California DHCS Issues RFP for Medi-Cal Managed Care Plan Contracts
DHCS is embarking on new relationships with the MCPs to redefine how care is delivered
By: Catie Hillard
February 18, 2022 – California’s Department of Health Care Services (DHCS) recently released a Request for Proposal (RFP) for commercial Medi-Cal managed care plan (MCP) contracts. The state relies on Medi-Cal managed care plans to provide Medicaid services.
This year, DHCS is starting a new relationship with its MCPs to redefine how care is provided. Through CalAIM, the state is committed to contracting with MCPs that can advance the quality, equity, and access of care. Additional oversight will be undertaken to ensure that MCPs are being held accountable.
The goal is to reduce health disparities and improve health outcomes for those utilizing plans in California. 1 in 3 Californians is enrolled in Medi-Cal. This includes more than half of children of school age. Additionally, more than two-thirds of long-term care patient days in the state are covered by Medi-Cal. With over 12 million individuals relying on Medi-Cal to provide care, California has the ability to transform the state’s entire health care system.
Partnering with Managed Care Plans
DHCS restructured its managed care plan contract to reflect the intention to hold plan partners and subcontractors accountable. These partners will need to show that they are committed to:
- Providing high-quality, accessible, and comprehensive care
- Reducing health disparities
- Improving health outcomes
DHCS has placed a strong emphasis on whole-person care, and the integration of social services into care plans through Community Supports. In parallel, California DHCS has also provided 17 counties conditional approval to change the type of managed care model that they participate in. In doing so, they provide counties the ability to increase oversight and coordination of care.
Managed care plan proposals are due by April 11, 2022. Contracts are expected to be awarded in August 2022. New contracts will apply to all Medi-Cal managed care plans effective January 1, 2024.
To learn more about Medi-Cal Managed Care Plan Procurement and updated contracts, click here.
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