Associated press reports North Carolina state government has begun the bidding process for insurance companies and health networks interested in $6 billion in contracts to help operate the state’s Medicaid system:

The Department of Health and Human Services announced Thursday it’s seeking proposals from entities interested in contracts with the state’s overhauled Medicaid program starting in late 2019. DHHS Secretary Dr. Mandy Cohen says the awards are valued at $6 billion annually for up to five years, making it the department’s largest procurement ever.

The General Assembly agreed in 2015 to shift Medicaid from a traditional fee-for-service program to one in which statewide managed-care companies or regional hospital and doctor networks get flat monthly amounts for each patient covered.

Four statewide contracts and 10 contracts covering six regions are expected to be awarded in February.