Integrated Health Partnerships

Applicant Eligibility & Participation Requirements

A. System Requirements

To be considered eligible to participate as an IHP for the purposes of responding to this RFP, a successful Responder must meet the following criteria:

1. Must provide or coordinate the full scope of health care services, as evidenced by provision of coordinated care, and/or prior/current participation in an outcomes-based contract with CMS or Medicaid. Accepted forms of evidence of provision of coordinated care include but are not limited to:

a. Health Care Home (HCH) Certification
b. NCQA PCMH Recognition
c. Current/past participation in IHP demonstration as an IHP
d. Additional evidence or documentation of ability to provide or coordinate full scope of health care services (See Appendix C-1: Example IHP Health System Characteristics)

2. All providers included in the IHP demonstration payment model must be enrolled MHCP providers.

3. Demonstrate, through the care delivery model, how the IHP will affect the total cost of care of its MHCP beneficiaries regardless of whether the services are delivered by the IHP. MHCP beneficiaries included in the demonstration are non-dually eligible Medical Assistance and MinnesotaCare enrollees attributed to the IHP for the performance period. (See Appendix C- 2: Eligible & Excluded Populations)

4. Demonstrate the ability to take on financial risk for the total cost of care of attributed MHCP beneficiaries. IHPs will enter into variable payment arrangements (one of two IHP Tracks) with the state based on the assessed level of ability to take on financial risk. DHS will evaluate applicants’ ability to take on financial risk by looking at a nexus of variables and thresholds which capture this, including but not limited to:

a. The risk and cost variability of the attributed population,
b. The catastrophic claims cap (i.e. maximum amount of a patients total cost of care that will be included in the IHP’s total cost of care calculation) necessary to reach a stable total cost of care estimate,
c. The percent of claim costs paid inside the applicant’s system,
d. The governance structure and geographic spread of the applicant’s system,
e. The electronic medical record (EMR) and health information exchange (HIE) environment,
f. Historical participation and/or progress in previous Integrated Health Partnership contracts, and
g. Other factors as deemed necessary by DHS.

5. Demonstrate established processes to monitor and ensure the quality of care provided. Participate in quality measurement activities as required by the State and engage in quality improvement activities.

6. Demonstrate the capacity to receive data from DHS via secure electronic processes and use it to identify opportunities for patient engagement and to stratify its population to determine the care model strategies needed to improve outcomes.

B. Legal Entity, Governance Structure, Leadership

An IHP is made up of a network of providers, and may include an organizing entity and agreement of shared governance. This may include but is not limited to a nonprofit, a county or group of counties, and other group types. The IHP as a network must meet or demonstrate ability to meet the requirements in Section IV.A, System Requirements, above. All IHP payments must be provided to and/or received from an MHCP enrolled provider. The IHP organizing entity must obtain agreement from participating providers, clinics, and/or health systems in the IHP program prior to the beginning of the contract period in January 1, 2018.

C. Community Partnerships & Patient Engagement

Responders to this proposal must demonstrate how formal and informal partnerships with community-based organizations, social service agencies, counties, public health resources, etc., are included in the care delivery model.

The responder must also demonstrate how the IHP will engage and coordinate with other providers, counties, and organizations, including county-based purchasing plans that provide services to the IHP’s patients on issues related to local population health, including applicable local needs, priorities, and public health goals. Responders should describe how local providers, counties, organizations, county-based purchasing plans, and other relevant purchasers were consulted in developing the application to participate in the demonstration project.

The responder must also demonstrate how the IHP will meaningfully engage patients and families as partners in the care they receive, as well as in organizational quality improvement activities and leadership roles.

D. Transition from Legacy IHP Program

The Legacy IHP Program is defined as any IHP contract originating from an IHP RFP prior to this RFP. Going into 2018, health systems that have a current, non-expiring Legacy IHP contract with DHS and that are not interested in participating in the 2018 IHP model will not be required to move into this model. Existing contracts may still be renewed up to their maximum of three years per the contract if requested, and the 90-day renewal notification terms still apply. However, DHS will not be releasing a Legacy IHP RFP for 2018.

IHPs whose Legacy contracts have reached their maximum three years of renewal at the end of 2017 must apply for the 2018 IHP model in order to continue participation in the program. The remaining IHPs that have a current Legacy IHP contract which is eligible for continuation through 2018 and are interested in participating in the 2018 IHP model will be required to submit a letter of intent as well as a completed IHP RFP application. Details can be found in Appendix A, RFP Application and Appendix A-1, Letter of Intent Template.

Additional informational webinars will be scheduled throughout the open response period prior to the application due date. The dates of these webinars will be announced through the DHS IHP Listserv and on the IHP Website no later than 10 days prior to the webinar occurring. Additional information webinars will be held May 29th - July 25th, 2017.

All potential provider responders may request one optional 30-minute Question and Answer (Q&A) session June 7th - July 25th, 2017 either in person or via conference call.

The optional Q&A sessions will serve as an opportunity for Responders to ask specific questions of State staff concerning the project. A Q&A session is not mandatory. DHS staff will record all questions and answers provided in the individual sessions and post them to the DHS website.

To schedule a Q&A session for your provider organization, please contact Mathew Spaan before or by July 18, 2017.

Letters of intent must be submitted by 4:30 PM Central Time on Friday, August 18th, 2017. Applicants that do not submit a letter of intent by Friday, August 18th, 2017 will not be considered for the IHP program in 2018.

Applications must be submitted by 4:30 PM Central Time on Friday, September 1, 2017.

Timeline:
-RFP Publication: May 15th, 2017
-Additional Informational Webinars: May 29th - July 25th, 2017
-Individual 30 minute meetings (Optional): June 7th - July 25th, 2017
-All RFP Questions Received: July 25th, 2017
-RFP Questions Answered and Posted on DHS Website: Anticipated August 1st, 2017
-Letter of Intent Due Date: August 18th, 2017
-Proposal Responses Due: September 1st, 2017
-RFP Review Completed: Anticipated September 15th, 2017
-Notice of Intent to Contract: Anticipated September 21st, 2017
-Potential IHP Plenary Sessions: Anticipated Sept. 18th – Sept. 30th, 2017
-Individual IHP Contract Negotiations Begin: Anticipated September 25th, 2017
-Performance period begins: January 1, 2018