Appendix%207.2%20Network%20Access%20Analysis%20Instructions.docx
DOCX document 43 KB Posted
- Solicitation number
- RFP 31786-00190
- Issued by
- Davidson County, Tennessee
About this file
This is an appendix containing network access analysis instructions for RFP #31786-00190 issued by the State of Tennessee for Third Party Administrator Services for the State's Public Sector Health Plans. The appendix establishes requirements for proposers to submit a Quest Analytics Network Access Analysis report demonstrating the accessibility of their provider networks, designated as "Efficient" and "Broad," to serve Tennessee state employees. Proposers must submit provider data files containing specific information including provider names, addresses, cities, states, ZIP codes, specialty codes, and patient acceptance status. The analysis must utilize the Quest Analytics Suite Access Analysis and Geocoder Module and be conducted separately for each network across urban, suburban, and rural classifications within Tennessee only. All provider network analysis is based on 2026 Tennessee ZIP code enrollment counts provided in Appendix 7.5, with distance calculations based on estimated driving distance rather than straight-line measurements.
The analysis requirements establish specific access standards for multiple provider groups including Primary Care Physicians, Obstetricians/Gynecologists, Pediatricians, Cardiologists, Endocrinologists, and Acute Care Hospitals, with varying distance thresholds depending on geographic classification and network type. The Efficient Network requires Primary Care Physicians to be within 10 miles in urban areas, 15 miles in suburban areas, and 20 miles in rural areas, while the Broad Network establishes more stringent requirements of 5 miles in urban areas, 10 miles in suburban areas, and 15 miles in rural areas. Proposers must ensure all analyses are geocoded at the address level, exclude providers not currently contracted or those terminating contracts before January 1, 2028, and include only providers delivering services within Tennessee. The State will accept written attestations as exceptions to access standard deficiencies caused solely by lack of available licensed providers in specific regional areas. Completed analyses must include cover pages, tables of contents, access summaries by ZIP code classification, detailed access reports by ZIP code, and statistics pages documenting report creation dates, software versions, and calculation methodologies.
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APPENDIX 7.2 –
Quest Analytics Analysis Instructions
Quest Analytics Provider & Facility Network Accessibility Analysis
RFP # 31786-00190
Data Requirements & File Layouts The State would like to know the potential of your organization’s provider network to service the accessibility needs of its members who choose to enroll in the Public Sector’s Health Plan. To measure that potential, this RFP requires each Proposer to submit a Quest Analytics Network Access Analysis report. Each network’s relative potential will be measured by 1) the current number of providers in the networks, Efficient and Broad, and practicing; and 2) the average distance to providers for all Plan Members within the pool of possible enrollees.
Data Items To analyze the accessibility of Proposers’ provider networks, Efficient and Broad, for the State’s population, the Quest Analytics Suite requires both an employee data file and a provider data file. Tennessee employee data, listed with tallies by ZIP code, are included in a file accompanying the RFP. The file is in Microsoft Excel format, and has also been provided to Quest Analytics. Your provider files must contain the following:
| • | Provider Name (Last Name, First Name) |
| • | Street Address – NOTE: For Network Providers who have more than one office location, the file should contain a distinct record for each office address. |
| • | City |
| • | State |
| • | Five-digit ZIP Code |
| • | Specialty Code – please include the coding scheme used |
| • | Accepting/Not Accepting Patients Practice Indicator (A=Accepting, N=Not Accepting) |
Data Format If you intend to have Quest Analytics conduct this analysis, you must submit your data to Quest Analytics in one of the following formats: Access, Excel, Text (Fixed Width or Delimited) and send electronically.
If you have the Quest Analytics Suite™ and need technical support on how to utilize the software, the team can be contacted at support@questanalytics.com or 920.739.4552. If you need Quest Analytics to perform the analysis on your behalf, please contact consulting@questanalytics.com.
Standards and Specifications The standards and specifications listed are to be followed by all proposers. This will enable the State to evaluate, on a consistent basis, the accessibility of each Proposer’s provider networks, Efficient and Broad. It is critical that each analysis meet the following data standards and report specifications.
Analysis Requirements
1. Use the Quest Analytics Suite™ Access Analysis and Geocoder Module most current update. If you do not have the Quest Analytics Suite™, call 920.739.4552 or email consulting@questanalytics.com at Quest Analytics to receive a quote for them to perform the analyses for you.
Data Standards
1. Use all employee ZIP codes data contained in APPENDIX 7.5 – 2026 TN ZIP Code Enrollment Counts, to analyze your network relative to the State of Tennessee member population.
2. Your Network Provider addresses should be geocoded at the address level. For any Network Provider’s address that cannot be exactly geocoded, the zip-distributive address points can be used, which takes into account population patterns to distribute locations. Placing providers at ZIP code centroids or randomly within ZIP codes is not permissible.
3. Distance is to be calculated based on Estimated Driving Distance, not on an “as-the-crow-flies” distance.
4. If more than one provider is located at the same address, all providers at that address should have the same geographic coordinates.
5. Providers should be classified based on their primary specialty.
6. Analyses should include all current providers in your networks, Efficient and Broad, which are delivering services within Tennessee only.
7. Providers who are currently contracted, but will not be on January 1, 2028, shall not be included in your analysis.
8. Providers who are not currently contracted shall not be included in your analysis.
Report Specifications
1. Prepare a network accessibility analysis for the entire State of Tennessee. The report should closely resemble the Sample Analysis contained in APPENDIX 7.4 - Quest Analytics Sample Reports and should include:
· a title page;
· a table of contents,
· an access summary page by county
· an access detail page by ZIP code classification
· a complete set of reports for EACH network, Efficient and Broad, for the provider types in each location category listed below (#2), and as described in the table at the bottom of this page; and
2. Conduct a separate independent analysis for each network, Efficient and Broad, for urban, suburban, and rural employee access to providers, with an access standard as shown in the boxes below. The State will accept a detailed written attestation as an exception to any access standard deficiency that is due solely to a lack of available licensed providers or facilities for which to contract in a specific regional area(s).
EFFICIENT NETWORK ACCESS STANDARDS
| Provider Group - Urban |
| Required Access Standard |
| Primary Care Physicians |
| 2 physicians within 10 miles |
| Obstetricians/Gynecologists |
| 2 physicians within 10 miles |
| Pediatricians |
| 2 physicians within 10 miles |
| Cardiologists |
| 1 physician within 10 miles |
| Endocrinologists |
| 1 physician within 15 miles |
| Acute Care Hospitals |
| 1 facility within 15 miles |
| Provider Group - Suburban |
| Required Access Standard |
| Primary Care Physicians |
| 2 physicians within 15 miles |
| Obstetricians/Gynecologists |
| 2 physicians within 15 miles |
| Pediatricians |
| 2 physicians within 15 miles |
| Cardiologists |
| 1 physician within 15 miles |
| Endocrinologists |
| 1 physician within 20 miles |
| Acute Care Hospitals |
| 1 facility within 15 miles |
| Provider Group - Rural |
| Required Access Standard |
Primary Care Physicians Obstetricians/Gynecologists 2 physicians within 20 miles 2 physicians within 30 miles
Pediatricians Cardiologists 2 physicians within 30 miles 1 physician within 30 miles
Endocrinologists Acute Care Hospitals 1 physician within 50 miles 1 facility within 25 miles
BROAD NETWORK ACCESS STANDARDS
| Provider Group - Urban |
| Required Access Standard |
| Primary Care Physicians |
| 2 physicians within 5 miles |
| Obstetricians/Gynecologists |
| 2 physicians within 5 miles |
| Pediatricians |
| 2 physicians within 5 miles |
| Cardiologists |
| 1 physician within 5 miles |
| Endocrinologists |
| 1 physician within 10 miles |
| Acute Care Hospitals |
| 1 facility within 10 miles |
| Provider Group - Suburban |
| Required Access Standard |
| Primary Care Physicians |
| 2 physicians within 10 miles |
| Obstetricians/Gynecologists |
| 2 physicians within 10 miles |
| Pediatricians |
| 2 physicians within 10 miles |
| Cardiologists |
| 1 physician within 10 miles |
| Endocrinologists |
| 1 physician within 15 miles |
| Acute Care Hospitals |
| 1 facility within 10 miles |
| Provider Group - Rural |
| Required Access Standard |
Primary Care Physicians Obstetricians/Gynecologists 2 physicians within 15 miles 2 physicians within 25 miles
Pediatricians Cardiologists 2 physicians within 25 miles 1 physician within 20 miles
| Endocrinologists |
| 1 physician within 50 miles |
| Acute Care Hospitals |
| 1 facility within 20 miles |
3. Analyses are to be conducted on provider groups and facilities within Tennessee only.
4. Mileage should be calculated on an estimated driving distance basis.
5. Analyses one for each proposed Network, Efficient and Broad, must include the following pages (see Appendix 7.4, Quest Analytics Sample Reports):
| Page |
| Content/Display |
| Cover |
| Report title, Proposing organization’s name, Date |
| Contents |
| Table of contents listing all analysis pages included. |
| 1 | |
| Access Summary by Zip Classification (for employees with and without desired access): Summarize by key geographic areas with and without desired access the required Access analysis specifications and Average Distance to the 1st and 2nd closet Network Provider Group. |
| 2 |
| Access Detail by Zip Code (for employees with and without desired access): Detail the Average Distance to the 1st and 2nd closest for each provider group above for Employees with Desired Access and without Desired Access including Zip Code Classification, and County. Check the Statistics Page Option when generating this page. (This is a summary page detailing, among other things, the report creation date, the software version, analysis inputs and calculation method.) |
| 3 |
| Checks for accuracy: Proposers are responsible for ensuring their Quest Analytics Analyses are accurate. The following items should be reviewed for accuracy: |
a. Title Page:
· Company name should appear on the title page.
· The date of the report should appear on the title page.
b. Accessibility analysis specifications:
· Provider Groups –
· Total for PCPs shall include only Doctors of Internal Medicine, General Practitioners, and Family Practitioners. Pediatricians SHOULD NOT be included in this group.
· Total for Obstetricians/Gynecologists shall NOT include Primary Care Physicians.
· Total for Pediatricians shall NOT include Pediatric specialists.
· Total for Cardiologists shall NOT include Pediatric Cardiologists.
· Total for Endocrinologists shall NOT include Primary Care Physicians or Pediatric Endocrinologists.
· Hospitals shall include only licensed free-standing, full service Acute Care Hospitals.
· Employee Group – The total number of State employees MUST MATCH EXACTLY the number contained in Appendix 7.5 2026 TN ZIP Code Enrollment Counts
· Access Standard – The Analysis report MUST MATCH EXACTLY standard required by the State (see page 2 of these instructions)
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