A. DHA Enterprise Referral Care Coordination Center Questions For Industry.docx

1. What solutions do you have for managing enterprise-scale healthcare appointment scheduling and referral management for large, geographically dispersed populations? What is the largest single beneficiary population you have supported under one contract?

2. What Care Coordination solutions have you implemented with health entities (Private or Public)? What approaches have you used and what tactics overcame the challenges encountered?

3. How do you provide real-time appointment availability visibility across a multi-site, multi-process environment?

4. What care coordination models have you implemented for high-utilization beneficiaries with complex issues? What care coordination models have you implemented for mental health referrals? How do you measure effectiveness, and what outcomes have you achieved?

5. How do you support beneficiary recapture determination processes in the private sector? Would that translate to the government or managed care environment? How do your processes enforce and document compliance at scale? What metrics do you use to evaluate performance? What clinical support tool does your company use in determinations?

6. How do you manage workforce transitions from multiple incumbent vendors/solutions to single source solutions? How do you retain institutional knowledge and minimize risk to continuity of care during consolidation?

7. In your experience, what is the most significant risk in large-scale healthcare services consolidations, and how did you mitigate it?

8. Describe when you successfully completed a phased regional rollout, a simultaneous enterprise cutover, and/or a hybrid consolidation approach. What were the tradeoffs? What is required before the transition begins?

9. How have you utilized Key Performance Indicators and Service Level Agreements and what were your performance results? What metrics did you use and which were most meaningful for measuring Care Coordination effectiveness from both a management and beneficiary experience standpoint? What industry benchmarks did you use for your KPIs?

10. What is your data architecture and enterprise reporting capability? What real-time enterprise dashboards, market-level drilldown, and support for oversight and audit requirements do you provide currently?

11. Describe how you perform any predictive demand modeling, appointing demand, referral pattern analysis, or care gap identification analyses.