HEALTH RESEARCH, INC.

Transcription

1 QPS HEALTH RESEARCH, INC. New York State Department of Health Office of Quality and Patient Safety State Health Innovation Plan / State Innovation Model Initiative Request for Applications Independent Validation Agent for Advanced Primary Care Practice Transformation Technical Assistance Question and Answer June 7, Q# Question Answer 1 Would the state consider that an entity who is/has worked with selected primary care practices to achieve practice transformation to have a conflict of interest if that work is funding through DSRIP or SIM? If yes, is there an opportunity for the entity to either build firewalls within their organization or recuse themselves from evaluating the specific practices they have worked with and subcontract with another independent entity to perform those assessments? HRI/NYSDOH will accept applications from individuals and organizations that demonstrate the ability to be a neutral, independent third party. Applicants with perceived conflicts of interest should specify a plan to mitigate any concerns. 2 Will the state consider regional approaches to the independent assessment and award multiple contracts? No. HRI/NYSDOH will award one contract. 3 Can an organization who is currently an APC TA vendor apply for this funding opportunity? See answer to #1.

2 4 On page 4 of 41, Section I. Introduction, Paragraph 1: Yes. Current PT Agents per region include: the state references Practice Transformation Technical Region 1: Assistance Agents PT Agents. Is it possible to receive a Adirondack Health Institute list of current PT Agents? Capital District Physicians Health Plan Chautauqua County Health Network Healthcare Association of New York State 5 On page 4 of 41, Section I. Introduction, Paragraph 3: the state references 10 PT Agents with 16 contracts. Can the state provide a definition of a contract? Region 2: New York ehealth Collaborative Niagara Falls Medical Center Region 3: Capital District Physicians Health Plan Solutions 4 Community Health Region 4: Coalition of Asian-American IPA EmblemHealth Services Company Institute for Family Health Island Peer Review Organization Maimonides Medical Center New York ehealth Collaborative Primary Care Developmental Corporation The Fund for Public Health in New York Region 5: Common Ground Health (Finger Lakes Health Systems Agency) Region 6: Common Ground Health (Finger Lakes Health Systems Agency) Island Peer Review Organization Region 7: Adirondack Health Institute Capital District Physicians Health Plan Region 8: EmblemHealth Services Company Healthcare Association of New York State Island Peer Review Organization New York ehealth Collaborative Solutions 4 Community Health The definition of a contract as it pertains to this RFA is a legally binding agreement between HRI and an entity for services and payment. For additional information regarding HRI s terms and conditions of the agreement,

3 please see Section IV, J, HRI Boilerplate Agreement of the RFA. 6 On page 5 of 41, Section III. Scope of Work A. Validation Type 1. Baseline, the state references intensive on site validation. It is our assumption that there are 10 PT Agents with an additional 7 PT Agents by July Should we assume 17 on site visits for baseline? 7 On page 6 of 41, Section III. Scope of Work B. Validation Processes, paragraph 2 states, The Contractor will use a Standardized Validation Tool for all validations. It is our assumption that this tool will developed and maintained by the Contractor and operate independent of the Practice Transformation Tracking System (PTTS) references on Page 4 Section 1. 8 NCQA requests clarification of the type of contract (e.g. fixed price per unit by validation type or at cost) that will be awarded out of this solicitation. The budget instructions in attachment 4 include all-inclusive pricing on a per unit basis. However, in section H1 it is indicated that reports of expenditures will be required with monthly invoicing. 9 Section V.5.a and b, Page 24 and 25: The RFA calls for submission of a "process map" that "illustrates all activities, outcomes and proposed timeframes for the scope of work..." Please elaborate on the requirements for and components of the process map. For example, does the process map include a flowchart, associated narrative and a timeline or are all elements of the process map to be incorporated within the flowchart? 10 Section II.A, Page 5: Would Practice Transformation Technical Assistance Agents/Contractors be deemed to have a perceived conflict of interest (COI) in serving as the Independent Validation Agent contractor? 11 Section III.A, Page 5: If so would the state allow and consider a mitigation plan to address the perceived COI? The number of on-site baseline validations is determined by the number of PT Agents and the DFS Regions that they cover. In accordance with the answer to number 4, there are currently 26 onsite baseline validations anticipated. That is correct. This will be a fixed-price contract. A report of expenditures will not be required. The first process map should illustrate all activities, outcomes and proposed timeframes for the scope of work in the RFA. The second process map should illustrate the validation process from the PT Agent's perspective. Applicants should include the elements in their process maps that best demonstrate the flow of work proposed. See answer to #1. See answer to #1.

4 12 Section III.A.1, Page 5: For Baseline assessments, please confirm our understanding that the Contractor will validate only one PC practice site assessment for each PT Agent and that these assessments will be conducted onsite. So, hypothetically, for 10 PT Agents, there would be 10 onsite Baseline reviews. See answer to #6 13 Section III.A.1, Page 5: How will practices be selected for the Baseline reviews? 14 Section III.A.3, Page 6: Will HRI/NYSDOH make the decision as to whether an Ad Hoc review will be conducted onsite versus offsite? 15 Section III.A.3, Page 6: Approximately how many Ad Hoc reviews will be conducted onsite? 16 Section III.A.2, Page 6: Are all Random Sample assessments to be conducted offsite? 17 Section V.A.8.b. Page 26: Approximately what percent of validations are expected to be conducted for PC practice sites that requested a Gate assessment, but did not want PT TA services or were ineligible for PT TA services (e.g., participating in another PT program[s])? 18 Att. 4, Page 40: What is the rationale for anticipating more reviews being conducted in the first 6 months of the program than in the following 12 months? 19 Who will the awarded contractor be specifically contracting with - HRI or the NYS Department of Health? If the contract is with a non-for-profit entity rather than a state entity, this will likely change various points of negotiation on the terms and conditions. It will also effect the specifics of clause 18 in the HRI Boilerplate Agreement regarding indemnification. 20 Please provide a list of the PT agents across the state. This information will be needed to appropriately ensure that there are no conflicts of interest and that there are no additional risks. 21 Is the RFA contract a 6 month contract with a 12 month option or is it an 18 month contract? The contractor will select one recently conducted, but not necessarily completed, Gate assessment for each PT Agent and their respective DFS Region(s). The HRI/NYSDOH Contract Manager will specify whether each Ad Hoc validation will be conducted on-site or offsite. We expect the majority of Ad Hoc validations to be conducted on-site. Yes. The percentage of validations is unknown at this time because that type of Gate assessment is included in the random sample and Ad Hoc validations. We expect that baseline validations will be completed in the first 6 months of the contract. The contract will be with HRI. See answer to #4 There will be an initial contract, and then a 12-month renewal effective February 1, 2018.

5 22 Page 4, Section I. Introduction, Practice Transformation Technical Assistance Services: Please provide the names of the organizations that currently serve as PT Agents. See answer to #4 23 Page 4, Section I. Introduction, Paragraph # 2 Practice Transformation Technical Assistance Service: When did the two (2) years begin for current practices that are engaged with PT Agents? 2/1/ Page 4, Section I. Introduction, Paragraph # 3 Practice Transformation Technical Assistance Service: What is the current number of practices enrolled in APC PT TA? 25 Page 4, Section I. Introduction, Paragraph # 3 Practice Transformation Technical Assistance Service: Are there enrolled practices in each NYSDOH region? 26 Page 4, Section I. Introduction, Applicant Considerations, Paragraph 2: Who are the payers and what are their roles? 27 Page 5, Section III. Scope of Work, A. Validation Types, Point 1, Baseline, Paragraph 1: Who determines what practice gets a Baseline assessment the PT Agent, the Contractor, or the NYSDOH Contract Manager? 28 Page 6, Section III. Scope of Work, B. Validation Processes, Paragraph 2: The Contractor will use a Standard Validation Tool that corresponds to the Gate Assessment Tool. Where can we get access to the Gate Assessment Tool? 29 Page 6, Section III. Scope of Work, B. Validation Processes, Paragraph 4: Will the Contractor findings and reports go to one HRI/NYSDOH Contract Manager or are there managers in each region? 30 Page 6, Section III. Scope of Work, B. Validation Processes, Paragraph 4: Will the Contractor findings and reports go to one HRI/NYSDOH Contract Manager or are there managers in each region? 31 Page 8, Section III. Scope of Work, E. Reporting, Paragraph 3: How often are the conference calls with the state and/or federal SIM evaluator? Enrollment of practices is ongoing. Currently, there are 112 primary care practice sites enrolled. Yes. Payer is the generic term for Medicaid and commercial insurance providers whose role is to provide support to practices undergoing transformation. The contractor. Please see Attachment 8 in the PT TA Services RFA available through the following link: The reports will be provided to a single HRI/NYSDOH Contract Manager. See answer to #29 We anticipate at least one monthly conference call.

6 32 Page 12, I. General Specifications. 1: Please clarify the location of the Application Cover Sheet. Should the Application Cover Sheet be embedded into the proposal as a picture and located before Program Summary? Or, be attached to proposal? The Application Coversheet should be included as a cover page before the Program Summary. 33 Page 12, IV. Administrative Requirements, H. Payment and Reporting Requirements of Awardees: What is the approximate budget for this scope of work? 34 Page 13, I General Specifications, 6: Should applicants be registered in the System for Award Management (SAM) database prior to proposal submission due date? 35 Page 23, V. Completing the Application, A. Application Format and Content: Can respondents use font color in their proposals? 36 Page 23, V. Completing the Application, A. Application Format and Content: Must multi-level lists contain hyphens between numbers as illustrated in the RFP's examples? Or, can the lists have periods between numbers? 37 Page 23, V. Completing the Application, A. Application Format and Content: 2. Organizational Capacity and Experience; The RFA states The applicant should include the section number and subsection (e.g., VI-I-a) of the requirement being addressed. Please confirm if the following format meets requirements for this specific section of the response. Example: V-A-2-a; V-A-2-b; V-A- 2-c. We are unable to provide the total dollar amount budgeted for this contract. Applicants should submit a budget based on the information in the RFA, ensuring reasonableness of cost and a best value to HRI/NYSDOH. No. Registration will be required before a contract is awarded. There are no requirements regarding font color. Please use the format provided in the RFA. Please use the format provided in the RFA. Or, can respondent s response be formatted as follows: 2.a; 2.b; 2.c; Please clarify numbering format for response. 38 Page 23, V. Completing the Application, A. Application Format and Content: Can proposals include a Cover Page (in addition to Attachment 1) and a Table of Contents? 39 Page 23, V. Completing the Application, A. Application Format and Content: Can proposals include Attachments section for resumes? 40 Page 23, V. Completing the Application, A. Application Format and Content: Should resumes be included in the proposal response? The cover page template provided should be the cover page for the application. You may include a table of contents. The Table of Contents will not be included in the page limit. Yes. Resumes should be included as an attachment and do not count towards the page limit.

7 41 Page 25, V. Completing the Application, A. Application Format and Content, 8. Budget/Cost Sheet, Item b, bullet point 1: Is it the expectation that 185 validation visits will be completed between August 1, 2017 and January 31, 2018? There are 185 validations estimated in Year 1. The number of visits (on-site validations) vary as specified in the RFA. 42 Page 28, Attachment 1, Application Cover Sheet: Can you provide Attachment 1 in Word format? The MS Word version of Attachment 1 has been uploaded to: independent-validation-agent-advanced-primary-carepractice-transformation-technical-assistance/ 43 Section III B.3: Are on-site secondary reviews for a PT Agent and PC practice site that has an Unsatisfactory validation result included in the budgeted estimated volumes for Baseline, Random or Ad Hoc validations? Yes, estimates for validations are inclusive of potential secondary reviews.