UNIVERSITY OF NORTH DAKOTA School of Medicine and Health Sciences Center for Rural Health NORTH DAKOTA Hospital Association NORTH DAKOTA Healthcare Review, Inc. NORTH DAKOTA EMS Association REQUEST FOR PROPOSAL for The North Dakota Medicare Rural Hospital Flexibility (Flex) Program 14 RFP #36-2014 RELEASE DATE: September 16, 2013 TECHNICAL ASSISTANCE CALL: September 24, 2013 (4:00pm CT) Participants interested in a review of the guidance; question & answer session should call: 1.866.809.4014 (passcode: 7776782#) APPLICATION DUE DATE: October 18, 2013 (Applications must be received by 5pm CST) AWARD NOTIFICATION DATE: November 4th, 2013 Prepared by the University of North Dakota Purchasing Department 1
PURPOSE This Request for Proposal is released by the University of North Dakota Purchasing Department on behalf of the North Dakota Medicare Rural Hospital Flexibility (Flex) Program. The North Dakota Flex Program is administered by the University of North Dakota Center for Rural Health, School of Medicine and Health Sciences. Its partners include the North Dakota Hospital Association, the North Dakota EMS Association, and the North Dakota Healthcare Review, Inc. (North Dakota s quality improvement organization). The Flex Program s Steering Committee is comprised of one or more members from each of the partners. The Steering Committee sets policy, develops guidelines, and reviews and determines the hospital grant awards. The ND Flex Grant Program is designed to support the goals of the Flex Program at the local level by supporting rural hospitals in remaining viable while maintaining access to care for rural North Dakotans. The Medicare Rural Hospital Flexibility Program is funded by the federal Office of Rural Health Policy (ORHP), Department of Health and Human Services. North Dakota Critical Access Hospitals (CAH) are eligible to apply for Flex Grant funding. Flex Grant funding is available specifically to support the measurable financial improvement of North Dakota Critical Access Hospitals. A Critical Access Hospitals can apply for more than one grant. A separate application form must be used for each area of focus. The Medicare Rural Hospital Flexibility Program is funded by the federal Office of Rural Health Policy (ORHP), Department of Health and Human Services. DEFINITIONS Application... Response to the RFP CAH... Critical Access Hospital Contractor... Hospital receiving contract award Flex.. Rural Hospital Flexibility Program ORHP... Federal Office of Rural Health Policy Proposal... Response to the RFP RFP... Request for Proposal Respondent... Hospital responding to RFP, Applicant Flex Steering Committee...... University of North Dakota, Center for Rural Health North Dakota Hospital Association North Dakota EMS Association North Dakota Healthcare Review, Inc. UND... University of North Dakota 2
SECTION 1 STANDARD TERMS AND CONDITIONS 1.1 Please refer to the attached sample subcontract. 1.2 UND Subcontract requirements: In order for the University to meet a federal requirement under the Federal Funding Accountability and Transparency Act (FFATA), all entities receiving federal flow-through funding are required to obtain a Dun and Bradstreet number and to be registered on the System for Award Management site prior to submitting a proposal. Below is a link to the registration site: 1. Must have active registration status with the official U.S. Government System for Award Management website. https://www.sam.gov 2. Must provide a Dun and Bradstreet number (also called the DUNS number). This is a 9-digit identification of the physical location of your business. Please note that there is good chance your organization is already registered with the SAM and has a DUNS number. Please check first with your contracting or business office. 3
SECTION 2 SCOPE OF WORK Funding is available to support CAHs in identifying potential areas of financial and operational improvement, as well as supporting CAHs and communities in developing implementation strategies and programming in response to identification of unmet community health and health service needs. NOTE: Rural Hospital Flexibility funds cannot be used to purchase or acquire real property or to improve existing property. The funds cannot be used for building and/or physical structural improvements. A. Critical Access Hospital Program Grant There are two areas that can be addressed through this grant initiative: comprehensive revenue cycle management analysis, and community health needs assessments strategic implementation activities. The following provides a description of each. 1A.1 Revenue Cycle Management Analysis: This activity will take the form of financial consultation for comprehensive revenue cycle management analysis/education, with the objective of increasing hospital revenue and cash flow. The CAH program grant will cover three awards of up to $15,000 for financial assessment performed by a qualified accounting firm with history and experience in the area of health care finance. The financial analysis must include the following: Chargemaster review Collections Admissions Billing & Coding Review Review of Medicare Cost Report Utilization Operating Departments Physician Documentation Ancillary Managers During the application review process, awards will be determined based on need, as outlined by data from the Flex Monitoring Team CAH Financial Indicators Reports, and other sources. NOTE: All application requests for consultant services must include a minimum of two bids from different consultants, both including a detailed budget narrative and a thorough description of what the analysis will include. The applicant must then provide rationale for using their consultant of choice. The Flex Steering Committee does not wish to interfere with the hospital s right to choose their own consultant, but does wish to understand the available options and a detailed description of the benefits that the analysis will provide to the specific hospital and its community. 4
Reporting requirements for 1A.1 Revenue Cycle Management Analysis Grants: 12-month post measure reporting will include, but is not limited to: Percent improvement in bad debt as a percent of gross charges and/or net patient revenue Improvement in point of service collections as a percent of total revenue Percent reduction in claims review and denial rates Percent improvement in days in AR, based on gross revenue - % change in gross revenue captured - % change in number of clean claims - % change in reduction of denials Number and percent of line items with CPT/HCPCS code changes added, deleted or revised - # and % of CDM items deleted - # and % of CDM items added - # and % of CDM items revised - # and % of CDM CPT codes deleted - # and % of CDM CPT codes added - # and % of CDM CPT codes revised # of line items with revenue code changes recommended, and implemented - # and % of CDM revenue codes revised % reduction in CDM errors % reduction in cost-report errors 1A.2 Community Health Needs Assessment Strategic Implementation Activities: The objective of this grant is to satisfy regulatory requirements of the Affordable Care Act; implement programs which address identified community health needs; encourage collaboration with other community organizations and stakeholders; and promote community engagement and healthy behaviors. This award will take the form of funding programming activities to help address the significant needs as identified by a hospital s most recent Community Health Needs Assessment (CHNA). The CAH program grant will cover up to seven awards of up to $15,000 for Strategic Implementation activities. Note: All application requests for strategic implementation funds must include the proposed activity which addresses the identified need, both including a detailed budget narrative and a thorough description of what the activity will include. The applicant must: (1) describe the collaborative partnerships involved, (2) define the anticipated impact the proposed activity will have on the community, (3) state the duration of the activity, (4) explain how the activity or program will be measured for effectiveness, and (5) list the other identified significant needs identified by the CHNA and explain how they are being addressed, or, if they are not being addressed by the hospital, explain why not. 5
The Flex Steering Committee does not wish to interfere with the hospital s right to design its own strategic implementation, but does wish to understand the proposed activity and a detailed description of the benefits that the activity will provide to the hospital s community. Reporting requirements for 1A.2 Community Health Needs Assessment Strategic Implementation Grants: 12-month post measure reporting will include, but is not limited to: Number of interventions implemented as a result of Community Health Needs Assessment Strategic Implementation award. Number of individuals in the target population served by these intervention activities. 6
SECTION 3 RULES FOR APPLICATION 3.1 It is the sole responsibility of the Respondent to be certain that it has received a full set of the Proposal Documents when preparing to respond. Upon submission of its Application, the Respondent shall be deemed conclusively to have been in possession of a full set of proposal documents. Respondents are expected to examine the entire RFP, including all specifications, requirements, and instructions. Failure to do so will be at the Respondent s risk. 3.2 UND will not be responsible for any costs incurred by Respondents which may result from preparation or submission of application to this RFP. 3.3 Proposal Application Respondents should use the attached application form. An electronic copy is also available at: http://ruralhealth.und.edu/projects/flex/grants.php Each sheet must be identified with the hospital s name. A Critical Access Hospital can apply for more than one grant. A separate application form must be used for each area of focus. Please refer to Section 2, Scope of Work, for additional application information. An electronic copy of the application is required. APPLICATION SUBMISSION: E-mail (required) to: angela.lockwood@med.und.edu Acceptance or Rejection of Application: The Steering Committee reserves the right to accept or reject any or all applications or parts of the application, and to waive informalities. The time line for this grant is as follows. RFP release date: September 16, 2013 Technical assistance: September 24, 2013 (4:00pm CT): Dial: 1.866.809.4014/passcode: 7776782#) Application due date: October 18, 2013 Award notice date: November 4, 2013 Work completion: August 31, 2014 7
APPLICATION GUIDELINES Instructions: The application form is to be completed by hospitals seeking support from the Flex Grant Program. For information on the grant or its application please contact Angie Lockwood at the UND Center for Rural Health, School of Medicine and Health Sciences at the following: UND Center for Rural Health School of Medicine and Health Sciences 501 N. Columbia Road, Stop 9037 Grand Forks, ND 58202-9037 701-777-5381 (Phone) 701-777-6779 (Fax) E-mail: angela.lockwood@med.und.edu World Wide Web Address: http://ruralhealth.und.edu/ In completing this application, be as specific as you can be in stating your needs, describing your situation, and identifying your actions. Maximum application length is eight pages, to include budget, budget narrative, and summary. If appendices are included, those are not counted against the eight page limit, but please provide only pertinent information. 8
SECTION 4 AWARD 4.1 Applications will be reviewed by the Flex Steering Committee consisting of the following: University of North Dakota, Center for Rural Health (Lynette Dickson, Jody Ward, Brad Gibbens, Angie Lockwood) North Dakota Hospital Association (Tim Blasl) North Dakota Healthcare Review, Inc. (Barb Groutt) North Dakota EMS Association (Curt Halmrast) 4.2 The criteria for application evaluation is the meeting of requirements as outlined in Section 2, Scope of Work and address the following in this order: A. SUMMARY (One page maximum for summary) 1. Provide a brief description of why your facility should be selected to complete a Revenue Cycle Management Analysis OR Community Health Needs Assessment Strategic Implementation Project (Choose only one.) 2. Provide a brief description of anticipated outcomes, overview of intended use for information gathered, plan for results and follow-through. 3. State the total dollar amount of funding being requested. B. BUDGET & BUDGET NARRATIVE 1. The budget section should cover such areas as contractual costs, as well as inkind match for expenses. 2. The budget narrative must follow the order of the budget and is a mechanism to assist the reviewers in understanding the budget. The budget narrative should explain how the line items are determined and/or calculated. 3. Copy of consultant bids (minimum of 2) and rationale for consultant/vendor choice. 4. A sample budget and narrative can be found on the Flex website at: http://ruralhealth.und.edu/projects/flex/grants.php Rural Hospital Flexibility funds cannot be used to purchase or acquire real property or to improve existing property. The funds cannot be used for building and/or physical structural improvements. PLEASE TAKE NOTE: Any expenditures made prior to the formal contractual signing by both parties are the responsibility of the hospital. These prior expenses cannot be submitted as grant expenses or reimbursements. All project activities must be completed by August 31, 2014. C. PROJECT DESCRIPTION 1. Provide a description of why your facility should be selected to complete a Revenue Cycle Management Analysis OR Community Health Needs Assessment Strategic Implementation Project (Choose only one per application.) 9
2. Include the goals, action steps, and specific project deliverables. Make sure that they are time sensitive and measurable. Include a time line. All project activities must be completed by August 31, 2014. 3. Provide a description of anticipated project outcomes. What is the intended plan for using the information/resources obtained through this project? Explain the plan for results and follow-through. 4. State the total dollar amount of funding being requested. 5. For Revenue Cycle Management Analysis applications only: a. Does your facility currently have a financial analysis team in place? i. If so, explain which staff serve on the team, as well as frequency of financial analysis meetings. ii. If not, please explain your facility s plans for establishing a financial analysis team, including which staff serve on the team, as well as frequency of meetings. 6. For Community Health Needs Assessment Strategic Implementation Project applicants only: a. What significant needs were identified by your hospital s Community Health Needs Assessment? b. Which need(s) are you seeking to address with this funding application? c. With respect to the other significant needs identified by the CHNA, how are those other needs being addressed by the hospital? For identified needs not being addressed by the hospital, please explain why they are not being addressed. d. Will the hospital collaborate with other community organizations or stakeholders on this proposed program or activity? If so, what are the other organizations and what is their anticipated involvement? e. What hospital personnel will be involved in carrying out the proposed activity or program? f. Explain in detail the proposed activity or program. g. What is the anticipated impact on the community of the proposed activity or program? h. What is the duration of the proposed activity or program? (Is it a continuing program or of limited duration?) i. How do you plan to measure the effectiveness of the proposed activity or program? D. PROJECT MANAGEMENT 1. Please identify the individual responsible for management and oversight of this project. 4.3 A contract will be provided as the award document. A sample copy of the subcontract is attached for your information. You do not need to complete the subcontract or return it with your proposal. It is simply meant to serve as an example of what a hospital/und subcontract will include. 4.4 Funded projects are required to submit a final report to the Center for Rural Health and participate 10
in the Flex Program s evaluation. 4.5 The North Dakota Rural Hospital Flexibility Program will coordinate news release information following award notification. 4.6 Please forward a copy of any press release, publication or marketing product that mentions the Center for Rural Health (CRH) for pre-approval to Angie Lockwood (angela.lockwood@med.und.edu). CRH logos and assistance with press releases are available upon request. The CRH may be described as follows: Established in 1980, the Center for Rural Health, located at the University of North Dakota School of Medicine and Health Sciences in Grand Forks, is one of the nation's most experienced rural health organizations. It has developed a full complement of programs to assist researchers, educators, policymakers, health care providers and, most importantly, rural residents to address changing rural environments by identifying and researching rural health issues, analyzing health policy, strengthening local capabilities, developing community-based alternatives, and advocating for rural concerns. 11
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