A multi-state Medicaid plan faced a competitive bid for contract renewal. The state is moving to mandatory managed Medicaid for its standard Medicaid population as well as dual-eligible and long-term services and supports’ enrollees who need home- and community-based services. It was a substantial rebid with a lot at stake.
The plan operates in a very crowded and competitive market. To protect its market share and win the bid, the plan needed to significantly expand its provider network and enhance enrollee access in multiple regions. Given the tight deadline to complete the expansion before the bid, the plan had to build enhanced networks rapidly and decided it required substantial outside support to complete the network expansion before the bid.