Organizations react to Medi-Cal managed care procurement request for proposals
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (California HealthCare Foundation)
- Author(s):
- Dyer, Mary Beth, author Waldman, Beth, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, September 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Competitive Bidding Managed Care Programs Medicare California United States
- Genre(s):
- Technical Report
- Abstract:
- The California Department of Health Care Services (DHCS) administers Medi-Cal, the largest Medicaid program in the country. The state’s Medi-Cal program provides coverage to almost 14 million Californians statewide, including children, adults, families, seniors, and people with disabilities.2 Over 11.6 million of these Medi-Cal enrollees get their health care through a Medi-Cal managed care plan (MCP).3 Of these, approximately 70% identify as people of color, including Latinx, Black, Asian, and American Indian and Alaskan Native individuals. In 2021, DHCS will spend over $50 billion paying MCPs to provide Medi-Cal enrollees with a comprehensive set of health care services, including behavioral health services to those with mild to moderate mental illness. Of the 24 MCPs contracting with DHCS, 16 are locally sponsored plans (10 local initiative plans and 6 County Organized Health System plans). The remaining MCPs are a mix of for-profit and nonprofit commercial plans operating in 22 of the 58 California counties. On June 1, 2021, DHCS released its Medi-Cal MCP draft request for proposals (RFP 20-10029), formally launching the first-ever statewide competitive procurement process for commercial MCPs. This procurement is a unique opportunity for DHCS to significantly revise and modernize the MCP contract and to critically assess the expertise and capabilities of prospective plans on behalf of a diverse Medi-Cal population. DHCS provided a 30-day public comment period for the draft RFP. At the same time, the California Health Care Foundation (CHCF) invited anyone submitting comments to DHCS to also share their comments with CHCF. CHCF’s goals were threefold: to listen to and learn from the feedback provided to DHCS, to make the feedback widely available by posting it online, and to foster greater transparency and accountability by identifying and sharing common themes. CHCF received 19 responses to DHCS’s request for comments, 15 of which are posted on CHCF’s website. The number of individuals and organizations represented in the responses ranged from a single individual to a col lection of over 400 organizations.5 CHCF contracted with Bailit Health to analyze these responses and present a summary of key recommendations and themes. This brief presents Bailit Health’s analysis, consisting of an overview of the MCP procurement timeline, a description of the study methodology, the results of Bailit Health’s analysis of the comments shared with CHCF, and a short conclusion.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (13 pages)).
- NLM Unique ID:
- 9918366981406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918366981406676