PA Re-bids Medicaid Managed Care Contracts

The Pennsylvania Department of Human Services (DHS) has issued a request for proposals (RFP) for organizations interested in serving the state’s Medicaid population through its HealthChoices Medicaid managed care program.

The HealthChoices program, introduced in 1997, currently serves nearly 2.5 million Pennsylvanians. Among them, 200,000 have enrolled in the program since the state’s Medicaid expansion began in January.

The new contracts will put a greater emphasis on value-based purchasing and will require participating insurers to provide at least 30 percent of their services in a value-based or outcomes-based manner within three years.   Among the tools managed care organizations are expected to employ to achieve this goal are accountable care organizations, bundled payments, and patient-centered homes.

With a projected value of about $17 billion, the RFP is expected to attract interest from national organizations that have not necessarily served Pennsylvania’s Medicaid population in the past.

To learn more about the state’s HealthChoices plans, see this news release from the Department of Human Services and this Philadelphia Inquirer article. Find the RFP itself here.

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