36C25721R0019 0006.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 06-03-2021 36C257 Department of Veterans Affairs VHA Regional Procurement Office West El Paso Contracting Office 11495 Turner Road El Paso TX 79936

SEE BLOCK 6

To all Offerors/Bidders

36C25721R0019 05-31-2021

X X X

10 JUNE 2021 AT 1200 MST

See CONTINUATION Page X The purpose of this Amendment is to revise the estimated numbers of billable patients for each contract period of performance, explain the basis of the revised PMPM estimates, and to allow offerors to submit proposals in response.

Patient estimates are provided for the purpose of proposal evaluation only. VA will use a 4% increase per year based on a 3-year historical average (see Table 1). Successful offeror shall be required to service all assigned patients.

All offerors must conform exactly to the price schedule in the solicitation and any deviations from the LIN structure will result in the proposal being rejected.

There are no other changes to the terms and conditions.

MARISELA GALARZA

VA-VHA-2020-534D2907

CONTINUATION PAGE

***Section B.2, Schedule of Services, on solicitation 36C257-21-R-0019 Amendment 0001, is hereby deleted and replaced with the Schedule of Services shown below.***

A.1 SCHEDULE OF SERVICES

ITEM INFORMATION

LINE ITEM NUMBER

(LIN)

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Base POP Begin: 09-01-2021 POP End: 08-31-2022

2,141

PMPM

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 1 POP Begin: 09-01-2022 POP End: 08-31-2023

2,227

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 2 POP Begin: 09-01-2023 POP End: 08-31-2024

2,316

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 3 POP Begin: 09-01-2024 POP End: 08-31-2025

2,408

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 4 POP Begin: 09-01-2025 POP End: 08-31-2026

2,505

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 5 POP Begin: 09-01-2026 POP End: 08-31-2027

2,605

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 6 POP Begin: 09-01-2027 POP End: 08-31-2028

2,709

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 7 POP Begin: 09-01-2028 POP End: 08-31-2029

2,817

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 8 POP Begin: 09-01-2029 POP End: 08-31-2030

2,930

Primary Care Services at Capitation Rates Per Member Per Month (PMPM).

Contract Period: Option 9 POP Begin: 09-01-2030 POP End: 08-31-2031

3,047

SUMMARY:

Estimate Assumptions

NOTE: The billable patient estimates for each contract period of performance shown in the revised Schedule of Services above are ESTIMATES ONLY based upon historical information available to VA as of the date of this Amendment. VA will use these estimates for the purpose of evaluating price proposals. These estimates, and the data underlying these estimates are provided to offerors AS IS. VA does not warrant that these estimates accurately reflect the actual number of patients who will be assigned to the SE San Antonio CBOC in the future or who will ultimately be “billable” during any given contract performance period. The contract resulting from this solicitation is an indefinite-delivery, indefinite quantity contract. The successful offeror is required to provide all of the services described herein regardless of the number of patients assigned to the CBOC or the number of actual billable patients during a given contract period of performance; offerors should price their proposals accordingly. The estimates shown in the revised Schedule of Services do not establish either a floor or ceiling regarding the number of patients the successful offeror must service during a given contract period of performance.

OFFERORS MUST SUBMIT PRICE PROPOSALS ONLY IN THE FORMAT SHOWN IN THE SCHEDULE OF SERVICES. OFFERORS WHO SUBMIT PRICE PROPOSALS THAT DEVIATE FROM THE SCHEDULE OF SERVICES WILL HAVE THEIR PROPOSALS REJECTED.

The revised PMPM estimates in the revised Schedule of Services assume a 12-month patient qualifying encounter cycle as required by the solicitation.

Basis for Base-Year Billable Patient Estimate: The actual number of billable patients for the incumbent contract for the SE San Antonio CBOC for April 2021 is 2,115 patients. This number is based upon a 16-month qualifying patient encounter cycle. This procurement requires a 12-month qualifying patient encounter cycle. Based upon information reported by the incumbent contractor in January 2021, depicted in Question 19 in Amendment 0002 to the solicitation, VA estimates that the actual number of billable patients for April 2021 could be reduced by as much as 3.5% to 2,041 billable patients (2,115 – 74 = 2,041) if a 12-month qualifying patient encounter cycle was applied to the current contract. For the period January 2021 – April 2021, historical data shows VA assigned an average of approximately 20 new patients per month to the CBOC. Each of these new patients becomes immediately “billable.” VA anticipates that this rate of new patient assignments is likely to continue in the near-term, and that historical patient assignment patterns will likely resume as the San Antonio area returns to normal after COVID-19. VA also anticipates contract performance for the base year of the contact will begin sometime on or after September 1, 2021. Therefore, VA’s estimate for the number of billable patients for the base year of the contract = 2,041 April 2021 billable patients (based on actuals adjusted for a 12-month encounter cycle) + 5 x 20 (May – Sep) new billable patients per month = 2,141 estimated average number of billable patients for each month of the base year of the contract.

Basis for Option-Year Billable Patient Estimates: VA’s estimates for the number of billable patients for each of the contract option years is based upon the adjusted actual billable patient numbers for April 2021 (discussed above) and the historical data of actual billable patients during the period May 2018 – April 2021. This data is provided in Table 1 below. VA notes that patient data from this period does not present a consistent pattern of year-to-year changes in the number of billable patients over time. To account for this year-to-year variability, VA has determined that using the average monthly billable patient information for each month over the 3-year period, and then calculating the aggregate effect of changes of the monthly averages over a 12-month period, provides a reasonable estimate of how billable patient numbers might vary, in the aggregate, each year over the life of the contract for this procurement. The aggregate change computed using the data from the 3-year average section of Table 1 is an increase of 3.95%. VA rounded this number up and used 4% as the number to adjust the estimated number of billable patients for each option year of the contract after the base-year period of performance. VA notes that this adjustment factor is consistent with VA’s experience with other VA CBOCs nationwide.

Provided below is a three-year average chart as well as three-year historical charts for the SE San Antonio CBOC. The numbers below are based on a 16-month qualifying encounter cycle. All estimated PMPM numbers on the revised B.2 Schedule of Services are based on a 12-month qualifying encounter cycle with a 4% annual increase.

Table 1 (includes 3-year average information and 3-year historical information)

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