North Carolina state government has formally begun a search for insurance companies and health networks that want to care for most of the state’s Medicaid patients.

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.

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North Carolina seeking contracts operating retooled Medicaid