I am writing today to announce the closure of the New Mexico Independent. After three and a half years of operation in New Mexico, the board of the American Independent News Network, has decided to shift publication of its news…
While environmental activists played their part yesterday during demonstrations at the capitol building, going so far as to dress up as solar panels and to sing the tune of “You Are My Sunshine,” their counterparts, the anti-cap-and-trade contingency who has…
Roughly one quarter of University of New Mexico students are unimpressed with the state’s flagship public school, according to a survey that questioned college students about their higher education experiences.
Four months after Gov. Bill Richardson seemingly set in motion a change in the state’s four-year $1 billion behavioral health contract, it appears that the state may not switch companies—for logistical reasons.
Health care providers and others across the state have told state officials in a series of recent public hearings that a transition would create havoc for those serving the state’s mentally ill and those struggling with substance abuse, as well as the people being served.
Those views were summarized Thursday at a meeting of the New Mexico Behavioral Health Collaborative, which oversees how behavioral health services are administered statewide.
“There were some saying we needed to go out for an RFP (request for proposals),” said Collaborative spokeswoman Betina Gonzales McCracken. “There were more saying ‘No, fix what is going on and work with the current statewide entity.’”
The Collaborative made no decisions Thursday on the fate of the contract, but has called a special meeting in June to decide what recommendation to send on to the governor – go out for an request for proposals for a new contractor or keep the current one – Optum Health New Mexico, McCracken said.
“I would suggest it’s at 90 percent or more to not go through another transition,” said David Ley, the executive director of New Mexico Youth Providers Alliance. “The state has heard a lot of feedback from everybody on the ground, saying ‘Look, this RFP concept paper is poorly planned. Don’t put us through another poorly managed, poorly planned transition.’”
In late January Richardson directed the Collaborative to put the state’s $1 billion contract out to bid, a surprise announcement that came seven months into the troubled tenure of Optum Health Care.
Optum took over the state’s four-year, behavioral health contract in July 2009, replacing Value Options. But Optum’s performance quickly failed to live up to state officials’ expectations, especially after it was discovered that hundreds of providers statewide had to wait up to several months to get paid for services already rendered.
The Collaborative, which hired Optum, reached an agreement earlier this year requiring Optum to pay $1.5 million into two separate funds in lieu of a penalty and to live under a revised plan with more scrutiny.
The problem was Optum Health’s electronic claims management system, which the company touted as a way to promptly pay nonprofits and others working with the mentally ill and those struggling with substance abuse. The system failed under the crush of real-world use soon after it went live July 1, 2009; the volume of invoices and claims that flooded the system were much greater than the test sample of claims the state used to conduct its readiness review.
Optum has since improved its performance, at least with many providers, Ley said.
“I don’t want to say that they were scared straight, but they sure are playing a different game now,” Ley said. “They are paying claims better. They are listening to us. Most providers are saying we would rather live with Optum with increased scrutiny and management and have the state figure out how to fix all the underlying problems.”
There’s also a sense that making a change now would force the state’s next governor to live with this decision, Ley said, referring to the fact that Richardson is term-limited and will be out of office in January.
