This week, our In Focus section reviews the Iowa Health Link request for proposals (RFP) for Medicaid managed care organizations (MCOs) to serve the state’s traditional Medicaid program, the Children’s Health Insurance Program (CHIP) known as Healthy and Well Kids in Iowa (Hawki), and the Iowa Health and Wellness Plan (IHAWP). The RFP was released by the Iowa Department of Human Services on February 17, 2022. Contracts are set to begin July 1, 2023, and are worth approximately $6.5 billion annually.
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California releases Medi-Cal RFP for Two-Plan, GMC, Regional Models
This week, our In Focus section reviews the California Medicaid (Medi-Cal) managed care request for proposals (RFP) released by the California Department of Health Care Services (DHCS) on February 9, 2022. DHCS is procuring contracts for commercial plans for three of the Medi-Cal managed care plan models in 21 counties, serving approximately 3 million beneficiaries. Contracts will be awarded to one managed care organization (MCO) in each of the Two-Plan model counties, two MCOs in each of the geographic managed care (GMC) model counties, and two MCOs in each of the Regional model counties. This procurement is the largest released by California, rebidding contracts for commercial plans statewide.
Delaware Releases Medicaid Managed Care RFP
This week our In Focus section reviews the Delaware request for proposals (RFP) for Diamond State Health Plan (DSHP) and Diamond State Health Plan Plus (DSHP Plus), the state’s Medicaid managed care programs. The RFP was released by the Delaware Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) on December 15, 2021.
Minnesota Releases Medicaid Medical Assistance, MinnesotaCare RFP Covering 80 Counties Outside Twin Cities
This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.
District of Columbia Releases Medicaid Managed Care RFP
This week, our In Focus section reviews the District of Columbia (DC) Medicaid managed care request for proposals (RFP), released on November 19, 2021, by the District of Columbia Department of Health Care Finance. The procurement will cover DC Healthy Families Program (DCHFP), including adults with special health care needs; District of Columbia Healthcare Alliance Program (Alliance); and Immigrant Children’s Program (ICP). DC expects to award contracts to up to three managed care organizations (MCOs), covering physical, behavioral health, and pharmacy services. Contract approval is expected by June 2022 and implementation in October 2022.
Missouri Releases Medicaid Managed Care RFP
This week our In Focus reviews the Missouri MO HealthNet (MHD) Medicaid Managed Care Program request for proposals (RFP), released on November 19, 2021, by the Department of Social Services (DSS). The MHD managed care program serves about 850,000 Medicaid and Children’s Health Insurance Program (CHIP) members including the state’s newly implemented Medicaid expansion population, across all regions of Missouri. Missouri’s General Plan managed care program covers TANF, CHIP, expansion and similar eligibility groups but does not include individuals with disabilities or those over age 65. The RFP also contains a separate section for a single, statewide Specialty Plan for foster children and children receiving adoption subsidy assistance. Managed care organizations must bid on and win a General Plan contract in order to be eligible for the Specialty Plan contract.
Rhode Island Releases Medicaid Managed Care RFQ
This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover over 300,000 individuals.
Former DoD Health Official Joins HMA
Former Assistant Secretary of Defense for Health Affairs Tom McCaffery has joined the Health Management Associates (HMA) team of expert healthcare consultants. McCaffery joins the national healthcare consulting firm as a principal in its Washington, D.C. office after serving as the senior civilian leader in the Department of Defense (DoD) Military Health System (MHS).
Highlights from Kaiser/HMA 50-State Medicaid Director Survey
This week, our In Focus section reviews highlights and shares key takeaways from the 21st annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and Health Management Associates (HMA). Survey results were released on October 27, 2021, in two new reports: States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022 and Medicaid Enrollment & Spending Growth: FY 2021 & 2022. The report was prepared by Kathleen Gifford, Aimee Lashbrook, and Sarah Barth from HMA; Mike Nardone; and by Elizabeth Hinton, Madeline Guth, Lina Stolyar, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors (NAMD).
Medicaid Managed Care Enrollment Update – Q2 2021
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. All 33 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2020. This report reflects the most recent data posted. HMA has made the following observations related to the enrollment data shown on Table 1 (below):
Health Management Associates Acquires Wakely Consulting Group
Today, Jay Rosen, founder, president, and co-chairman of Health Management Associates (HMA), announced the firm’s acquisition of Wakely Consulting Group (Wakely).
Webinar Replay: Continuing the Path to Medicare-Medicaid Integration
This webinar was held on October 4, 2021.
Federal and state policy makers have long been working to expand enrollment in Medicare-Medicaid integrated care programs (ICPs). ICPs can advance independent living and health equity for individuals who are dually eligible for both programs. However, approximately only one in 10 dually eligible individuals was enrolled in an ICP as of 2019. To encourage ICP enrollment and retention, HMA identified 10 essential elements of ICPs centered around, informed by, and made available to dually eligible individuals. (See HMA Brief #3 and the brief fact sheet.)
During this webinar, HMA shared these 10 essential elements for establishing and simplifying ICPs specifically tailored to diverse individuals’ needs and preferences. Panelists involved in health justice and community-based healthcare offered practical next steps for advancing ICPs.
Learning Objectives
- Hear about the 10 essential elements for ICPs identified through interviews with diverse stakeholders
- Engage panelists to share their views on how to advance ICPs tailored around members’ needs
- Consider the types and level of investment required to advance the essential elements for ICPs
Speakers
- Arielle Mir, MPA, Vice President of Health Care, Arnold Ventures, Washington, DC
- Sarah Barth, JD, Principal, HMA, New York, NY
- Ellen Breslin, MPP, Principal, HMA, Boston, MA
- Dennis Heaphy, M.Div., M.Ed., MPH, Health Justice Policy Analyst, Disability Policy Consortium, Malden, MA
- Linda Little, MBA, RN, CCM, President and CEO, Neighborhood Service Organization (NSO), Detroit, MI