Hawaii releases Med-QUEST re-procurement RFI

The Department of Human Services (DHS) released a new request for information (RFI) last week, seeking information to prepare for the upcoming re-procurement of QUEST Integration (QI) health plans.

The RFI comes after DHS announced it was rescinding the Medicaid managed care contract awards previously announced in January due to the “evolving needs of the community” during the COVID-19 crisis.



Prior to the cancellation, the transition to the new contracts — which pared five plans to two on the neighboring islands — was turbulent. AlohaCare filed a Notice of Protest, legislators introduced a bill pushing against the decision to limit options on neighbor islands, and Maui and Hawaii County Councils adopted resolutions calling for the delay of the contracts.

After rescinding the contract awards, Med-QUEST stated it was too early to determine if the number of health plans would be limited for the neighbor islands in the new RFP. The recently-released RFI asks stakeholders what they believe is the optimal number of QI health plans to offer in Hawaii and asks if the number of health plans should vary on a regional versus statewide basis.

The RFI is also seeking information on how the QI program can continue responding to the COVID-19 pandemic.

“The COVID-19 pandemic has already had profound impact on healthcare delivery in Hawai‘i due to social distancing. Looking forward, Hawai‘i will experience further health, social, and economic effects related to COVID-19,” reads the RFI.

Specifically, Med-QUEST is looking for program flexibilities that should continue beyond the public health emergency and ways the division can expand and promote telehealth.

The state is also continuing with its Hawai‘i ‘Ohana Nui Project Expansion (HOPE) initiative in an effort to transform the Medicaid health system. One priority of the HOPE initiative, which is highlighted in the RFI, is care and service coordination for Medicaid beneficiaries with the most complex health and social needs.

The RFI asks for feedback on strategies and policies that DHS should adopt to leverage care and service coordination at the community level.

“What care and service coordination services should remain at the QI health plan level? What is the best way to subcontract or delegate these responsibilities that results in shared accountability for whole patient care, while also improving outcomes?” asks the RFI.

Questions related to promoting a behavioral health continuum and value-based payments and alternative payment models are also included in the RFI.

The Department released a separate RFI related to the reprocurement of the specialty behavioral health carve-out Community Care Services program.

The state is seeking information from all stakeholders, not just potential QI health plans. Responses are due by 2:00pm HST on August 14, 2020.