Kentucky’s Beshear Administration wants to implement managed care within the state Medicaid Program to help balance the state’s budget. To accomplish that goal, the Administration initially issued a Request for Information (RFI) to gather ideas and suggestions on how managed care principals might be applied to the program. Several companies responded to the RFI.
On April 7, 2011, the Administration issued a Request for Proposals (RFP) regarding managed care within Medicaid so that the state can begin to hire vendors to set up and manage services for the state.
The Commonwealth through the RFP titled “CHFS Medicaid Managed Care Organizations” (758 1100000276) is going to contract with multiple managed care organizations in each of the Medicaid Managed Care Regions that deliver healthcare services to Kentucky Medicaid members at the most favorable, competitive prices. Companies can bid to manage Medicaid throughout the state but also to manage Medicaid within one of eight geographic regions of the state.
The goals of the RFP are to measurably improve healthcare outcomes in diabetes, coronary artery disease, colon cancer, cervical cancer, behavioral health, prenatal care, and oral health. In addition, the goal is to reduce unnecessary ER visits, improve care coordination especially for individuals with chronic illnesses, promote wellness and healthy lifestyles, and to lower the overall cost of healthcare. Vendors would also be responsible for customer service, financial management, claims management, and for maintaining sufficient information systems.
Companies that are interested must respond by May 25, 201. Questions must be received by April 20th, and the vendors’ conference will be held May 11th. The goal is to have one or more managed care companies operational by July 1, 2011. To view the RFP, go to https://emars.ky.go/online/vss/Advantage or call (502) 564-4510.