Common use of Auto-assignment Methodology for Medicaid MCOs Clause in Contracts

Auto-assignment Methodology for Medicaid MCOs. HHSC may revise its auto-assignment methodology during the Contract Period for new Medicaid Members who do not select an MCO (Default Members). The new assignment methodology may reward those MCOs that demonstrate superior performance and/or improvement on one or more key dimensions of performance. In establishing the assignment methodology, HHSC will employ a subset of the performance indicators contained within the Performance Indicator Dashboard. HHSC may recognize those MCOs that exceed the minimum geographic access standards defined within Section 8, “Operations Phase Requirements,” and the Performance Indicator Dashboard. HHSC may also use its assessment of MCO performance on annual quality improvement goals (described in Section 8, “Operations Phase Requirements”) in developing the assignment methodology. The methodology will disproportionately assign Default Members to the MCO(s) in a given Service Area that performed comparably favorably on the selected performance indicators. HHSC reserves the right to implement a performance-based auto-assignment algorithm. HHSC will invite MCO comments on potential approaches prior to implementation of the new performance-based auto-assignment algorithm.