With 8,800 nurse positions posted for hiring in New Mexico, hospital leadership told the Legislative Health and Human Services Committee on Tuesday that access to healthcare will remain a problem as long as workforce issues continue.

Troy Clark, president and chief executive officer of New Mexico Hospital Association, spoke before the HHSC to discuss the state of hospitals in New Mexico. He said that, with regard to the 8,800 nursing positions currently open, there were over 6,000 open last year.

“We’re definitely not going in the right direction,” he said. 

His solution is to try to find ways to recruit students in New Mexico into going into the profession. He said he’d like to see the high school core curriculum “out of the way sooner” to enable high school students to start nursing classes while in high school. 

He said due to a shortage of emergency medical technicians and paramedics in rural areas, just under 67 percent of medical transfers were not medically justified to go by air ambulance but had to anyway because of a lack of on-the-ground ambulance service. Air ambulance rides can cost tens of thousands of dollars and Clark called the high percentage  “just awful.” He said the lack of paramedics and EMTs in rural areas can also lead to delays in care. 

But Clark did have some good news. He said the enactment of the Healthcare Delivery and Access Act in 2024, which led to a state tax on New Mexico hospitals to tap $1.5 billion in federal Medicaid matching dollars, has rural hospitals “giddy.”

“They can finally be in the position of not having to look at what they have to cut but look at the community healthcare needs and address them,” he said. 

Clark said urban hospitals are bearing the largest share of that state tax but that, because of what he called the “spider web effect” they were willing to do so. The spider web effect happens when one hospital in the state closes, all hospitals around the state feel it. He said one way that happens is when one rural hospital needs to transfer a patient to a higher acute care facility in an urban area, there can be delayed care if the other hospitals are full.

Clark said that last year there were three or four hospitals that were in the single-digit number of days for cash on hand. He said that with better funded hospitals, those that were in the red before will be able to break even and be sustainable and those that were “operating in the black” can expand. 

He said that with the COVID-19 pandemic came more complex needs for care, due to delayed care. He said that is now over but that the continued increased demand for healthcare services is because the baby boomer population is “nearly double the size of any other age group” and  has “entered the highest healthcare utilization point of life and that’s going to go on for another 15 years.”

Clark said New Mexico is unique because of the state’s “payer mix.” He said that hospitals in most states rely on Medicaid dollars less than 20 percent of the time but, currently, 43 percent of individuals in New Mexico are relying on Medicaid. He said Medicaid pays at cost in some instances and below cost in others. He said having such a high amount of hospital needs covered by Medicaid causes financial instability for hospitals. 

Several of the state senators and representatives asked Clark about private equity firms taking over hospitals in the state, although Clark did not address that during his remarks. State Rep. Liz Thomson, D-Albuquerque, who chairs the House Health Committee, said that she has read that New Mexico is at a very high risk for private equity takeovers. She said the committee would be looking into ways to address the problem. 

“This is a major red flag for New Mexico,” she said. 

State Rep. Eleanor Chávez, D-Albuquerque, said she had heard from a nurse that the caseloads for nurses are “unsafe and too heavy.”

State Sen. Antoinette Sedillo Lopez, D-Albuquerque, asked if hospitals do better financially if that would help alleviate the trend toward private equity buying out rural hospitals. 

Clark said it would “mitigate some of that motivation.”

Sedillo Lopez said she would like to see a bill that would create a review process before a private equity buy-out could take place.