Health and Wellness Services
The State seeks the assistance and expertise of a health management and wellness vendor to provide
programmatic supports to members who agree to identify health risks and take actions to reduce those
risks. The over-arching goal of this initiative is to improve the health of members, principally by arresting
the growth in the prevalence of chronic disease among members of the public sector plans and to slow or
stop the progression of disease among those currently living with chronic illnesses. To the extent that the
State and plan members are able to accomplish this goal, the annual rate of growth in the expenditures of
the public sector plans will slow. As a result, the State is better able to preserve more comprehensive,
affordable and dependable health coverage and do so with minimum cost-shifting to members.
The State intends to secure one statewide contract to provide a full continuum of health management and
wellness services to members of the public sector plans. The Contractor shall have the primary
responsibility for ensuring that members know their health risks by providing members access to health
questionnaires (as known as health risk assessments in similar contexts) and health screening
(commonly referred to as biometric screening). The Contractor shall assess member risk, offer
feedback, and provide a continuum of health coaching and health management services (including
lifestyle management, disease management (DM) and case management) as indicated. These services
include but are not limited to lifestyle management (least intensive), disease management (more
intensive), and case management (most intensive). The Contractor will also assist members with their
health care decisions, including but not limited to providing a nurse advice line and patient decision aids to
inform patients of options and alternatives after they identify particular health risks or receive a specific
diagnosis. In addition, the Contractor shall have responsibility for educating members regarding general
health and wellness topics, preventive services, and the availability of program supports.
