Policy & Practice | Fall 2025

significant transformation is taking shape in New Mexico. The state has been working on a multiyear Medicaid Management Information System Replacement (MMISR) journey to replace a more than 25-year-old Medicaid Management Information System (MMIS) with a modern and modular solution. It’s more than a Medicaid Enterprise System (MES), it’s the home, or “Casa Medicaid,” within the broader “neighborhood” of integrated human services that New Mexico is building. It’s part of its Health and Human Services 2020 (HHS2020) initiative that is creating an integrated ecosystem where human services programs work in harmony to address the diverse needs of New Mexicans. The journey to build Casa Medicaid and a broader human services neighborhood has been a complex and multifaceted endeavor. Like any large-scale transformation, it has required deep coordination, course corrections, and problem solving. But today, with most core modules deployed and the final core modules, Financial Services and Quality Assurance, slated to go live within the next several months, the state is entering a critical phase—one focused on long term operations, continuous improvement, and the capacity to adapt. This is not a moment of arrival, but one of transition. As New Mexico moves from building to sustaining, the state is actively navi By Paula Morgan, Kate Morandi Dickens, Amiran Gelashvili, and Anil Sharma A

Governance: Making the Neighborhood Work Together One of the most critical enablers of New Mexico’s progress has been its governance model. From the start, New Mexico recognized that deploying a complex modular system isn’t just a technical challenge—it’s a relational one (see Figure 1). The state has had to bring together multiple vendors, programs, and partners under a shared vision and operational framework with strong executive oversight. Governance isn’t a phase; it’s a practice. And it must evolve as systems, policies, and expectations change. A strong foundation of executive oversight has helped keep efforts aligned, but New Mexico has also invested in building a cohesive “familia” and fostering collaboration across its ecosystem. A signature example of this investment is New Mexico’s “Partner Paloozas”—now semiannual gatherings of vendors, stakeholders, agency staff, and state leadership, designed to break down silos, promote transparency, align priorities, and nurture strong governance. These gatherings were born out of a simple realization: meaningful coordination happens when people know each other, trust each other, and share ownership. The Paloozas go far beyond traditional coordination meetings. The immersive gatherings include col laborative workshops, shared planning, social activities, and philanthropic efforts, such as a toy drive for foster children in support of one of the

gating the complexities of managing a modern, multi vendor ecosystem and putting in place the governance, data, and operational frameworks needed to keep pace with evolving policies, technology, and public needs into the future.

Figure 1: HHS 2020 Governance

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