Pennsylvania to open bidding on $17B in Medicaid business, including home- and community-based services

September 16, 2015

The Pennsylvania Department of Human Services is taking steps to put $17-billion worth of Medicaid business out for bid to private companies. Officials have opened the bidding for new managed Medicaid contracts, which will require the winners to ensure that at least 30% of their Medicaid payments to providers are based on value or quality, not strictly on the amount of care provided. The contracts will cover $12 billion in spending. Meanwhile, the department, in conjunction with the department of aging, released its plan turn over to private companies the management of $5-billion worth of long-term services for seniors and disabled adults. The proposal, called Community HealthChoices, aims to shift money toward home- and community-based services and away from institutions, such as nursing homes. DHS expects to put the long-term services contract out to bid in November, with services scheduled to start on Jan. 1, 2017, in southwestern Pennsylvania.
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