IMT Trip.docx

This is a Pre-Proposal Network Opportunities Form for Request for Proposal 27-88343 issued by the Indiana Family and Social Services Administration's Office of Medicaid Policy and Planning to procure managed care organizations to provide statewide risk-based Medicaid services. The RFP solicits proposals to serve approximately 1.5 million Hoosiers across four programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging. Proposals are due November 6, 2026, with a pre-proposal conference scheduled for September 10, 2026. Written questions are due September 11, 2026, with responses by October 2, and a second question round closing October 9 with responses by October 23. Proposal discussions, oral presentations, and Best and Final Offers are anticipated in May 2027, with Award Recommendation in July 2027. The contract term is four years with two optional one-year renewals available at the state's discretion, for a potential total of six years.

Respondents must be Indiana-licensed health maintenance organizations with current MCO service in at least one state and at least five years of prior MCO experience, achieving NCQA accreditation by contract start or no later than the end of the second full calendar year of operation. Administrative offices must be located within five miles of the Indiana Government Center in Indianapolis. The estimated base capitation value exceeds $4.9 billion across all programs for the initial rating period, with state fiscal year 2027 rates ranging from $305.42 PMPM for Hoosier Healthwise to $3,468.29 PMPM for PathWays for Aging. Evaluation criteria total 90 points (91 with bonus) covering Adherence to Mandatory Requirements, Management Assessment and Quality, Oral Presentations, Buy Indiana Initiative (5 points), and Indiana Veteran Owned Small Business subcontracting (5 points with 1 bonus point available, with a 3 percent subcontracting goal). Contractors must maintain minimum Risk Based Capital ratios of 300 percent per NAIC standards and are subject to a pay-for-outcomes program withholding 1.85-2.25 percent of capitation payments annually from 2029-2034, with estimated recovery of 60-70 percent based on performance against HEDIS and outcome measures.