REQUEST FOR PROPOSAL. Data Services for Clinical Support. RFP # BC Responses to Questions

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1 REQUEST FOR PROPOSAL Data Services for Clinical Support RFP # BC Responses to Questions 1 P a g e

2 UC Davis Health System received questions from potential bidders on July 2, The questions, and UCDHS s response, are presented below. Similar questions were grouped together to reduce redundancy in the responses, and are presented in categories that align to the sections of the RFP. Thank you for your continued interest in this process. Introduction 1. What is the population you are looking to cover? Can you tell us how many lives per plan P4P, MACRA, plan or quality review? 2. What is the total number of lives to be reported? Please list the lines of business (LoBs), the contracts within each LoB and the number of lives covered by each contract 3. Please specify the number of health plan specific P4P reports. Response: We expect that all individuals seen by our primary care physicians and specialists, and admitted to our hospital or seen in our Emergency Department will be included. As an integrated delivery system, we report multiple measures to multiple sources, each of which has a unique way of calculating the numerator and denominator. What is the predicted Year Over Year patient growth rate trend across LoBs? Response: For purposes of estimating volume, it would be reasonable to assume a growth rate of approximately 10% annually. With which department will the vendor have a primary relationship (IT, Quality, etc.?) Response: The primary relationships will be with Quality and Safety Department, Clinical Operations, and IT Applications 1. Other than IHA P4P, is UCDHS participating in any APMs today? Are there any specific APMs UCDHS desires to participate in in the future? 2. UCDHS currently part of an ACO? If not, does UC Davis intend to join one or some during the term of this contract? Response: UCDHS is not participating in a Medicare ACO. We do have contractual relationships in our commercial lines of business that incorporate APM concepts, including shared risk, shared savings, attribution of fee for service patients to primary care physicians. We expect these arrangements to continue and increase. We are evaluating whether and how we might enter into Advanced Alternative Payment models in the future. How many TINs does UC Davis anticipate reporting for? Response: UCDHS reports under three TINs. How many eligible clinicians (individual NPIs) does UC Davis anticipate reporting for? Response: Under MACRA, UCDHS expects to report under the group structure and has approximately 1200 eligible clinicians Has UCDHS engaged in any MACRA consulting to date? Response: No Can UCDHS identify other payers they are interested in planning for? Response: As noted above, we continue to work with payors on the implementation of alternative payment models. Pre-Qualification Will the vendor need to provide dispensing, storage and refrigeration capacity? 2 P a g e

3 Response: Thank you for bringing that to our attention. The attached revised RFP deletes that requirement. Can an organization apply for the RFP if it had applied for NCQA certificate but have not received the certification yet? Response: Respondents who do not have NCQA certification at the time the response is submitted will be disqualified Can an organization bid for the RFP if they don t have any prior experience with academic medical center but have worked with bunch of other healthcare organizations like ACOs, HIEs, Clinics. Response: Respondents are not required to have prior experience with academic medical centers, but should understand that lacking this experience will result in a lower score Terms and Conditions [UCD assumes this means vendor of choice and answers this question consistent with that assumption.] Is it the expectation that VOC will use the contract language and BAA language that is provided in the RFP? Is there an option to begin with VOC s license agreement and BAA and negotiate from that, if in fact we are awarded the business? Response: We refer to Section VII. Terms and Conditions. The terms and conditions for the resulting agreement are stated in this RFP and its Exhibits. Proposed changes and/or modifications to the terms and conditions are not invited and may cause the Bidder s proposal to be rejected. Is it possible to submit insurance documents at the award of the contract and not along with the proposal response? Response: No, a Vendor must provide proof of insurance with response to the RFP Functional Capabilities With regards to vendor responses to the requirements listed in the tables within 15 A 15 E, is UCDHS desiring a simple Yes or No answer for each, or a written narrative description as well? If written narrative is desired for each requirement, how would reviewers prefer to see these answers? In an additional column built into the table, or as an Appendix? Response: Please indicate Yes or No in response to each requirement. A written narrative description should not be submitted as part of this response. Can an organization bid for RFP if it does not meet all the requirements listed in Section 1.A: Functional Capabilities Response: Any company can submit a response. Respondents should understand that failure to meet the Functional Capabilities will result in a lower score. Please specify the non-hedis NQF measures that are in scope for this RFP. Response: Any non-hedis NQF measures that will be reported under MACRA. Organization of Data: Ii Multiple Lines of Business: Can you clarify and provide an example of what lines of business you are referring to? Response: The term multiple lines of business refers to the various types of contracts that we hold with payors. For example, capitation, fee for service, full risk, shared risk, partial risk 3 P a g e

4 Relating to #16 and the DRG Comments 1. In terms of the development of DRGs, is this referring to our knowledge of how DRGs are constructed or is the ask around developing parallel and/or new payment methodologies that mirror the DRG system or one of its derivatives (e.g., MS, APR)? 2. Is UC Davis looking for assistance in developing custom weights and rates using MS/APR/AP DRGs? 3. To confirm, we assume this is the case, is UC Davis looking for actuarial and financial projection modeling assistance around transitioning from current state contracts (e.g., per diem) to DRG contracts? 4. You reference DRG development in the RFP, particularly Section IX-Item #16. Could you please elaborate and provide more clarity, beyond the RFP information, around the expectations and goal for the DRG development? Response to questions regarding DRGs: UC Davis is seeking actuarial and financial support in developing payment methodologies that move away from per diem-based payments, similar to DRGs. UC Davis expects the vendor to bring necessary expertise, including financial and actuarial, to evaluate our current payment models and work with us to develop alternative payment methodologies and understand their potential revenue impact so that we can make the most appropriate contracting decisions. Are you seeking for license software for both Annual HEDIS Reporting (Retrospective) and Prospective Care Gap Reporting? Other than the support services mentioned in the RFP, are you looking for a Service-Bureau Support (which includes resources support to take care of HEDIS operational activities, monthly prospective data loads, annual retrospective refreshes, supplemental data integration, application maintenance, HEDIS season support, hybrid data integration and other day-to-day HEDIS operational system activities, etc.)? Is California the only State for which Reporting is required? If not, please specify other states. Technical Capabilities Are you looking for an on-premise or cloud hosted solution? Response: A hosted solution is preferred. Are the participating organisations currently exchanging data, if yes what are the various formats in which data is exchanged? Response: UC Davis, through various means, currently supplies data to numerous entities, including health plans, the Integrated Healthcare Association and CMS. The format of these submittals varies based on the specific requirements of each organization. What is the technology stack and total number of records currently available with UCDavis? Response: We do not believe this question is relevant to developing a response to this RFP. Can data be stored in H-base instead of SQL and Oracle, considering H-base will be more efficient in handling large volume of data compared to SQL and Oracle? Response: No. 4 P a g e

5 Please provide details on your Supplemental Data Collection process and sources. Response: Supplemental data, when required, is extracted from our Epic system to supplement claims data. It may also include pharmacy and lab data files external data sources. Do you require Medical Record Review/ Chart Abstraction Software, Services or Both? Response: No. UCDHS has an existing contract for those functions. Pricing: 1. How many EHRs does UCDHS currently use? Aside from EPIC are there any others? 2. For the scope of this project, how many instances of EMR s are you going to connect to? and which vendor? Response: Epic is the only EHR. Connect to a single instance of Epic is required. How many data sources will we be expected to integrate with? Can UCDHS identify them? Response: Data will be extracted from our Epic and data warehouse systems and transmitted to the selected vendor. How many and what type of adjudicated claims data sources are included in your scope? How many lives fall under each contract? Response: We are pursuing receiving adjudicated claims from our payers but do not yet receive them. We anticipate that the claims files will be sent from our data warehouse. Do any EMR instances span beyond UC Davis as part of a shared risk program? If so, how many annual admissions for those facilities with EMR s outside of UC Davis? How many outside EMRs? and which vendor(s)? Response: We do not currently have any EMR instances that go beyond UC Davis. What is the estimated budget allocated to this project? Response: UC Davis is not disclosing this information. 1. Please elaborate the cost head "Access to Reporting Suite" and specify the number of users requiring access? 2. How many users would need the vendor's system? Response: We recognize that some vendors provide P4P and HEDIS reporting without providing access to a client-facing portal, as described in Functional Capabilities. We also recognize that there are costs associated with providing this client-facing portal such as licensing fees, help desk functions, training and other activities. Generally, we consider these to be part of Access to Reporting Suite. We expect a maximum of 40 users would access the system 5 P a g e