Louisiana’s Department of Health and Hospitals (DHH) develops and provides health and medical services for the prevention of disease. This is especially needed for those individuals who are indigent and uninsured, persons with mental illness, persons with developmental disabilities, and those individuals with addictive disorders.
On July 28, the Louisiana Department of Health and Hospitals (DHH) issued a Request for Proposals (RFP) seeking qualified Managed Care Organizations to provide healthcare services statewide to Medicaid enrollees participating in the Bayou Health program in return for a monthly capitation payment.
Bayou Health program is a managed care organization healthcare delivery system responsible for providing specified Medicaid core benefits and services included in the Louisiana Medicaid State Plan to Medicaid recipients.
The RFP process is being used so that DHH may selectively contract with at least three and up to five MCO entities but no more than required to meet Medicaid enrollment capacity requirements. This will assure choice for Medicaid recipients as required by federal statute. A contract is necessary to help DHH ensure accountability while improving access, coordinated care, and to promote healthier outcomes.
The Bayou Health Program will need to achieve:
- Improved coordination of care
- A patient-centered medical home for Medicaid recipients
- Increased quality of care as measured by metrics such as HEDIS
- Earlier diagnosis and treatment of acute and chronic illness
- A more financially sustainable system
- Cost savings to the state as compared to a fee-for-service Medicaid delivery system
The deadline for the receipt of the Letter of Intent to propose is August 8, 2014, written proposals are due October 15, 2014, and the contract award will be announced November 3, 2014.
Go to http://new.dhh.louisiana.gov/assets/docs/contracts/BayouHealthPrepaidFINAL72814.pdf for more information. For questions or inquires, email Mary Fuentes at Mary.Fuentes@la.gov or call (225) 342-5266.