A state Medicaid agency was directed to design and procure a managed care program for the state’s intellectually and developmentally disabled (IDD) population. The pilot would test the effectiveness of a managed care approach for the IDD members. The pilot was to include both allowing provider organizations to bid alongside managed care organizations (MCOs. The agency enlisted Sellers Dorsey to assist with each step of the process.
Crafting this procurement to meet all the state’s goals proved an intricate process, and Sellers Dorsey provided comprehensive guidance at every stage. Key points in the project included:
- Reviewing and analyzing request for information (RFI) responses
- Recommending policy and program strategies to address stakeholder concerns raised in the RFI
- Designing and developing a model for the pilot structure
- Writing a request for proposal (RFP) in collaboration with state staff
- Recommending policy, program, and reimbursement strategies with stakeholder input
- Managing and obtaining stakeholder input, including stakeholder forums to gather input on the IDD managed care pilot
- Designing and developing a procurement evaluation process
- Developing readiness review criteria, timeline, and work plans for the pilot
The procurement led to the selection of two MCOs to operate the pilot. Although the state later chose not to move forward with the pilot, some of the procurement enhancements and innovations introduced by Sellers Dorsey were incorporated into another of the state’s Medicaid managed care procurements.