Medicaid Managed Care Procurements: A Toolkit for State Medicaid Agencies

Bailit Health

Implementing a statewide, competitive procurement for Medicaid managed care is one of the more important things state purchasers do to improve value. Medicaid managed care contracts have evolved over time to cover more enrollees and services, often making them the largest contracts awarded by states. Medicaid managed care procurements are a powerful tool to advance Medicaid programs, policies, and innovations; however, their size, scope, and intensity can pose significant resource challenges for Medicaid agencies. In addition, because these large, multi-year procurements occur only once or twice a decade, Medicaid leaders and state staff responsible for the procurement may not have experience with a procurement of this nature or size.

This toolkit is designed to help states develop a procurement process focused on improving program performance in specific areas valued by the state. It guides Medicaid agencies through key action steps and considerations in the major phases of the procurement cycle: 1) strategic procurement planning, 2) solicitation development, 3) bid review and selection, 4) contract execution, readiness review and implementation, and 5) contract management.

Initially published in 2017, this 2022 update to the toolkit reflects current procurement best practices and refreshed state examples, drawn in part from a scan of recent Medicaid managed care procurements.

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