DHHS Releases Request for Proposal for Prepaid Health Plans
Today the
In 2015, the
This RFP reflects three years of collaboration with and extensive feedback from beneficiaries, clinicians, hospitals, counties, health plans, elected officials, advocates and other stakeholders to design the managed care program. DHHS hosted listening sessions across the state, reviewed more than one thousand written public comments and released 15 policy papers on different aspects of the program.
This RFP is the largest procurement in DHHS history. It clearly communicates DHHS' requirements and defines the standards that PHPs must adhere to in contracting with DHHS. All plans will be subject to rigorous oversight by DHHS to ensure strong provider networks, a full range of benefits, accountability for quality and outcomes, a positive beneficiary experience and timely payments to providers among aspects of a successful managed care program.
"DHHS is committed to improving the health and well-being of all North Carolinians through an innovative, whole-person centered, and well-coordinated system of care that addresses both medical and non-medical drivers of health," said DHHS Secretary
Among the innovations in this RFP for the North Carolina Medicaid managed care program are:
* The integration of physical health, behavioral health and pharmacy services so all managed care beneficiaries will have one insurance card and one health plan managing their care.
* An Advanced Medical Home (AMH) program that will preserve broad access to primary care services for Medicaid enrollees while strengthening the role of primary care in local care management, care coordination and quality improvement.
* Encouraging smart investments in areas that impact health outside of health care services, known as Opportunities for Health, in the domains of housing, food, transportation, employment and interpersonal safety, to build on work already being done in communities.
This procurement is only for the Standard Plans in which most Medicaid managed care beneficiaries will be enrolled.
DHHS will accept proposals from potential PHPs until
This is an official procurement. Send all procurement inquiries to
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