The Agency for Health Care Administration (Agency) has posted a Request for Information (RFI) relating to the procurement of the Statewide Medicaid Managed Care (SMMC) Program (AHCA RFI 014-21/22 Re-Procurement of the SMMC Program. The RFI may be viewed HERE.  

In preparation for the upcoming procurement, the Agency is seeking information from entities and stakeholders with direct experience in the managed health and long-term care industries regarding best practices and innovations in business models as well as service delivery for Medicaid managed care.  

The Agency is interested in innovative ideas and best practices to:  

  • Leverage the managed care delivery system, either through expanded benefits or other mechanisms, to promote sustainable economic self-sufficiency among Medicaid recipients in the short and long term. 
  • Improve birth outcomes for mothers and infants through and beyond 12-month postpartum coverage period. 
  • Utilize value-based payment designs to simultaneously increase quality and reduce costs.
  • Maximize home and community-based placement and services through proactive aging-in place strategies. 
  • Improve integration of dental and primary care services for children and adolescents. 
  • Align quality metrics and outcomes with the Florida State Health Improvement Plan. 
  • Enhance specialty health plans services to improve outcomes for recipients. Increase the number of plans to address target populations with specific health conditions or needs. 
  • Increase access to community-based pharmacists within prescription benefit manager networks.
  • Improve mental health outcomes for children and adolescents. 
  • Improve coordination of care for individuals enrolled in both the Medicare and Medicaid programs. 
  • Decrease mortality rates for recipients with complex chronic diseases and address payment strategies for high-cost therapies and prescription drugs in development. 
  • Consider innovative delivery methods, including care bundling, that empower recipients in making more informed health care decisions. 
  • Improve providers’ experience with the SMMC Program.
  • Improve recipients’ experience with the SMMC Program. 
  • Increase timely access to providers and services. 
  • Achieve cost savings throughout the SMMC Program.  

The Agency will consider information gathered from responses to this RFI in preparing the competitive procurement for the Statewide Medicaid Managed Care program which is scheduled for release in the fourth quarter of CY (Calendar Year) 2022.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.