On June 1, 2021, the California Department of Health Care Services (DHCS) released its Medi-Cal draft Request for Proposals (RFP 20-10029), formally launching the first-ever statewide competitive procurement process for commercial Medi-Cal managed care plans (MCPs). This procurement is a unique opportunity for DHCS to significantly revise and modernize the MCP contract and to critically assess the expertise and capabilities of prospective plans on behalf of a diverse Medi-Cal population.

DHCS provided a 30-day public comment period for the draft RFP. At the same time, CHCF invited anyone submitting comments to DHCS to also share their comments with CHCF. CHCF’s goals were threefold: to listen to and learn from the feedback provided to DHCS, to make feedback widely available by posting online, and to foster greater transparency and accountability by identifying and sharing common themes.

CHCF received 19 responses to DHCS’s request for comments, 15 of which are posted on the CHCF website. The number of individuals and organizations represented in the responses ranged from a single individual to a collection of over 400 organizations. CHCF contracted with Bailit Health to analyze these responses and present a summary of key themes from the feedback to DHCS.

Bailit Health identified three types of recommendations. Commenters urged DHCS to:

• Release a complete and clear set of procurement documents for review and comment. Many respondents expressed their disappointment that the draft RFP released for comment was incomplete and unclear, and want DHCS to release a full set of procurement documents for public review and comment before the final RFP is issued.
• Strengthen MCP requirements related to improving access, quality, and equity. Many respondents would like MCP contract requirements to be strengthened, clarified, and expanded, particularly those relating to improving access to quality care, reducing racial and other disparities, and improving health equity for various groups and populations.
• Ensure adequate and fair payment policies and foster local partnerships. Respondents remarked that MCP rates should reflect and require adequate payment at the county and provider level, commensurate with expanded MCP requirements and expectations. Some respondents also encouraged DHCS to require successful bidders to partner with local providers, counties, and community-based organizations (CBOs) in a meaningful way to support, achieve, and sustain the goals that DHCS and stakeholders have for this procurement and for Medi-Cal managed care overall.

These recommendations were also presented in a webinar CHCF held on August 5, 2021.

DHCS has an unprecedented opportunity to consider and act on stakeholder feedback before releasing the final MCP procurement documents later in 2021 and again when finalizing the version of the MCP contracts that will be implemented on January 1, 2024. Through this procurement and reform of MCP contracting requirements, DHCS has the chance to improve quality care for Medi-Cal members and to make meaningful progress toward eliminating racial and other disparities in care.