Overview Document Mailing Services



Request For Proposal 17-05-SSP

Commercial Benchmarking Services

EXECUTIVE OVERVIEW

The H. Lee Moffitt Cancer Center & Research Institute (Moffitt), located in Tampa, Florida, began operations in 1986. As an academic and research medical center, MCC is the only National Cancer Institute-designated oncology research institute in Florida and one of the Southeast's leading cancer centers.

Comprised of an inpatient facility, ambulatory outpatient surgery center, ambulatory clinics, a cancer screening facility and research laboratories, Moffitt offers a sophisticated network of services and technologies that assure the citizens of its region convenient, cost-effective, high quality health care. Moffitt’s workforce is currently comprised of approximately 5300 employees, 700 medical residents, 600 volunteers, and 1000 students and interns.

Moffitt is solely focused on treating cancer patients and supports all aspects of a patient’s cancer treatment. Moffitt leverages a multi-disciplinary care team that collaborates to identify the most appropriate treatment for each patient. In addition, Moffitt has developed over 50 cancer Pathways that define its care for each cancer type. Through its multidisciplinary care model and pathways, Moffitt is uniquely positioned to provide the most efficient and effective cancer care. Moffitt believes that this model translates to value relative to other cancer providers when the total cost of care is measured over a cancer care continuum or episode.

See attached for a summary of Moffitt’s current hospital reimbursement structure.

OBJECTIVE

Moffitt is seeking to improve its understanding of its pricing position within the commercial market with the recognition that it must manage reimbursement within two markets, traditional fee for service reimbursement (FFS) and value-based fee arrangements (VBF). Moffitt seeks to engage an external firm to provide benchmark analysis and pricing advisory services. These services will inform Moffitt’s pricing strategies in both the FFS and VBF reimbursement markets.

Within the FFS market, Moffitt will leverage the information to inform FFS payer contract negotiations and pricing strategies. Within the VBF market, Moffitt seeks to understand how its total cost of care (TCOC) over a cancer care continuum, compares to the TCOC of other providers for high volume cancer types (i.e. breast, lung, colon).

TECHNICAL REQUIREMENTS

The benchmarking analysis requires the vendor to have access to a robust commercial claims data set with appropriate coverage of the Tampa market, regional Florida markets and national markets. In addition, the data set must accommodate the unique requirements of both the FFS and VBF specific market analysis.

• FFS Market Analysis: requires that average commercial reimbursement can be derived at varying levels (DRG, APC, ASC grouper, CPT, J-code, etc.)

• VBF Market Analysis: requires ability to follow individual patients over a period of time and attribute those patients to the facilities where cancer services were provided.

COMMUNICATION

All proposals, communications, and correspondence required during the Request for Proposal process must be directed to:

Lori Perks

Sr. Business Operations Analyst

rfp@

Failure to adhere to this requirement may result in your organization not being considered.

TIMELINE

This Request for Proposal shall be conducted under the following time line, which is subject to change only upon prior approval by Purchasing and granted to all vendors.

Issuance of Bid 10/28/16

Return of Intent to Bid 11/04/16

Vendor Conference Call 11/10/16

Bid Packages Due from Vendors 11/28/16

Award of Bid TBD

VENDOR PRE-SUBMISSION CONFERENCE

Moffitt will conduct a vendor Pre-Submission conference call to further clarify and discuss the requirements of this RFP on November, 10, 2016 at 10:00 a.m. at: 813-745-6900 Conference ID: 554672.

On the date indicated in the timeline section of this RFP Overview, your bid must be received via e-mail to contact listed above no later than 2:00 p.m.

RFP CONTENTS

The RFP package includes the following documents, which require response as part of the vendor’s proposal as indicated:

1. Cover Letter (e-mail)

2. Overview Document

3. Vendor Acknowledgement Form – requires response

4. Supplier Diversity Utilization and Subcontracting Plan – requires response

5. Statement Of Work/Need Requirements – requires response

Your response should be provided in electronic format. All responses will be confidential.

AWARD CRITERIA

The award of this Request for Proposal is subject to terms and conditions contained herein and any that will be developed by Moffitt during the Request for Proposal process to augment purchase order conditions of purchase.

Quality of service, pricing, products, and other terms of purchase will be an integral part of the decision selection process.

If you are awarded this bid, a guideline will be developed that will quantify, monitor, and provide a plan for cure of deficiencies which shall include, but not be limited to, reimbursement of personnel and administrative costs, monetary assessment for continual deficiencies, and possible cancellation of agreement.

We reserve the right to award this agreement in whole or in part to the vendor that can best meet Moffitt’s business needs.

H. Lee Moffitt Cancer Center assumes no responsibility and bears no liability for costs incurred by a Company in the preparation and submittal of a quote proposal in response to this RFP.

STATEMENT OF WORK

1. Moffitt is seeking to engage an external firm to provide benchmark analysis and pricing advisory services.

2. Services to be provided include, but are not limited to:

FFS Benchmark Analysis and Pricing Advisory Services:

• Compare Moffitt’s commercial inpatient (IP) and outpatient (OP) hospital reimbursement rates to local, regional and national benchmarks.

• Compare Moffitt’s commercial physician reimbursement rates to local, regional and national benchmarks.

• Local and regional market benchmarks to include the Tampa market and other Florida regional markets.

• National market benchmarks to include academic medical centers and the National Comprehensive Cancer Network centers.

• Ability to complete analysis with multiple billings perspectives (DRG, APC, ASC groupers, CPT, J-code, etc.).

• Calculate and report Moffitt’s price position under the multiple billing perspectives relative to the Tampa, Florida regional and national markets for all service types and billing perspectives.

• Market comparison should differentiate cancer and non-cancer specific services, where applicable, based on available claims data.

• Physician reimbursement analysis completed based on the professional component only (excludes technical component of physician office rate).

VBF Benchmark Analysis and Pricing Advisory Services:

• In collaboration with Moffitt, develop claim- and provider-based attribution methodologies to identify cancer patients and attribute them to healthcare providers that rendered cancer services.

• Patients categorized by cancer type.

• Two cancers evaluated in the benchmark analysis.

• Total cost of care (TCOC) measured at the patient level over a defined period of time or episode

• Compare Moffitt’s TCOC to the average non-Moffitt’s TCOC by cancer type.

• Provide analysis of Moffitt/non-Moffitt TCOC cost variation drivers.

Other Proposal Requirements

• Provide specifications of claims data set that would be leveraged in the analysis including, covered lives and local, regional and national coverage.

• Discuss ability to provide benchmark comparisons by payer in the FFS related benchmark reports.

• Provide overview of the analytics framework and reporting structure that would be used to complete the FFS and VBF analysis. Include discussion on the approach to OP and physician benchmark methodologies with consideration of the multiple billing perspectives (DRG, APC, ASC groupers, CPT, J-code, etc.).

• Include discussion on tools and systems that will be leveraged to analyze TCOC components.

• Provide overview of the level of reporting and analysis that will be available for the VBF work effort.

• Provide overview of history of similar services offered to other clients.

• Provide 3 client references.

Moffitt Cancer Center Vendor Acknowledgement Form

Intent to Respond

|SUBMIT TO: | |

| |RFP NUMBER: 17-05-SSP |

|Lori Perks | |

|rfp@ | |

|813-745-8706 |RFP TITLE: COMMERCIAL BENCHMARKING SERVICES |

|813-449-8277 (Fax) | |

| | |

|VENDOR NAME and MAILING ADDRESS: |INTENT TO BID: |

| |Yes ______________ |

| | |

| |No _______________ |

| | |

| |(If unable to bid, indicate reason below) |

| | |

|TELEPHONE NUMBER | |

| | |

| | |

|FACSIMILE NUMBER | |

| | |

|VENDOR’S AUTHORIZED CONTACT FOR RFP |Please let us know how you heard about this RFP: |

| | |

|NAME |__ Notified by Purchasing |

| | |

| |__ Community or MWBE Organization |

| | |

|E-MAIL |__ Monitoring Moffitt Website |

| | |

| |___ Advertisement |

| | |

| |___ Other: |

| |

|SUPPLIER DIVERSITY INFORMATION |

| |

|Is your firm a “Minority, Women-Owned, Veteran, Service Disabled Veteran-Owned Business Enterprise” defined as a business concern engaged in |

|commercial transactions and is a least fifty-one (51%) percent minority, woman, veteran, service-disabled veteran-owned, and whose management and |

|daily operations are controlled by such persons? |

| |

|Yes ________________________ No ____________________ |

| |

|Is your firm certified as a “Minority, Woman, Veteran, or Service Disabled Veteran-Owned Business Enterprise”? If yes, please provide the name of |

|the certifying entity and certification dates: |

| |

|Name of Certifying Entity ______________________________ |

| |

|Certification Date Begins _______________ ______________ Ends _____________________________ |

|I certify that this response is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a |

|response for the same materials, supplies or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all |

|conditions of this response and certify that I am authorized to sign this response for the vendor and that the vendor is in compliance with all |

|requirements of the Request for Qualifications. |

| |

| |

| |

|__________________________________________________________ ________________________________________________ |

|Signature Printed Name and Date |

SUPPLIER DIVERSITY UTILIZATION AND SUBCONTRACTING PLAN

REQUIREMENT

Moffitt Cancer Center recognizes the importance of supplier diversity in all aspects of our business and procurement practices and actively encourages the development, utilization and economic growth of certified Minority, Women, Veteran and Service Disabled Veteran-owned Business Enterprise (MBE/WBE/VBE/SDVBE).  Central to this initiative is the inclusion and participation of a diverse group of vendors doing business with Moffitt Cancer Center and as such, Moffitt encourages the participation of MBE/WBE/VBE/SDVBEs in its procurement process both at the prime vendor level as well as at the subcontractor level of its prime contracts.   Moffitt Cancer Center is committed to a comprehensive Supplier Diversity Program that ensures maximum opportunities exist for such diverse businesses

RFP responses should include bidder’s ability to provide fifteen percent (15%) spend with Minority, Women, Veteran and Service Disabled Veteran-owned Business Enterprise (“MBE/WBE/VBE/SDVBE”) related to the specific commodity or services identified in the proposal.  Moffitt Cancer Center is an equal opportunity corporation, and, as such, strongly encourages the lawful use of certified MBE/WBE/VBE/SDVBEs in the provision of services by providing a fair and equal opportunity to compete for, or for participation in, providing services. Moffitt Cancer Center believes in equal opportunity practices which conform to both the spirit and the letter of all laws against discrimination, and is committed to non-discrimination because of race, creed, color, sex, age, national origin, or religion.  To be considered for inclusion the potential bidder commits to MBE/WBE/VBE/SDVBEs Participation. 

The successful bidder shall endeavor to provide fifteen percent (15%) spend with MBE/WBE/VBE/SDVBE related to the specific commodity or services identified in the proposal. A certification letter from any of the following agencies will be required of any bidder and/or identified subcontractor claiming MBE/WBE/VBE/SDVBE status at the time of the RFP response.

Moffitt accepts all Local, State and Federal Government agencies MBE/WBE certifications, including the following:

• City of Tampa

• Hillsborough County

• State of Florida

• Small Business Administration (SBA) 8A Program Certification

Other MBE/WBE certifications accepted include:

• Florida State Minority Supplier Development Council (FSMSDC)

• National Minority Supplier Development Council (NMSDC) & regional affiliates

• Women’s Business Enterprise National Council (WBENC)

• National Women Business Owners Corporation (NWBOC)

Veteran & Service Disabled Veteran (VBE/SDVBE) Certification/Verification accepted:

•  Department of Veterans Affairs

• State of Florida Office of Supplier Diversity

Please respond to the section below:

Supplier Diversity Utilization and Subcontracting Plan Requirement: Moffitt Cancer Center recognizes the importance of supplier diversity in all aspects of our business and procurement practices and actively encourages the development, utilization and economic growth of certified Minority, Women, Veteran and Service Disabled Veteran-owned Business Enterprise (MBE/WBE/VBE/SDVBE s).  Central to this initiative is the inclusion and participation of a diverse group of vendors doing business with Moffitt Cancer Center and as such, Moffitt encourages the participation of MBE/WBE/VBE/SDVBEs in its procurement process both at the prime vendor level as well as at the subcontractor level of its prime contracts.   Moffitt Cancer Center is committed to a comprehensive Supplier Diversity Program that ensures maximum opportunities exist for such diverse businesses.

Supplier Diversity Utilization and Subcontracting Plan - Vendors responding to this solicitation are required to submit a Supplier Diversity Utilization and Subcontracting Plan for diverse supplier opportunity and participation of certified MBE/WBE/VBE/SDVBEs with their proposal. The Supplier Diversity Utilization and Subcontracting Plan submitted must include the following:

• Description of your Supplier Diversity Program.

• Proposed percentage of spend with MBE/WBE/VBE/SDVBEs related to the specific commodity or service identified in the proposal.

• Outline the plan for achieving 1st tier spend with MBE/WBE/VBE/SDVBEs and identify the percentage of spend.

• Outline the plan for achieving 2nd tier spend with MBE/WBE/VBE/SDVBEs and identify the percentage of spend

• A list of the certified MBE/WBE/VBE/SDVBEs that will be utilized as 2nd tier subcontract(s)

Reports - The successful Vendor will be required to provide monthly Subcontract Expenditure Reports to Moffitt Cancer Center identifying certified MBE/WBE/VBE/SDVBE participation that lists total payments made to subcontractor(s).  The report shall include the names, addresses, type of service or commodity provided, dollar amount paid, payment date, FEID #, name of certification entity, business classification, and copy of vendor certification for each vendor identified in the report.

Summary of Reimbursement Methodologies For Moffitt’s Top 5 Managed Care Payers

| |Inpatient |Outpatient |BMT |Physicians |Medicare Advantage |

|UNITED HEALTHCARE |MS-DRGs with first |OP chemo paid on a fee |Hospital only case rate |Fee Schedule |Not contracted. |

| |dollar per diem stop |schedule; Fixed rates |with second dollar stop | |Patients with out-of-network |

|(3 contracts plus a |loss provision. |for CT, MRI, and PET |loss based upon billed | |benefits can come to Moffitt |

|Medicaid contract | |scans; OP surgery |charges. | |and authorization is not |

|which pays the |Percentage of charge |grouper; Percentage of | | |required. United pays 100% of|

|Medicaid allowable) |for OptionsPPO and |billed charges for all |Percentage of billed | |Medicare as described above |

| |Cancer Resource |other OP services. |charges for UHC Medicare | |with the exception of OP |

| |Services product | |and Medicaid patients. | |hospital claims for which UHC |

| |lines. |Percentage of charge | | |pays the greater of the APC |

| | |for OptionsPPO and | | |payment or cost-to-charge |

| | |Cancer Resource | | |ratio. |

| | |Services product lines.| | | |

|HUMANA |Percentage of billed |Percentage of billed |Global case rate with |Fee Schedule |Hospital: Per diem for IP and |

| |charges. |charges. |minimum reimbursement | |percentage of billed charges |

|(2 contracts) | | |provision. | |for OP. |

| | | | | |Physicians: Medicare Fee |

| | | | | |Schedule |

|AETNA |MS-DRGs with second |Percentage of billed |Global case rate with |Fee Schedule |100% of Medicare |

| |dollar stop loss based|charges. |second dollar stop loss | |Hospital: CMS interim per diem|

|(1 contract) |upon billed charges. | |based upon billed | |for IP and interim |

| |Several DRGs paid at a| |charges. | |cost-to-charge ratio for OP. |

| |percentage of billed | | | |Physicians: Medicare Fee |

| |charges. | | | |Schedule |

|CIGNA |Percentage of billed |Percentage of billed |Global case rate with |Fee Schedule |Not contracted. |

| |charges. |charges. |second dollar stop loss | | |

|(2 contracts) | | |based upon billed | | |

| | | |charges. | | |

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