36C10G23Q0058_1.docx

SUBJECT*

RFI CCN NEXT GENERATION

GENERAL INFORMATION

SET-ASIDE

OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

POINT OF CONTACT*

Contracting Officer Jacqueline Boudreaux jacqueline.boudreaux@va.gov see email

PLACE OF PERFORMANCE

ADDRESS

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

Sources Sought Notice Sources Sought Notice This Request for Information is for information and planning purposes.

Sources Sought Notice

Community Care Network Next Generation Request for Information

Department of Veterans Affairs Integrated Veteran Care Veterans Health Administration

Date: March 28, 2023

FAR Part 52.215-3 (a) The Government does not intend to award a contract on the basis of this solicitation or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, Bid and proposal costs, of the Federal Acquisition Regulation. (b) Although "proposal" and "offeror" are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal. (c) This solicitation is issued for the purpose of information and planning.

TABLE OF CONTENTS

REQUEST FOR INFORMATION

1.0 INTRODUCTION

THIS IS NOT A SOLICITATION.

The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) is issuing this Request for Information (RFI) as Market Research used for the potential procurement of services for a contractor to develop and maintain a national or regional network of high-performing licensed healthcare providers and practitioners. In addition to developing and maintaining this provider network, where providers deliver standard healthcare services to include medical, surgical, complementary and integrative services, durable medical equipment, pharmacy, and dental, the contractor shall provide enhanced community care services such as scheduling appointments, case management, disease management, population health management, and other innovative industry best practices and lessons learned. VHA looks to become the trend-setter and standard-bearer for streamlined healthcare services and to deploy an innovative healthcare model throughout the nation via the Community Care Network Next Generation (CCN Next Gen).

This RFI is issued solely for information and planning purposes. There is no obligation for the Government to acquire any products or services described in this RFI. In accordance with the Federal Acquisition Regulations (FAR) Subpart 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. No funds have been authorized, appropriated, or received for this effort. The information provided may be used by VA in developing its acquisition strategy and informing, refining, and finalizing a Performance Work Statement (PWS). Interested parties are responsible for adequately marking proprietary, confidential, restricted, or competition sensitive information contained in their response. Only electronic responses to this RFI will be accepted. The Government will not pay for any time expended or information submitted in response to this RFI. Eligibility in participating in a future acquisition does not depend upon a response to this RFI.

2.0 BACKGROUND

The VA provides care to Veterans through community providers when VA cannot provide the care needed or when Veterans are unable to access local VA medical centers. Community care is based on specific eligibility requirements, availability of VA care, and the needs and circumstances of individual Veterans.

In an effort to streamline VA’s community care programs, the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act was signed into legislation on June 6, 2018, providing more choices and robust care coordination for Veterans using one consolidated program instead of multiple programs. Over time, community care program needs evolved with requirements for expanded healthcare services and improvements in customer service, accountability, health information exchange, referrals, scheduling, and provider payments. This evolution led to development of the VA Community Care Network (CCN).

The Contractor shall serve as a third-party administrator with responsibility to provide regional or national managed healthcare services. The Contractor shall (i) provide exemplary customer service; (ii) monitor and manage quality outcomes; (iii) use data and performance metrics to improve services; and (iv) process and pay claims for services ordered against the contract.

CCN is VA’s direct link with community providers to ensure Veterans receive timely, high-quality care. CCN uses industry and VA standard approaches and guidelines to administer services, promptly pay for services, and manage the network to its full potential.

CCN is comprised of five (5) regional networks that serve as the primary contract vehicles for VA to purchase care for Veterans from community providers, covering all U.S. states and territories. VA is currently in its market research phase of its acquisition planning schedule for CCN Next Generation. The solicitation phase is tentatively scheduled for the latter part of fiscal year 2024. These dates are subject to change.

While the CCN program has sought to address expanding Veteran healthcare requirements and needed improvements, VA’s Office of Integrated Veteran Care (IVC) plans to further streamline and enhance community care processes and services through the CCN Next Generation (Next Gen) contract initiative. CCN Next Gen looks to build upon CCN lessons learned and implement industry best practices through extensive market research, innovative acquisition strategies, and review and analysis of acquisition and contract requirements.

3.0 PURPOSE

The VA is using this RFI to help guide the shaping of CCN Next Gen and to plan and prepare for potential site visits. VA seeks industry’s input regarding potential paths forward and recommendations as to where the VA should focus its efforts in developing a solicitation for proposals. The intent is to gain information from industry relative to the North American Industry Classification Code (NAICS) 524114 and the incorporation of small business size standards that are to be determined.

The information included in this RFI looks to:

0. Communicate a vision of the scope of services that VHA would ideally like to implement; to convey context regarding VHA’s needs.

0. Review approaches that VA might pursue to accomplish its priorities.

0. Collect information about market capabilities and state of practice.

0. Understand the processes, procedures, resource requirements, operations, and systems used in developing and maintaining a network of healthcare providers.

VA’s goal in this exercise is to 1) communicate the challenges/opportunities faced by the VA, and 2) gather input on how industry would address these challenges and opportunities. To that end, the more specific your answers are, the more useful your response will be to the VA. VA may also use responses for site visit planning and preparation. Respondents may be notified, at a later date, of VA’s desire to conduct a site visit. Only contactors that respond to this RFI will be considered for site visits. Site visits will occur solely at VA’s discretion and responding to this RFI does not guarantee that VA will visit the contractor’s site.

4.0 INFORMATION SOUGHT

The VA is seeking the following information to be provided by the vendors when responding to the RFI:

· Vendor Information

· Vendor Responses to Questions

4.1 Vendor Information

Vendors shall provide the following information:

· Vendor Name

· Vendor Address

· DUNS Number

· Vendor Website

· Vendor Point of Contact name, telephone number, and email address

· Unique Entity Identifier (EUID), number under which the vendor is registered in SAM.gov and/or VetBiz.gov

· Vendor Socioeconomic Status; Business Size and Status [e.g., Large Business, Service-Disabled Veteran-Owned Small Business (SDVOSB), Veteran-Owned Small Business (VOSB), Small Business (SB), etc.]

· GSA or similar Governmentwide contract vehicle to include contract number, schedule, and SIN category(s), if applicable.

· The number of years in business operating under NAICS 524114, if applicable.

4.2 Vendor Responses to Questions

The vendor shall provide answers to each question in the List of Questions in Paragraph 6.0 below of this RFI. The Vendor’s response shall address the company’s approach to satisfy the objectives, constraints, and requirements described in this notice and shall consider all additional information contained in this RFI.

5.0 SUBMISSION INSTRUCTIONS

Please submit responses via email only to NextGenRFI_Industryday@va.gov. Submissions are due no later than April 17, 2023 at 4:00 p.m. EST. The email subject line must contain the following: “Response to RFI 36C10G23Q00058, Community Care Network Next Generation.” VHA reserves the right to not reply to any emails, responses, questions, and materials submitted in response to the RFI.

Mark your response as “Proprietary Information” if the information included is considered to be business sensitive and/or includes trade secrets. Interested vendors are directed to respond to this RFI with documents in PDF format and RFI responses shall not exceed 20 pages total (exclusive of the title/cover page, and table of contents). VA will not review any other data or attachments that are in excess of the 20-page limit. All documents must measure 8.5 x 11-inches (charts may be landscaped but must be 8.5 x 11-inches) and shall be in Times New Roman, font size (12), with 1” margins. All pages of the response shall be appropriately numbered, and identified with the RFI number (i.e., 36C10G23Q00058). Any documents not in conformance with these requirements may not be reviewed.

6.0 LIST OF QUESTIONS

When responding to the questions below, please provide examples from within the last five (5) years, if applicable.

General

1. If CCN did not exist today and you were responsible for establishing an organization to provide community healthcare to Veterans, what would your approach look like?

2. Describe challenges, issues, and/or pain points that your organization faces in the provider networks you currently administer or have recently administered. Include mitigations or solutions that may address these.

3. For those vendors that attended previous CCN industry engagements, what additional topics would you like VA to address or provide more information on?

4. What additional questions would you recommend VA ask vendors that are not included in this set?

Operations

5. Without requiring legislative action, how could CCN requirements be modified to reduce VA and vendor administrative burden and still obtain the outcomes/objectives of the contract?

6. Describe ways that your organization manages data integrity and quality regarding provider data (e.g., contact information, appointment availability, etc.) for provider networks you administer. Include mitigation, incentives or solutions that may have been used to address pain points encountered in this area and any metrics used for monitoring.

7. Describe how your organization ensures program and payment integrity and provide suggestions on your approach to mitigate fraud, waste and abuse.

Network

8. What is your approach to building and maintaining a demand-based network? The VA has stringent network adequacy requirements, especially in highly rural areas and with scarce medical resources. How do you measure network adequacy and utilization of the networks you administer? Describe your approach to defining and optimizing your network in areas such as urgent care, highly rural areas and with scarce medical resources.

9. How would your organization ensure that providers that appear on the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) exclusionary list are prohibited from practicing in the networks you administer?

10. How do you identify providers in your network that have excellent patient experience, quality scores, positive clinical outcomes and demonstrated value? What Key Performance Indicators (KPIs) do you use to rate providers in your network? Describe your rating scale.

11. Describe how provider satisfaction is monitored. What efforts are made to improve provider satisfaction rates in the networks you administer?

12. Which Health Information Technology (HIT) standards has your organization incorporated in your network (i.e., interoperability, content, data transfer)? What were the challenges associated with implementation and what has the impact been?

13. What is your organization’s approach on medical documentation submissions? Do providers in your network submit for all services rendered and if yes, how? Describe any efforts to increase compliance such as incentives or types of technology utilized.

14. What challenges and opportunities would your organization face if the Community Care Network included nursing home care?

15. What methods and technologies does your organization use to ensure that the network can provide schedulers access to providers by specialty, provider availability and any other useful scheduling information to schedule care efficiently and effectively?

Contract Structure

16. Discuss mechanisms that promote or allow for flexibility within the CCN contracts for the networks you administer.

17. Based on your organization’s experience, how might VA predict or plan for long-term emerging requirements? How would you recommend incorporating emerging/unknown requirements and contingency planning into the CCN Next Gen contract in a way that avoids the need for constant contract modifications? Consider new Congressionally mandated training for providers as an example.

18. What pricing strategies best enable flexibility in contract execution, and how would your organization incorporate those into the CCN Next Gen contracts?

Performance Indicators and Incentives

19. Describe how your organization assesses the performance of your networks. Include leading and lagging indicators, identification of the data that is collected, how the data is analyzed, and methods for reporting performance.

20. Are there performance monitoring techniques that your organization would like to employ in the future?

21. Identify specific areas where performance, by the Third-Party Administrator (TPA) and/or Provider, would benefit from incentives. What incentives would you propose?

22. Describe how your organization measures clinical quality, including specific quality KPIs/metrics you track, how you use provider profiling approaches based on clinical quality or cost, and how you ensure providers within your network are providing quality healthcare services.

23. Discuss any cost control efforts that are in place in the networks your organization administers. How are the efforts structured and what is the effectiveness?

Health Equity

24. Describe efforts to promote and ensure health equity within the patient population of the networks your organization administers. Please be specific with targeted populations including but not limited to those impacted by social determinants of health and any disease management programs, demographics, and interventions. How do you measure your progress and success? How do you determine future targets and efforts?

Alternative Payment Models and Value-Based Care

25. Describe alternative payment models (APMs) and/or value-based care (VBC) aspects within the networks your organization administers. Where have you demonstrated improvements in patient care or cost reductions with APM/VBC models? How would you recommend VA utilize APMs /VBCs in the future?

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