State Medicaid Data Analytics & Oversight Solution

The Pennsylvania Department of Human Services is issuing an RFI to collect innovative solutions that leverage Medicaid data for greater transparency, oversight, and evidence‑based rate‑setting across the state’s managed‑care system. Respondents are asked to describe analytical methodologies, technologies, and strategies that can integrate diverse data sources (claims, financial, ownership, utilization) to reveal organizational relationships, funding flows, and utilization trends, especially in high‑cost service categories such as ABA, pharmacy, LTC, and HCBS. The RFI is purely informational; no contract will be awarded based on this solicitation. • Goal: Identify cutting‑edge data‑analytics and oversight approaches for Pennsylvania Medicaid. • Scope: Statewide Medicaid managed‑care ecosystem, including MCOs, county primary contractors, affiliates, and providers. • Desired outputs: Conceptual solutions, organizational experience, innovative practices, and recommendations for translating analytics into policy and rate‑setting. • Submission: Up to 10 pages (excluding cover letter/attachments), 12‑point font, electronic email by 12:00 PM on 13 Nov 2026. • No pre‑bid meeting, site visit, or Q&A deadline; administrative questions accepted via the same email address. • This RFI will inform future procurement; no payment or award is associated with the response.