36C10G25Q0091.docx

SUBJECT*

CCN Next Gen Medical Network - West

GENERAL INFORMATION

SET-ASIDE

POSTAL CODE

COUNTRY

CONTACT INFORMATION

OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

POINT OF CONTACT*

Contracting Officer Jessica Portillo Jessica.Portillo1@va.gov See email

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

Presolicitation Notice Presolicitation Notice

DESCRIPTION

Presolicitation Notice

Community Care Network Next Generation Medical Network - West Request for Information (RFI)

Department of Veterans Affairs Integrated Veteran Care Veterans’ Health Administration

Date: May 30, 2025

36C10G25Q0091 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.

Disclaimer: The following document is NOT a solicitation or Request for Proposal. This document is for informational purposes only. The VA is requesting industry feedback on the program concepts as drafted however these concepts are not finalized and are subject to change.

TABLE OF CONTENTS

No table of contents entries found.

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 part of market research for a potential procurement to acquire contractor services to develop and maintain a national network of high-performing, licensed medical providers and practitioners. In addition to developing and maintaining a robust medical provider network, where providers deliver standard medical services in accordance with industry standards, to include medical, surgical, complementary and integrative services, durable medical equipment, and pharmacy. The contractor shall also provide enhanced community medical care services such as appointment scheduling, case management, and other innovative, industry-recognized best practices and lesson 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) program.

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), Medical Network Contractor Manual, Quality Assurance Surveillance Plan (QASP) and other associated documents relevant to this concept. 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.

This RFI is for CCN Next Gen Medical Network – West only.

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 current CCN program is comprised of five (5) regional IDIQ contracts that serve as the primary vehicle through which VA purchases care from community-based providers for Veterans, covering all U.S states and territories. The VA is presently conducting market research as part of its acquisition planning process for the upcoming CCN Next Gen initiative. While the CCN program has made significant efforts to expand access and improve the quality of care for Veterans, the VA aims to further streamline and enhance community care processes and service delivery through this initiative. CCN Next Gen seeks to build upon lessons learned from previous efforts and incorporate industry best practices through comprehensive market research, innovative acquisition strategies, and in-depth analysis of acquisition and contract requirements. This RFI represents a key step in gathering insights to inform the development of a more effective, responsive, and outcomes-driven community care medical network.

The Contractor shall serve as a Third-Party Administrator (TPA) with responsibility to provide regionally managed medical services for Veterans referred to community-based medical providers. 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.

3.0 PURPOSE

The Veterans Health Administration (VHA) Office of Integrated Veteran Care (IVC) is seeking information in support of Community Care Next Generation (CCN-Next Gen) Medical Network – West.

The purpose of this Request for Information (RFI) notice is to:

1. Communicate a vision of the scope of services that VHA would ideally like to implement.

2. Inform potential respondents that the Veterans Health Administration (VHA) is seeking industry feedback on the attached draft Performance Work Statement (PWS), Medical Network Contractor Manual, and corresponding Quality Assurance Surveillance Plan (QASP), in support of refining requirements and ensuring effective performance oversight and accountability.

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

4.0 REQUESTED INFORMATION

Interested parties are invited to submit the following when responding to the RFI:

4.1 Vendor Information

· Vendor Name

· Vendor Address

· DUNS Number

· Vendor Website

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

· Unique Entity Identifier (UEI), 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 Instructions

Vendors shall provide responses to the Questions outlined in section 6.0 of this RFI on attachment 6 -Vendor Responses Template. Each response should clearly and concisely address the vendor’s approach to meet the objectives, requirements, and constraints described in this notice. Responses should reference the specific section of the RFI or associated documents (e.g., PWS, QASP) to which the feedback pertains. General comments or recommended revisions should include sufficient context to ensure clarity.

When preparing responses, vendors are encouraged to consider all relevant information contained in this RFI, including the Performance Work Statement (PWS), and the Quality Assurance Surveillance Plan (QASP). Where applicable, vendors are requested to include examples of relevant experience or solution from the past five years.

5.0 SUBMISSION INSTRUCTIONS

Vendors shall submit written feedback in response to this RFI via email in PDF and/or excel format to the following point of contact:

Email: NextGenRFI_Industryday@va.gov

Subject Line: “Response to RFI 36C10G25Q0091, Community Care Network Next Generation Medical Network - West.”

Submission Deadline: June 30, 2025, 2:00 PM EST.

Feedback may include responses to the questions in Section 6.0 Questions of this RFI, as well as: comments on the draft Performance Work Statement (PWS), Medical Network Contractor Manual, Quality Assurance Surveillance Plan (QASP), Program Concepts, recommended revisions, industry best practices, potential risks, innovative solutions, and any additional input relevant to this RFI.

Formatting Guidelines:

Vendors shall not submit any documents in response to this RFI that are password protected. Any documents not in conformance with these requirements may not be reviewed.

Vendors may submit clarification questions regarding this RFI to the contact above no later than June 6, 2025. The Government may issue a consolidated response to all questions received, at its discretion.

Disclaimer: VHA reserves the right to not respond to any emails, questions, or materials submitted in response to this notice. Responses are for market research purposes only and do not obligate the Government in any way.

Proprietary Information: If your submission contains proprietary information, business sensitive or includes trade secrets, please clearly mark it as “Proprietary Information” on each applicable page. The Government will handle all submissions in accordance with applicable procurement regulations and confidentiality guidelines.

6.0 QUESTIONS

When responding to the questions below, please provide examples from within the last five (5) years, if applicable. If you have addressed or partially addressed answers to any of these questions in your prior CCN Next Generation responses, feel free to include what you previously provided in your response. Please be as specific as possible in your responses.

PWS Questions

1. Are there areas within the PWS that will create barriers or challenges for industry? If so, please explain.

2. Are there any areas of the PWS that are unclear?

3. Do you have any suggested changes or enhancements to the requirements? Please explain.

4. Are there requirements that do not align with the industry standard? If so, please list and provide the industry standards and specifications.

5. After reviewing the following sections, are there any comments or proposed revisions?

· PWS 7.0 Referrals including Request for Services and Utilization Management

· PWS 9.2 Medical Documentation Central Submission

· PWS 13 Program Integrity Analytics and Review

· PWS 14.2 Clinical Quality and Patient Safety Issues Identification and Reporting

· PWS 15.2 Software Development (Optional Task)

Medical Network Manual Questions

1. Does the Medical Manual provide clarity on VA processes?

2. Is the Medical Manual helpful to you? Please provide details as how it is helpful or isn’t helpful.

QASP and Performance Requirements Summary (PRS) questions

1. Are the performance objectives and standards clear as stated? If not, which aspects are confusing or ambiguous?

2. For each performance objective, is it clear what data will be used by VHA to assess / evaluate performance? If not, please elaborate on what is unclear.

3. Regarding the data to be used by VHA to assess / evaluated performance, do you anticipate any issues, concerns, or nuances that VHA should be aware of. If so, please explain.

4. What additional information, if any, do you recommend be included in the PRS and why?

5. Is the Acceptable Quality Level (AQL) for each of the performance objectives reasonable to achieve? If not, which one(s) and why? If not reasonable, what would you propose as a reasonable AQL(s) for the stated performance objective(s)?

6. Are there any perceived conflicts between meeting the performance objectives / standards and performance of the PWS requirements? If so, explain the conflict(s). Please reference the specific standard and the PWS section in the response.

7. What recommendations, if any, do you have for improving the QASP, PRS, or methods for evaluating overall contract performance?

Price/Cost Schedule

1. After reviewing the following sections, are there any comments or proposed revisions?

· Schedule of Services:

· Clarity of the VA Payment Hierarchy

· Medical CLIN Structure

· PMPM methodology

General

1. What elements of the PWS, Manual, etc. would you change or revise and why?

2. Are there industry standards that could streamline or improve any of the requirements contained herein? Please explain.

3. Are there any other recommendations or changes you would like to highlight for VA?

4. Is there anything that would inhibit your consideration to quote on potential RFPs with similar requirements?

5. Are the geographic regions as defined in East and West reasonable and achievable? If not, why?

7.0 ATTACHMENTS

See attached document: Attachment 1 – CCN Next Gen – West Medical Network - PWS See attached document: Attachment 2 – CCN Next Gen – West Medical Network Contractor Manual See attached document: Attachment 3 – CCN Next Gen – West Medical Network Program Concepts See attached document: Attachment 4 – CCN Next Gen – West Medical Network - QASP by CA See attached document: Attachment 5 – CCN Next Gen – West Medical Network – QASP PRS by CA See attached document: Attachment 6 - Vendor Responses Template See attached document: Attachment 1 Medical Network West PWS.

See attached document: Attachment 2 CCN Next Gen West Medical Network Contractor Manual.

See attached document: Attachment 3 CCN Next Gen West Medical Network Program Concepts.

See attached document: Attachment 4 CCN Next Gen West QASP by CA.

See attached document: Attachment 5 CCN Next Gen West QASP PRS by CA.

See attached document: Attachment 6 - Vendor Responses Template.

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