Publications by CHI staff


Policy Goals to Support the Healthcare Workforce in Healthy Aging Communities

With funding from the New Mexico Department of Health, the Center for Health Innovation engaged five rural Southern New Mexico counties in research, analysis and discussion about their healthcare workforce development needs now and in the future. The five counties included Grant, Sierra, Socorro, Catron and Valencia. Project participants included representatives from NM Department of Health-Health Promotion, health councils, hospitals, Community Health Centers, schools, universities, community organizations, Council of Governments, county government, elected officials, and others.

The six month project spanned the period from January to June 2020. The project design included: (1) secondary data analysis; (2) surveys for primary data and analysis; and (3) group discussions for identifying provider and community needs; analyzing current and projected workforce challenges; and discussing and framing system alignment and policy issues that impact
needs, services, and capacity to recruit and retain the healthcare workforce.

Click here to download the full report.

Policy Goals to Improve Behavioral Health Needs of Individuals, Employers and Communities in Rural New Mexico

With funding from the New Mexico Department of Health, the Center for Health Innovation engaged five rural Southern New Mexico counties in research, analysis and discussion about their healthcare workforce development needs now and in the future. The five counties included Grant, Sierra, Socorro, Catron and Valencia. Project participants included representatives from NM Department of Health-Health Promotion, health councils, hospitals, Community Health Centers, schools, universities, community organizations, Council of Governments, county government, elected officials, and others.

The six month project spanned the period from January to June 2020. The project design included: (1) secondary data analysis; (2) surveys for primary data and analysis; and (3) group discussions for identifying provider and community needs; analyzing current and projected workforce challenges; and discussing and framing system alignment and policy issues that impact needs, services, and capacity to recruit and retain the healthcare workforce.

Click here to download the full report.

RCORP Southern New Mexico Outcomes

CHI received a grant from the U.S Health Resources & Services Administration (HRSA) Rural Communities Opioid Response Program to engage 16 southern New Mexico counties to meet their prevention, treatment and recovery needs in a community-driven comprehensive assessment process.

The southern New Mexico counties in the program include Catron, Chaves, Cibola, De Baca, Eddy, Grant, Hidalgo, Lea, Lincoln, Luna, Otero, Roosevelt, Sierra, and Socorro, as well as the rural-designated regions of Torrance and Valencia.

The following publications have resulted from this ongoing project. Please click the title to download the document.

CHI 2019 Annual Report

As New Mexico’s designated Public Health Institute, the Center for Health Innovation (CHI) is dedicated to working with communities to advance health and social justice through innovative and effective policies and programs for all the residents in our state, and beyond. In our 2019 Annual Report you can read about how we engage with New Mexicans of all ages, ethnicities and socio-economic backgrounds to create informed solutions to the challenges facing New Mexico’s residents. We accomplish this by offering a unique mix of cutting-edge research, community collaboration, innovative programs and health care workforce development. Click here to download the report.

Alcohol Outlet Density Report 2020

Our new report details the Unified Prevention Coalition of Doña Ana County’s process of bringing together GIS maps of Las Cruces, New Mexico, alcohol sales locations with overlaid maps of select calls for services to law enforcement for alcohol-related crimes and identifies community “hot spots”.  Download it by clicking here.

Comprehensive, Collaborative Health Systems Planning and Implementation in New Mexico: Two Case Studies

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How and why do some New Mexico community collaborative efforts to build a healthy community work better than others? To help answer this question we completed an in-depth study of two New Mexico counties, Santa Fe and Doña Ana. From this study, we developed and tested a framework with two those counties that are engaging in Comprehensive, Collaborative Community Health Planning (CCCHP).

For our study, we identified and reviewed more than 50 relevant studies and models in health planning, population health, and social determinants of health. Of the models reviewed, we performed thematic comparisons of four evidence-based models widely used for planning, and four models widely used for sustainability

Our findings in these two case studies support the six elements of the initial CCCHP framework. However, the lived experiences of these two communities with different needs, resources, and people suggest additional activities and considerations for use of the framework.

We caution that we conducted only two case studies, both in areas with relatively large populations in comparison to the remainder of New Mexico. Our findings may not be applicable to rural and frontier areas or populations with other characteristics. Because both CCCHP projects were in relatively early stages of implementation, we were not able to document health outcomes. Further empirical research is needed to test and further develop the framework. Despite these limitations, our examination of two CCCHP initiatives allows us to propose that our CCCHP framework can provide a useful guide for community health planners.

This study was funded by the McCune Charitable Foundation.

Toward A High Performing Rural Health Care System: Key Issues and Recommendations From Rural Health Care Innovators

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Our CEO, Charlie Alfero was among the Rural Health Care System Innovators to serve on a Rural Health Policy Research Institute’s (RUPRI) Health Panel to discuss strategies and models for rural health care system innovation. Alfero was one of the convened state and community leaders with firsthand knowledge of diverse, innovative health financing and service delivery initiatives as well as national rural health experts and stakeholders. The Health Panel identified the participating rural health care system innovators based on their groundbreaking approaches to health care financing and service delivery.

While the diversity of innovative strategies, programs, and models defies an easy summary of “lessons learned,” the innovators agreed that “incentives and relationships matter.” From that common perspective, the Panel extracted three themes common to many of the innovations:

  • Innovative rural models employ flexible financing strategies that incentivize greater collaboration and care coordination across different service systems;
  • Initiation and implementation of innovation is effectively supported by infrastructure, including locally based structures, collaborative leadership models, adequate workforce, and data capacity; and
  • Innovations have governance and accountability frameworks that support sustained engagement of participating organizations and stakeholders, facilitate transparency, and enable participants to track progress.

Note the publicaion is linked to the RUPRI website for download.

Addressing Health Inequities in New Mexico: The Role of the New Mexico Public Health Institute

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The New Mexico Public Health Institute was formed to address health disparities that stem from the deep historical and current inequities that frame the lives of New Mexico residents.  NMPHI envisions that in New Mexico, “health equity is achieved [and] social and health issues continue to be prioritized through evidence, policy, civic engagement, and social justice.”
This document provides a review of current major health inequities in New Mexico, as well as disparities in the social, economic, and environmental factors that influence health. Current efforts to address population health are reviewed broadly. The report concludes with a summary of recommended roles and actions for the New Mexico Public Health Institute, and was published in December 2017.

Please note: The purpose of last document was for internal use to guide the NMPHI in its future direction. The NMPHI did not have the capacity and resources to dive deep into local and county level assessments while developing this assessment – please keep that in mind. This document is meant to be read with a broad, statewide and system’s level perspective.

Bridging Population Health & Behavioral Health in Rural New Mexico

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There is growing recognition that public health and health care need to work together differently to achieve mutual goals of cost containment, better quality of care and investments in upstream factors influencing health and well-being. There remain significant challenges to collaboration in New Mexico.

The New Mexico Public Health Institute hosted state-wide forums aimed at advancing collaboration among public health and health care sectors. This publications includes the findings of those forums and the next steps to advance health systems transformation to better integrate health systems, lower costs and improve population health. Bridging Population Health & Behavioral Health In Rural New Mexico was released in April 2018.

AHEC Health Careers in New Mexico Manual

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There are not enough health care professionals in New Mexico to meet the population’s need for health care services. The demand for health care workers and providers is much greater than the supply of graduates in the health field. See what health careers best suit your interests with this handy manual that includes quizzes and personality tests to better match you to the field that’s right for you. Also it includes resources and educational guidance so you can successfully launch your future career in health care. Tailor made for junior high and high school students in New Mexico.

After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care

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Our CEO, Charlie Alfero sat on a RURPI panel to discuss “After Hospital Closure: Pursuing High
Performance Rural Health Systems without Inpatient Care”. The panel focuses on the opportunities for rural communities to develop a high performance rural health system after hospital closure. Communities with hospitals that are vulnerable to closure may also find the approaches outlined here constructive when considering options for optimal care delivery.

Health Education Centers promote rural practice in primary care

A new project report from Rural and Remote Health Journal , by JD Taylor and SE Goletz, found that health education centers (AHEC) promote interest in rural practice in medical students. CHI hosts the regional AHEC in southern New Mexico, part of our efforts to promote health education in rural communities. Read the abstract and conclusion to learn how “significantly positive association between participation in medical clerkship experiences in a rural primary care setting and the intent to practice in a rural setting upon graduation.”

Medicaid Payment and Delivery System Reform: Challenges and Opportunities for Rural Health Systems

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Compared to their urban counterparts, rural populations tend to be older, poorer, and sicker and have less access to employer-sponsored insurance plans. Consequently, a higher proportion of rural people are potentially eligible for Medicaid. Indeed, as of 2014, 22 percent of rural residents were enrolled in Medicaid while 20 percent were enrolled in Medicare, signifying that Medicaid has surpassed Medicare as the largest source of public health coverage in rural areas, and is second in coverage only to employer-sponsored insurance plans.

The Role of Community Health Centers in Assessing the Social Determinants of Health for Planning and Policy: The Example of Frontier New Mexico

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This article examines the experience of a frontier-based community health center when it utilized the Tool for Health and Resilience in Vulnerable Environments (THRIVE) for assessing social determinants of health with a local health consortium. Community members (N = 357) rated safety, jobs, housing, and education among the top health issues. Community leaders integrated these health priorities in a countywide strategic planning process. This example of a frontier county in New Mexico demonstrates the critical role that community health centers play when engaging with local residents to assess community health needs for strategic planning and policy development.

Advancing the Transition to a High Performance Rural Health System

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Despite decades of policy efforts to stabilize rural health systems through a range of policies and funding programs, accelerating rural hospital closures combined with rapid changes in private and public payment strategies have created widespread concern that these solutions are inadequate for addressing current rural health challenges. This paper presents strategies and options that rural health providers may use in creating a pathway to a transformed, high performing rural health system, which are then categorized into four distinct approaches. We elaborate each approach, and discuss a related set of public policy implications that should be considered when following each strategy. We follow the discussion of policy implications with four demonstration ideas that reflect the essential elements of each strategic approach in achieving the aims of a high performing rural health system.

Community Health Workers and Medicaid Managed Care in New Mexico

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We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico’s 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.

Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

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The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease.

The Health Commons and Care of New Mexico’s Uninsured

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A seamless system of social, behavioral, and medical services for the uninsured was created to address the social determinants of disease, reduce health disparities, and foster local economic development in 2 inner-city neighborhoods and 2 rural counties in New Mexico. We helped urban and rural communities that had large uninsured, minority populations create Health Commons models. These models of care are characterized by health planning shared by community stakeholders; 1-stop shopping for medical, behavioral, and social services; employment of community health workers bridging the clinic and the community; and job creation.