HealthChoices for Physical Health Services

The Pennsylvania Department of Human Services, Bureau of Procurement & Contract Management is issuing a Request for Information on HealthChoices Physical Health services, with responses due November 20, 2026 at 12:00 p.m. This is a pre-procurement RFI gathering design input for a future Request for Applications covering managed care delivery to approximately 2.3 million Medical Assistance beneficiaries across five geographic zones in Pennsylvania: Southeast, Southwest, Lehigh/Capital, New West, and New East.

The Department seeks conceptual solutions and strategies across three priority focus areas: Poorly Controlled Chronic Conditions, Perinatal and Child Health, and Children with Complex Health Needs. Respondents may address all or any part of the RFI, with requested input spanning general program design (MCO structure, benefit carve-ins and carve-outs, network access standards, prior authorization processes), outcomes measures and metrics, value-based payment and financing structures, initiative development and partnerships, technology and data systems, and program integrity measures. The Department is evaluating a shift from process-based to outcomes-based contracting while addressing health equity, health-related social needs, and stabilizing MA spending.

Responses are limited to 20 pages (excluding cover letters and attachments), formatted in 12-point Serif or Sans-Serif font with straightforward language, and must be submitted electronically to RA-PWRFICOMMENTS@PA.GOV. All responses become public information; the Department will not honor confidentiality claims and will not notify respondents of review results or whether a future procurement is issued. The RFI does not constitute a current solicitation, obligate the Department to award any contract, or require payment for information received. Administrative questions and answers will be posted at http://www.emarketplace.state.pa.us.