August 07, 2023
Nevada Medicaid is set to expand its Managed Care insurance from urban Clark and Washoe counties to every county in the state starting January 1, 2026. To prepare for this effort, Nevada Medicaid is asking for input from medical providers, advocacy groups, local governments, health plans and associations in a Request for Information.
This rural expansion of Managed Care is anticipated to affect approximately 75,000 Nevadans who are currently covered by the State’s Fee-For-Service (FFS) model, where doctors and other providers bill Medicaid directly for services. The request will help inform next steps as the Division of Health Care Financing and Policy moves toward the expansion.
This shift would transfer many rural members from FFS to Managed Care, which will allow the State to better monitor and improve access to, and the quality of, care and coverage provided in rural areas. Today, about 75 percent of the State’s Medicaid members are enrolled in one of four Managed Care plans.
“The statewide expansion of Medicaid Managed Care presents us with an exciting opportunity to improve the health of Nevadans who are covered by Medicaid, regardless of their zip code,” said Nevada Medicaid Administrator Stacie Weeks. “We need everyone’s feedback to ensure it is a success and meets the health care needs of rural Nevadans.”
The Division of Health Care Financing and Policy (DHCFP) is seeking feedback on ways to improve health care in seven key areas with its upcoming Managed Care procurement:
• Provider Networks
• Maternal and Child Health
• Value-Based Payment Design
• Behavioral Health Care
• Innovation
• Market & Network Stability
• Social Determinants of Health
The Request for Information includes questions regarding each of the key areas identified above. Responses must be provided by October 10, 2023, at 4:00 p.m. PST to StatewideMCO@dhcfp.nv.gov. At least three public workshops will also be planned. Meeting dates and times; project documents, updates, and progress will be posted on the Statewide Managed Care website. Interested parties can sign up for email notifications. Feedback received will inform the Request for Proposal in the next Managed Care Contract Period to be issued no later than January 1, 2025.