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Procurement for One Care Plans and Senior Care Options (SCO) Plans for 2026

Information about procurement for One Care Plans and SCO Plans.

This information is also available on COMMBUYS under EHS Document Number 23EHSKAONECARESCOPROCURE.

Table of Contents

Procurement Updates and Resources

RFR for One Care Plans and SCO Plans – November 30, 2023

Bidder's Conference Information:

One Care and SCO RFR Bidders Conference Information (PDF)
One Care and SCO RFR Bidders Conference Information (DOCX)

Today, the Executive Office of Health and Human Services (EOHHS) released the Request for Responses (RFR) for One Care and Senior Care Options (SCO) Plans. The RFR and Model Contracts are posted on COMMBUYS at http://www.commbuys.com under COMMBUYS Bid Number BD-23-1039-EHS01-ASHWA-84773.

EOHHS will be selecting One Care and SCO plans through a single, aligned RFR process that will result in separate One Care and SCO contracts. Selected organizations will operate a One Care plan, a SCO plan, or both. Although the RFR process is aligned, One Care and SCO will remain separate and distinct programs. The RFR will result in One Care and SCO contracts that will provide coverage beginning in CY2026 (January 1, 2026).

The updated procurement timeline is as follows:

  1. RFR Issued: Thursday, November 30, 2023
  2. Bidders’ Written Questions Due: January 11, 2024, at 5:00 pm (EST)
  3. Letter of Intent Due: February 29, 2024, at 5:00 pm (EST)
  4. Bidders’ Electronic Responses Due: April 5, 2024, at 4:00 p.m. (EST)
  5. Anticipated Plan Selection Date: By November 1, 2024
  6. Anticipated Contract Execution Date: By May 1, 2025
  7. Medicare Open Enrollment: October 15, 2025 – December 7, 2025
  8. Coverage Begins: January 1, 2026

These dates are subject to change. Changes, if any, will be made to the COMMBUYS posting and may not be reflected on other websites. Potential Bidders and interested parties are advised to review COMMBUYS for the most up to date information. Any questions about this announcement or the RFR should be directed to: Amy Butcher at amy.butcher@mass.gov.

Model Contracts and RFR:

2023 One Care Model Contract (PDF)
2023 One Care Model Contract (DOCX)
2023 SCO Model Contract (PDF)
2023 SCO Model Contract (DOCX)
2023 RFR One Care and SCO Plans (PDF)
2023 RFR One Care and SCO Plan (DOCX)

Appendices: 

One Care

One Care Appendix A Programmatic Reporting Requirements (PDF)
One Care Appendix A Programmatic Reporting Requirements (DOCX)
One Care Appendix B Performance Improvement Goals (PDF)
One Care Appendix B Performance Improvement Goals (DOCX)
One Care Appendix C Covered Services Definitions (PDF)
One Care Appendix C Covered Services Definitions (DOCX)
One Care Appendix D Base Capitation Rates (PDF)
One Care Appendix D Base Capitation Rates (DOCX)
One Care Appendix E Risk Sharing (PDF)
One Care Appendix E Risk Sharing (DOCX)
One Care Appendix F Service Area (PDF)
One Care Appendix F Service Area (DOCX)
One Care Appendix G Behavioral Health and Gender-affirming Care Services (PDF)
One Care Appendix G Behavioral Health and Gender-affirming Care Services (DOCX)
One Care Appendix H Encounter Expanded Data Set (PDF)
One Care Appendix H Encounter Expanded Data Set (DOCX)
One Care Appendix I Credentialing Websites and Tibco (PDF)
One Care Appendix I Credentialing Websites and Tibco (DOCX)
One Care Appendix J MMIS Interfaces (PDF)
One Care Appendix J MMIS Interfaces (DOCX)
One Care Appendix K Model Subcontractor Checklist (PDF)
One Care Appendix K Model Subcontractor Checklist (DOCX)
One Care Appendix L Quality Improvement Program Initiative (PDF)
One Care Appendix L Quality Improvement Program Initiative (DOCX)
One Care Appendix M Disruptive Conduct Disenrollment Procedures (PDF)
One Care Appendix M Disruptive Conduct Disenrollment Procedures (DOCX)
One Care Appendix N Enrollee Rights (PDF)
One Care Appendix N Enrollee Rights (DOCX)
One Care Appendix O Contractor Information (PDF)
One Care Appendix O Contractor Information (DOCX)
One Care Appendix P Dental Access (PDF)
One Care Appendix P Dental Access (DOCX)
One Care Appendix Q POPS Batch Interfaces (PDF)
One Care Appendix Q POPS Batch Interfaces (DOCX)

SCO

SCO Appendix A Programmatic Reporting Requirements (PDF)
SCO Appendix A Programmatic Reporting Requirements (DOCX)
SCO Appendix B Performance Improvement Goals (PDF)
SCO Appendix B Performance Improvement Goals (DOCX)
SCO Appendix C Covered Services Definitions (PDF)
SCO Appendix C Covered Services Definition(DOCX)
SCO Appendix D Base Capitation Rates (PDF)
SCO Appendix D Base Capitation Rates (DOCX)
SCO Appendix E Risk Sharing (PDF)
SCO Appendix E Risk Sharing (DOCX)
SCO Appendix F Service Area (PDF)
SCO Appendix F Service Area (DOCX)
SCO Appendix G Behavioral Health and Gender-affirming Care Services (PDF)
SCO Appendix G Behavioral Health and Gender-affirming Care Services (DOCX)
SCO Appendix H Encounter Expanded Data Set (PDF)
SCO Appendix H Encounter Expanded Data Set (DOCX)
SCO Appendix I Credentialing Websites and Tibco (PDF)
SCO Appendix I Credentialing Websites and Tibco (DOCX)
SCO Appendix J MMIS Interfaces (PDF)
SCO Appendix J MMIS Interface(DOCX)
SCO Appendix K Model Subcontractor Checklist (PDF)
SCO Appendix K Model Subcontractor Checklist (DOCX)
SCO Appendix L Quality Improvement Program Initiatives (PDF)
SCO Appendix L Quality Improvement Program Initiatives (DOCX)
SCO Appendix M Disruptive Conduct Disenrollment Procedures (PDF)
SCO Appendix M Disruptive Conduct Disenrollment Procedures (DOCX)
SCO Appendix N Enrollee Rights (PDF)
SCO Appendix N Enrollee Rights (DOCX)
SCO Appendix O Contractor Information (PDF)
SCO Appendix O Contractor Information (DOCX)
SCO Appendix P Dental Access (PDF)
SCO Appendix P Dental Access (DOCX)
SCO Appendix Q POPS Batch Interfaces (PDF)
SCO Appendix Q POPS Batch Interfaces (DOCX)
SCO Appendix R Exhibit 1 Frail Elder Waiver Cover (PDF)
SCO Appendix R Exhibit 1 Frail Elder Waiver Cover (DOCX)
SCO Appendix R Exhibit 2 Frail Elder Waiver (2023.03.01) (XLXS)

RFR

One Care-SCO RFR Attachment C - One Care-SCO Additional Services Model Contract (PDF)
One Care-SCO RFR Attachment C - One Care-SCO Additional Services Model Contract (DOCX)
One Care-SCO RFR Attachment D - Programmatic Response Templates (XLXS)
One Care-SCO RFR Attachment E - APM Data Collection Template (XLXS)
One Care-SCO RFR Attachment F1 PCP Ratios and Panels (XLXS)
One Care-SCO RFR Attachment F2 PCP Time-Distance (XLXS)
One Care-SCO RFR Attachment F3 Hospital and Nursing Facilities (XLXS)
One Care-SCO RFR Attachment F4 Medical Specialties (XLXS)
One Care-SCO RFR Attachment F5 Behavioral Health (XLXS)
One Care-SCO RFR Attachment F6 Pharmacies (XLXS)
One Care-SCO RFR Attachment F7 LTSS (XLXS)
One Care-SCO RFR Attachment F8 Dental (XLXS)
One Care-SCO RFR Attachment F9 Required Providers (XLXS)
One Care-SCO RFR Attachment G - Material Subcontractor Checklist (PDF)
One Care-SCO RFR Attachment G - Material Subcontractor Checklist (DOCX)
One Care-SCO RFR Attachment H - Business Response Templates (XLXS)
One Care-SCO RFR Attachment I - Federally Required Disclosure Form (XLXS)

Announcement of Consumer Reader Procurement

The Executive Office of Health and Human Services (EOHHS) is seeking your help in selecting future health plans for One Care and Senior Care Options (SCO) in Massachusetts. One Care and SCO are comprehensive health programs for adults with disabilities (One Care) and older adults (SCO) that both aim to provide the best possible care and support to enhance enrollees’ well-being and independence. As you may have heard, EOHHS has started a multi-year process to re-procure these programs, and the selected health plans will begin coverage in 2026.  

To assist EOHHS with the health plan selection process, EOHHS would appreciate feedback on the responses submitted by future One Care and SCO plans from individuals who are enrolled in, or have experience with, One Care or SCO.  If you, or someone you know, would be interested in providing this feedback, we invite you to apply to become a “Consumer Reader.” Selected Consumer Reader applicants will review key sections of the detailed responses from potential future One Care or SCO plans. In addition, Consumer Readers will engage with MassHealth staff to discuss these responses and share feedback. Consumer Readers will be offered stipends for their time and participation. 

Consumer readers will:  

  • Attend a kick-off meeting in early 2024 
  • Read certain parts of responses from 3-9 One Care or SCO bidders from February to May of 2024 (approximately 12 hours of reading per response) 
  • Attend approximately ten meetings in the Spring of 2024  
  • Attend presentations in the Spring to Summer of 2024 

All meetings will be held virtually with accommodations to support Consumer Reader participation. Documents will be provided in an accessible format convenient for the reader (e.g., hard copy, electronic, accessible electronic, large print, etc.). 

In addition, EOHHS may request certain program input from Consumer Readers in Fall 2023. 

We welcome you to apply if you are:  

  • At least 21 years of age 
  • A MassHealth member with a disability or at least 65 years of age 
  • A family member of a MassHealth member who is an adult with a disability or at least 65 years of age 
  • Have knowledge of or experience with One Care and SCO, personally or through family 

To apply, please review the Notice of Opportunity and then complete the Consumer Reader Application form below under Additional Resources or COMMBUYS. Please send your completed applications to Amy Butcher (Amy.Butcher@mass.gov) by 4pm on Friday, September 15th, 2023. 

We look forward to reviewing your applications! 

Additional Resources

Announcement of Upcoming Procurement – February 21, 2023

The Executive Office of Health and Human Services (EOHHS) intends to conduct a procurement for One Care plans and SCO plans through an aligned Request for Responses (RFR) process. The RFR will result in One Care and SCO contracts that would provide coverage beginning in CY2026 (January 1, 2026). Through the procurement, EOHHS will select organizations to operate a One Care plan, a SCO plan, or both.

EOHHS will be selecting One Care and SCO plans through a single, aligned RFR process to leverage certain process and timing efficiencies – both for MassHealth and for prospective bidders. Despite this aligned process, One Care and SCO serve very different populations, and they will remain separate and distinct programs with care models and other requirements appropriate to each.

Additional Resources

May Stakeholder Forum - One Care and SCO Procurement / One Care Transition

Additional Resources

March Stakeholder Forum - One Care Transition Planning/ One Care and SCO Programs

Additional Resources

Date published: February 21, 2023
Last updated: April 23, 2024

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