MM Curator summary
Delaware is beginning the process to shape its next Medicaid managed care RFP.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
NEW CASTLE (July 13, 2021) – The Department of Health and Social Services’ Division of Medicaid and Medical Assistance (DMMA) is beginning the process of identifying Managed Care Organizations (MCOs) to operate its Medicaid Managed Care Program beginning Jan. 1, 2023.
DMMA currently contracts with two MCOs, AmeriHealth Caritas Delaware and Highmark Health Options. to provide physical health, behavioral health, and long-term services and supports to individuals, families, children, and seniors enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) in Delaware. Those contracts expire at the end of 2022.
Delaware’s Medicaid managed care program provides comprehensive health coverage to more than 240,000 eligible Delawareans, or almost 25% of the state’s population.
This procurement process is an opportunity for DMMA to reexamine and improve the program and expectations for the MCOs. Strategic principles for the 2023 procurement include:
• Member focus: Medicaid innovation should improve quality and outcomes for members and advance health equity.
• Accountability: MCOs will have increased accountability to the Delaware Department of Health and Social Services (DHSS) for program costs, performance, and creativity.
• Lead by example: Medicaid, in partnership with the MCOs, will lead by example when it comes to innovation across Delaware’s health care system.
• Promote program evolution: DMMA will use the procurement process as an opportunity to build upon the existing contract and our successes in Medicaid and CHIP.
• Cross-agency collaboration: DMMA will look for ways to align with other DHSS programs and state initiatives.
DMMA will host four virtual town hall meetings to get input on goals and procurement priorities for the managed care delivery system. Meetings are open to the public; however, each meeting will focus on getting feedback from either members or providers. Closed captioning and an ASL interpreter will be available for all meetings.
“Medicaid managed care offers flexibility to implement innovative programs that support health care providers and enhance health outcomes for our members,” said Steve Groff, Director of DMMA. “We hope the Town Halls will give interested parties the opportunity to share best practices and provide input with regard to program improvements.”
The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.