Healthchoices For Physical Health Services

The Pennsylvania Department of Human Services (“Department”), Bureau of Procurement & Contract Management issues this Request for Information (“RFI”) to gather input and information concerning the development of a Request for Applications (“RFA”) for a HealthChoices Physical Health services procurement the Department intends to release in the future as well as ideas and strategies for improvements to the Department’s mandatory managed care program.

Specifically, this RFI seeks information to assist the Department in reprocuring managed care organizations to administer the delivery of physical health services to Medical Assistance (“MA”) beneficiaries and optimizing the design and requirements of the HealthChoices Physical Health agreement and program to continuously improve healthcare quality and access while stabilizing Pennsylvania’s Medical Assistance spending.

Through this RFI, the Department hopes to become aware of and knowledgeable about the most promising models supported by evidence to promote the health of MA beneficiaries, including but not limited to:

• Medicaid managed care program design and priorities;
• Targeted community and population health initiatives;
• Programs to address health equity and Health-Related Social Needs (“HRSN”);
• Value-based purchasing and alternative payment models;
• Quality measures and performance standards that focus on outcomes;
• Partnerships with healthcare providers and community-based organizations;
• Information Technology, Systems, and Data; and
• Program Integrity.

The Department has identified three specific priority areas on which it proposes to focus in the future. [...] The proposed areas of focus are:

1. Poorly Controlled Chronic Conditions
2. Perinatal and Child Health
3. Children with Complex Health Needs

The Department encourages vendors and other interested parties to provide feedback in response to this RFI or any part thereof. A vendor may respond to all or any of the specific questions or topics included in this RFI.

The Department is requesting that all responses to this RFI be submitted by **12:00 p.m.** on the due date, **November 20, 2026**. Responses must be submitted electronically to the following email account with “HealthChoices Physical Health Program RFI” in the email subject line: RA-PWRFICOMMENTS@PA.GOV.

Please prepare responses simply, providing straightforward and concise language and descriptions. All responses should be produced in 12 point Serif or Sans-Serif font. Please limit your response to no more than 20 pages, not including the cover letter or attachments. Please refrain from sending marketing materials to the Department.

This RFI is issued for information and planning purposes only and does not constitute a solicitation for future business, an offer for procurement, or any other type of current or future procurement action, and is only intended to gather information and input. The Department will not award an agreement on the basis of this RFI or otherwise pay for any of the information received.