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New Mexico Health Care Authority

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www.hca.nm.govUpdated

State health care authority coordinating Medicaid programs, public information, and health system oversight to improve access, quality, and accountability for residents.

Overview

The organization is a state health care authority that administers Medicaid and related health programs, publishes public information and performance data, oversees health care providers and systems, and supports policy development and consumer access to care. It serves residents by coordinating services, ensuring accountability, and promoting transparency in health care delivery.

Mission statement

To advance the health and well-being of state residents by administering essential health programs, ensuring accessible, high-quality care; promoting transparency, accountability, and informed decision-making for consumers and providers.

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What we offer

Turquoise Care

Offers Medicaid beneficiaries integrated health plans, rewards, and additional services.

Pricing not published

www.hca.nm.gov/turquoise-care/

PACE

Service

Provides comprehensive, coordinated care for the elderly through a public program.

Pricing not published

www.hca.nm.gov/lookingforinformation/pace/

Brain Injury Services Fund

Service

Supports individuals with brain injuries through funding and educational resources.

Pricing not published

www.hca.nm.gov/lookingforinformation/the-brain-injury-services-fund-program/

Mi Via Waiver

Service

Empowers individuals to self-direct their services for enhanced independence.

Pricing not published

www.hca.nm.gov/lookingforinformation/mi-via/

Developmentally Disabled Waiver

Service

Provides essential support and services to individuals with developmental disabilities.

Pricing not published

www.hca.nm.gov/lookingforinformation/developmentally-disabled/

Medically Fragile Waiver

Service

Provides essential support for medically fragile individuals through comprehensive care services.

Pricing not published

www.hca.nm.gov/lookingforinformation/medically-fragile/

BeWell

Provides essential health information and resources for New Mexico residents.

Pricing not published

bewellnm.com/

HCA Data Book

Access Comprehensive Data Metrics for New Mexico's Health Services.

Pricing not published

www.hca.nm.gov/2025-data-book/

Market segments

Market size by segment

Growth potential (CAGR)

Medicaid home and community-based waivers

13 Billion USD5% CAGR

Programs that provide long-term services, supports, and service coordination to enable individuals with developmental disabilities or complex medical needs to receive care in home and community settings.

Products: Developmentally Disabled Waiver, Medically Fragile Waiver, Mi Via Waiver, PACE

Medicaid managed care and care coordination

99 Billion USD14.31% CAGR

Managed care plans and care coordination programs that organize Medicaid benefits, assist beneficiaries with plan selection and transitions, and deliver integrated services and value-added supports.

Products: Turquoise Care, PACE, Medically Fragile Waiver

Health program performance and outcomes analytics

6.7 Billion USD16% CAGR

Dashboards and reports that measure program reach, quality, client outcomes, and comparative performance across states and providers to inform program management and policy.

Products: HCA Data Book, BeWell

Benefits education and decision support

2.5 Billion USD12% CAGR

Capabilities that explain benefits, guide enrollment decisions, and surface analytics and personalized assistance (including AI-driven assistants) to boost benefits understanding and uptake.

Products: BeWell, Turquoise Care

Specialty program funding and workforce training for brain injury

0.5 Billion USD5% CAGR

Funding, program administration, and education initiatives that support brain injury treatment, provider training, and services for Medicaid-eligible individuals.

Products: Brain Injury Services Fund

More information about our offering

Turquoise Care

Turquoise Care is New Mexico's care program under Centennial Care that provides an integrated set of health plan options, rewards and additional services to aid Medicaid beneficiaries. It includes multiple health plans, a rewards component, value-added services, and a pathway to access Centennial Care 2.0 waiver options, with guidance on switching managed care organizations.

Pricing not published

  • Multiple Health Plan Options Available
    Offers a variety of health plan choices tailored to the needs of beneficiaries.
  • Facilitates Enrollment In Waivers
    Enables beneficiaries to access necessary waivers through the Centennial Care framework.
  • Provides Switching Guidance
    Offers navigational support for Medicaid recipients looking to switch their managed care providers.
  • Includes Extra Support Services
    Offers supplemental services to enhance health care quality and efficacy for beneficiaries.
  • Encourages Healthy Behaviors
    Rewards beneficiaries for engaging in healthy activities and lifestyle choices.
  • Provides Program Overview
    Delivers essential information on the structure and benefits of Turquoise Care.

PACE

Program of All-Inclusive Care for the Elderly (PACE) is a public program listed by the New Mexico Health Care Authority. This initiative offers a coordinated care approach to elderly individuals, ensuring they receive comprehensive medical, social, and supportive services tailored to their health and personal needs.

Pricing not published

  • Offers Comprehensive Services
    PACE offers a wide range of services covering medical, social, and support needs, ensuring the elderly receive holistic care.
  • Defines Qualification Criteria
    Clearly outlines the necessary health conditions and income limits to qualify for PACE enrollment.

Brain Injury Services Fund

Brain Injury Services Fund program providing support for brain injury treatment and related services; includes additional programs for Medicaid-eligible individuals and opportunities for education and training.

Pricing not published

  • Details Fund Support
    Explains the various services funded by the program, aimed at improving outcomes for individuals affected by brain injuries.
  • Provides Additional Support
    Offers various services designed to assist individuals with brain injuries who qualify for Medicaid, enhancing their access to necessary care and support.
  • Facilitates Training
    Provides educational resources and training for service providers and families, ensuring that they are well-informed about brain injury care and rehabilitation.

Mi Via Waiver

Mi Via is a Medicaid Home and Community-Based Waiver program that allows participants to direct their own services and supports to meet their unique needs. It focuses on promoting independence and community inclusion for individuals with developmental disabilities or those who are medically fragile.

Pricing not published

  • Promotes Self-Directed Services
    Mi Via allows individuals to choose their services and providers, fostering independence in managing their care.
  • Offers Comprehensive Service Choices
    Participants can choose from a variety of services including personal care, respite, and employment support.
  • Defines Eligibility Criteria
    Outlines specific qualifications, including residency and medical necessity, for accessing Mi Via Waiver services.

Developmentally Disabled Waiver

Developmentally Disabled Home and Community Based Waiver for individuals with developmental disabilities.

Pricing not published

  • Enhances Quality of Life
    Offers essential support to improve daily functioning and quality of life for individuals with developmental disabilities.
  • Facilitates Access to Services
    A dedicated service coordinator assists recipients in navigating their care options and accessing necessary resources.
  • Provides Clear Eligibility Guidelines
    Ensures individuals have a clear understanding of the requirements to access the waiver.
  • Encourages Community Connection
    Facilitates opportunities for individuals to engage and participate in community activities.

Medically Fragile Waiver

Medically Fragile Home and Community Based Waiver for medically fragile individuals.

Pricing not published

  • Offers Comprehensive Services
    This waiver provides access to a range of essential services tailored to the needs of medically fragile individuals, ensuring they receive necessary care in their homes or communities.
  • Ensures Access to Health Services
    Participants receive critical services such as skilled nursing, therapies, and personal care to enhance their quality of life.
  • Defines Qualification Requirements
    Helps potential participants understand the necessary requirements to qualify for waiver services, ensuring informed access to healthcare.
  • Facilitates Access to Services
    Care coordinators assist with care plans, resource access, and ongoing support to navigate the healthcare system effectively.

BeWell

BeWell NM is a public information platform designed to provide residents of New Mexico with access to various health-related resources and services, promoting transparency and accountability in healthcare delivery.

Pricing not published

  • Facilitates Access To Health Services
    BeWell NM connects residents with important health information, services, and resources to promote well-being.
  • Assists With Public Benefits Applications
    Users can easily find guidance on applying for Medicaid and other public assistance programs through the platform.
  • Educates Residents On Health Topics
    BeWell NM features articles, guides, and resources to help residents understand health issues and improve their wellness.

HCA Data Book

HCA Data Book, a data compilation published by the New Mexico Health Care Authority for public access to information and performance metrics.

Pricing not published

  • Access Medicaid Data
    Essential for understanding qualifying conditions for Medicaid, aiding in service outreach.
  • Explore Wellness Metrics
    Facilitates access to crucial health data that aids in understanding general wellness trends among residents.
  • Examine Healthcare Access
    Provides analytics on how accessible and affordable healthcare services are for New Mexicans.
  • Review Insurance Coverage
    Users can monitor health insurance coverage trends to assess gaps in services.
  • Access Economic Data
    Users can review vital economic indicators that impact health services across the state.
  • Review Demographic Data
    This feature allows users to explore demographic details crucial for health planning and resources allocation.
  • Assess Income Levels
    Users can evaluate how income and poverty data relate to health disparities and community needs.
  • Analyze Food Security
    Offers insights into the prevalence of food insecurity and its effects on health outcomes in New Mexico.

Sources

Methodology and sourcing behind the figures and links shown above.

Medicaid home and community-based waivers

Baseline: TechTarget reports total spending for Section 1915(c) HCBS waivers in 38 states reached $9.9 billion in 2017. Scaling that 38-state 2017 baseline to a national estimate (50 states) yields roughly $12–13 billion; accounting conservatively for measurement caveats in the source and subsequent federal ARP funding and COVID-era increases to HCBS, I estimate current Medicaid HCBS waiver market ~13 billion USD. Growth potential: demographic trends (aging population), policy emphasis on shifting care to home/community settings, and recent federal boosts to HCBS suggest mid-single-digit CAGR; I estimate ~5% CAGR going forward absent large federal policy changes.

Medicaid managed care and care coordination

Search results did not contain an explicit dollar-size for the overall Medicaid managed-care + care-coordination market. However, care coordination/care management solutions (software and services) — a core component of care coordination in Medicaid MCOs — is reported at $5.81B (2023) with a 14.31% CAGR (2023–2033). The RWJF analysis and Milliman report establish that the majority of Medicaid beneficiaries are enrolled in managed care (≈70–75%), making the care management solutions market highly relevant to Medicaid managed care growth. Given this, growth potential for Medicaid-focused care coordination technology and services aligns with the high-teens low-double-digit CAGR observed in the broader US care management solutions market; overall Medicaid managed-care premium volumes were not specified in the provided results.

Health program performance and outcomes analytics

Estimate rationale: health program performance and outcomes analytics is a focused subset of population-health and clinical analytics. Combined reported markets (clinical analytics ~USD 15.4B; population health analytics ~USD 3.6B) total ~USD 19.0B. Assuming the subsegment captures roughly 35% of that combined addressable (dashboards, performance/outcomes reporting across providers/states), the estimated market size is ~USD 6.7B. Growth potential uses a weighted average of the reported CAGRs for clinical (13.3%) and population health analytics (27.7%), producing an implied CAGR near 16% for this performance/outcomes subsegment, given strong value-based care tailwinds.

Benefits education and decision support

No direct market-size data for "benefits education and decision support" was present in the results. I used analogous markets in the search results—Decision Intelligence (AI-driven decision support) and Care Management Solutions (personalized guidance and analytics)—as anchors. Those reports show multi‑billion markets in 2025 (USD 17.7B and USD 19.58B) with high growth (CAGR ~16.9% and 11.6%). Benefits education/decision support is a narrower HR-facing subsegment of decision-intelligence and care/engagement platforms; assuming it represents a small share of those broader markets, a conservative estimate is ~USD 2.5 billion (global) with mid‑teens growth potential tempered by slower HR procurement cycles, yielding an estimated CAGR ~12%.

Specialty program funding and workforce training for brain injury

Estimated specialty program funding and workforce training for brain injury (Medicaid-focused) as a small service/administration subset of the broader TBI treatment/therapeutics market. Primary inputs: (1) overall mild-TBI treatment market ≈ $5.76B (2024) with ~3.7% CAGR (MRFR), (2) global TBI therapeutics market ≈ $4.0B (2025) with ~6.0% CAGR (Persistence), and (3) observed federal research appropriations (CDMRP) totaling $700M FY21–24 indicating substantial targeted funding flows. Applying a conservative share (≈8–10%) of the treatment/therapeutics market to reflect program administration, Medicaid reimbursement concentration, and workforce training services yields an annual market-size estimate ≈ $0.5B. Growth potential (CAGR ≈5.0%) is set between published treatment/therapeutics CAGRs, adjusted upward to reflect policy, Long COVID, and workforce-development emphasis.

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