Southeast Wisconsin Medicaid Managed Care Organizations RFP

The Wisconsin Department of Health Services (DHS), Division of Health Care Access and Accountability (DHCAA) is requesting Proposals from qualified managed care organizations (MCOs) seeking to contract with DHS for providing and managing the health care services for members enrolled in BadgerCare Plus Standard and Benchmark plans in Milwaukee, Washington, Ozaukee, Waukesha, Racine and Kenosha counties.  

A copy of this Request for Proposal (RFP) can be found on the DHS website: http://www.dhs.wisconsin.gov/rfp/  or on the VendorNet website: http://vendornet.state.wi.us.

Information and registration instructions for the Vendor Conference, scheduled for November 11, can be found here: Southeast Wisconsin Medicaid Managed Care Organizations RFP Vendor Conference Announcement  (PDF, 47 KB)

During August and September 2009, the Department held a series of listening sessions to solicit comments on the Medicaid managed care delivery system in southeast Wisconsin. A copy of the presentation provided at the listening sessions can be found here: Listening Session Presentation (PDF, 38 KB).  A summary of some of the comments the Department received about the Medicaid managed care delivery system can be found here: Listening Session Ideas Summary (Excel  20 KB)

Questions regarding the Southeast Wisconsin Medicaid MCOs RFP should be directed to Susan McKercher at: Susan.McKercher@dhs.wisconsin.gov or at (608) 267-7637.

Data Resources 

The following data resources and information related to the BadgerCare Plus population are available. The Department will post additional data resources and information below as it becomes available. Interested parties are encouraged to check this website regularly for the most current information.

Birth Data:

• Babies Born in 1998-2008 by MA Eligibility at Birth and Teen Mothers (Excel  39 KB)

Dental Utilization:

• 2008 Dental Utilization by Member month (Excel  39 KB)

Enrollment data: 

• Monthly HMO Enrollment Reports (Excel, 612 KB) 

• BadgerCare Plus Benchmark and Standard plan for Milwaukee, Washington, Ozaukee, Waukesha, Racine and Kenosha counties by children and adults: BadgerCare Plus enrollment by child/adult (Excel, 30 KB) 

• BadgeerCare Plus Benchmark and Standard plan for Milwaukee, Washington, Ozaukee, Waukesha, Racine and Kenosha counties by zip BadgerCare Plus Enrollment by zip (Excel, 85 KB) 

• General Wisconsin Medicaid enrollment data

• Wisconsin Medicaid members (FFS and managed care), by county, by month

• Wisconsin Medicaid members (managed care only), by county, by HMO, by month

• BadgerCare Plus members, by county, by health benefit plan, by month

HealthCheck data:

HMO auto-assignment and member choice rates:

• Auto-assignment and choice rate (Word, 44KB)

HMO quality performance:

• Quality reports including HEDIS results and CAHPS survey results: Located under “Quality Reports”.

• 2007 quality performance results for Regions 5 and 6: HMO Quality Performance measures (Word, 44 KB)

Managed Care Continuous enrollment:

• Managed Care Continuous enrollment (Excel, 37 KB) 

Community-based agencies and organizations in Wisconsin:

• Wisconsin Local Public Health Departments 

• Birth to 3 Program County Contacts 

• Wisconsin Community Program, Social Service, and Human Service Agencies

• School Based Services Providers: SBSProviders_SFY09 (Excel  44 KB)

• Targeted Case Management (TCM) Agencies (Excel  27 KB)
  

Last Revised: October 25, 2011