5333~1.pdf

5333 RFP

DAS Procurement Services, Version 4.4 July 1, 2021 Page 1 of 67

STATE OF OREGON

COVER PAGE

Oregon Health Authority (OHA) – Health Policy and Analytics

Is issuing this Request For Proposals (RFP) under OregonBuys Bid Number S-44300-00001685 for

HB 2010 GLOBAL BUDGET: MODELING AND RESEARCH

CONSULTANT (CONSULTANT 2)

Date of Issue: January 7, 2022

Opening Date and Time: February 4, 2022

Single Point of Contact (SPC): Mark Bustamante

Address: 635 Capitol Street

City, State, Zip Salem, OR 97301

Phone (voice) 503-947-5257

E-mail: mark.bustamante@dhsoha.state.or.us

The State of Oregon promotes equal opportunity for all individuals without regard to age, color, disability, marital status, national origin, race, religion or creed, sex or gender, sexual orientation, or veteran status.

mailto:mark.bustamante@dhsoha.state.or.us

DAS Procurement Services, Version 4.4 July 1, 2021 Page 2 of 67

TABLE OF CONTENTS

SECTION 1: GENERAL INFORMATION

1.1 INTRODUCTION

1.2 SCHEDULE

1.3 SINGLE POINT OF CONTACT (SPC)

SECTION 2: AUTHORITY, OVERVIEW, AND SCOPE

2.1 AUTHORITY AND METHOD

2.2 DEFINITION OF TERMS

2.3 OVERVIEW AND PURPOSE

2.4 PROJECT BACKGROUND AND SCOPE

2.5 SCOPE OF WORK/SPECIFICATIONS

SECTION 3: PROCUREMENT REQUIREMENTS

3.1 MINIMUM QUALIFICATIONS

3.2 MINIMUM SUBMISSION REQUIREMENTS

3.3 PROPOSAL REQUIREMENTS

SECTION 4: SOLICITATION PROCESS

4.1 PUBLIC NOTICE

4.2 PRE-PROPOSAL CONFERENCE

4.3 QUESTIONS / REQUESTS FOR CLARIFICATIONS

4.4 SOLICITATION PROTESTS

4.5 PROPOSAL DELIVERY OPTIONS

4.6 PROPOSAL MODIFICATION OR WITHDRAWAL

4.7 PROPOSAL DUE

4.8 PUBLIC OPENING

4.9 PROPOSAL REJECTION

4.10 EVALUATION PROCESS

4.11 POINT AND SCORE CALCULATIONS

4.12 RANKING OF PROPOSERS

SECTION 5: AWARD AND NEGOTIATION

5.1 AWARD NOTIFICATION PROCESS

5.2 INTENT TO AWARD PROTEST

5.3 APPARENT SUCCESSFUL PROPOSER SUBMISSION REQUIREMENTS

5.4 CONTRAct NEGOTIATION

SECTION 6: ADDITIONAL INFORMATION

6.1 CERTIFIED FIRM PARTICIPATION

6.2 GOVERNING LAWS AND REGULATIONS

6.3 OWNERSHIP/PERMISSION TO USE MATERIALS

6.4 CANCELLATION OF RFP; REJECTION OF PROPOSAL; NO DAMAGES

6.5 COST OF SUBMITTING A PROPOSAL

6.6 STATEWIDE E-WASTE/RECOVERY PROCEDURE

6.7 RECYCLABLE PRODUCTS

LIST OF ATTACHMENTS

DAS Procurement Services, Version 4.4 July 1, 2021 Page 3 of 67

ATTACHMENT A SAMPLE CONTRACT/PRICE AGREEMENT

ATTACHMENT B DISCLOSURE EXEMPTION AFFIDAVIT

ATTACHMENT C PROPOSER INFORMATION AND CERTIFICATION SHEET

ATTACHMENT D REFERENCE CHECK FORM

ATTACHMENT E PRICE PROPOSAL FORM

ATTACHMENT F COBID CERTIFICATION / OUTREACH PLAN

ATTACHMENT G RESPONSIBILITY INQUIRY

5333 RFP Page 4 of 67

SECTION 1: GENERAL INFORMATION

1.1 INTRODUCTION

The State of Oregon, acting by and through the OHA Health Policy and Analytics Office, (“Agency”), is issuing this Request for Proposal under the provisions of ORS 279B.060 for a Value-based Population Payment Modeling and Research Consultant (Consultant 2)

Additional details on the Scope of the goods or services or both are included in the Scope of Work/Specifications section.

Agency anticipates the award of one Contract/Price Agreement from this RFP.

The initial term of the Price Agreement is anticipated to be 2 years with options to renew up to a cumulative maximum of 5 years.

1.2 SCHEDULE

The table below represents a tentative schedule of events. All times are listed in Pacific Time.

All dates listed are subject to change. N/A denotes that event is not applicable to this RFP.

Event Date Time

Questions / Requests for Clarification Due 01/ 21/ 2022 3:00PM

RFP Protest Period Ends

7 calendar days prior to RFP Opening

Opening (Proposal Due) See RFP cover page

Opening of Proposal 02/07/2022 3:15 PM

Issuance of Notice of Intent to Award (approx.) 02/14/2022 3:00 PM

Award Protest Period Ends 7 calendar days after Notice of Intent to Award

1.3 SINGLE POINT OF CONTACT (SPC)

The SPC for this RFP is identified on the Cover Page, along with the SPC’s contact information.

Proposer shall direct all communications related to any provision of the RFP only to the SPC, whether about the technical requirements of the RFP, contractual requirements, the RFP process, or any other provision.

SECTION 2: AUTHORITY, OVERVIEW, AND SCOPE

2.1 AUTHORITY AND METHOD

5333 RFP Page 5 of 67

Agency is issuing this RFP pursuant to its authority under ORS 279A.050 and OAR 413.033.

Agency is using the Competitive Sealed Proposal method, pursuant to ORS 279B.060 and OAR 137-247-0260. Agency may use a combination of the methods for Competitive Sealed Proposals, including optional procedures: a) Competitive Range; b) Discussions and Revised Proposals; c) Revised Rounds of Negotiations; d) Negotiations; e) Best and Final Offers; and f) Multistep Sealed Proposals.

2.2 DEFINITION OF TERMS

For the purposes of this RFP, capitalized words are defined in OAR 137-046-0110.

2.3 OVERVIEW AND PURPOSE

2.3.1 Agency Overview and Background

The Oregon Health Authority (OHA) is responsible for most state health services and for implementing health care reforms and is comprised of a Director’s Office (DO) which includes Tribal Affairs in addition to eight divisions: (1) Agency Operations, (2) Fiscal (3) External Relations, (4) Equity and Inclusion, (5) Health Policy and Analytics, (6) Health Systems, (7) Public Health, and (8) the Oregon State Hospital.

The Oregon Health Policy Board (OHPB) serves as the policymaking and oversight body of OHA and is responsible for working towards comprehensive health reform in our state. The nine-member board is comprised of community members from across the state who have an interest in health and health care and have strong relationships with the communities they represent.

OHA Vision: A healthy Oregon.

OHA Mission: Ensuring all people and communities can achieve optimum physical, mental, and social well-being through partnerships, prevention, and access to quality, affordable health care.

To fulfill OHA’s vision and mission, the agency is developing a strategic plan with a single overarching goal: to eliminate health inequities in Oregon by 2030.

OHA definition for Health Equity:

Oregon will have established a health system that creates health equity when all people can reach their full potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances.

Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address:

• The equitable distribution or redistribution of resources and power; and

• Recognizing, reconciling and rectifying historical and contemporary

5333 RFP Page 6 of 67 injustices.

Core Values: Health Equity, Service Excellence, Integrity, Leadership, Partnership, Innovation, and Transparency.

The Health Policy and Analytics Division (HPA) within the Oregon Health Authority provides agency-wide policy development, strategic planning, clinical leadership, development of statewide delivery system technology tools to support care coordination, Coordinated Care Organization (CCO) and delivery transformation support, and health system performance evaluation reports. The Division develops and implements innovative approaches working with the Governor's Office, the Legislature, other state and federal agencies, partners and stakeholders, local governments, advocacy and client groups, and the private sector to achieve the triple aim of better health, better care, and lower costs.

2.3.2 Project Overview and Background and Purpose

Oregon Health Authority has embarked upon a strategic plan, designed to eliminate health inequities in Oregon by 2030. The Agency is at the forefront of conversations to re-imagine approaches to removing systemic barriers facing Tribes, Tribal communities, communities of color, people with disabilities and communities at the intersection of other identities most harmed by inequities. OHA has contracted with consultants to assist with Anti-Racism training and education for its leadership. The prospective proposer, in addition to skills and tasks described in the scope of work, will hold knowledge, skills, and abilities related to health equity, anti-racism, ADA and universal accessibility, trauma-informed principles, mitigating unconscious bias and cultural responsiveness to work with OHA in meeting its goal of eliminating health inequities in Oregon by 2030.

In line with state goals to support value-based payment and health care cost growth containment, Oregon is exploring opportunities to expand population-based payment models (sometimes referred to as global budgets or advanced value-based payments).

These health care payment models involve setting a prospective, fixed amount for health care services provided to a population or within a facility over a period of time, and are one strategy in the movement to shift health care reimbursement from payment based on services to payment based on outcomes. Oregon has a particular interest in multi-payer models (e.g. multiple health care plans) and multi-purchaser models (e.g. health care purchasers across markets, such as employer-based, public, and commercial markets), and in population-based payment strategies that provide flexibility and incentives to invest in upstream prevention and social determinants of health.

The purpose of this RFP is to procure an innovative, forward thinking Contractor with the experience and expertise described in Section 3.1 to provide technical modeling, analytics, and actuarial services to support expanded use of global budget models and other advanced value-based payment models in Oregon.

5333 RFP Page 7 of 67

2.4 PROJECT BACKGROUND AND SCOPE

Contractor shall provide Agency assistance with the development and analysis of innovative models to explore feasibility, cost, implementation considerations, and other aspects of global budget and other advanced value-based payment models between the state, health care purchasers, payers, and providers. Assistance will fall into the following broad categories:

• Development of a scalable, multi-payer/purchaser value-based population payment model for Oregon to pilot in one or more regions of the state. OHA seeks to build on the successful health care transformation efforts taking place in Oregon's Medicaid and public employee health coverage programs which includes a new multi-payer value-based payment compact, and a new statewide health care cost growth target. See first

WOC for required assistance related to legislation passed in Oregon’s 2021 legislative session.

• Development of new models and/or modification of existing modeling to support Oregon in efforts to expand use of global budget, advanced and other population-based payment models.

• Exploration, consultation, technical and application support for Oregon related to federal opportunities to support expansion of value-based payment models in the state.

• Planning, monitoring, and technical assistance around OHA’s value-based payment efforts.

• Policy analysis, development, and modeling related to broader state efforts to increase adoption of population-based value-based payments and other advanced value-based payment models among Oregon payers and providers, potentially including but not limited to:

• Payment models to support providers with lower historical participation in value-based payment arrangements, such as behavioral health providers, rural health care providers, safety net providers, and culturally specific providers

• Payment models that support health equity and investments in population health and social determinants of health

• Payer alignment, including quality measure alignment, shared payment models, and other strategies to align health care system payments and quality

2.5 SCOPE OF WORK/SPECIFICATIONS

Background

The first Work Order Contract (WOC #1) issued under the Price Agreement awarded to the Successful Proposer for this RFP will require the Contractor to provide targeted assistance to develop and perform modeling and analytics necessary to make recommendations regarding

5333 RFP Page 8 of 67 the structure of a global budget pilot program for Oregon, for inclusion in a legislative report by June 30, 2022, as required by HB 2010.

A detailed description of the tasks and deliverables, expected project timeline, and NTE amount is included in Attachment 1, Sample Work Order: WOC #1.

SECTION 3: PROCUREMENT REQUIREMENTS

3.1 MINIMUM QUALIFICATIONS

To be considered for evaluation, The Key Person(s) whom Proposer designates to perform actuarial work must collectively possess the following qualifications (i.e. – the project lead does not need to have all these qualifications):

• One or more Key Person(s) must have at least 10 years of total actuarial and data analysis experience.

• All Key Person(s) must have a minimum of five (5) years of operation in health actuarial consulting.

Preferred key person qualifications

The qualifications of multiple Key Persons may be used to document that Proposer meets the following qualifications. Preferred qualifications will not be used to eliminate Proposers from the pool, but will be reviewed and scored as indicated under 4.10.2 Evaluation Criteria.

• Subject matter expertise (10+ years) with innovative health care financing mechanisms, value-based payment, health care economics, or other closely related topics;

• Subject matter expertise (10+ years) with insurance programs, including Medicaid, ACA Health Insurance Marketplaces, other publicly funded health care programs, and commercial insurance;

• Subject matter expertise (10+ years) with health care cost analysis and trending, health care cost driver analysis, cost attribution methodologies, and other closely related topics;

• Demonstrated experience (10+ years) in statutory and regulatory compliance

• Demonstrated experience (5+ years) with policies and payment strategies that advance health equity and public health;

• Demonstrated experience (5+ years) working in Oregon’s health care policy landscape and/or similar state health care policy environments;

• Demonstrated experience (5+ years) in program and policy development in a state government context; and

• One or more Key Person(s) be Member(s) in good standing with the American Academy of Actuaries (MAAA) and meets the American Academy of Actuaries’ U.S. qualification standards to sign statements of actuarial opinion.

5333 RFP Page 9 of 67

• The Key Person(s) include a Fellow in the Society of Actuaries (FSA) who is accessible to the OHA project team when needed.

3.2 MINIMUM SUBMISSION REQUIREMENTS

3.2.1 Proposal Submissions

To be considered for evaluation, Proposal must contain each of the following elements (further detailed in Proposal Requirements section below):

• A written narrative answering the following questions:

1. Contractor commitment and implementation of health equity strategies. Please describe your firm’s experience promoting equity in your business practices and processes:

a. How does the firm ensure equity in their business practices and processes? For example, what are the organization or firm’s goals, plans and practices around increasing the diversity of staff who are hired, and to ensure equitable retention and advancement among current staff from diverse backgrounds?

b. For this particular opportunity, how will the firm operationalize health equity, anti-racism, and universal accessibility practices?

2. Please describe your experience that demonstrates expertise in the following areas:

a. Working toward innovative health care financing and value-based payment strategies, including identification of potential challenges to payment reform and ability to provide solutions;

b. Working with health system regulatory agencies such as CMMI, Medicare, Medicaid, and insurance regulators in a way that is innovative and exhibits use of creative or novel approaches;

c. Financial and analytical modeling to produce cost estimates of health care financing strategies;

d. Working with health insurance spending and utilization data across private and public health insurance programs;

e. Familiarity with payer-provider payment negotiations;

f. Working at an executive leadership level within state government and understanding of state governmental policy process;

g. Oregon’s health system transformation goals and goals for a global budget pilot.

• Disclosure Exemption Affidavit (Attachment B)

5333 RFP Page 10 of 67

• Proposer Information and Certification Sheet (Attachment C)

• Reference Check Form (Attachment D)

• Price Proposal Form (Attachment E)

• COBID Certification / Outreach Plan (Attachment F)

• Responsibility Inquiry (Attachment G)

• Key Persons and Resumes

• Work Samples (one (1) to two (2) work samples to illustrate your experience in the areas described above in #2 and that also incorporate health equity, anti-racism, and universal accessibility practices)

3.2.2 Proposal Format and Quantity

Proposal should follow the format and reference the sections listed in the Proposal Requirements section. Responses to each section and subsection should be labeled to indicate the item being addressed.

OregonBuys Electronic Response. Proposer should submit its Proposal electronically through OregonBuys.

The Price Proposal must be submitted as a separate electronic response file.

Proposer shall submit one copy of its Proposal and all other submittal requirements, with Attachment C - Proposer Information and Certification Sheet bearing the Proposer’s authorized representative’s Signature, in one of the following formats: Adobe Acrobat (pdf), Microsoft Word (docx), or Microsoft Excel (xlsx). If Proposer believes any of its Proposal is exempt from disclosure under Oregon Public Records Law (ORS 192.311 through 192.478), Proposer shall complete and submit the Disclosure Exemption Affidavit (Attachment B).

Proposer shall also mark as “Confidential” in OregonBuys all attachments to its Proposal that Proposer believes are exempt from disclosure

The Proposer Information and Certification Sheet (Attachment C) must bear the Proposer’s authorized representative’s Signature.

3.2.3 Authorized Representative

Failure of Proposer’s authorized representative to sign the Proposal may result in rejection of the Proposal by Agency.

3.3 PROPOSAL REQUIREMENTS

Proposal must address each of the items listed in this section and all other requirements set forth in this RFP. Proposer shall describe the Goods to be provided or the Services to be performed or both. A Proposal that merely offers to provide the goods or services as stated

5333 RFP Page 11 of 67 in this RFP may be considered non-Responsive to this RFP and will not be considered further.

Proposal should not include extensive artwork, unusual printing or other materials not essential to the utility and clarity of the Proposal. Do not include marketing or advertising material in the Proposal, unless requested. Proposal should be straightforward and address the requests of the RFP. Proposal containing unsolicited marketing or advertising material may receive a lower evaluation score if required information is difficult to locate.

3.3.1 Proposer Information and Certification Sheet

Proposer shall complete and submit the Proposer Information and Certification Sheet (Attachment C).

Failure to demonstrate compliance with Oregon Tax Laws and sign the Proposer Information and Certification Sheet may result in a finding of non-Responsibility.

3.3.2 References

Provide 3 references from current or former client firms for similar projects performed for any clients within the last 2 years. References must be able to verify the quality of previous, related Work.

Agency may check to determine if references provided support Proposer’s ability to comply with the requirements of this RFP. Agency may use references to obtain additional information, or verify any information needed. Agency may contact any reference (submitted or not) to verify Proposer’s qualifications.

Proposer shall send the Reference Check Form (Attachment D) to its references.

Reference forms must be completed by the reference, returned to the Proposer and submitted with the Proposal.

3.3.3 Price Proposal

Submit a detailed Price Proposal (Attachment E) in a separate Option 1: Electronically though e-mail to the Single Point of Contact.

3.3.4 Key Persons and their Resumes

Specify key persons to be assigned to this project, and include a current resume (not to exceed two pages each) for each key person that demonstrates the person’s qualifications and experience for the Work described in this RFP.

3.3.5 Project Implementation Plan

Briefly describe how Proposer would carry out the major activities of this project in context with the Scope of Work. Provide a comprehensive management plan that the Proposer intends to follow. Illustrate how the plan will serve to coordinate and accomplish the Work.

5333 RFP Page 12 of 67

SECTION 4: SOLICITATION PROCESS

4.1 PUBLIC NOTICE

The RFP and attachments are published in the State of Oregon’s electronic procurement system OregonBuys at https://oregonbuys.gov/. Documents will not be mailed to prospective Proposers.

Modifications, if any, to this RFP will be made by written Amendment(s) published in OregonBuys. Prospective Proposer is solely responsible for checking OregonBuys to determine whether or not any Amendment(s) have been issued. Amendment(s) are incorporated into the RFP by this reference.

4.2 PRE-PROPOSAL CONFERENCE

A Pre-Proposal conference will not be held for this RFP.

4.3 QUESTIONS / REQUESTS FOR CLARIFICATIONS

All inquiries, whether relating to the RFP process, administration, deadline or method of award, or to the intent or technical aspects of the RFP must:

• Be delivered to the SPC via email;

• Reference the OregonBuys bid number ;

• Identify Proposer’s name and contact information;

• Refer to the specific area of the RFP being questioned (i.e. page, section and paragraph number); and

• Be received by the due date and time for Questions/Requests for Clarification identified in the Schedule in Section 1.2.

4.4 SOLICITATION PROTESTS

4.4.1 Protests to RFP

Prospective Proposer may submit a Written protest of anything contained in this RFP, including but not limited to, the RFP process, Specifications, Scope of Work, and the Sample Contract/Price Agreement. This is prospective Proposer’s only opportunity to protest the provisions of the RFP, except that Proposer may protest as provided below.

4.4.2 Protests to Amendment(s)

Prospective Proposer may submit a Written protest of anything contained in an Amendment. Protests to an Amendment, if issued, must be submitted by 5:00 p.m. Pacific Time on the second Business Day following the issuance of the Amendment or the https://oregonbuys.gov/

5333 RFP Page 13 of 67 date/time specified in the Amendment, or they will not be considered. Protests of matters not added or modified by the Amendment will not be considered.

4.4.3 Requirements for Protests

All protests must:

• Be delivered to the SPC via email.

• Reference the OregonBuys bid number;

• Identify prospective Proposer’s name and contact information;

• Be sent by an authorized representative;

• State the reason for the protest, including:

o the grounds that demonstrate how the Procurement Process is contrary to law, Unnecessarily Restrictive, legally flawed, or improperly specifies a brand name; and o evidence or documentation that supports the grounds on which the protest is based; and

• State the proposed changes to the RFP provisions or other relief sought.

Protests to the RFP must be received by the due date and time identified in the Schedule.

Protests to an Amendment must be received by the due date identified in the Amendment.

4.5 PROPOSAL DELIVERY OPTIONS

Proposer is solely responsible for ensuring its Proposal is received by the SPC in accordance with the RFP requirements before Opening. Agency is not responsible for any delays in mail or by common carriers or by transmission errors or delays, or for any mis-delivery for any reason. A Proposal submitted by any means not authorized below will be rejected. The following delivery options are permitted for this RFP:

Delivery through OregonBuys

Proposal submission should be electronically through OregonBuys. at: OregonBuys.gov

Detailed instructions on how to submit a Proposal can be found at OregonBuys Vendor Formal Solicitation Response.pdf

4.6 PROPOSAL MODIFICATION OR WITHDRAWAL

If a Proposer wishes to make modifications to a submitted Proposal, the Proposer must submit its modification in one of the authorized methods listed in Section 4.5 (Proposal Delivery Options). To be effective the modification must include the OregonBuys bid number and be submitted to the SPC prior to Opening.

https://www.oregon.gov/das/ORBuys/Documents/OregonBuys%20Vendor%20Formal%20Solicitation%20Response.pdf https://www.oregon.gov/das/ORBuys/Documents/OregonBuys%20Vendor%20Formal%20Solicitation%20Response.pdf

5333 RFP Page 14 of 67

If a Proposer wishes to withdraw a submitted Proposal, it must submit a Written notice signed by an authorized representative of its intent to withdraw to the SPC via email prior to the Opening in accordance with OAR 125-247-0440. To be effective the notice must include the OregonBuys bid number.

4.7 PROPOSAL DUE

A Proposal (including all required submittal items) must be received by the SPC on or before Opening. All Proposal modifications or withdrawals must also be received prior to Opening.

A Proposal received after Opening is considered LATE and will NOT be accepted for evaluation. A late Proposal will be returned to the Proposer or destroyed.

4.8 PUBLIC OPENING

A public Opening will be held on the date and time listed in the Schedule set forth in Section

1.2 and in the manner stated on the Cover Page. Only the name of the Proposer will be read at the Opening, no other information will be made available at that time. Proposals received will not be available for inspection until after the evaluation process has been completed and the notice of Intent to Award is issued pursuant to OAR 125-247-0630.

4.9 PROPOSAL REJECTION

Agency may reject a Proposal for any of the following reasons:

• Proposer fails to substantially comply with all prescribed RFP procedures and requirements, including but not limited to the requirement that Proposer’s authorized representative sign the Proposal.

• Proposer has liquidated and delinquent debt owed to the State or any department or agency of the State.

• Proposer fails to meet the responsibility requirements of ORS 279B.110.

• Proposer makes any contact regarding this RFP with State representatives such as State employees or officials other than the SPC or persons authorized by the SPC, or inappropriate contact with the SPC.

• Proposer attempts to influence a member of the Evaluation Committee.

• Proposal is conditioned on Agency’s acceptance of any other terms and conditions or rights to negotiate any alternative terms and conditions that are not reasonably related to those expressly authorized for negotiation in the RFP or Amendment(s).

4.10 EVALUATION PROCESS

4.10.1 Responsiveness and Responsibility Determination

4.10.1.1 Responsiveness determination

A Proposal received prior to Opening will be reviewed to determine if it is Responsive

5333 RFP Page 15 of 67 to all RFP requirements including compliance with Section 3.1 (Minimum Qualifications) and Section 3.2 (Minimum Submission Requirements). If the Proposal is unclear, the SPC may request clarification from Proposer. However, clarifications may not be used to rehabilitate a non-Responsive proposal. If the SPC finds the Proposal non-Responsive, the Proposal may be rejected; however, Agency may waive mistakes in accordance with OAR 125-247-0470.

4.10.1.2 Responsibility Determination

Agency will determine if an apparent successful Proposer is Responsible prior to award and execution of the Contract/Price Agreement. Proposers shall submit a signed Responsibility Inquiry form (Attachment G) with Proposal.

At any time prior to award, Agency may reject a Proposer found to be not Responsible.

4.10.2 Evaluation Criteria

Each Proposal meeting all Responsiveness requirements will be independently evaluated by members of an Evaluation Committee. Evaluation Committee members may change and Agency may have additional or fewer evaluators for optional rounds of competition.

Evaluators will assign a score for each evaluation criterion listed below in this Section 4.10.2 up to the maximum points available as specified in Section 4.11 (Point and Score Calculation).

SPC may request further clarification to assist the Evaluation Committee in gaining additional understanding of a Proposal. A response to a clarification request may only clarify or explain portions of the already submitted Proposal and may not contain new information not included in the original Proposal.

4.10.2.1 Evaluation Item 1: Health Equity Strategies (Max Score 26)

1. How well does Proposer describe ensuring equity in their business practices and processes through the hiring and retention of diverse staff?

2. How well does the Proposer describe how they will operationalize Health Equity, Anti-Racism, and Universal Accessibility practices as it relates to this particular opportunity?

4.10.2.2 Evaluation Item 2 : Relevant Experience (Max Score 21)

How well does the Proposer’s described experience (in the Proposal Narrative) demonstrate expertise in the following areas (3 points each):

a. Working toward innovative health care financing and value-based payment strategies, including identification of potential challenges to payment reform and ability to provide solutions;

5333 RFP Page 16 of 67

b. Working with health system regulatory agencies such as CMMI, Medicare, Medicaid, and insurance regulators in a way that is innovative and exhibits use of creative or novel approaches;

c. Financial and analytical modeling to produce cost estimates of health care financing strategies;

d. Working with health insurance spending and utilization data across private and public health insurance programs;

e. Familiarity with payer-provider payment negotiations;

f. Working at an executive leadership level within state government and understanding of state governmental policy process;

g. Oregon’s health system transformation goals and goals for a global budget pilot.

4.10.2.3 Evaluation Item 3: Work Samples (Max Score 24)

• How well do the work samples illustrate Proposer’s experience in the areas above?

• How well do the work samples incorporate health equity, anti-racism, and universal accessibility practices?

4.10.2.4 Evaluation Item 4: Key Persons Qualifications (Max Score 29)

• How well does the Proposal demonstrate Proposer’s and Proposer’s Key Persons’ knowledge and experience supporting projects similar to the Work described in Sections 2.4 Project Background, Section 2.5 Scope of Work, and Attachment 1, Sample Work Order Contract: WOC#1? (worth 11 points)

• How well does the Proposal demonstrate Proposer’s and Proposer’s Key Persons’ subject matter expertise in the areas of Preferred Qualifications specified in this RFP, including (each worth 2 points for a total of 18 points):

a. Subject matter expertise (10+ years) with innovative health care financing mechanisms, value-based payment, health care economics, or other closely related topics;

b. Subject matter expertise (10+ years) with insurance programs, including Medicaid, ACA Health Insurance Marketplaces, other publicly funded

5333 RFP Page 17 of 67 health care programs, and commercial insurance;

c. Subject matter expertise (10+ years) with health care cost analysis and trending, health care cost driver analysis, cost attribution methodologies, and other closely related topics;

d. Demonstrated experience (10+ years) in statutory and regulatory compliance

e. Demonstrated experience (5+ years) with policies and payment strategies that advance health equity and public health;

f. Demonstrated experience (5+ years) working in Oregon’s health care policy landscape and/or similar state health care policy environments;

g. Demonstrated experience (5+ years) in program and policy development in a state government context; and

h. One or more Key Person(s) be Member(s) in good standing with the American Academy of Actuaries (MAAA) and meets the American Academy of Actuaries’ U.S. qualification standards to sign statements of actuarial opinion.

i. The Key Person(s) include a Fellow in the Society of Actuaries (FSA) who is accessible to the OHA project team when needed.

4.10.3 PRICE EVALUATION

The SPC will conduct the cost evaluation. The SPC will award a cost score to each Cost Proposal based upon the percentage of the proposed cost as compared to the lowest Proposer’s cost using the following formula:

(lowest cost of all Proposers ÷ cost being scored) X cost points possible = cost score

Total Points Possible: 25 points.

4.10.4 PREFERENCES

4.10.4.1 Recycled Materials

Agency will give preference to Goods manufactured from Recycled Materials if each of the conditions specified in ORS 279A.125 (2) exists following any adjustments made to the price of the Goods according to any applicable reciprocal preference.

4.10.4.2 Tiebreakers

If Agency receives Proposals identical in price, fitness, availability and quality and chooses to award a Contract/Price Agreement, Agency shall award the Contract/Price Agreement in accordance with the procedures outlined in OAR 137-046-0300.

5333 RFP Page 18 of 67

4.11 POINT AND SCORE CALCULATIONS

Scores are the values (according to the maximum score listed below) assigned by each evaluator. Total scores per section will be divided by each question and sub-question within the given section, unless otherwise specified. For example, there are two questions within “Health Equity Strategies” and each question will receive up to 13 points for a total of up to 26 for the section.

Points are the total possible for each section as listed in the table below.

The SPC will add all the scores for a total amount of points for the proposal. Price points are calculated as stated in the Price Evaluation section.

4.12 RANKING OF PROPOSERS

The SPC will average the scores for each Proposal in a given round of competition (calculated by totaling the points awarded by each Evaluation Committee member and dividing by the number of members). The SPC will combine the average score for each Proposal with Proposer’s price score and reference score.

After any applicable preference has been applied, the SPC will determine the rank of each Proposal, with the highest score receiving the highest rank, and successive rank order determined by the next highest score.

Agency may, in Agency’s sole discretion, determine an apparent successful Proposer with no additional rounds of competition. If additional rounds are conducted, Agency will rank advancing Proposers at the conclusion of each subsequent round and may determine an apparent successful Proposer at any time during the solicitation process.

NEXT STEP DETERMINATION

4.12.1 Competitive Range Determination

If Agency, in its sole discretion, determines that one or more additional rounds of competition is necessary, it will select a Competitive Range to indicate the Proposers that

TOTAL POINTS POSSIBLE : 125

POINTS POSSIBLE 100

4.10.2.1 Evaluation Item 1: Health Equity Strategies 26

4.10.2.2 Evaluation Item 2: Relevant Experience 21

4.10.2.3 Evaluation Item 3: Work Samples 24

4.10.2.4 Evaluation Item 4: Key Persons Qualifications 29

4.10.3 PRICE POINTS POSSIBLE 25

5333 RFP Page 19 of 67 will be invited to participate in a subsequent round. The Competitive Range may include all, or at Agency’s sole discretion, some (based primarily on a natural break in the distribution of scores), of the Proposers from a previous round. Agency will post a notice in OregonBuys of its Competitive Range Determination and provide details about the process and schedule for the subsequent round.

4.12.2 Competitive Range Protest

Proposers excluded from a round may submit a Written protest of Competitive Range.

Protests must:

• Be emailed to the SPC;

• Reference the OregonBuys bid number ;

• Identify Proposer’s name and contact information;

• Be sent by an authorized representative

• State the reason for the protest; and

• Be received within 7 calendar days after issuance of the Notice of the Competitive Range unless a different due date and time is specified in such notice.

Agency will address all protests within a reasonable time and will issue a Written decision to the respective Proposer. Protests that do not include the required information may not be considered by Agency.

SECTION 5: AWARD AND NEGOTIATION

5.1 AWARD NOTIFICATION PROCESS

5.1.1 Award Consideration

Agency, if it awards a Work Order Contract, will award a Work Order Contract to the highest ranking Responsible Proposer(s) based upon the scoring methodology and process described in Section 4. Agency may award less than the full Scope of Work described in this RFP.

5.1.2 Intent to Award Notice

Agency will notify all Proposers in Writing that Agency intends to award a Work Order Contract to the selected Proposer(s) subject to successful negotiation of any negotiable provisions.

5.2 INTENT TO AWARD PROTEST

5.2.1 Protest Submission

An Affected Proposer shall have 7 calendar days from the date of the Intent to Award notice to file a Written protest.

5333 RFP Page 20 of 67

A Proposer is an Affected Proposer only if the Proposer would be eligible for Contract/Price Agreement award in the event the protest was successful and is protesting for one or more of the following reasons as specified in ORS 279B.410:

• All higher ranked Proposals are non-Responsive.

• Agency has failed to conduct an evaluation of Proposals in accordance with the criteria or process described in the RFP.

• Agency abused its discretion in rejecting the protestor’s Proposal as non-Responsive.

• Agency’s evaluation of Proposal or determination of award otherwise violates ORS Chapter 279B or ORS Chapter 279A.

If Agency receives only one Proposal, Agency may dispense with the evaluation process and Intent to Award protest period and proceed with Contract/Price Agreement Negotiations and award.

5.2.1.1 Protest Requirements

Protests must:

• Be delivered to the SPC via email

• Reference the OregonBuys bid number ;

• Identify Proposer’s name and contact information;

• Be signed by an authorized representative of Proposer;

• Specify the grounds for the protest; and

• Be received within 7 calendar days of the Intent to Award notice.

5.2.2 Response to Protest

Agency will address all timely submitted protests within a reasonable time and will issue a Written decision to the respective Proposer. Protests that do not include the required information may not be considered by Agency.

5.3 APPARENT SUCCESSFUL PROPOSER SUBMISSION REQUIREMENTS

Proposer(s) who are selected for a Contract/Price Agreement award under this RFP will be required to submit additional information and comply with the following:

5.3.1 Insurance

Prior to award, Proposer shall secure and demonstrate to Agency proof of insurance as required in this RFP or as negotiated. Insurance Requirements are found in Exhibit C of Attachment A.

5.3.2 Taxpayer Identification Number

Proposer shall provide its Taxpayer Identification Number (TIN) and backup withholding status on a completed W-9 form when requested by Agency or when the backup

5333 RFP Page 21 of 67 withholding status or any other relevant information of Proposer has changed since the last submitted W-9 form, if any.

5.3.3 Business Registry

If selected for award, Proposer shall be duly authorized by the State of Oregon to transact business in the State of Oregon before executing the Contract/Price Agreement. Visit http://sos.oregon.gov/business/pages/register.aspx for Oregon Business Registry information.

5.3.4 Responsibility Inquiry

Prior to award, Proposer shall be required to complete and submit Attachment G — Responsibility Inquiry.

5.3.5 Nondiscrimination in Employment

As a condition of receiving the award of a Contract/Price Agreement under this RFP, Proposer must certify by its Signature on Attachment C - Proposer Information and Certification Sheet, in accordance with ORS 279A.112, that it has in place a policy and practice of preventing sexual harassment, sexual assault, and discrimination against employees who are members of a protected class. The policy and practice must include giving employees a written notice that the policy both prohibits, and prescribes disciplinary measures for, conduct that constitutes sexual harassment, sexual assault, or unlawful discrimination.

5.3.6 Other Required Information

5.4 CONTRACT NEGOTIATION

5.4.1 Negotiation

After selection of a successful Proposer, Agency may enter into Contract negotiations with the successful Proposer. By submitting a Proposal, Proposer agrees to comply with the requirements of the RFP, including the terms and conditions of the Sample Contract (Attachment A), with the exception of those terms listed below for negotiation.

Proposer shall review the attached Sample Contract and note exceptions.

Proposer must submit those exceptions to Agency during the Questions / Requests for Clarification period set forth in Section 1.2. If Agency agrees to make any requested changes to the Sample Contract/Price Agreement, Agency will issue an Amendment to notify Proposers of such changes. Unless Agency issues an Amendment modifying any of the terms and conditions, Agency intends to enter into a Contract with the successful Proposer substantially in the form set forth in Sample Contract (Attachment A).

Following the selection of the apparent successful Proposer, Agency may agree to negotiate changes to the negotiable provisions of the Sample Contract/Price Agreement listed below. However, Agency is not required to make any changes and many http://sos.oregon.gov/business/pages/register.aspx

5333 RFP Page 22 of 67 provisions cannot be changed. Proposer is cautioned that the State of Oregon believes modifications to the standard provisions constitute increased risk and increased cost to the State.

Any subsequent negotiated changes are subject to prior approval of the Oregon Department of Justice.

In the event that the parties have not reached mutually agreeable terms within 30 calendar days, Agency, at its discretion, may terminate Negotiations and commence Negotiations with the next highest ranking Proposer.

Agency is willing to negotiate all items, except those listed below:

• Choice of law

• Choice of venue

• Constitutional requirements

• Requirements of applicable federal and State law

SECTION 6: ADDITIONAL INFORMATION

6.1 CERTIFIED FIRM PARTICIPATION

Pursuant to Oregon Revised Statute (ORS) Chapter 200, Agency encourages the participation of small businesses, certified by the Oregon Certification Office for Business Inclusion and Diversity (“COBID”) in all contracting opportunities. This includes certified small businesses in the following categories: disadvantaged business enterprise, minority-owned business, woman-owned business, a business that a service-disabled veteran owns or an emerging small business. Agency also encourages joint ventures or subcontracting with certified small business enterprises. For more information, visit:

https://oregon4biz.diversitysoftware.com/FrontEnd/VendorSearchPublic.asp?XID=6787&T N=oregon4biz

If the Contract has potential subcontracting opportunities, the successful Proposer may be required to submit a completed Certified Disadvantaged Business Outreach Plan (Attachment F) prior to execution.

6.2 GOVERNING LAWS AND REGULATIONS

This RFP is governed by the laws of the State of Oregon. Venue for any administrative or judicial action relating to this RFP, evaluation and award is the Circuit Court of Marion County for the State of Oregon; provided, however, if a proceeding must be brought in a federal forum, then it must be brought and conducted solely and exclusively within the United States District Court for the District of Oregon. In no event shall this Section 6.2 be construed as a waiver by the State of Oregon of any form of defense or immunity, whether sovereign immunity, governmental immunity, immunity based on the eleventh amendment to the Constitution of the United States or otherwise, to or from any claim or consent to the https://oregon4biz.diversitysoftware.com/FrontEnd/VendorSearchPublic.asp?XID=6787&TN=oregon4biz https://oregon4biz.diversitysoftware.com/FrontEnd/VendorSearchPublic.asp?XID=6787&TN=oregon4biz

5333 RFP Page 23 of 67 jurisdiction of any court.

6.3 OWNERSHIP/PERMISSION TO USE MATERIALS

All Proposals are public records and are subject to public inspection after Agency issues the Notice of Intent to Award. Application of the Oregon Public Records Law will determine whether any information is exempt from disclosure.

All Proposals submitted in response to this RFP become the Property of Agency. By submitting a Proposal in response to this RFP, Proposer grants the State a non-exclusive, perpetual, irrevocable, royalty-free license for the rights to copy, distribute, display, prepare derivative works of and transmit the Proposal solely for the purpose of evaluating the Proposal, negotiating a Contract, if awarded to Proposer, or as otherwise needed to administer the RFP process, and to fulfill obligations under Oregon Public Records Law (ORS

192.311 through 192.478). Proposals, including supporting materials, will not be returned to Proposer, except in the case of Proposals that were submitted late and rejected by Agency.

6.4 CANCELLATION OF RFP; REJECTION OF PROPOSAL; NO DAMAGES.

Pursuant to ORS 279B.100, Agency may reject any or all Proposals in-whole or in-part, or may cancel this RFP at any time when the rejection or cancellation is in the best interest of the State or Agency, as determined by Agency. Neither the State nor any State agency is liable to any Proposer for any loss or expense caused by or resulting from the delay, suspension, or cancellation of the RFP or a Contract/Price Agreement award, or the rejection of any Proposal.

6.5 COST OF SUBMITTING A PROPOSAL

Proposer shall pay all costs incurred in connection with its Proposal, including, but not limited to, the costs to prepare and submit the Proposal, costs of samples and other supporting materials, costs to participate in demonstrations, and costs associated with protests.

6.6 STATEWIDE E-WASTE/RECOVERY PROCEDURE

If applicable, Proposer shall include information in its Proposal that demonstrates compliance with the Statewide E-Waste/Recovery Procedure #107-011-050_PR. Visit the DAS website www.oregon.gov/das and use the search bar feature to locate the procedure.

6.7 RECYCLABLE PRODUCTS

Proposer shall use recyclable products to the maximum extent economically feasible in the performance of the Services or Work described in this RFP and the subsequent Contract.

(ORS 279B.025)

https://www.oregon.gov/das

5333 RFP Page 24 of 67

Attachment A

Price Agreement Number 159576

STATE OF OREGON

PRICE AGREEMENT

In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audio recordings, Web-based communications and other electronic formats. To request an alternate format, please send an e-mail to dhs-oha.publicationrequest@state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to arrange for the alternative format.

This Price Agreement is between the State of Oregon, acting by and through its Oregon Health

Authority, hereinafter referred to as “OHA,” and

Contractor hereinafter referred to as “Contractor.”

OHA – Public Health

Delivery Systems Innovation

421 SW Oak Street

Portland, OR 97204

Work to be performed under this Price Agreement relates principally to OHA’s mailto:dhs-oha.publicationrequest@state.or.us mailto:dhs-oha.publicationrequest@state.or.us

5333 RFP Page 25 of 67

This Price Agreement is entered into by OHA and the Contractor for the purpose of identifying the form of Work Order Contract to be used, the general terms and conditions applicable to subsequent Work Order Contracts (“Work Order Contract”) entered into between OHA and

Contractor pursuant to which Contractor will provide training and technical assistance services to

OHA, and the process through which the Work Order Contracts will be assigned and authorized.

This Agreement, by itself, is not a binding contract. There is no guarantee that any specific level of work or overall dollar amounts will be authorized for and required of Contractor. Rather, OHA and Contractor intend to enter into binding and enforceable Work Order Contracts for training and technical services by execution of a Work Order Contract substantially in the form attached hereto as Attachment 1 that specifies the work to be performed and that makes the terms and conditions set forth in this Agreement applicable to the authorized Work Order Contract.

Each executed Work Order Contract shall create a separate Contract between the parties

(consisting of the Work Order Contract together with the Price Agreement terms and conditions) enforceable in accordance with the terms thereof and independent of all other such Work Order

Contracts.

Work Order Contract Assignment Procedure: Any Work Order Contract issued pursuant to this Price Agreement for program evaluation related services will be issued according to the process described below.

OHA will select a firm from among the pool of Price Agreement Contractors using a simple selection process. OHA will create a request specific to each project and email that request to each of the Price Agreement Contractors directly. The email request may include but will not be limited to, required Contractor information, selection criteria, the date and time for receipt of response, the estimated budget for the project, a description of the project, and any other project-specific details.

The selected Contractor will be chosen based on criteria defined within each request. Criteria may include but is not limited to, the ability to meet the project-specific requirements, the ability to meet the project timeline and all requirements necessary to deliver the services and products needed for the project, the specific qualifications and experience of proposed staff, and cost.

OHA will…