GMCB Requests for Proposal and Information

Open RFIs

Vermont Health Care Uniform Reporting and Evaluation System - VHCURES 3.0

This Request for Information (RFI) is issued for the State of Vermont, Green Mountain Care Board (State) to gather input and obtain information to use in possible Requests for Proposals (RFPs) to replace and enhance the Vermont Health Care Uniform Reporting and Evaluation System (VHCURES), Vermont’s All-Payer Claims Database (APCD). VHCURES data allows for population-based analyses of health care system performance. Through data use agreements, VHCURES data is utilized by state agencies, state contractors and academic researchers to support analysis of health care access, spending, utilization, and quality.

All communications concerning this Request for Information (RFI) are to be addressed in writing to the attention of: Erin Collier, State of Vermont, Green Mountain Care Board, 89 Main Street - Montpelier, VT 05620. Erin Collier is the sole contact for this RFI Response. Attempts by RFI Responders to contact any other party could result in the rejection of their RFI Response.

CLOSING DATE: The closing date for the receipt of RFI Responses is 2:00 PM September 27, 2017.  Responses must be delivered to: Erin Collier, State of Vermont, Green Mountain Care Board, 89 Main Street - Montpelier, VT 05620 prior to that time. RFI Responses or unsolicited amendments submitted after that time will not be accepted and will be returned to the vendor.

NOTE: Please disregard Section 7.2 - there is no Questionnaire attached to this RFI.

NOTE: There is no formal opening for this RFI - This RFI will be published on our website.

The following document is a compendium of additional information based on the questions received from the RFI.

We thank the responses that we received from many organizations. The following respondents submitted documents supporting our requests for information:

Open RFPs

GMCB Business Performance Management System

The Office of Purchasing & Contracting on behalf of the Green Mountain Care Board (the State) is soliciting competitive sealed, fixed price proposals (Proposals) for its Business Performance Management System to enhance GMCB’s budgeting, planning, performance management, and analytic reporting capabilities (the Work) from qualified offerors.

If a suitable offer is made in response to this Request for Proposal (RFP), GMCB may enter into a contract (the Contract) to have the selected offer (the Contractor) perform all or part of the Work. This RFP provides details on what is required to submit a Proposal in response to this RFP, how Proposals will be evaluated, and what will be required of the Contractor in performing the Work. If you are interested in submitting a bid, please go to the following website: http://bgs.vermont.gov/purchasing/bids.

PLEASE BE ADVISED THAT ALL NOTIFICATIONS, RELEASES AND AMENDMENTS WILL BE POSTED on the BGS website. THE STATE WILL MAKE NO ATTEMPT TO CONTACT VENDORS WITH UPDATED INFORMATION. IT WILL BE THE RESPONSIBILITY OF EACH VENDOR TO PERIODICALLY CHECK THIS SITE FOR THE LATEST DETAILS. If you should have any problems in downloading the documents, please contact Stephen.Fazekas@vermont.gov.

Health Resource Data Planning Technical Assistance

Through this Request for Proposal (RFP) the Green Mountain Care Board is seeking to establish service agreements with one or more companies to provide a data landscape study and make recommendations for approaches that will help Vermont policy makers assess current and future community and statewide needs and appropriate allocation of health care resources in the state. This is a short-term contract. The State anticipates the start date will be February 1, 2018.

Proposals due by December 8, 2017 by 4:00PM. Please contact Erin Collier, Administrative Services Coordinator at (802) 828-2901 or erin.collier@vermont.gov.

Certificate of Need Analyst Services

Through this Request for Proposal (RFP) the Green Mountain Care Board (hereinafter the "State") is seeking to establish contracts with one or more companies that can provide analyst services regarding certificate of need submissions. Contracts arising from this RFP will be for a period of two years with an option to renew for up to two additional twelve-month periods. The State anticipates the start date will be February 1, 2018.

Proposals due by November 27, 2017 by 2:00PM. Please contact Erin Collier, Administrative Services Coordinator at (802) 828-2901 or erin.collier@vermont.gov.

 

Suspended RFPs

Cycle IV Public Use FIle Expert Determination

The Board is soliciting Proposals from qualified vendors to evaluate, design, and develop a Vermont Healthcare Claims Uniform Reporting and Evaluation System ( VHCURES) Public Use File, including conducting an “Expert Determination” to certify that the Public Use File complies with the security and privacy standards set forth in the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

Contact regarding this RFP should be addressed to Janet Richard.

 

All-Payer Waiver Contractor Support

The Green Mountain Care Board (GMCB) is seeking a contractor to assist in development of an all-payer waiver proposal. The development of this proposal, and negotiation of specific waiver terms and conditions with the federal government, will be overseen by an inter-agency team. For futher description, see 1.2 RFP Background and 3.1 General Overview of the RFP.

As of January 15, 2015, the Green Mountain Care Board has suspended the procurement of the services outlined in the VHCURES 2.0 RFP.  The Board made this decision because the Vermont Department of Information and Innovation’s independent review of the procurement process identified insufficient in-house staffing levels for implementation as a high risk, an assessment the Board agreed with.  

Closed RFPs

Statewide Analytics Vendor Related to the All-Payer Accountable Care Organization Model

The Office of Purchasing & Contracting on behalf of the State of Vermont Green Mountain Care Board (GMCB) is soliciting competitive sealed, fixed price proposals (Proposals) for its analytic services to support implementation of Vermont's All-Payer Accountable Care Organization (“ACO”) Model Agreement (“the Agreement”) with the Centers for Medicare and Medicaid Services (“CMS”). The Agreement and additional information about the All-Payer ACO Model Agreement can be found on the GMCB website: http://gmcboard.vermont.gov/payment-reform/APM.

GMCB may enter into a contract to have the selected offer or perform all or part of the work. This RFP provides requirements for proposal submissions, how GMCB will evaluate the proposals, and what will be required of the successful bidder in performing the contracted work. If you are interested in submitting a bid, please go to the following website: http://bgs.vermont.gov/purchasing/bids.

PLEASE BE ADVISED THAT ALL NOTIFICATIONS, RELEASES AND AMENDMENTS WILL BE POSTED on the BGS website. THE STATE WILL MAKE NO ATTEMPT TO CONTACT VENDORS WITH UPDATED INFORMATION. IT WILL BE THE RESPONSIBILITY OF EACH VENDOR TO PERIODICALLY CHECK THIS SITE FOR THE LATEST DETAILS. If you should have any problems in downloading the documents, please contact Stephen.Fazekas@vermont.gov.

 

All-Payer ACO Model Agreement Technical Support

The Green Mountain Care Board (GMCB) is soliciting proposals from qualified vendors to provide support related to Vermont’s All-Payer ACO Model Agreement. The GMCB is seeking to align its new regulatory and oversight responsibilities, including implementation of the All-Payer ACO Model Agreement and ACO regulatory oversight. Primary staff support for the effort will come from the GMCB.

The GMCB seeks bid proposals from qualified contractors to provide policy, actuarial, and implementation expertise for the new regulatory responsibilities gained in the APM and Act 113.

The Agreement and additional information about the All-Payer ACO Model Agreement can be found on the GMCB website: http://gmcboard.vermont.gov/payment-reform/APM.

Actuarial Services for Review of Major Medical Insurance, Accountable Care Organizations, and Hospital Budgets

Through this Request for Proposal (RFP) the Green Mountain Care Board (hereinafter the "State") is seeking to establish contracts with one or more companies that can provide actuarial review services. Contracts arising from this RFP will be for a period of one year with an option to renew for up to three additional twelve-month periods. The State anticipates the start date will be January 1, 2018.

Proposals due by October 27, 2017 by 2:00PM. Please contact Erin Collier, Administrative Services Coordinator at (802) 828-2901 or erin.collier@vermont.gov.

Construction Audit Consulting Services for Certificate of Need Program

The Green Mountain Care Board (GMCB) is currently soliciting proposals from qualified vendors to provide construction audit consulting services of health care projects for the Certificate of Need (CON) program. The selected vendor will assist the GMCB with monitoring CON construction activity by reviewing contracts, identifying and quantifying non-compliant construction costs and excessive billing practices, monitoring change order compliance, evaluating the established project control environment including labor costs, tracking of payments to vendors and validation of purchase order amounts, and identifying compliance issues and opportunities for cost savings and/or recovery.

Vermont Health Care Innovation Project State-led Evaluation

The SIM Initiative is to test whether new payment and service delivery models will produce superior results when implemented in the context of a state-sponsored health care innovation plan. The Vermont Health Care Improvement Project (VHCIP) is searching for a vendor who will assist in the evaluation by focusing on activities that facilitate continuous improvement and evaluation of Vermont-specific pilots and innovations.  The evaluation has two primary goals: provide timely feedback to inform corrections in the implementation and operation of VHCIP sponsored-initiatives, and generate actionable recommendations to guide Vermont state-leadership’s decisions to scale-up and diffuse VHCIP-supported initiatives.

Simplified Bid: All Payer Model Agreement Technical Assistance

The Green Mountain Care Board (GMCB) is soliciting proposals from qualified vendors to assist with planning for and implementing the GMCB’s provider rate setting authority through an all-payer payment model. The qualified vendor will have experience setting provider rates in an all-payer model, including Medicaid, Medicare, and Commercial payers. In addition, the qualified vendor will have experience with Medicare waivers.

Evaluation of Models for Internet Consumer Health Care Cost and Quality Information

This RFP seeks a vendor who can assist the GMCB in preparing a report for legislative review that includes the assessment of multiple options for providing Vermont consumers of health care services with internet access to comparative health care cost and quality information. 

Simplified Bid for Financial Analyst Services

This Simplified Bid process seeks a vendor who can provide financial analyses of projects subject to the Certificate of Need review. All instructions and deadlines regarding this Simplified Bid are contained in Simplified Request for Proposals. You will also need to review the Scope of Work and the Schedule A: Summary of Costs.

Cycle II Rate Review Enhancement Grant Evaluation

This RFP seeks a vendor who can assist the GMCB in developing performance measures and benchmarks, as well as carry out and report on the evaluation process for the Cycle II Federal Rate Review Grant held by the GMCB.  The vendor must have the ability to develop and perform the evaluation of these measurements. The evaluation must consider measures related to the consumer experience, transparency, and access to quality health insurance. The vendor must also be able to evaluate the effectiveness of the Health Care Advocate (HCA) in the rate review process. In addition to these quantitative measures, the Board expects the winning vendor analyze and provide qualitative measures in relation to the grant activities.

All Payer Claims Database

The Green Mountain Care Board (GMCB) is soliciting competitive sealed, fixed-price proposals to replace and enhance the State’s current all-payer claims database (APCD), known in Vermont as the Vermont Health Care Uniform Reporting and Evaluation System (VHCURES). This RFP provides details on what is required to submit a proposal, how GMCB will evaluate the proposals, and what will be required of the vendors in performing the tasks associated with this project.

Statewide Analytics Contractor Related to the State Innovation Model Grant

RFP for an Analytics Contractor to support payment reform activities through the SIM grant (specifically the ACO programs). Funding for this Contract is provided in the SIM Grant. The Green Mountain Care Board, in coordination with the Department of Vermont Health Access (DVHA), is seeking an independent, third-party contractor to assume responsibility for statewide analytics activities related to the implementation, monitoring, reporting, and evaluation of the Accountable Care Organization Commercial and Medicaid Shared Savings pilot program.

Actuarial Services for Major Medical Insurance Rate Review

The Green Mountain Care Board (GMCB) is soliciting Proposals from qualified vendors to provide health insurance actuarial analysis for insurance carrier rate review. The GMCB seeks a contractor with whom to work on developing a more efficient, effective and integrated rate review process for this new set of products. Our aim is a review process that is not piecemeal, eliminates redundancy and improves transparency. A successful contractor will combine actuarial skill and policy analysis, understanding the complex nature of major medical insurance product review in Vermont. The work requires a broad range of actuarial and business expertise. The performance of these duties requires sensitivity to, and familiarity with, the Vermont insurance market, general financial standards, actuarial requirements, and standards and guidelines of the National Association of Insurance Commissioners (NAIC) and Vermont law.

(Revised) Evaluation Services Related to the State Innovation Model Grant

The Green Mountain Care Board (GMCB) is soliciting Proposals from qualified vendors to provide Evaluation Services to Vermont's State Innovation Model (SIM) grant. This grant will fund activities inside and outside of state government over the next four years to:

Increase both organizational coordination and financial alignment between Blueprint advanced primary care practices and specialty care;
Implement and evaluate the impact of value-based payment models;
Coordinate with those payment models a financing and delivery model for enhanced care management and new service options for dual-eligibles; and,
Accelerate development of a Learning Health System infrastructure designed to meet the needs of providers engaged in delivery system reform and the state’s needs for ongoing evaluation of the impact of reforms

In addition to the SIM grant, the State is engaged in numerous payment reform pilots in various stages of development. Each of these pilots and models needs to be rigorously evaluated to determine whether there were improved health outcomes and cost savings. We also need a vendor to assist in identifying the appropriate measures for evaluation and feedback throughout the evaluation period to assure continuous quality improvement. The state of Vermont is committed to evaluating payment reform pilots and all models being tested under the SIM grant.

Project Management Services Related to the State Innovation Model Grant

The focus of the services to be provided will be to provide support to the SIM staff in order to ensure that the SIM Project achieves the State’s stated objectives as identified in the State Innovation Plan and SIM grant narrative. The SIM Project is a multi-agency, collaborative effort involving state staff and contractors, providers, payers and consumers.  The SIM Project has several working groups and these groups are comprised of stakeholders from within and outside state government. The vendor will need to provide Project Management of the various components of SIM that include three key project management roles.  These roles will operate in a structure where the overall project management lead is responsible for the activities of all other project managers.  The Project Management Team will be responsible for providing support to the SIM Project Director, SIM work groups, Government Operations Team, Core Team and staff of the SIM Project

Technical Assistance for Rate Review of Health Benefit Exchange Plans

This RFP seeks a vendor who will assist the GMCB with the review of the new products designed for Vermont’s Health Insurance Exchange.  The new products will have an effective date of January 1, 2014.  The GMCB seeks a contractor with whom to work on developing a more efficient, effective and integrated rate review process for this new set of products.  Our aim is a review process that is not piecemeal, eliminates redundancy and improves transparency.   A successful contractor will combine actuarial skill and policy analysis, understanding the complex nature of major medical insurance product review in Vermont.  The GMCB’s task is to improve health while lowering cost. 

Price Variation Analysis

Review the 2013 Payment Variation Study developed by VAHHS-NSO in Phase I of this project.  Describe whether there are clear reasons why some hospitals or providers are paid more than others for the same services, i.e. : 

         a)  Result of negotiations between payers and providers

         b)  Reimbursement for the cost of medical education 

         c)  Reimbursement rules related to the site of serviced)  Other

Explore how the differentials in payments between public and private payers impact the premium cost for residents and businesses in Vermont  and impact the cost of health care for the uninsured and/or those individuals with high deductible health plans.

Suggest how the impact of these variations in payments (or steps toward the elimination of these variances) might influence the policy options the GMCB should consider as it develops its own rules and regulations regarding payment methodologies, the basis for payment amounts, reduction in the cost shift, insurance rate review, and standards and criteria related to Accountable Care Organizations (ACOs) in Vermont. 

Graphic Design

This RFP seeks graphic design services to help with various projects that include proposing creative elements and designing for the following items:  Green Mountain Guides (brochures) and graphics for reports and presentations. Graphics are also needed for our Dashboard and other public engagement materials. Development of creative elements might range from charts and graphs of data to cartoon images. The qualified graphic designer will propose and create materials, such as the Green Mountain Guides, that will effectively communicate to the public. Some charts and graphs will be converted to pdf to use in reports/presentations and in our Dashboard. The contractor will have data and information graphically displayed in a clear, concise, and visually-appealing manner. Meeting deadlines and working collaboratively with a team are required.

Evaluation of Vermont's Payment Reform Pilots

This RFP seeks a vendor who can perform an evaluation of payment and delivery system pilot projects based on three payment models: bundled payments, hospital/physician budgets, and population-based global payments—in specific geographic areas. In addition to assessing actual performance related to delivery system improvements, the evaluation must assess patient experience, provider experience, caregiver experience, access to care, quality of care, and reduction in the growth of health care expenditures compared to initial projections. This evaluation must also assess whether or not the models being piloted are appropriate for statewide application.

Medicaid Shared Savings Proposal Design

There will not be a decision issued regarding this RFP until April 25, 2013.

The State of Vermont, through the Green Mountain Care Board (GMCB), seeks assistance with development of new provider payment models for the state’s Medicaid-related health care coverage programs (known collectively as Green Mountain Care).  Under the State’s section 1115 waiver, the Agency of Human Service (AHS) contracts with the Department of Vermont Health Access (DVHA) to function as a managed care entity for all Medicaid enrollees. DVHA contracts directly with health care providers to serve Medicaid enrollees, and pays providers primarily fee-for-service, along with very limited use of bundled payments for specific diagnoses or procedures. 

DVHA is working to develop new provider payment models that move away from fee-for-service and provide incentives for both cost and quality management.  These efforts are part of a broader state strategy endorsed by the legislature and led by the GMCB, which is aimed at developing all-payer payment reforms that will reduce health care cost growth and improve the health of Vermonters.  Due to its over-arching interest in multi-payer payment reform, the GMCB is seeking expertise that will enable DVHA to develop payment models that have been conceptualized but not developed in detail.  Concurrently Vermont providers have developed two Medicare shared savings accountable care organizations (one of them statewide) and the GMCB is overseeing an effort to develop shared savings program specifications for the commercially-insured market. 

Specifically, the state is seeking a contractor who can assist with design of a Medicaid shared savings ACO program, facilitate the development of a DVHA request  for proposal (RFP) and assist in drafting a Concept Paper and State Plan Amendment (SPA) supporting the shared savings ACO model.

 Research Into the Vermont Dental Landscape

This RFP seeks a vendor who can provide information about Vermont’s current oral health care delivery and financing systems to inform system improvement and solutions to reduce barriers and increase access to quality, risk-based and evidence-based care.

This RFP seeks a vendor who can provide information about Vermont’s current oral health care delivery and financing systems to inform system improvement and solutions to reduce barriers and increase access to quality, risk-based and evidence-based care.

Insurance Carrier Rate Review Technical Assistance (Withdrawn)

The Green Mountain Care Board (GMCB) was created by Act 48 of the Vermont Legislature in 2011 to oversee a broad range of health care reforms in Vermont, including the eventual transition to a publicly-financed single payer system known as Green Mountain Care.  The reforms mandated by Act 48 are designed to increase Vermonters’ access to quality health care services while at the same time containing the rapid rise of health care costs.  Although Act 48 will be implemented in coordination with the federal Affordable Care Act, its reforms go significantly beyond those required by federal law, particularly in the areas of payment reform and cost containment. The GMCB seeks a contractor who can assist in the development of an efficient rate review process that optimizes the data and information provided to the agency and streamlines the agency’s decision-making. 

Business Performance Management System

The Green Mountain Care Board (GMCB) was created by the Vermont legislature in 2011 to oversee the design of Green Mountain Care, a comprehensive health care system to serve the health care needs of every Vermonter. Through the coordinated efforts of this independent board, state government, and the citizens of Vermont, and with valuable input from health care professionals, and the business community, the Board will offer implementation strategies and innovative systems to keep Vermont among the leading states in expanding quality, affordable health care to all Vermonters while reducing waste and controlling costs.

The Green Mountain Care Board is soliciting competitive sealed, fixed priced Proposals for a new Business Performance Management System. to enhance GMCB’s budgeting, planning, performance management and analytic reporting capabilities (the Work) from qualified offerors. This could be either a Commercial Off The Shelf (COTS) solution or a custom developed solution, but the State has a preference for a COTS solution. This solution could live in the State’s data center environment or be a private Cloud Hosted solution. If a suitable offer is made in response to this Request for Proposal (RFP), GMCB may enter into a contract (the Contract) to have the selected offeror (the Contractor) perform all or part of the Work. This RFP provides details on what is required to submit a Proposal in response to this RFP, how GMCB will evaluate the Proposals, and what will be required of the Contractor in performing the Work. (Bid will close Wednesday, December 19, 2012)

Actuarial Support

The Green Mountain Care Board (GMCB) has to perform many tasks including approval of hospital budgets, implementation of payment reform, and approval of insurance rate increases.  In order to have successful delivery system reforms and control health care costs while improving the health of Vermonters, the GMCB needs to know and make use of medical expense trend data.

The GMCB seeks bid proposals from qualified, licensed and experienced actuaries to perform health actuarial consulting work for the GMCB.  The work requires a broad range of actuarial and business expertise.  The performance of these duties requires sensitivity to, and familiarity with, the Vermont insurance market, general financial standards, actuarial requirements, and standards and guidelines of the National Association of Insurance Commissioners (NAIC) and Vermont law. (Bid closed Monday, June 25, 2012)

Stakeholder Engagement Coordinator

The Green Mountain Care Board (GMCB) has an array of powers and duties that are complex and inter-related and have the potential to affect all Vermonters.  To optimally fulfill our charge, we must communicate clearly to the public regarding our scope of responsibility and our policy decisions and we must gather input from the public regarding the central choices inherent in our work.

The Green Mountain Care Board (GMCB) seeks a vendor who can provide the following: 

Assist with the development of the public engagement plan to assure that it reflects Vermont’s needs.
 Distill our work into materials that aid the general public and our key audiences in understanding our work, our work process, and their potential role in contributing to and influencing our work.
Implement a public engagement process designed by the Robert Wood Johnson Foundation to gather meaningful input from Vermonters on the GMCB’s tasks and demonstrate how their participation impacts our work.

Data Analytic Plan

The Green Mountain Care Board (GMCB) has to perform many tasks including approval of hospital budgets, implementation of payment reform, and approval of insurance rate increases. In order to have successful delivery system reforms and control health care costs while improving the health of Vermonters, the GMCB needs to know and make use of key pieces of data about the Vermont population and their use of medical and health resources.

The GMCB is seeking a data vendor who can work with various State data sets including the all-payer claims database, the Vermont Health Care Utilization Reporting and Evaluation System (VHCURES). Specifically, the vendor will work with the State to develop an analytic plan and recommend analysis for that plan.

Contact Us

Green Mountain Care Board
3rd Floor City Center
89 Main Street
Montpelier, Vermont 05620-3601
802-828-2177

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