RFP 2021-08 Behavioral Health Plan Cost Study

CareOregon, a nonprofit healthcare organization serving Coordinated Care Organizations (CCOs) in Oregon, specifically in Multnomah County and Portland, issued Request for Proposals (RFP) #2021-08 for a comprehensive Behavioral Health Plan Cost Study. The organization seeks a detailed analysis of the costs associated with providing various behavioral health services within its networks, with the primary objective of developing a consistent Medicaid rate structure across multiple providers. The successful proposer will be required to develop total cost estimates per service or staff type, understand provider workflow processes, and analyze data to determine appropriate payment rates that ensure provider sustainability. The scope of work includes examining behavioral health staff types and provider types across three CCO regions: Portland metro, North Coast, and Southern Oregon. Evaluation criteria encompass the proposer's general background and qualifications, proposed scope of work, equity and diversity efforts, and proposed fees. The RFP was posted on December 8, 2021, with proposals due by January 11, 2022, at 2:00 PM Pacific Time, and an anticipated contract start date of February 2022, with substantial completion expected by May 31, 2022.

CareOregon explicitly encourages proposals from minority, women, service-disabled veteran, and emerging small businesses, demonstrating a commitment to diverse vendor participation. The organization has a budget estimated between $150,000 and $200,000 for this project and will provide deidentified claims and payment data to support the study. Proposers are expected to engage with and obtain financial data from 8-12 pre-identified providers across the three CCOs, though participant numbers may fluctuate based on provider willingness and capacity. The RFP was ultimately awarded to Health Management Associates, Inc., which received the highest evaluation score of 89.3 out of 100 points. The contract will be contingent on successful negotiation of terms and conditions, with CareOregon reserving the right to offer the contract to the next highest-ranked proposer if initial negotiations fail. The study will utilize various existing payment methodologies, including case rates and individual capitated amounts, to develop a comprehensive understanding of behavioral health service costs.