Advantages for Medical Providers

NM Health Security Plan: Some Advantages to Providers

To grasp what this statewide, cooperative-style, premium-based Plan would look like, imagine the following:

  • No insurance company networks, which currently greatly complicate the lives of both providers and patients

  • One set of prior authorization and formulary rules and data sets for almost all patients we treat

  • Utilization rules made by an accountable, independent, nonprofit, geographically representative commission, with open meetings and 1/3 of its members representing provider and health facility interests

  • Every NM resident having comprehensive health coverage

  • Mental and behavioral health care being covered the same as other medical services

  • The large patient-care obstacle of out-of-pocket costs being reduced

  • Patients no longer being confused and worried about what’s covered and how their coverage works

  • Drug prices being negotiated down to reasonable levels for all patients

  • No more arguing with multiple insurers regarding the terms of “fair” contracts

  • Ready access to dispute resolution for financial issues providers might have with the Plan

  • Lower practice and hospital costs for billing and prior authorizations

  • Little wasting of health care dollars on marketing of insurance plans and their schemes to only insure the healthy 

  • Far fewer middlemen (clerks and reviewers) making health decisions

  • Elimination of most of the cost-shifting, for both inpatient and outpatient care

For a printable PDF, please click here.

If you’re a medical provider and have questions, please email us or contact Executive Committee member Dr. Tyler Taylor at 505.412.3792.