Rural Hlth Transformation Primary Acct Care Transform Reimburse Design

The State of South Dakota’s Department of Social Services seeks a consulting firm to design and document a population‑based, value‑based payment methodology for Medicaid primary‑care services (the PACT model). The vendor will validate historic Medicaid cost data, develop capitation and case‑management payment formulas, create quality‑based incentive structures, design a recipient‑reward program, and support the preparation of any necessary federal waiver or State Plan applications. Stakeholder outreach to rural providers and coordination with a parallel RHT project‑management vendor are also required. The contract runs for three years with two optional one‑year extensions, and the work is expected to begin in June 2026 and culminate in a final model recommendation by January 2027. • Design and test a prospective primary‑care payment model (population‑based, case‑management, quality incentives). • Conduct data validation using Medicaid claims extracts and produce actuarial adjustments and budget impact estimates. • Facilitate stakeholder engagement (FQHCs, RHCs, IHS, Tribal clinics) and assist with federal demonstration applications. • Deliver a comprehensive methodology document, update mechanisms, and optional cost proposals for up to three years of service.