Michigan Releases Medicaid Managed Care Request for Proposals (RFP)

This week, our In Focus section reviews the Medicaid managed care request for proposals (RFP) issued by the Michigan Department of Health and Human Services (MDHHS) on Friday, May 8, 2015. MDHHS is rebidding its Medicaid managed care contracts across all 10 regions of the state, covering more than 1.6 million Medicaid lives as of April 2015. While the RFP is built upon the existing managed care program, it represents a shift in bidder evaluation toward population health management, payment reform, and other goals of Michigan’s State Innovation Model (SIM) initiative. These health reform goals are not only the basis of selecting successful bidders but are also reflected in many new requirements that bidders must meet, either at the time new contracts begin or within specified timeframes. Additionally, the RFP presents the possibility for a reduction in the number of contracted health plans. A total of 13 plans currently serve the Medicaid managed care population, with four plans holding around two-thirds of the market share. Bids are due to the state in August 2015, with an implementation date of January 1, 2016.

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