulously building the rooms of this house, the proverbial “Casa Medicaid.” It is now about execution, ensuring each space serves its purpose, enriches the lives within, and contributes to the creation of a thriving home for all New Mexicans (see Figure 1). As the MMISR program has pro gressed, common challenges have emerged—from resource constraints and integration challenges to data management issues. Changes abound, both planned and unplanned. As we navigate the development of “Casa Medicaid,” our lessons learned continue to be the building blocks that guide the transformation: n Pivot, pivot, pivot, continuously examining and refining the roadmap The Building Blocks of Transformation

n Prioritize collaboration, fostering effective relationships n Embrace people-centric, business-led transformation, keeping the con stituent at the center of all decisions Architecting Agility: Revisiting the Roadmap This year introduced new leadership in key positions across the Medicaid program, as well as the broader New Mexico health and human services ecosystem and state. The New Mexico Health Care Authority (NM HCA), formed in July 2024, merged the Human Services Department and several other health care–related teams, creating a single agency respon sible for health care purchasing, policy, and regulation. Embracing the integration of new stakeholders as an opportunity rather than just a challenge, our NM HCA Information Technology (IT) division and larger agency have actively engaged new leaders and stake holders, inviting them to examine and probe the MMISR roadmap. This has enabled us not only to uncover invaluable fresh insights, but to drive innovation and foster a culture of col laboration that has been instrumental in navigating the complexities of such a large-scale project. Throughout the MMISR trans formation, our IT division has itself

Paula Morgan is the Chief Information Officer of the New Mexico Health Care Authority.

Anil Sharma is a Managing Director in the

KPMG LLP Health and Government Solutions practice.

Amiran Gelashvili is a Managing Director and the US Health and Human Services Lead at KPMG LLP.

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Policy & Practice Fall 2024