SFHSS launches Medicare RFP for 2025, sets procurement blackout through June 2024

San Francisco — The San Francisco Health Service System (SFHSS) told its Health Service Board on Nov. 9 that it will issue a competitive request for proposals (RFP) for Medicare plans covering the 2025 plan year, starting with the large UnitedHealthcare PPO population and aiming to broaden the provider network and stabilize year‑to‑year costs.

Executive Director Abby Yant said the procurement will focus first on the PPO population, which she and staff described as roughly 17,000 covered lives. Contracts Administration Manager Michael Visconti said the RFP will require robust bidder qualifications, include 3–5 year rate commitments to limit annual volatility, and seek continued access to CMS innovation value‑added services such as meal and transportation programs.

"We want a provider that can offer a nationwide passive PPO with no confusing in‑network/out‑of‑network differential for our members, and meaningful rate predictability," Visconti said. He told commissioners the RFP would be released around Dec. 8, with a pre‑proposal conference planned for about Dec. 15 and a board recommendation expected in May or June 2024.

Commissioners pressed staff on panel composition, whether one or multiple carriers could be selected, and how the panel will validate network robustness. Visconti said the selection panel will follow prior practice of limiting SFHSS representation to no more than half the panel and including external subject‑matter experts, but panelist names will not be disclosed until the process concludes to avoid ex parte contact.

The board unanimously adopted a communications blackout covering Nov. 9, 2023 through June 2024 to prevent improper contacts during the RFP and the concurrent rates‑and‑benefits process. Staff asked stakeholders to submit written input to refine RFP requirements during the comment window that will precede the December release.

Next steps: staff will collect written stakeholder input, publish the RFP, hold the pre‑proposal meeting and then evaluate nonfinancial and financial proposals on a staggered schedule before returning to the board with a recommendation in late spring.