RFI 6097-0 final tlh~1.pdf

OB #S-44300-00013336 OHA RFI #6097 Page 1 of 17

State of Oregon

Oregon Health Authority Oregon Health Plan

REQUEST FOR INFORMATION (RFI)

RFI OHA # RFI 6097

OregonBuys # S-44300-00013336

Date of Issue: March 26, 2025

Closing (Responses Due): April 16, 2025 at 4:00 PM (Pacific Time)

Issuing Office: Office of Contracts & Procurement on behalf of the Oregon

Health Authority, Public Health Division

Single Point of Contact: Tammy L. Hurst, Procurement Specialist Address: 500 Summer Street NE E-03 City, State, Zip Salem, Oregon 97301 Phone (voice) 971-208-4108 E-mail: tammy.hurst@odhsoha.oregon.gov

You can get this document in other languages, large print, braille, or a format you prefer free of charge.

Contact the Contract Administrator at the contact information found below. We accept all relay calls.

mailto:tammy.hurst@odhsoha.oregon.gov

OB #S-44300-00013336 OHA RFI #6097 Page 2 of 17

Table of Contents SECTION 1: General Information

1.1 INTRODUCTION

1.2 BACKGROUND

1.3 REQUEST FOR INFORMATION: PURPOSE

1.4 RESPONDENTS

1.5 PROJECT OVERVIEW

1.6 DUE DATE

1.7 SINGLE POINT OF CONTACT (SPC)

SECTION 2: Scope

2.1 SERVICE AREA CONSIDERATIONS / RATE SETTING

2.2 COMMUNITY PARTNERSHIPS

2.3 HEALTH EQUITY

2.4 TRADITIONAL HEALTH WORKERS & WORKFORCE

2.5 LANGUAGE ACCESS AND ACCESSIBILITY

2.6 CHILDREN’S SERVICES & SCHOOL-BASED HEALTH

2.7 CARE COORDINATION SERVICES

2.8 BEHAVIORAL HEALTH

2.9 ORAL HEALTH

SECTION 3: SUBMISSION AND RESPONSE REQUIREMENTS

3.1 SUBMISSION REQUIREMENTS

3.2 OWNERSHIP/PERMISSION TO USE MATERIALS

ATTACHMENT A — RESPONDENT INFORMATION AND CERTIFICATION SHEET 9

ATTACHMENT B — DISCLOSURE EXEMPTION AFFIDAVIT 10

ATTACHMENT C - RESPONSE COVER SHEET 12

ATTACHMENT C-1 - RESPONSE 13

SERVICE AREA CONSIDERATIONS / RATE SETTING

COMMUNITY PARTNERSHIPS

HEALTH EQUITY

TRADITIONAL HEALTH WORKERS & WORKFORCE

LANGUAGE ACCESS AND ACCESSIBILITY

CHILDREN’S SERVICES & SCHOOL-BASED HEALTH

CARE COORDINATION SERVICES

BEHAVIORAL HEALTH

ORAL HEALTH

OB #S-44300-00013336 OHA RFI #6097 Page 3 of 17

SECTION 1: GENERAL INFORMATION

1.1 INTRODUCTION

The State of Oregon, acting by and through Oregon Health Authority (“OHA” or “Agency”), is seeking information from entities about providing coordinated care to Oregon Health Plan (OHP) members. This Request for Information (RFI) aims to gather insights and innovative concepts in the following categories:

• Service Area Considerations

• Community Partnership

• Health Equity

• Traditional Healthcare Workers & Workforce

• Language Access and Accessibility

• Rate Setting Considerations

• Children’s Services & School Based-Health

• Care Coordination Services

• Behavioral Health

• Oral Health

The purpose of this RFI is to gather information needed to drive the development of a future procurement and contracting process. OHA intends to release a Request for Application (“RFA”) at a later date.

This RFI will not result in any kind of contract or agreement, nor will it obligate OHA to procure goods or services of any kind. The information gained in this RFI may be used by OHA to gain an understanding from current industry experts in order to help develop a future application selection process that could result in a contract(s). OHA is not responsible for any expenses or costs incurred by any Respondent (a Respondent is defined as a person or entity that submits answers to the questions in the RFI) in submitting a Response (a Response is defined as answers submitted to the RFI) to this RFI.

Each Respondent does so solely at the Respondent’s own expense. All costs incurred in preparing and submitting a Response will be the responsibility of the Respondent and will not be reimbursed by OHA.

1.2 BACKGROUND

a. Coordinated Care Organizations

The Oregon Health Plan (“OHP”) is the source of health coverage for approximately 1.4 million Oregonians. Approximately 90 percent of coverage for OHP members is provided through a network of 16 regional coordinated care organizations (CCOs) that are contracted with the state.

OHA is currently planning for the next round of CCO contracts, which are expected to begin in 2027. The process for this effort is referred to as, “CCO Procurement,” and involves the process of awarding contracts to entities to provide services as CCOs and what services and accountability will be required.

This RFI and planned forthcoming RFA will build upon the success of the last CCO contract and look to address the challenges that persist in Oregon’s health care system.

CCOs are community-based comprehensive managed care organizations that operate under a risk contract with the state to improve care, lower costs and achieve better health for OHP members.

CCOs are responsible for integrated and coordinated health care for their members’ physical health, behavioral health, and oral health, with a focus on prevention, quality care and elimination of health disparities. The networks within the CCO delivery system emphasize patient-centered primary care homes (PCPCH), evidence-based practices, and health information

OB #S-44300-00013336 OHA RFI #6097 Page 4 of 17 technology. CCOs are expected to improve the coordination of care for individuals with chronic conditions and those experiencing health disparities and to increase preventive services that will improve health and health care for all eligible members—all managed within a global budget.

The Centers for Medicare and Medicaid Services (CMS) regulations state that CCOs are managed care organizations and will generally meet the requirements of 42 CFR part 438. CCOs will provide a governance structure to align the specialized services under one managed care organization and are the primary agents of health system transformation in Oregon.

b. Background of Oregon’s Integrated and Coordinated Health Care Model CMS initially approved the OHP section 1115 demonstration for a five-year period beginning February 1, 1994. Oregon sought to expand eligibility and manage costs by using managed care and a Prioritized List of Health Services. The Prioritized List of Health Services is updated every two (2) years, whereby services are added, deleted, or moved to a different ranking within the list based on the effectiveness and importance on public health. OHA has continued to refine the OHP model, with the most recent section 1115 application submitted in 2022 with subsequent amendments.

In February 2022, OHA submitted an application to extend the demonstration, continuing foundational elements of OHP, while addressing health-related social needs (HRSN) to improve health outcomes of OHP members within the state. Approval of this request will allow the state to: provide continuous eligibility for children from birth up to age six, as well as twenty-four month continuous eligibility for those ages six and above; expand coverage to Youth with Special Health Care Needs ages nineteen through twenty-six; cover new services to address a defined set of evidence-based health-related social needs; and authorize Designated State Health Programs (DSHP) funding to support state funding of these initiatives. The demonstration was approved by CMS Sept. 2022.

In April 2023, OHA submitted an amendment to this demonstration, which continues enrollment for OHP members with incomes from 133 to 200 percent of the federal poverty level (FPL). The qualification is based on the income at the time of the OHP member’s redetermination, following the end of the continuous enrollment condition under section 6008(b)(3) of the Families First Coronavirus Response Act (FFCRA, as amended) and any subsequent redetermination, and who would otherwise lose eligibility for Medicaid due to income. The objective of the amendment was to prevent an OHP member’s loss of health care coverage as a result of the end of the continuous enrollment condition of the FFCRA. The amendment was approved in July 2024.

On October 16, 2024, CMS approved an amendment to provide expenditure authority for coverage of traditional health care practices received through Indian Health Service facilities, facilities operated by Tribes or Tribal organizations under the Indian Self-Determination and Education Assistance Act, or facilities operated by urban Indian organizations under Title V of the Indian Health Care Improvement Act by Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries who are able to receive services delivered by or through these facilities.

This most recent OHP demonstration makes a significant change, in that the state is not seeking a renewal of its Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) waiver. As of that January 1, 2023, the State will follow all Title XIX requirements with respect to coverage of services for individuals under age 21 and provide all medically necessary services to children consistent with EPSDT requirements. For all other populations, the State has agreed to phase out the Prioritized List by January 1, 2027.

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1.3 REQUEST FOR INFORMATION: PURPOSE

OHA has initiated this RFI to gather information from the market, to hear from interested entities and help OHA develop future procurement strategies. The goal is to facilitate a CCO Procurement that will continue the vision of creating a collaborative, accountable, high quality health care system that not only upholds, but advances Oregon’s unique model.

CCO Procurement aims to accomplish:

a. Improve member experiences by ensuring high-quality, comprehensive care that invests in prevention and upstream health care and non-medical drivers of health.

b. Strong CCO accountability through a transparent process that sets expectations to meet health care quality measures and improvements to health care outcomes.

c. Provide a framework for a focus on health equity by aligning the CCO contract with OHA’s strategic goal to eliminate health inequities by 2030.

d. Support community-centered care and strengthen local partnerships that support effective health care system collaboration. Encouraging and bolstering contracting with local health entities and community-based organizations can ensure that those social and emotional drivers of health care.

e. Reinforce responsible stewardship of public resources to ensure that limited resources are being distributed effectively.

Providing responses to this RFI will assist the OHA in developing OHA’s CCO Procurement.

1.4 RESPONDENTS

OHA is seeking information from those who have experience in providing coordinated care for Medicaid or Medicare programs and any other health care plan.

1.5 PROJECT OVERVIEW

This RFI is a key step in ensuring a transparent and inclusive procurement process that strengthens the Oregon Medicaid system through implementation of the next CCO contract.

A primary focus of the CCO Procurement effort is enhancing CCO accountability to ensure CCOs are meeting the needs of OHP members, delivering high-quality and comprehensive care, and demonstrating responsible and effective stewardship of public funds. This RFI will also help shape a procurement approach that aligns with OHA’s 2030 strategic goals of eliminating health inequities, fostering stronger collaboration across the health care system, and promoting evidence-based investments in community health. Public input is critical to this process, reinforcing OHA’s commitment to holding CCOs accountable for improving health outcomes and eliminating inequities.

1.6 DUE DATE

Responses to this RFI will be received until the Closing Date and time as referenced on the cover page of this RFI. Responses received after the Closing Date and time shall be deemed late and will not be considered.

1.7 SINGLE POINT OF CONTACT (SPC)

The SPC for this RFI is identified on the Cover Page, along with the SPC’s contact information.

Respondents shall direct all communications related to any provision of this RFI only to the SPC, whether about the technical requirements of the RFI, the RFI process, or any other provision.

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SECTION 2: SCOPE

OHA asks that entities share experiences and insights on how your program has navigated challenges and achieved success in key areas—such as care coordination, behavioral health integration, and community partnerships—that are critical to future procurement efforts. Detailed responses, including innovative practices that may be outside of OHA’s current awareness, will help OHA identify emerging best practices and inform the design of future CCO contracts. Responses to this RFI will directly shape OHA’s CCO Procurement strategy by helping to develop performance metrics, contract requirements, and support mechanisms, ensuring OHA’s approach is grounded in real-world, evidence-based strategies that enhance care for Oregon communities.

2.1 SERVICE AREA CONSIDERATIONS / RATE SETTING

a. If you are a current CCO, please describe your organization's current service area, and indicate whether you would consider expanding or reducing your coverage. If you are not a current CCO, please describe the regions where you would be interested in serving.

b. How do regional differences, such as workforce availability, infrastructure, or community partnerships, impact your ability to expand or sustain services in different areas?

c. What changes to rate methodologies (e.g., adjustments for rural vs. urban areas, risk stratification, value-based incentives) would help improve financial sustainability and service delivery?

d. Are there any anticipated mergers, acquisitions, or other organizational shifts that could impact service delivery, provider networks, or community partnerships?

2.2 COMMUNITY PARTNERSHIPS

a. What strategies have you used to build and sustain partnerships with community-based organizations, local governments, and health care providers to improve member outcomes? What partnerships have been most impactful?

b. How do you ensure that members, particularly those from historically marginalized communities, are meaningfully included in decision-making processes?

c. What partnerships or collaborations have you built to address social determinants of health (e.g., housing, transportation, food insecurity) that impact members? What have been the key successes and challenges in these efforts?

2.3 HEALTH EQUITY

a. How do you measure and report progress on health equity goals to your members and other key partners? What metrics or benchmarks are most meaningful in tracking impact on members?

b. What tools, funding opportunities, or policy changes would help strengthen collaboration between organizations working toward shared health goals for members?

c. Can you describe a specific initiative within your networks or collaborative partnerships that is advancing efforts to eliminate health inequities in alignment with OHA’s 2030 strategic goal?

Please detail the strategies used, the measurable outcomes that demonstrate progress, and any challenges encountered.

2.4 TRADITIONAL HEALTH WORKERS & WORKFORCE

a. What barriers exist to integrating traditional health workers (e.g., community health workers, peer support specialists) into community-based settings?

b. What innovative payment models, incentives, or financial strategies have you implemented to expand the use of traditional health workers?

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2.5 LANGUAGE ACCESS AND ACCESSIBILITY

a. How do you ensure that providers meet language access and accessibility requirements, including interpretation, translation, and accessible formats?

b. How do you identify communication barriers in healthcare among your members and in the broader community?

2.6 CHILDREN’S SERVICES & SCHOOL-BASED HEALTH

a. What strategies ensure school-based prevention efforts (e.g., dental sealants, social-emotional health, suicide prevention) align with community needs?

b. What are examples of barriers have you encountered between school-based health services and primary care providers? What about Behavior Health supports?

c. What strategies have been effective in ensuring smooth transitions for children moving between different levels of care (e.g., hospital to home, foster care placements, pediatric to adult care)?

2.7 CARE COORDINATION SERVICES

a. Describe a specific example of a successful care transition procedure you have implemented

(e.g., from hospital discharge to long-term care, or between different provider types)? Please detail the strategies that contributed to its success, the key metrics you used to measure effectiveness, and any barriers you encountered.

b. What improvements in data-sharing or communication tools would help better coordinate care across different provider types and settings?

2.8 BEHAVIORAL HEALTH

a. What practices have helped bridge gaps between behavioral health and other care services in your organization?

b. In what ways have you successfully aligned behavioral health services with broader care delivery to support members with multifaceted needs?

c. Describe a specific innovative approach you have used to expand your behavioral health network in response to rising demand among populations affected by substance use, mental health challenges, serious mental illness, and houselessness? Please detail the strategies you employed, the key metrics you used to gauge its success, and any challenges you encountered.

2.9 ORAL HEALTH

a. What are the primary barriers to accessing timely and high-quality dental care, particularly for

Medicaid members in underserved regions? What strategies have proven effective in overcoming these barriers, and how do you measure their success?

b. How does your organization integrate community partnerships and alternative care models (e.g., teledentistry, mobile units, school-based programs) into your dental care strategy? What evidence-based practices guide your approach, and how do you assess their effectiveness?

c. What strategies does your organization employ to recruit and retain dental providers in Medicaid? How do you support dental workforce expansion, particularly in rural areas?

d. How does your organization ensure that treatment plans for Medicaid patients are completed in a timely and comprehensive manner? What strategies do you use to prevent excessive appointment fragmentation, and prolonged treatment delays?

e. How does your organization promote and incentivize preventive dental care, and what value-based payment models have you implemented or considered for Medicaid dental services?

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SECTION 3: SUBMISSION AND RESPONSE REQUIREMENTS

3.1 SUBMISSION REQUIREMENTS

OregonBuys Electronic Response. Respondent must submit its Response electronically through OregonBuys. Respondent must follow the procedures outlined in detailed instructions on how to submit an Response can be found at OregonBuys Vendor Formal Solicitation Response.

Respondents to this RFI must upload the following files in pdf format, in the form found in each Attachment. A word document is provided for each attachment for easy use. Once the word documents are completed, save to pdf and upload to OregonBuys:

• Attachment A – Respondent Information and Certification Sheet

• Attachment B – Disclosure Exemption Affidavit

• Attachment C – Response Cover Sheet

• Attachment C-1 - Questions and Answer

3.2 OWNERSHIP/PERMISSION TO USE MATERIALS

All Responses are public record and are subject to public inspection. Application of the Oregon Public Records Law will determine whether any information is actually exempt from disclosure.

All Responses submitted to this RFI become the property of Agency. By submitting a Response to this RFI, Respondent grants the State of Oregon a non-exclusive, perpetual, irrevocable, royalty-free license for the rights to copy, distribute, display, prepare derivative works of and transmit the Response solely for the purpose of reviewing the Response, or as otherwise needed to administer the RFI process, and to fulfill obligations under Oregon Public Records Law (ORS 192.410 through 192.505). Responses, including supporting materials, will not be returned to Respondent.

If Respondent believes any of its Response is exempt from disclosure under Oregon Public Records Law (ORS 192.311 through 192.478), Respondent shall complete and submit the Disclosure Exemption Affidavit (Attachment B) and Respondent also shall submit a fully redacted version of its Response, clearly identified as the redacted version.

https://www.oregon.gov/das/ORBuys/Documents/OregonBuys%20Vendor%20Formal%20Solicitation%20Response.pdf

OB #S-44300-00013336 OHA RFI #6097 Page 9 of 17

ATTACHMENT A — RESPONDENT INFORMATION AND

CERTIFICATION SHEET

Legal Name of Respondent:

Address: City, State, Zip:

State of Incorporation: Entity Type:

Contact Name: Phone: Email:

Any individual signing below hereby certifies they are an authorized representative of Respondent and that:

1. No attempt has been made or will be made by the Respondent to induce any other person or organization to submit or not submit a Response.

2. All contents of this Respondent Information and Certification Sheet are truthful and accurate and have been prepared independently from all other Responses, and without collusion, fraud, or other dishonesty.

3. Respondent acknowledges that the Response for any of the services described in this RFI will be used for planning and informational purposes only. Agency may issue a separate procurement in the future or directly negotiate for the services required by Agency.

4. 5. 6.

Authorized Signature Date

7. 8. 9.

(Printed Name and Title) 0.

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ATTACHMENT B — DISCLOSURE EXEMPTION AFFIDAVIT

____________________ (Affiant), being first duly sworn under oath, and representing [insert Respondent Name] (hereafter “Respondent”), hereby deposes and swears or affirms under penalty of perjury that:

1. I am an employee of the Respondent, I have knowledge of the Request for Information referenced herein, and I have full authority from the Respondent to submit this affidavit and accept the responsibilities stated herein.

2. I am aware that the Respondent has submitted a Response, dated on or about [insert date] (the “Response”), to the State of Oregon (State) in response to Request for Information [insert RFI #], for [insert description of RFI], and I am familiar with the contents of the RFI and Response.

3. I have read and am familiar with the provisions of Oregon’s Public Records Law, Oregon Revised Statutes (“ORS”) 192.311 through 192.478, and the Uniform Trade Secrets Act as adopted by the State of Oregon, which is set forth in ORS 646.461 through ORS 646.475. I understand that the Response is a public record held by a public body and is subject to disclosure under the Oregon Public Records Law unless specifically exempt from disclosure under that law.

4. I have reviewed the information contained in the Response. The Respondent believes the information listed in Exhibit A is exempt from public disclosure (collectively, the “Exempt Information”), which is incorporated herein by this reference. It is my opinion that the Exempt Information is exempt from disclosure under Oregon’s Public Records Law under the specifically designated sections as set forth in Exhibit A or constitutes “Trade Secrets” under either the Oregon Public Records Law or the Uniform Trade Secrets Act as adopted in Oregon because that information is either:

A. A formula, plan, pattern, process, tool, mechanism, compound, procedure, production data, or compilation of information that:

i. is not patented,

ii. is known only to certain individuals within the Respondent’s organization and that is used in a business the Respondent conducts,

iii. has actual or potential commercial value, and

iv. gives its user an opportunity to obtain a business advantage over competitors who do not know or use it.

or

B. Information, including a drawing, cost data, customer list, formula, pattern, compilation, program, device, method, technique or process that:

i. Derives independent economic value, actual or potential, from not being generally known to the public or to other persons who can obtain economic value from its disclosure or use; and

ii. Is the subject of efforts by the Respondent that are reasonable under the circumstances to maintain its secrecy.

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5. I understand that disclosure of the information referenced in Exhibit A may depend on official or judicial determinations made in accordance with the Public Records Law.

Affiant’s Signature State of ___________) ) ss:

County of ________) Signed and sworn to before me on ___________ (date) by ______________________ (Affiant’s name).

Notary Public for the State of _________________ My Commission Expires: _________

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ATTACHMENT C - RESPONSE COVER SHEET

Respondent Information - RFI # 6097

Respondent Legal Entity Name:

Primary Contact Person Name:

Title:

Address:

City, State, Zip:

Telephone:

E-mail Address:

Name and title of the person(s) authorized to represent the Respondent for any program follow up questions.

Name:

Title:

Telephone:

E-mail Address:

By signing this page and submitting a Response, the Authorized Representative certifies that the following statements are true:

1. No attempt has been made or will be made by the Respondent to induce any other person or organization to submit or not submit a Response.

2. Information included in this Response shall remain valid for 90 days after the Response due date or for informational purposes only with the understanding that no Contract will be awarded as a result of this

RFI.

3. The statements contained in this Response are true and complete to the best of the Respondent’s knowledge and Respondent accepts as a condition Respondent and the Informational Response and information provided shall be in compliance with Respondent’s knowledge that descriptions and suggested answers shall comply with the applicable state and federal requirements, policies, standards, and regulations as required. The undersigned recognizes that this is a public document and open to public inspection.

4. Respondent acknowledges that the Informational Response for any of the services described in this RFI shall be used for planning and informational purposes only. OHA may issue a separate procurement in the future for the services required by OHA.

Signature: Date:

(Authorized to Bind Respondent)

Printed Name:

OB #S-44300-00013336 OHA RFI #6097 Page 13 of 17

ATTACHMENT C-1 - RESPONSE

Please provide the following information to the extent possible. No fields are mandatory, but the information is appreciated. If you do not answer a question leave that answer blank, do not delete.

SERVICE AREA CONSIDERATIONS / RATE SETTING

a. If you are a current CCO, please describe your organization's current service area, and indicate whether you would consider expanding or reducing your coverage. If you are not a current CCO, please describe the regions where you would be interested in serving.

b. How do regional differences, such as workforce availability, infrastructure, or community partnerships, impact your ability to expand or sustain services in different areas?

c. What changes to rate methodologies (e.g., adjustments for rural vs. urban areas, risk stratification, value-based incentives) would help improve financial sustainability and service delivery?

d. Are there any anticipated mergers, acquisitions, or other organizational shifts that could impact service delivery, provider networks, or community partnerships?

COMMUNITY PARTNERSHIPS

a. What strategies have you used to build and sustain partnerships with community-based organizations, local governments, and health care providers to improve member outcomes? What partnerships have been most impactful?

b. How do you ensure that members, particularly those from historically marginalized communities, are meaningfully included in decision-making processes?

OB #S-44300-00013336 OHA RFI #6097 Page 14 of 17

c. What partnerships or collaborations have you built to address social determinants of health (e.g., housing, transportation, food insecurity) that impact members? What have been the key successes and challenges in these efforts?

HEALTH EQUITY

a. How do you measure and report progress on health equity goals to your members and other key partners? What metrics or benchmarks are most meaningful in tracking impact on members?

b. What tools, funding opportunities, or policy changes would help strengthen collaboration between organizations working toward shared health goals for members?

c. Can you describe a specific initiative within your networks or collaborative partnerships that is advancing efforts to eliminate health inequities in alignment with OHA’s 2030 strategic goal? Please detail the strategies used, the measurable outcomes that demonstrate progress, and any challenges encountered.

TRADITIONAL HEALTH WORKERS & WORKFORCE

a. What barriers exist to integrating traditional health workers (e.g., community health workers, peer support specialists) into community-based settings?

b. What innovative payment models, incentives, or financial strategies have you implemented to expand the use of traditional health workers?

OB #S-44300-00013336 OHA RFI #6097 Page 15 of 17

LANGUAGE ACCESS AND ACCESSIBILITY

a. How do you ensure that providers meet language access and accessibility requirements, including interpretation, translation, and accessible formats?

b. How do you identify communication barriers in healthcare among your members and in the broader community?

CHILDREN’S SERVICES & SCHOOL-BASED HEALTH

a. What strategies ensure school-based prevention efforts (e.g., dental sealants, social-emotional health, suicide prevention) align with community needs?

b. What are examples of barriers have you encountered between school-based health services and primary care providers? What about Behavior Health supports?

c. What strategies have been effective in ensuring smooth transitions for children moving between different levels of care (e.g., hospital to home, foster care placements, pediatric to adult care)?

CARE COORDINATION SERVICES

a. Describe a specific example of a successful care transition procedure you have implemented (e.g., from hospital discharge to long-term care, or between different provider types)? Please detail the strategies that contributed to its success, the key metrics you used to measure effectiveness, and any barriers you encountered.

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b. What improvements in data-sharing or communication tools would help better coordinate care across different provider types and settings?

BEHAVIORAL HEALTH

a. What practices have helped bridge gaps between behavioral health and other care services in your organization?

b. In what ways have you successfully aligned behavioral health services with broader care delivery to support members with multifaceted needs?

c. Describe a specific innovative approach you have used to expand your behavioral health network in response to rising demand among populations affected by substance use, mental health challenges, serious mental illness, and houselessness? Please detail the strategies you employed, the key metrics you used to gauge its success, and any challenges you encountered.

ORAL HEALTH

a. What are the primary barriers to accessing timely and high-quality dental care, particularly for Medicaid members in underserved regions? What strategies have proven effective in overcoming these barriers, and how do you measure their success?

b. How does your organization integrate community partnerships and alternative care models (e.g., teledentistry, mobile units, school-based programs) into your dental care strategy? What evidence-based practices guide your approach, and how do you assess their effectiveness?

OB #S-44300-00013336 OHA RFI #6097 Page 17 of 17

c. What strategies does your organization employ to recruit and retain dental providers in Medicaid? How do you support dental workforce expansion, particularly in rural areas?

d. How does your organization ensure that treatment plans for Medicaid patients are completed in a timely and comprehensive manner? What strategies do you use to prevent excessive appointment fragmentation, and prolonged treatment delays?

e. How does your organization promote and incentivize preventive dental care, and what value-based payment models have you implemented or considered for Medicaid dental services?