Policy & Practice | Fall 2026

Figure 1: Casa Medicaid and the New Mexico HHS Neighborhood

Paula Morgan is the Chief

Information Officer, New Mexico Health Care Authority.

Shanita Harrison is the Deputy Chief Information Officer, New Mexico Health Care Authority.

ensure modernization efforts remain tightly aligned to outcomes for the New Mexicans the system serves. Business and IT leaders remain closely engaged in joint decision making, supported by structured com munication cadences and consistent information sharing across internal teams and external stakeholders, including vendor partners and the Centers for Medicare & Medicaid Services (CMS). Paula Morgan, Chief Information Officer (CIO) for the New Mexico HCA, has led the continued evo lution of the governance, technical, and delivery coordination model enabling this complex transformation at scale. What began as foundational governance has matured into a sustained operating discipline supporting execution across business, technology, and vendor teams. “Governance isn’t a phase—it’s a practice,” Morgan reflected. The result is an operating model in which strategic business objectives and day-to-day execution continuously reinforce one another—sustained through strong governance, deliberate communication, and ongoing coordi nation across the ecosystem.

being reused, new integrations can be introduced rapidly, and the archi tecture is scaling to absorb additional requirements. From Policy Change to Operational Response The approach reflects more than technical flexibility. It demonstrates organizational clarity. Roles, owner ship, and decision-making processes were well established and reinforced through prior experience, enabling HCA to move quickly and confidently. Teams could assign ownership and move forward as new changes emerged. This speed and coordination are critical to maintaining consistent service delivery, particularly when changes affect how customers access or retain coverage. The response to H.R. 1 reinforced something leaders had learned over years of transformation: resilience is not built at the moment change arrives. It is built through years of intentional investment in architecture, gover nance, and relationships. Governance as the Operating System of the Ecosystem Under the strategic direction of New Mexico HCA Cabinet Secretary Kari Armijo, the state’s Medicaid and broader health and human services transfor mation has continued to advance as a unified enterprise portfolio. Her lead ership helped establish clear business direction, reinforce accountability, and

Lorrina Rivera is the Assistant Deputy Director, New Mexico Health Care Authority.

Amiran Gelashvili is the Principal, Health and Human Services Lead, KPMG LLP.

Anil Sharma is the Managing Director, KPMG LLP.

Building a Shared Enterprise Culture

Critically, the state did not rely on vendors to self-coordinate. Instead, HCA leaders took ownership of bringing vendor partners together intentionally, establishing clear

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