2-RFI HOSPITAL REFERRAL MANAGEMENT.pdf

RFI_Template_Rev._01-09-2026

Request for Information (RFI) – RFI 26-07036

Hospital Referral Management

Issuing Entity: Inland Empire Health Plan (IEHP)

10801 6th Street

Rancho Cucamonga, CA 91730

Issue Date [March 6, 2026]

Response Due [April 9, 2026 at 2:00 PM PT]

Submission Portal http://iehp.bonfirehub.com

Primary Contact Troy Girard

Procurement Contract Specialist

Troy.girard@iehp.org

Secondary Contact: Cliff Goss

Procurement Supervisor

Cliff.Goss@iehp.org

Reference: Non-binding market research for future RFP planning http://iehp.bonfirehub.com/ mailto:Troy.girard@iehp.org mailto:Shelley.Phillips@iehp.org

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Confidentiality Notice:

Responses may include proprietary information. However, submissions may be subject to disclosure under the California Public Records Act (CPRA). See ‘Public Records and Compliance Notice’.

TABLE OF CONTENTS

Part I

1. Background and Context

2. Purpose

3. Statement of Work

4. Objective

5. Public Records and Compliance Notice

6. Submission Instructions

7. Vendor Checklist

Part II

8. Detailed Scope of Services

9. Bidder Questions (Questionnaire (Q-05LX)

10. Accessibility and Equity

11. Evaluation and Next Steps

12. Legal and Policy References

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Part I

1. Background and Context

Established on July 26, 1994, Inland Empire Health Plan (IEHP) is a not-for-profit health plan and a local public entity of the State of California. IEHP serves over 1.5 million members in San Bernardino and Riverside counties, supported by 7,500+ providers and 4,000+ employees. Upon receiving its Knox-Keene license from the California Department of Managed Health Care on July 22, 1996, IEHP commenced operations on September 1, 1996, steadfast in its mission: “We heal and inspire the human spirit.”

Membership Totals (as of January 2026):

Program Members Medi-Cal 1,408,544 DualChoice

(D-SNP)

38,656

Covered California 21,077 Total 1,468,277

2. Purpose

The goal of this RFI is to gather market intelligence, identify qualified vendors, and inform a potential future RFP. This RFI is non-binding and for planning purposes only.

3. Statement of Work

BU: IEHP is seeking to better understand technology associated with referral management. Initial scope includes any authorization impacting, related to or coming from the inpatient hospital setting.

4. Objective

The goal of this RFI is to gather market intelligence, identify qualified vendors, and inform a potential future RFP. This RFI is non-binding and for planning purposes only.

5. Public Records and Compliance Notice Responses may be subject to disclosure under the California Public Records Act.

Vendors must certify no conflicts of interest with IEHP staff or governing board.

6. Submission Instructions

• Submit responses via EUNA Procurement website:

www.iehp.bonfirehub.com http://www.iehp.bonfirehub.com/

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• Late submissions will not be accepted

• For technical issues, contact EUNA Procurement via the website.

7. Vendor Checklist

• Letter of Interest

• Completed Questionnaire (Q-05LX)

• Certifications (Non-Debarment, CA SOS (for corporations) and FTB Good

Standing)

• Demo Video or Presentation Deck

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Part II

8. Detailed Scope of Services The organization seeks a software platform that streamlines patient transitions across the care continuum, including discharge planning, post-acute care placement, and coordination with community-based providers. The solution should enable:

• Provider Network Management: Ability to maintain and update a comprehensive directory of post-acute care providers (SNFs, HHAs, IRFs, LTACHs, etc.).

• Referral Management: Automated workflows for sending, tracking, and confirming referrals.

• Patient Engagement: Secure communication tools for patients and families to review options and participate in care decisions.

• Data Analytics & Reporting: Real-time dashboards and reports on referral patterns, provider performance, and patient outcomes.

• Integration Capabilities: Seamless interoperability with existing EHR systems (e.g., Epic, Cerner) and other care coordination tools via HL7/FHIR standards.

Compliance Requirements The solution must adhere to all applicable federal and state regulations, including:

• HIPAA Compliance: Full protection of PHI through encryption (in transit and at rest), secure authentication, and audit trails.

• Licensing & Certification: Vendor must maintain all necessary certifications (e.g., SOC 2, HITRUST) and provide documentation upon request.

Performance Expectations Vendors must commit to measurable service levels and performance metrics, including:

• System Availability (SLA): Minimum 99.9% uptime, excluding scheduled maintenance.

• Response Times:

o Referral transmission: < 2 minutes o Provider acceptance/decline notifications: Real-time

• Support & Issue Resolution:

o Critical issues: Response within 1 hour; resolution within 4 hours

P a g e | 6 o Non-critical issues: Resolution within 24 hours

• Key Performance Indicators (KPIs):

o Average referral completion time o Percentage of successful electronic provider responses o Patient satisfaction scores related to discharge process o Reduction in avoidable delays in care transitions

9. Bidder Questions (Questionnaire (Q-05LX) Q.1.01: Company Profile (Legal name, SOS registration, FTB status) Q.1.02: Experience and Capacity (similar projects, references)

Q. 1.03: Compliance (licenses, certifications, exclusion checks)

Q. 1.04 Innovation and Value-Add (additional features, cost-saving ideas)

Q.1.05: Please provide a detailed list of vendor’s responsibilities as they would pertain to the Scope of Services contained in this RFI.

Q.1.06: Please provide a detailed list of IEHP’s responsibilities as they would pertain to the Scope of Services contained in this RFI.

Q1.07: BU: Provide additional questions you would like respondents to answer.

1. Technical Architecture & Integration

• Describe your platform’s architecture (cloud-based, on-premises, hybrid) and hosting environment.

• What integration methods do you support (APIs, HL7, FHIR, SFTP)?

• How do you ensure seamless interoperability with major EHR systems and other care coordination tools?

2. Data Security & Privacy

• Explain your approach to data encryption (in transit and at rest).

• How do you manage user authentication and access controls?

• Provide details on your audit logging and breach notification process.

3. Performance & Reliability

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• What is your guaranteed system uptime (SLA)?

• Provide historical uptime and incident resolution metrics for the past 12 months.

• How do you monitor and maintain system performance under high-volume usage?

4. Reporting & Analytics

• What analytics capabilities are included (e.g., referral trends, provider performance, patient outcomes)?

• Are dashboards customizable by user role?

• Can your platform export data for external analysis? If so, in what formats?

5. Implementation & Training

• Outline your implementation timeline for a health plan of our size.

• What training resources do you provide for staff and providers?

• Describe your approach to change management and user adoption.

6. Support & Maintenance

• What are your support hours and escalation protocols?

• Do you offer dedicated account management or customer success teams?

• How do you handle software updates and patches?

7. Scalability & Future Enhancements

• How does your solution scale to support multiple facilities and service lines?

• What is your roadmap for future enhancements and innovation?

• How do you incorporate client feedback into product development?

8. Cost Transparency

• Describe your pricing model (subscription, per-user, per-transaction).

• What additional costs should we anticipate (implementation, training, integrations)?

• Do you offer multi-year agreements or volume discounts?

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10. Accessibility and Equity IEHP encourages participation from small businesses, minority-owned, and disadvantaged vendors.

11. Evaluation and Next Steps Responses will be reviewed to inform potential future RFP development. No scoring or ranking will occur at this stage.

12. Legal and Policy References

• California Corporations Code §§17708.03, 2105

• Revenue & Taxation Code §23101

• IEHP Internal Procurement Policies and Procedures Manual (Policy #

FIN/PUR 01)