UNM Hospital reports new critical care tower, warns of Medicaid eligibility changes and budget impact

UNM HospitalCEO Kate Becker updated the Bernalillo County Board of Commissioners on Oct. 28 on capital, financial and workforce issues, highlighting the Oct. 5 opening of the hospital—ritical care tower and a modest first-quarter surplus while warning of significant Medicaid-driven budget pressures ahead.

Becker said the new tower opened Oct. 5 and staff moved 132 patients from existing intensive care units, the adult emergency room and the pavilion into the new facility. "We actually moved 132 patients...and everybody got there safely and none of the staff got hurt," she said. Becker reported a $37,000 positive bottom line for fiscal-year 2026 Q1 and said patient experience scores have started to improve.

But Becker told commissioners she expects a meaningful rise in uncompensated care because of state and federal changes. "The first really big impact we're going to see is going to be 01/01/2027 when the Medicaid eligibility rules will change," she said, citing a Healthcare Authority estimate that roughly 100,000 people statewide could lose Medicaid coverage at that time. Becker said UNMCare, the hospitalsystem—atch-all program for uninsured patients, currently serves about 4,000 people and could grow fivefold—back toward pre-ACA levels of roughly 30,000 to 35,000—if eligibility shifts.

Becker also warned of a reduction in state-directed Medicaid payments: UNM Hospital has participated in those payments for five years, and she said a phase-in beginning Jan. 1, 2028 would reduce payments by roughly 10% per year, representing roughly $27 million annually to the system. "That change starting 01/01/2028 will be a decrease of 10% per year in that amount of that state directed payment," she said.

Commissioners asked for details about UNM Care eligibility and patient collections. Becker said financial counselors review documents for UNM Care enrollment and that patients in UNM Care are not sent to collections; she described recent efforts to make the application process language-accessible and easier to reach eligible patients. On physician staffing she explained the "match" process for residents and said the hospital offers competitive salaries for the region; residents were the only UNMH employees offered a wage increase in FY26.

Why it matters: UNM is the county's level 1 trauma center and a major health-care employer. Anticipated Medicaid eligibility and payment changes could increase uncompensated-care loads and require county and hospital budgeting adjustments.

What's next: Becker said the hospital will present more detail during winter budget planning as administrators model uncompensated-care increases and state-directed-payment reductions for FY27 and FY28.