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Medicaid MCO RFPs by State

Delivered July 2nd, 2019. Contributors: Ezeonye J., Jasleen A., Shaun T. and

Part
01
of three
Part
01

Medicaid MCO RFPs by State, Part 1

We provided the date when Florida, California, Texas, Ohio, and Indiana will be issuing new requests for proposals (RFP) for Medicaid managed care organizations (MCO). Also, we have provided an estimate of how often they issue them. These can be accessed from rows 3-7 of the attached spreadsheet.

KEY FINDINGS

  • On July 14, 2017, Florida issued its last RFP for MCOs. Hence, the projected date when it will issue new RFPs for MCOs is on the 14th of June 2022. The frequency is five years.
  • California has updated its new RFP schedules for MCOs to hold in January 2020.
  • Between September 15, 2017, and December 4, 2017, Texas issued, canceled and re-issued RFPs for MCOs for various reasons. Hence, the projected date when it will issue new RFPs for MCOs is between September 15, 2019, and On December 4, 2019; as Texas offers a contract duration of two years to MCOs.
  • On October 5, 2015, Indiana released the last RFPs for MCOs. Therefore, because it offers a base contract duration of four years, the projected date for the next release would be on October 5, 2019. The estimated frequency is four years.


RESEARCH STRATEGY

To address this request, for each state, we sought for any announcements from their respective healthcare administration agencies and state medicare agencies on the when they will take new RFPs. This strategy yielded the next RFP schedule for California but did not provide the frequency. Also, there were no RFP schedules for the rest of the states — Florida, Texas, Ohio, and Indiana. Furthermore, we searched through industry reports and some local media outlets for any news on their RFP schedules for MCOs but found no additional information.

Alternatively, we sought to provide an estimate of the requested information based on the most recent RFP that was issued out and the contract duration. By simply adding the contract duration to the date the most recent RFP was issued, we projected a very likely date for the next time RFPs will be issued. While we could prove that Florida issues a statewide RFPs for MCOs once, we could not prove the same for the rest of the requested states. Hence, we went ahead to apply this strategy based on the assumption that the states (Texas, Ohio, and Indiana) do not issue new, additional RFPs for MCOs within the projected period or duration.

For Florida, we provided the projected date when the next RFP for MCOs would be issued as a range of months. This because there were several cancellations and withdrawals of their RFPs for reasons, such as making modifications to the RFPs to include a target population and others. Thus, we picked the first date and the last date that they were issued, added the contract duration to obtain a projected range.

However, the above strategy could not be applied for California and Ohio. For California, we could not find the contract duration that it offers to MCOs. While we identified some articles that published some MCOs that are in contract with the state, no information on the contract duration was provided. We also found the boilerplate contract templates it uses for MCOs but no information on the duration was included in these templates. For Ohio, the state recently issued its first-ever RFPs for MCOs because in the past, "Ohio contracted private health insurance corporations to assist it in managing Medicaid benefits for Ohioans." Therefore, we provided the date it issued the first RFP for MCOs, as it appears that the window is still open.
Part
02
of three
Part
02

Medicaid MCO RFPs by State, Part 2

Missouri's next date for issuing new rests for proposals (RFPs) for Medicaid Managed Care Organizations (MCOs) is on 05/01/2022, while for New York, it will be on 11/05/2019. This information is not available for Massachusetts, Tennessee, and Virginia. Details have been entered in the attached spreadsheet.

MISSOURI

  • Date of the last issuance of RFPs for Medicaid MCOs: 05/01/2017 
  • Next date for issuing new RFPs for Medicaid MCOs: 05/01/2022 
  • Frequency of issuance: every 5 years 

NEW YORK


OTHER HELPFUL FINDINGS

Below are the dates of the last issuance of RFPs for Medicaid MCOs of the following states:

RESEARCH STRATEGY:

In order to determine the date each of the assigned states will be issuing new requests for proposals (RFPs) for Medicaid Managed Care Organizations (MCOs) and the length of these contracts, we commenced our research by scanning through the annual reports, press releases, white papers and other resources in the health and medical section of the respective government websites of Missouri, Massachusetts, Tennessee, New York, and Virginia. This strategy helped us in identifying the date New York will be issuing new RFPs for Medicaid MCOs. The government website of the other states did not disclose the next date when RFPs will be issued.

Secondly, we shifted our focus to when the assigned states last issued contracts and see how long the contracts will be through the state government websites as well as other organizations covering the latest updates on RFPs for Medicaid MCOs for different states. A white paper by Missouri Foundation for Health identified the date when they last gave out contracts and then we checked how long the contracts will be. For the remaining states, Massachusetts, Tennessee, and Virginia, we only found the dates when they last gave out contracts but we were not able to identify the length of the contract. Since neither of the official websites nor any public sources mentioned the length or frequency of such contracts, therefore, we could not calculate/derive the date of issuance of the new RFPs for Medicaid MCOs for Massachusetts, Tennessee, and Virginia.

As our last resort, we attempted to look for Medicaid MCOs that won the RFPs for Massachusetts, Tennessee, and Virginia. The idea was to check the websites, press releases, and any other publication by these Medicaid MCOs that talk about the length of contract. This strategy helped us find some MCOs associated with the respective states and their terms and lengths of contracts. But none of these contract pertained to the issuance RFPs for Medicaid MCOs. The contracts we found include Tennessee with 3 MCOs (UnitedHealthcare Plan, Amerigroup, and Volunteer State Health Plan), Virginia with 6 MCOs (Virginia Premier, UnitedHealthCare Community Plan, UnitedHealthCare Community Plan, Optima Health, Magellan Complete Care, and Aetna Better Health and Anthem HealthKeepers Plus), and 2 MCOs associated with Massachusetts (Boston Medical Center Health Plan [BMCHP] and Tufts Health Public Plans [Tufts]).

As per the research conducted, we found the dates of the issuance of the next RFPs for Medicaid MCOs and the frequency of issuance for Missouri and New York. We only found the dates of the last issuance for Massachusetts, Tennessee, and Virginia and the other required information is not available in the public domain. Therefore, we entered N/A in sections pertaining to the 3 states in the attached spreadsheet.

Part
03
of three
Part
03

Medicaid MCO RFPs by State, Part 3

The four states researched for managed care organizations (MCOs) request for proposals (RFP) are Washington, Arizona, Georgia, and Colorado. Of the four states, Colorado does not have a state centralized Medicaid system and is regionally based. The State calls the program “Accountable Care Collaborative” (AAC). According to AIS Health, Georgia is possibly open to the renewal of its RFP in 2019. The details are in the attached spreadsheet, rows 13 to 16, and columns B to D. Below, we discuss the topic in more detail.

Washington

  •  Washington runs their Medicaid MCO RFP annually with the option to renew yearly for the following two years. 
  • The RFP is issued in February and the subsequent date the RFP would be issued is 15th February 2020.
  • Though no 2019 details were found for the 2020 RFP, there were clear details laid out for the date of submissions and requirements for the 2019 year. This is possibly due to the current contracts being renewed.
The details were used in the brief below as an example of what is needed annually. 
  • For the 2019 season, the RFP was issued on February 15th, 2018.
  • The “Mandatory LOI Due” date was March 1st, 2018.
  • Their proposals were due by April 12th, 2018.
  • Washington awarded the Medicaid MCO on May 22nd, 2018.
  • The RFP was implemented on January 1st, 2019.

Arizona

  •  Arizona runs their Medicaid MCO RFPs on a three-year term with the option to renew for another two two-year option. 
  • The last RFP was issued on November 2nd, 2017 and implemented on October 1st, 2018. The next date they would issue the RFP is November 2nd, 2020.
Arizona’s Medicaid details used in the brief below are an example of what they need every three years. 
  • For the 2018 season, the RFP was issued on November 2nd, 2017.
  • A “Pre-proposal Prospective Offerors Conference,” was held November 8th, 2017.
  • The first questionnaire was due November 14th, 2017.
  • The second questionnaire was due December 8th, 2017.
  • A proposal due date was on January 25th, 2017.
  • The contract awards were on or Before the March 28th, 2018. 
  • The 2018 implementation was on or After October 1st, 2018.

Georgia

  • Please note Georgia Swaps the MCO around and calls it Care Managed Organization CMO.
  •  Georgia runs their Medicaid CMO RFPs annually with the option to renew yearly for the following five years.
  • Georgia issued the last precise details of the RFP process in February 15th, 2015. The State was due to implement the RFP on July 1st, 2016. According to a "OPEN MINDS" report the implementation was delayed until July 1st 2017 due to protests. 
  • According to an AIS Health report the next date they might have issued the RFP is 2019. As the last known new RFP date was February 15th, 2015, the next new issue of a new RFP or renewal is likely to be February 15th 2020.

Colorado

  • Colorado does not issue a state Medicaid MCO RFP, and the system is managed in each region separately.
  • The State calls their MCOs a “Regional Accountable Entity” (RAE) and Medicaid the “Accountable Care Collaborative” (AAC).
  • On May 11th, 2017 an RFP was issued for RAE’s in the ACC program. Colorado implemented the program July 1st, 2018 which runs for seven years with an extension if needed.
  • The next request for proposals date will be May 11th, 2024.
  • RAE’s had a startup period which began February 1st, 2018 and ended June 30th, 2018. This was to ensure all the necessary requirements were in place before the program was operational on July 1st, 2018.
Sources
Sources
From Part 01

Florida awards Medicaid contracts as expansion speculation builds`

modernhealthcare.com
Publication Year: 2018
h

Health Management Associates - HMA Weekly Roundup

healthmanagement.com
Publication Year: 2017

Texas

nasuad.org
Publication Year: 2017
h

Health Management Associates - HMA - Weekly round up - Texas

healthmanagement.com
Publication Year: 2017
d

Medi-Cal Managed Care Request for Proposal (RFP) Schedule by Model Type

dhcs.ca.gov
Publication Year: 2019
h

HMA - Indiana

healthmanagement.com
Publication Year: 2015

DeWine Directs Medicaid To Bid Managed Care Contracts

leadingageohio.org
Publication Year: 2019

Engineering outcomes: Managed care and value-based design in Ohio Medicaid - The Center for Community Solutions

communitysolutions.com
Publication Year: 2019

Ohio to rebid costly private Medicaid contracts

daytondailynews.com
Publication Year: 2019

Medicaid MCOs

docs.google.com
Publication Year: 2019
From Part 02
m

Medicaid Managed Care Final Rule: Implications for Missouri

mffh.org
Quotes
  • "Renewable five-year terms, rather than three-year terms."
h

Trends in State Health Policy

healthmanagement.com
Publication Year: 2017

TennCare Timeline

tn.gov
Quotes
  • "October 2, 2013: The State issued an RFP for three MCOs to provide managed care services statewide, rather than in selected Grand Regions, with service delivery set to begin on January 1, 2015."
h

Request for Proposals

health.ny.gov
Publication Year: 2019

TennCare Contracts

tn.gov

MassHealth contracts with two Managed Care Organizations

mass.gov
Publication Year: 2017

Compare Plans

virginiamanagedcare.com

Medicaid MCOs

docs.google.com
Publication Year: 2019
From Part 03

Washington Releases 2019/2020 Integrated Managed Care RFP | Health Management Associates

healthmanagement.com
Publication Year: 2018
Quotes
  • "MCOs are required to submit a mandatory letter of intent to propose by March 1. Proposals are due on April 12, with “Apparently Successful Bidders” selected on May 22, 2018. Contracts run for one year, with renewal options for two (2) one (1)-year periods."
h

ARIZONA, MEDICAID MANAGED CARE RFPS REVIEWED

healthmanagement.com
Publication Year: 2017
Quotes
  • "The initial term of the contract is three years with two two-year optional extensions, for a full potential term of seven years. Implementation of the contracts is expected on or after October 1, 2018. "

Medicaid Plans Face Busy Year of Procurements, Waivers - AIS Health

aishealth.com
Publication Year: 2019
Quotes
  • "Other experts cite states’ activities on Medicaid managed care contracting. “We’re entering into a ‘warm’ bid year where you have perhaps Georgia open for RFP, North Carolina will close its RFP, Minnesota will presumably open an RFP as well as Kentucky [and] perhaps Ohio,” says Alex Shekhdar, vice president of policy at Medicaid Health Plans of America. "

Georgia Medicaid Finalizes MCO Contracts With Amerigroup, Centene, Wellcare, & CareSource | OPEN MINDS

openminds.com
Publication Year: 2016
h

GEORGIA ISSUES MEDICAID MANAGED CARE REQUEST FOR PROPOSALS (RFP)

healthmanagement.com
Publication Year: 2015
Quotes
  • "RFP responses are due on May 4, 2015, with two rounds of questions and answers in the meantime. The state currently plans to announce awards in early July. Services under the new contracts will begin on July 1, 2016. Timeline "

Care Management Organization Procurement for Georgia Families and Georgia Families 360 Programs

dch.georgia.gov
Publication Year: 2019
Quotes
  • "The State Purchasing Division (SPD) has issued a Request for Proposal (RFP) on behalf of the Department of Community Health (DCH) to establish a contract with up to four (4) qualified Care Management Organizations (CMOs) for the provision of services and benefits for Georgia Families, the State’s managed care program for Medicaid, PeachCare for Kids® members and Planning for Healthy Babies (P4HB) participants. "

Health First Colorado Regional Organizations - Health First Colorado

healthfirstcolorado.com
Publication Year: 2019
Quotes
  • "You and your primary care provider belong to a regional organization that helps you make sure you get the health care and services you need"

Medicaid MCOs

docs.google.com
Publication Year: 2019
t

Regional Accountable Entity for the Accountable Care Collaborative

tre.org
Publication Year: 2017
Quotes
  • "The Operational Start Date will be July 1, 2018."
  • "The total duration of the Contract, from the Operational Start Date until termination, and including the Department’s exercise of any options, is not anticipated to exceed seven (7) years. "