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Lincoln – Nebraska Medicaid has released a request for proposals (RFP) seeking bids to provide healthcare benefits for at least the next five years to Nebraskans enrolled in Medicaid. Nearly all Nebraska Medicaid beneficiaries currently receive their physical health, behavioral health, and prescription drug benefits through Heritage Health, Nebraska's integrated managed care program. These new contracts will continue this program.
Nebraska Medicaid's RFP seeks proposals from entities best able to effectively deliver quality services. With these new contracts, the health plans will also be required to provide dental benefits. (Currently, these services are provided by a separate contract.) Similarly, Nebraska Medicaid will be increasing dental rates to providers and removing the annual dental benefit limits for adults. These changes will promote preventative care that is timely and aimed at improving health outcomes.
Medicaid Director Kevin Bagley is thankful to stakeholders across the state who attended listening sessions in January to share their experiences with Heritage Health. This feedback informed key changes to the updated contracts.
“Hearing directly from Medicaid members and providers on what we could do to improve our managed care program was an invaluable experience," Bagley said. “Fostering consistency between our health plans in regard to provider credentialing and service delivery was a common theme we heard in many of these sessions, as was finding ways to improve access to dental services. We hope these new additions to Nebraska's next managed care contracts make positive progress in improving the member and provider experience."
One of the key features of the new contracts will be an integrated service delivery across the spectrum of core services. This includes physical, mental and behavioral health, pharmacy and dental benefits. This will better align incentives for Heritage Health plans to provide meaningful access to services, which should allow for improved health outcomes for Medicaid members statewide.
The RFP also includes a requirement for bidders awarded a contract to establish a common provider credentialing service. Providing a single point of entry for provider credentialing through Medicaid managed care plans will reduce administrative burdens on providers and streamline the process to improve member access.
In response to additional feedback Nebraska Medicaid heard during these listening sessions, the program is working to develop better ways to evaluate health plan performance. The new contracts will require the health plans to report to Nebraska Medicaid certain clinical quality and program efficiency metrics developed by the federal government. Nebraska Medicaid is also continuing to look into ways care and case management can be better utilized, as well as offering more opportunities for stakeholders to provide feedback about how Heritage Health is working.
Nebraska Medicaid is planning to announce the winning bidders in August 2022. To view the full RFP, and for more details on how to submit a bid, please visit https://das.nebraska.gov/materiel/purchasing/112209%20O3/112209%20O3.html