Indiana



RFP # 18-066Attachment F2Technical Proposal Template for Population Health ManagementInstructions: Please provide a narrative response, addressing each of the following topics. Where appropriate, supporting documentation may be referenced by specific page and/or paragraph number(s). Failure to provide responses that address all topics may result in the proposal being eliminated from consideration. POPULATION HEALTH MANAGEMENT DEFINED:Identifying at-risk individuals through analysis of multiple data sources, Developing programs to address health risksProactively engaging individuals in those programs Administering programs in order to improve the health and wellbeing of the populationAt a minimum, the State is seeking the following services:Biometric screeningsHealth Risk Assessment Targeted programs for:Behavioral Health SupportDisease or Condition ManagementLifestyle Risk ReductionHealth Coaching Identification of individuals that would benefit from offered programs Member Outreach and Engagement Integration of such tools as Biometric Screenings and Health Risk Assessments into overall data analytics programsQUALIFICATIONS & EXPERIENCEState the number of years of experience your company has performing these services as described in this RFP. How many employers are currently using your services for the needs described in this RFP?Describe your experience within the last 3 years in providing Population Health Management services to organizations with more than 10,000 employees.Describe your experience in providing population health management services to employers with multiple worksites with diverse employee populations at each worksite.Provide a description of your clinical staff and the different functions they provide. How many lives do you currently manage? What is your total capacity?For each of areas listed below, provide the following information about the account management team working on this contract: Name, Title, Location, Experience with the Private and Public Sector, amount of time the team member will be committed to the implementation, and the amount of time committed to this account. Account ManagerCompliance Contact Clinical ContactImplementation CoordinatorTechnical Contact Accounting Contact Do you have a full-time medical director on staff? Where is he/she located? What are his/her roles and responsibilities? What credentials are required for staff that are administering health improvement programs? If different credentials are used for different programs, please outline required credentials by program. What type of ongoing training and education is required for your staff?Including the number of lives you currently manage, describe your ability to integrate the State’s membership into your organization in its current state, if your system has the capabilities to expand, and how long it would take you to expand (if needed). IDENTIFICATION & ANALYSISThe State of Indiana has a data warehouse that risk indexes individuals based on medical claims, Rx claims, dental claims, vision claims, HRA responses, biometric screenings, employment data, and lab values from onsite clinic claims. The data warehouse has a broad range of criteria that can be used for identifying individuals for applicable programs. Are you able to use the State of Indiana data warehouse as your primary tool for identifying State of Indiana plan members for programs?Describe how you plan to use the State of Indiana data warehouse to determine relevant and impactful programs for the State of Indiana population.If you plan to use the State of Indiana data warehouse as described above, skip to question 29.If you do not plan to use the State of Indiana data warehouse, please answer questions 14-28.How is your data aggregation process innovative and different from other vendors?Is the system used for data analytics proprietary or purchased?Describe in detail the system you will use to house, aggregate and analyze data.Do you currently receive data files from Anthem and/or CVS/Caremark?How frequently can you receive data files?How is the data validated to ensure integrity? What is your procedure to match incoming data with an existing profile?How many total days lapse between receipt of data and identification for programs? Provide a data information flowchart with timing including receipt of data through risk indexing and identification for programs.Does the system assign a risk score to each individual? If yes, describe what data/factors influence the risk score, how often the risk score is recalculated and the methodology behind the risk indexing algorithm.Provide a list of conditions that the system identifies/assigns based on data. What is your philosophy for maintaining this list?How are biometric screening and HRA data integrated into the risk and identification analysis?Does the system identify any potential gaps in care?Please detail any policies and procedures you use to ensure the integrity, security and privacy of member data.Do you support industry recognized, encrypted data / file transfer capabilities (FTPS, SFTP, FTP with Encryption, etc.)?Have you experienced any data/privacy breaches? If so, what was the breach and how did you manage it?Do you have SAS 70 certification?BIOMETRIC SCREENINGSIndicate the worksite biometric screening services your organization can offer.Screening ServiceProvideComments(Yes/No)Blood Pressure FORMDROPDOWN FORMTEXT ?????Body Composition FORMDROPDOWN FORMTEXT ?????Cholesterol FORMDROPDOWN FORMTEXT ?????HDL FORMDROPDOWN FORMTEXT ?????Triglycerides/LDL FORMDROPDOWN FORMTEXT ?????Calculated cholesterol/HDL ratio FORMDROPDOWN FORMTEXT ?????Blood Glucose FORMDROPDOWN FORMTEXT ?????Height/Weight FORMDROPDOWN FORMTEXT ?????Waist Circumference FORMDROPDOWN FORMTEXT ?????Nicotine Testing FORMDROPDOWN FORMTEXT ?????Other FORMTEXT ????? FORMDROPDOWN FORMTEXT ?????Other FORMTEXT ????? FORMDROPDOWN FORMTEXT ?????Are there alternative solutions available through your organization for employees at smaller locations or for remote employees that cannot attend worksite screenings?Lab access FORMTEXT ?????Home Test Kits FORMTEXT ?????Physic FORMTEXT ?????Retail clinic FORMTEXT ?????Other FORMTEXT ?????Do you have a minimum fee/minimum participation number for conducting single-site-screenings? If so, please describe.If you conduct cholesterol, lipid and/or blood glucose testing, please indicate the method(s) used for the blood draw (finger-stick, venipuncture, both).How do members schedule a biometric screening? Provide a detailed description of the member biometric screening experience starting with the scheduling experience and ending with receiving results of the screening.Describe the State’s roles and responsibilities in hosting onsite screening events.Please indicate the lag time between participant completion of biometric screening and when the data is loaded into your system and then passed to the State’s data warehouse.HEALTH RISK ASSESSMENT (HRA)How and where your organization was HRA-developed? What differentiates your HRA for other HRAs in the industry? Please provide a sample HRA.What medium can the member use to complete the HRA (e.g. online, telephonic, mobile app, paper)?What biometric values, if any, are required fields in your HRA? Does the ability exist to populate the HRA with biometric data from the worksite biometric screenings or physician collected data?Upon completion of the online HRA, are individuals who are eligible for your coaching programs sent an immediate electronic online invitation to enroll in the coaching program? If yes, are they provided with an opportunity to choose the method of communication they prefer (e.g. text, email, and phone call)? After completing the HRA and receiving a personal feedback report, do users receive an individualized health score? If so, what does the health score report represent (e.g. what components are involved)? Does it show most recent results compared to past HRA results? Please provide a sample report.ENGAGEMENTDescribe your approach to engaging members in programs including at what point the following contact methods are used:Personal Phone CallAutomated Phone CallMailing to Home AddressText MessageEmail MessageAny other forms of contactHow are your engagement strategies innovative and unique from other vendors in this space?The State has employees throughout the state. What is your strategy for engaging individuals in remote locations?Provide your definition of engaged in a program. At what point would an “engaged” member be considered no longer engaged?What percent of your currently managed population is engaged in a program (as defined above)?What are your hours of operation?Describe the overall structure of your engagement team (e.g. staffing model, qualifications, etc…).What is your process for accepting after hours telephone calls?How do you handle cases where an individual is only available outside of normal operating hours?Identify which languages are supported by your staff and which are supported using an independent service. What additional services are available to accommodate special populations such as hearing and visually impaired? Is there a web portal that employees will use to access results and available programs? If so, describe the capabilities and essential functions it performs.How does your organization provide communication and engagement materials to participants? How often? Would you be willing to customize these materials for the State? Are marketing pieces created in-house or is a third party used? Will unique pieces be created specifically for the State of Indiana account?Provide a sample of the most recent communications materials. Does your organization provide a communication’s “tool kit” that provides an employer’s staff the tools/resources to develop site-specific communication materials?PROGRAMS & SERVICESDescribe your overall philosophy around Population Health Management.What is your definition of an effective population health management program?What program elements do you believe are key to the success of a program?How do you integrate with other programs that are offered by a Third Party Administrator or wellness platform (e.g. disease management, case management, fitness challenges)? How do you coordinate efforts and avoid multiple vendors outreaching to the same individual?When targeting members for programs, how do you take the following into account:Diagnosis of chronic diseasesBehavioral Health SupportLifestyle risk factorsRisk scoreClaims cost in current or previous periodHow often do you update your analysis of individuals and which programs are most appropriate?What do you do when an individual meets the criteria for multiple programs?Are there situations where an individual would be excluded from participating in offered programs?Do you have experience creating custom programs for employers based on population needs? If yes, describe the need identified and program created to address this need.What factors do you consider when determining if there is a need to create a new program to address health risks?Provide program descriptions for all available population health management programs including:a. Program name and descriptionb.Is this an individual or group program?c.Length of programd.Program goalse.How the program is administered (e.g. telephonic, web portal, face-to-face)f.Which risk factors trigger identification for this programg.Qualifications of the person facilitating the program (if applicable)h.How is success in this program determined? Provide outcomes from at least three completed cohorts.How do you promote utilization of preventive care services?How do you integrate Behavioral Health services in your programs?Is individual health coaching available to all individuals? How does individual health coaching integrate with other population health management programs?How are individuals motivated to stay engaged in programs? What do you consider the best practices to providing incentives for participation/completion?What if the member’s coach is not working due to being sick or on vacation? Would your other team members have access to the member’s information and if so would they be able to help them? Describe your capabilities to provide and utilize video conferencing technologies for care management and coaching. Describe your ability to apply predictive modeling and evidenced-based medicine to your outreach programs. REPORTING & MEASURING PERFORMANCEAre you able to report on enrollment, engagement and completion of programs for incentive purposes? How frequently can this reporting be provided and what is the lag?Are you able to report on health improvement and risk reduction? Provide examples of improvements that would be ideal for these purposes.Provide an example of your reporting package. How often are these reports available?How many segmentations can you accommodate for reporting purposes? What benchmark measures are included in the reports? How are benchmarks determined?Do clients have access to a reporting portal where reports can be customized?What is the process to request ad hoc and customized reports? What is the turnaround time on these types of requests?Provide a list of metrics that are used to monitor the effectiveness of the population health management programs. How often are these metrics reviewed and reported on?Describe how you report on health improvement in the population.Describe in detail how you define and calculate ROI.Describe how your programs impact the following areas:Reduction in risk factorsEmergency Room visitsHealth care utilization in generalCompliance with preventive careStress ManagementHealth plan costsIf available, provide an independent evaluation of your services and products. IMPLEMENTATIONDetail your implementation steps/processes and identify the time requirements for each. What support, if any, would you require from the State during implementation? What support, if any, would you require from the State throughout the duration of the contract? COMPLIANCESummarize your HIPAA/HITECH internal compliance to maintain a secure environment. ‘Discuss how you will conduct due diligence to ensure that all subcontractors (if any) are also in compliance with HIPAA and these specifications. Has your organization ever been involved in a lawsuit involving any services being proposed in this response? If yes, provide details including dates and outcomes. During the past five years, has your organization, related entities, principals or officers ever been a party in any material criminal litigation, whether directly related to this RFP or not? If so, provide details including dates and outcomes. ................
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