By OPEN MINDS Circle
On July 11, 2022, the Minnesota Department of Human Services (DHS) released a request for proposals (RFP) for provider organizations interested in participating in the stateās Integrated Health Partnerships (IHP) Demonstration. The IHP is an accountable care model that serves Medicaid fee-for-service and MinnesotaCare managed care enrollees under a total cost of care and risk/gain sharing payment arrangement. The goal of the IHP program is to improve the quality and value of the care provided to the citizens served by Minnesotaās public health care programs. The request for proposals (RFP GK201) was released on July 11, 2022. Letters of intent are due on August 19, 2022, and proposals must be submitted by August 26, 2022.
The contracts are anticipated to run from January 1, 2023, to December 31, 2026, with the option to extend up to a total of five years. Minnesota currently has 27 delivery systems participating in the IHP program providing care to over 445,000 Minnesotans. Existing IHPs whose contract expires December 31, 2022, or earlier must submit a response to this RFP to be considered for participation in the IHP program for the next contract period.
Responders must provide or coordinate the full scope of health care services, as evidenced by provision of coordinated care, and/or prior or current participation in an outcomes-based contract with Centers for Medicare and Medicaid Services (CMS) or Medicaid. Accepted forms of evidence of provision of coordinated care include but are not limited to:
- Health Care Home (HCH) Certification for most clinics planning to participate in the Respondentās proposed IHP
- National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) Recognition
- Current/past participation in IHP demonstration as an IHP
- Additional evidence or documentation of ability to provide or coordinate full scope of health care services
The IHP program was designed to reduce the Total Cost of Care (TCOC) for Medicaid beneficiaries while maintaining or improving the quality of care. The goal of the IHP program is to allow provider organizations to participate in value-based payment arrangements, support innovations that address social determinants, and close health disparity gaps.
In the IHP, participating provider organizations contract with DHS to serve beneficiaries enrolled in Minnesota Health Care Programs (MHCP), whether they are in the fee-for-service program or enrolled in a Medicaid managed care organization. The IHPs are accountable for the total cost of care and quality of services provided to their attributed beneficiaries. Within this structure, DHS seeks to expand the IHP program in different geographic regions of the state and across different models of care delivery that will integrate health care with addiction treatment and mental health services, safety net provider organizations, social service agencies, and community-based organizations. The RFP did not state how many provider organizations would be selected for IHP contracts, nor did it specify whether the selected provider organizations could serve more than one geographic area.
The IHP projects will include clear incentives for improving quality of care, closing health disparities, addressing social determinants of health, targeted savings, and will result in increased competition in the marketplace through direct contracting with providers. Core principles of the program are:
- Recognition that āvalue-basedā payment arrangements for health care consists of cost, utilization, and quality components.
- Emphasis on quality and quality improvement to close gaps in care and ensure equitable care for MHCP enrollees.
- Promoting IHP sustainability and innovation through population-based payments paid on a quarterly basis for IHP-attributed beneficiaries which will encourage IHP responsibility for beneficiary care coordination, quality of care provided, and TCOC.
- Addressing non-medical health factors by incentivizing community partnerships between medical and non-medical providers; both recognizing the additional risk and investment required to establish and incorporate non-medical community partnerships into the health system, and rewarding non-medical providers appropriately for contribution to beneficiary and population health.
- Commitment to the identification and elimination of health disparities faced by people enrolled within an MHCP program, whether based on race, ethnicity, sexual orientation, geography, age, sex, disability status, socio-economic background, or other factors.
- Claims-based attribution with an emphasis on primary care but that is flexible based on services provided and coordinated by the IHP.
IHPs will be evaluated on quality, health equity, and utilization measures to determine eligibility to continue participation in the IHP program after the conclusion of each contract cycle. Proposals will be evaluated in three phases: required statements review, evaluation of proposal requirements, and selection of successful responder(s).
The proposals will be evaluated based on eight criteria, as follows:
- Cover sheet: 5 possible points
- Background information and organizational structure: 10 possible points
- Leadership and management: 15 possible points
- Financial plan and experience with risk sharing: 10 possible points
- Clinical care model: 20 possible points
- Quality measurement: 15 possible points
- Population Health: 15 possible points
- Community partnerships: 10 possible points
For more information about the procurement, or about the current IHP Program, contact: Mathew Spaan, Manager, Care Delivery & Payment Reform, Health Care Administration, Minnesota Department of Human Services, Health Care Administration; Email: Mathew.Spaan@state.mn.us; Website: https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-health-care-programs/integrated-health-partnerships/