Disease State Management Programs
03.02.05 DCH Issues RFP for Disease State Management for the Aged, Blind and Disabled
On March 2, 2005, the Georgia Department of Community Health released a Request for Proposal for Disease State Management programs for the aged, blind and disabled Medicaid populations. The Proposals are due by April 13 with an award date slated on or about May 10. The Disease Management programs are expected to “go live” by August 15 with the implementation of performance measures the following month, on September 15, 2005. DCH states that the objective of the procurement is: “to obtain the services of qualified, experienced, accredited, and financially sound disease management organizations ("DMOs") to develop and administer a disease management program in one of two regions of the state.”
For purposes of the RFP, the State has been divided into two Service Regions: Atlanta/North Georgia (Region 1), and Central/South Georgia (Region 2). DCH plans to award one Contract per Service Region for the services described in the RFP. Offerors have been allowed to bid on both Service Regions by submitting a separate proposal for each Service Region. However, no Offeror is allowed to be awarded more than one Service Region. Offerors are also allowed to engage in Subcontractor agreements with specialty vendors used in performance of the proposed scope of work, subject to DCH approval. DCH states that Proposals for partial work will not be accepted.
Offerors have been offered detail data containing information on medical, long term care, and pharmacy claims history, and eligibility information for the Medicaid ABD population spanning State Fiscal Years 2000-2002; they will also be provided pharmacy claims and eligibility information for the Medicaid ABD population spanning State Fiscal Years 2003-2004.
MAG has met with a few of the Managed Care Plans and is currently looking at their track record in other states. MAG’s initial concerns are that the proposal was developed without input from the impacted physicians and patients, thus we are not assured that the primary care physician is sufficiently involved in the disease management process. Preliminary discussions with other state medical society staff reveal that problems do occur if there is insufficient lead-time for beginning the program or if the physician isn’t readily informed of each stage of development and activities by the program.
MAG will continue to keep your informed as the final bidders are selected.