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FBO DAILY ISSUE OF SEPTEMBER 12, 2012 FBO #3945
DOCUMENT

Q -- Home Health - Attachment

Notice Date

9/10/2012
 

Notice Type

Attachment
 

NAICS

621610 — Home Health Care Services
 

Contracting Office

Department of Veterans Affairs;Health Administration Center;3773 Cherry Creek Drive North, Suite 450;Denver CO 80209
 

ZIP Code

80209
 

Solicitation Number

VA74112I0470
 

Response Due

9/21/2012
 

Archive Date

10/1/2012
 

Point of Contact

Jan Bertapelle-Anderson
 

E-Mail Address

8.5158<br
 

Small Business Set-Aside

N/A
 

Description

THIS IS A SOURCES SOUGHT NOTICE ONLY. THIS IS NOT A REQUEST FOR PROPOSAL Home Health Services Market Research Request for Information (RFI) This sources sought notice is issued in an effort to conduct additional market research for information and planning purposes. The Department of Veterans Affairs (VA), Veterans Health Administration (VHA) National Non-VA Care Program Office (NNPO) is issuing this Request for Information (RFI), to determine what types of companies are available to potentially support our Home Health Services CMS pricing implementation. INTRODUCTION: The Department of Veterans Affairs (VA) Office of Geriatrics & Extended Care (GEC) advances care for chronically ill and aging Veterans by providing policy direction of Geriatrics and Long Term Care clinical programs, to include Home Health Care. The Contractor must be URAC (Utilization Review Accreditation Commission) certified and/or NCQA (National Committee for Quality Assurance) certified. PURPOSE: The purpose of market research is to allow Government the opportunity for dialogue and interaction with industry in order to: "Seek new ideas and approaches; "Get a more complete understanding of what the market has to offer; "Initiate dialogue with subject matter experts; and "Improve understanding of best practices and lessons learned. The primary goal for this information gathering effort is to better understand best practice offerings from Home Health support for claims processing (i.e. from eligibility, authorization, care provided, provider bill, through claims processing and pricing). Additionally, the VA would like to pursue better ways to improve Home Health Services provider support to our veterans. RESPONSE: All interested parties are requested to provide the following information: Company name, address, point of contact information, size and business status (small, large, veteran owned etc.), location, DUNS number, GSA Schedule information, if applicable; and a description of the firm's capabilities with respect to the requirements described. Respondents are requested to provide information via email to the contracting officer Janice.Bertapelle-Anderson@va.gov no later than 4:30 PM September 21, 2012, local Denver, Colorado time (MST). NOTE: We cannot discuss the prospect of any future VA requirements, and providing responses to this questionnaire in no way provides your firm with any advantage or disadvantage toward a potential VA solicitation. The information collected by VA for the purpose of this effort will not be distributed or utilized for any other use or intent. Questions 1.Please tell us about your company and how you are positioned in the health care marketplace. a.Company type [e.g. Public, for-profit or non-profit] b.Are you classified as a small business or SDVOSB? c.Organizational chart for the overall system d.Number of covered lives or enrolled beneficiaries as of Jan 1, 2012 (or other specified date) for Home Health Services e.Current year Home Health Services premium revenues f.Current year Home Health Services claims paid g.States/locations served "Please provide the zip codes of your service areas or another geographic description such as counties. h.Home Health Services product and service offerings "How do you describe these offerings i.Have you previously contracted with the federal government to offer insurance products and services (e.g., Medicare Advantage, Medicaid Managed Care, Federal Employee Health Benefit Program, TRICARE, etc.)? "If so please describe the contract period; typical contract renewal timeframe? 2.If registered in the federal government's Central Contractor Registration (CCR), what are your NAICS codes? 3.Please describe Home Health Services provided through your network. a.Skilled Home Health Care b.Home Health Aide c.Homemaker Services d.Home Respite Care Services e.Home Hospice Care f.Home Bowel & Bladder Care g.Adult Day Care h.Home Respiratory Care i.Home Dialysis Care j.Home-Based Primary Care Program k.Home Infusion Therapy 4.Describe your Home Health Services process(es) to include eligibility, consult, authorization, provider bill, claims processing, and provider paid. 5.The Home Health CMS PPS is composed of five main features: a.Payment for the 60-day episode b.Case-mix adjustment c.Outlier payments d.Adjustments for beneficiaries who require only a few visits during the 60-day episode e.Adjustments for beneficiaries who change HHAs "Budget neutrality "Consolidated billing How do you handle these from a process, best practice perspective? What are your challenges ? 6.Do you provide Home Health Services in rural areas? a.Do you provide Home Health Services (i.e., Homemaker, Home Health Aide, etc.) in these areas and, if so, describe the process? b.Please describe any lessons learned you have learned from work in rural areas c.Please describe other metrics of network adequacy or timeliness of care, particularly for specialty care services 7.Do you see yourself as a national, regional (multi-state), or local (single state) provider of Home Health care products and services? a.What are the advantages/disadvantages of these geographic breakouts? b.At what level of geography is it your preference to contract? Why? 8.Please describe your credentialing and acceptance of Home Health Services network provider processes and best practices. a.Access (do you have providers where you have beneficiaries?) b.What tools are in place to describe where the providers are; what kind of providers are available etc. c.Processes, best practices in place and requirements for certification? d.What steps do you take to ensure current valid licenses are in place as required by law and provider has not been excluded from participation in the Medicare and Medicaid programs? e.How often do you update your provider network listings? 9.How do you measure and report quality of Home Health Services care in your network? a.Should VA pursue a partnership with your network, what considerations about measuring and reporting clinical care quality should be taken into account? b.Please describe the structures that are used to communicate quality issues to providers 10.How do you ensure privacy and security of patient information, clinical information, etc.? a.Describe your policies and procedures for protecting health information. b.What are your medical documentation sharing expectations of your network providers and any entity that you have existing contracts or partnerships with? c.How is medical documentation shared? d.What are the timeline expectations for response of submitting medical documentation? e.How is quality of documentation ensured, inspected and what are the expectations that current partners have in this regard? f.Describe the information systems that are in place to support the integrated system. g.Summarize your electronic records approach. h.Indicate how physician data, hospital data and health plan data are integrated. i.Describe your EDI capability. 11.What are the most appropriate pricing strategies, methodologies, systems (etc.) (or combination of these pricing schemes) that correspond to Home Health Services support both contract and non-contract: a.Pricing arrangements common in your business lines b.Rural network c.Local versus regional versus national pricing schemes d.CMS pricing vs. Home Health Services not covered by CMS pricing 12.Do you apply service fees or costs above the actual Home Health Services care costs? What would you suggest the VA consider in regards to service fees? 13.Describe your claims processing infrastructure to capture and process Home Health Services provided in a timely and compliant manner. a.Do you capture referral data as part of your claims process? b.Are you aware of the 5010 and ICD-10 regulations timelines and have evidence that you are on track to meet these requirements? c.Indicate what level of claims detail you could provide and how frequently (e.g., monthly?). At the line item level? "Including procedure and diagnostic detail (CPT codes, ICD-9/10, etc.) "In what electronic format? "What types of cost data could be provided on these claim records? 14.What would be the most significant and useful performance metrics VA could use for Home Health Services care? a.Are any of these measures more difficult to obtain? If so, why? 15.In terms of care coordination and management contracts, how have you used financial and other incentives with providers and with contracting entities (to maintain quality of services, share risks e.g. with medical groups, maintain access standards, manage costs)? a.Describe any positive or negative incentives used. b.Objective and/or subjective measurements used to determine incentives. c.Who is responsible for clinical quality; how it is measured? d.Incentives and/or measurement programs that were least useful, did not work as intended, or had unintended consequences? e.What positive or negative financial incentives should be tied to meeting or falling short of these achievement standards? f.What portion of total revenue should explicitly be linked to achieving quality standards compared to the health care cost capitation? 16.Do you think this effort will require one firm or do you think subcontractors would be required in order to accomplish the objectives? 17.If you have experience working under performance measures external to your organization, please describe those measures and how they affected your solutions and ability to perform a service. 18.What are the most important contract administration strategies to ensure successful, mutually beneficial care management contracts? DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI.
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/spg/VA/VAHAC741/VAHAC741/VA74112I0470/listing.html)
 

Document(s)

Attachment
 

File Name: VA741-12-I-0470 VA741-12-I-0470_1.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=472578&FileName=VA741-12-I-0470-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=472578&FileName=VA741-12-I-0470-000.docx

 

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
 

Record

SN02875496-W 20120912/120911000538-299cf67c8d0bed45dca93c2f33b1c004 (fbodaily.com)
 

Source

FedBizOpps Link to This Notice
(may not be valid after Archive Date)

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