Assessing the Effectiveness of Policies to Improve Access to Primary Care for Underserved Populations: A Case Study Analysis of Grant County, New Mexico

Multipayer Primary Care Network
Focus Area:
Primary Care Transformation
Health Equity
Funding for this project was provided by the National Institute for Health Care Reform. Read a related report reviewing the evidence on the effectiveness of these policies.


This case study of rural Grant County, New Mexico is the first in a series of case studies designed to assess the effectiveness of various policy initiatives to expand access to primary care in a region, particularly for underserved populations. Many policy approaches have been deployed in the county, which is classified as a primary care health professional shortage area, to increase the number of primary clinicians, bring outpatient clinics to the community, make primary care affordable, and build relationships between providers and patients.

With the help of state and local leadership, for example, Grant County has established a successful residency program that has increased the number of health care professionals in the county. The county has also been able to successfully leverage both the federally qualified health center and school-based health center models to develop a robust network of safety net providers. Generous public sector employment and union-negotiated health benefits, as well as expanded Medicaid eligibility, have made primary care affordable for many low-income residents. Still, barriers persist, such as the lack of broadband infrastructure to support telehealth and stringent rules prohibiting the expansion of non-emergency medical transportation.

COVID-19 has brought together Grant County stakeholders to respond to the pandemic and many of them hope that the financing and infrastructure supporting this collaboration will continue to provide the leadership, goal-setting efforts, and planning needed to meet the community’s long-term population health and primary care needs.

Read the case study


Kona M, Houston M, Clark J, Walsh-Alker E. Assessing the Effectiveness of Policies to Improve Access to Primary Care for Underserved Populations: Case Study Analysis of Grant County, New Mexico. The Milbank Memorial Fund, May 12, 2022.

 Case Study

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