attachment-D.technical-reply-with-weight.xlsx

XLSX spreadsheet 112 KB Posted Apr 30, 2025

Attached to: ITN NO. DMS-2425-258 COMPREHENSIVE SURGICAL AND MEDICAL BUNDLED SERVICES AND CANCER CARE COORDINATIO
Solicitation number: ITN-12526
Issued by: Leon County, Florida

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Written by GovTribe AI · Jun 2, 2025

This file is a Technical Reply Instructions document from the Florida Department of Management Services (DMS) for Invitation to Negotiate (ITN) No. DMS-24/25-258 for Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination. The procurement seeks a single contractor for a four-year contract with up to four optional one-year renewals, commencing on January 1, 2026, for the State Group Insurance Program serving 388,313 members. The selected vendor will develop a Bundled Services Program allowing members to access surgical and medical procedures, establish a high-quality healthcare provider network, create a member website, maintain a customer service unit, and implement cancer care coordination with oncology nurse coordinator access. The technical response is due by May 30, 2025, at 2:00 PM Eastern Time, with a public opening at 3:00 PM on the same day.

The estimated annual contract amount is $4,400,000.00, subject to legislative appropriation. The evaluation will assess vendors across ten comprehensive sections, including business operations, service provision, quality of care, network management, data processing, supportive services, customer service, implementation, audits, and corporate information, with a total of 50 raw points and 125 weighted points. Vendors must comply with Florida Statutes regarding vendor eligibility, labor practices, and international business conduct. The contract requires vendors to maintain multiple insurance policies totaling at least $5 million per annual aggregate and potentially provide a performance bond or irrevocable letter of credit not exceeding 20% of the annual contract amount. While no specific set-aside designations for disadvantaged enterprises are mentioned, the ITN emphasizes robust capabilities in healthcare service delivery, data security, and transparent reporting on program utilization and cost savings.

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Other files

File	Type	Posted
Q&A.pdf	PDF	Apr 30, 2025
Attachment-A.Statment-of-Work.docx	DOCX document	Apr 30, 2025
Attachment-F.PUR-7801-Vendor-Certification-Form.docx	DOCX document	Apr 30, 2025
Attachment-B.Cost-Reply.xlsx	XLSX spreadsheet	Apr 30, 2025
ITN-DMS-2425-258.Comprehensive-Med-Surgical-Bundled-Srvc-and-Cancer-Care-Coord.docx	DOCX document	Apr 30, 2025
Addendum No.1.pdf	PDF	Apr 30, 2025
Attachment-E.Business-Associate-Agreement.docx	DOCX document	Apr 30, 2025
attachment-D.technical-reply-with-weight.xlsx	XLSX spreadsheet	Apr 30, 2025
Attachment-C.Contract-Draft.docx	DOCX document	Apr 30, 2025

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D-1 Instructions

Invitation to Negotiate for the State of Florida, Department of Management Services.

DMS-24/25-258, Comprehensive Surgical and Medical Bundled Services

Spreadsheet D-1: Technical Reply Instructions

Instructions: In a separate PDF document, Respondents shall provide a Portfolio replying to each of the questions and/or requested information listed within the Technical Reply workbook. Under Column C of each Technical Response table, Respondents shall indicate the page number their response appears within their Portfolio. Submitted Portfolios shall be written in at least 11-point type using Calibri, Arial, or Times New Roman font. Failure to submit a reply to any portion of the Technical Reply shall negatively impact the Respondent’s evaluation score.

This section will be scored pursuant to subsection 4.3 (“Evaluation of the Reply”) of this ITN. Evaluators may consider information contained in the other sections of the Respondent’s Reply, except pricing in the Cost Reply, to arrive at their evaluation scores.

&G &"-,Bold"Attachment D - Technical Reply D-1: Instructions

ITN No.: DMS-24/25-258 Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination &P of &N

D-2 Technical Reply

DMS-24/25-258, D-2 Technical Reply

Insert Respondent's Name

	1. BUSINESS OPERATIONS AND INDUSTRY EXPERIENCE
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	1.1	The Respondent shall describe the characteristics of its business model. Topics include, but are not limited to:		5		2	10	0.0
	1.1.1	Whether the Respondent is a broker or facilitator of Bundled Services arrangements or offers direct-to-employer Bundled Services arrangements.
	1.1.2	Who bears the risk if a procedure or service exceeds the target price for a Bundled Service.
	1.1.3	Whether the Respondent’s business model is based on a prospective or retrospective payment for Bundled Services.
	1.1.4	Provide data to demonstrate how the Respondent’s business model offers a reduction in costs and improvements in quality or clinical outcomes through Bundled Services.
	1.2	The Respondent shall describe any other characteristics of its business model, customer service, and any other operational functions that set it apart from other vendors. Topics must include, but are not limited to
	1.2.1	Approaches offered by the Respondent that could provide best value for the State;
	1.2.2	How the Respondent maximizes the use of its services by plan participants.
	1.2.3	The functionality of the Respondent’s website, mobile-optimized website, smartphone application, or other electronic devices.
	1.2.4	Any additional services offered by the Respondent.
	Subtotal			5	0	2	10	0
	2. PROVIDING BUNDLED SERVICES
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	2.1	The Respondent shall describe its experience in providing Bundled Services. Topics must include, but are not limited to:		5		4	20	0.0
	2.1.1	The length of time the Respondent has provided Bundled Services.
	2.1.2	List all Bundled Services the Respondent offers (e.g., musculoskeletal, women’s health, cardiac). The list shall include:

a. The scope of each Bundled Service (e.g., all services or CPT codes that are included in the episode of care).

b. Qualifying criteria.

c. Exclusions.

d. Quality measures for each Bundled Service.

e. Respondent’s ability to prioritize or customize Bundled Service arrangements based on utilization in a client’s population.

f. Total cost for each Bundled Service.

2.1.3	Describe how the Respondent determines an episode of care for its Bundled Services, such as a pre-selected grouping of related services, related services based upon a client’s claims data, and/or by duration.
2.1.4	Describe to what extent, if any, the Respondent’s Bundled Services include post-discharge services.
2.1.5	Describe how the Respondent determines whether to offer a Bundled Service, how often its Bundled Services offerings are updated, and how the cost of the Bundled Service is determined.
2.1.6	Describe the cost sharing structure of the Respondent's Bundled Service arrangements (e.g., copayments, deductibles).
2.1.7	Describe the Respondent’s provider payment process, including whether the payments are retroactive (remitted after the provision of medical services) or prospective and whether there are any payment incentive or disincentives for patient outcomes.
2.1.8	Describe the Respondent’s processes for controlling costs, including whether the Respondent or healthcare provider bears the risk for meeting the target price for a Bundled Service. In addition, describe any costs to the Respondent’s client if the target price for a Bundled Service is not met.
2.1.9	The average utilization (i.e., the percentage of members who received a Bundled Service) of the Respondent’s clients for the past three (3) calendar years.
2.1.10	The average amount of annual savings generated to the Respondent’s clients as a result of offering Bundled Services as an alternative to traditional payment models.
2.1.11	The average return on investment experienced by Respondent’s clients.
Subtotal		5	0	4	20	0

	3. QUALITY OF CARE
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	3.1	The Respondent shall describe the assistance it provides participants in accessing and coordinating care. Topics must include, but are not limited to:		5		4	20	0.0
	3.1.1	The process the Respondent uses to coordinate care for Members.
	3.1.2	How the Respondent engages Members.
	3.1.3	How access for Members is provided.
	3.1.4	What decision support tools are provided to Members.
	3.1.5	How care is coordinated, including the use of any nurse navigators or similar personnel. This should include cancer care coordination.
	3.1.6	The level of follow-up provided to Members after a Bundled Services arrangement.
	3.1.7	Risk management strategies and efforts.
	3.1.8	How the Respondent initiates enhancements in care delivery and seeks to reduce readmissions.
	3.1.9	The type of data (quality, cost, or otherwise) and frequency with which data is shared with plan participants to encourage engagement
	3.1.10	Level of customer service online, by email and by phone
	3.2	The Respondent shall describe how it incorporates quality of care and provider performance measures into its business model. Topics must include, but are not limited to:
	3.2.1	The Respondent’s procedures and evidence-based standards used to ensure the inclusion of only high-quality healthcare providers and facilities.
	3.2.2	Whether the Respondent determines quality at the provider level, group level, and/or facility level;
	3.2.3	Whether the Respondent utilizes an independent entity to determine quality ratings of healthcare providers and facilities.
	3.2.4	How the Respondent determines quality
	3.2.5	To what extent, if any, the Respondent utilizes patient-specific indicators to determine quality, such as mortality rates, re-admission rates, and post-acute care utilization
	3.2.6	To what extent, if any, the Respondent utilizes performance measures to assess whether providers reach quality benchmarks
	3.2.7	To what extent, if any, the Respondent utilizes payment incentives for attaining quality benchmarks.
	3.2.8	The sources that the Respondent uses to determine quality ratings of healthcare providers and facilities, the frequency with which Respondent determines quality ratings, and the transparency of the Respondent’s quality ratings and methodology
	3.2.9	Any audits or analyses that the Respondent conducts in order to determine patient outcomes and the quality of healthcare providers and facilities
	3.3	The Respondent shall describe the process used to determine medical necessity for Bundled Services, including a description of the clinician who determines medical necessity and the use of medical guidelines, if any. In addition, describe whether the Respondent or its clinicians review any health risk factors (e.g., comorbidities) when determining whether a member will undergo a surgical or medical procedure.
	3.4	The Respondent shall describe how it handles complications resulting from the provision of Bundled Services and identify the complication rate experienced by members of other clients. In addition, describe how complications may impact the cost of the Bundled Service; the continuity of care with the member/patient's regular physicians, including any necessary travel arrangements; and the role, if any, of the member/patient's health insurance carrier.
	3.5	The Respondent shall describe to what extent, if any, it utilize patient-specific indicators to determine quality, such as mortality rates, re-admission rates, post-acute care utilization, and the length of recovery process.
	3.6	The Respondent shall describe to what extent, if any, the Respondent has established quality ratings for its providers and facilities, including the sources that Respondent uses to determine quality ratings, the frequency with which Respondent determines quality ratings, and whether the Respondent utilizes an independent entity to determine quality ratings.
	3.7	The Respondent shall provide a complete description (including a flowchart) of the Respondent’s process for providing Bundled Services to member/patients (including points of contact with the member/patient, travel, procedure, follow-up care, etc.).
	3.8	The Respondent shall describe how cost sharing with Enrollees would be accomplished. Topics must include, but are not limited to:
	3.8.1	Whether the Respondent currently uses a shared savings model with any of its other clients or, if not, its ability to facilitate shared savings.
	3.8.2	The methodology the Respondent recommends for sharing savings with Enrollees.
	3.8.3	Necessary data feeds with the Department, its health plans, and/or its anticipated healthcare transparency Respondent.
	3.8.4	The Respondent's procedures for handling and resolving inquiries from members and the Department.
	3.9	The Respondent shall describe how it would determine, using only the State's claims data, the savings to Members and the State of Florida as a result of the provision of Bundled Services.
	3.10	The Respondent shall describe how its services meet the statutory requirements of section 110.12303(2), Florida Statutes, and (3)(c) 10. of Section 8 under Chapter 2024-231, Laws of Florida.
	Subtotal			5	0	4	20	0

	4. NETWORK / PROVIDER MANAGEMENT
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	4.1	The Respondent shall complete the 4.1 Network-Provider Chart spreadsheet by listing each provider and facility in the Respondent’s network or organization.	See 4.1 Network-Provider Chart spreadsheet	5		2	10	0.0
	4.2	What percentage of providers are board certified?
	4.3	The Respondent shall describe how it monitors wait times for patients seeking appointments, including the average number of working days between the date an appointment is made and the date of the actual provision of the Bundled Service.
	4.4	The Respondent shall describe the process used by network physicians or its staff to assist in arranging for services such as home health care, hospice, skilled nursing, rehabilitation therapy, durable medical equipment and mental health/chemical dependency.
	4.5	The Respondent shall describe what happens to members receiving treatment from a provider who elects to terminate its contract (or is no longer affiliated) with the Respondent.
	4.6	The Respondent shall describe utilization controls that are in place to reduce the number of unnecessary services being performed.
	4.7	The Respondent shall describe its process to perform provider profiling or other quality measures to identify providers with patterns of over/under treatment to members and the actions taken to address such patterns.
	4.8	The Respondent shall indicate if it partially owns or subcontracts any part of its network (e.g., chiropractic, behavioral health). If yes, describe partially owned and subcontracted parts of network.
	Subtotal			5	0	2	10	0

	5. DATA PROCESSING / INTERFACE AND SECURITY
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	5.1	The Respondent shall describe its current and proposed data submission policies and procedures. Topics must include, but are not limited to:		5		2	10	0.0
	5.1.1	Description of the current and/or proposed methods for exchanging data files with the Department and its contracted vendors.
	5.1.2	Description of current protocols for secure data submission.
	5.1.3	Monitoring for compliance with established data standards.
	5.1.4	Identification of, and recommendation of solutions to overcome, any barriers to contract implementation.
	5.2	The Respondent shall describe its system update process.
	5.3	The Respondent shall describe any electronic system changes planned for the contract term.
	5.4	The Respondent shall provide details regarding the frequency the:
	5.4.1	Respondent's database systems get backed up;
	5.4.2	Disaster recovery procedures are tested.
	5.4.3	When were the systems last tested and what were the results?
	5.5	The Respondent shall describe how the claims, customer service, case management, and utilization review systems are linked.
	5.6	The Respondent shall describe its online reporting tool ad hoc reporting capabilities.
	5.7	The Respondent shall explain its process for routine maintenance for all related systems to be used for this Contract.
	5.8	The Respondent shall describe what its company does to prevent security incidents and its process for responding to them.
	5.9	The Respondent shall provide detailed information regarding its ability to protect State of Florida Data including HIPAA-protected information. Describe any instance of a data breach or security incident and how the Respondent responded to the circumstances. Also describe the protocols in place ensuring personal health information remains secure. Topics include, but are not limited to:
	5.9.1	Monitoring of all electronic systems and personnel;
	5.9.2	Established processes and fail safes to mitigate breaches;
	5.9.3	Resolution, notification, and reparation protocols when a breach is discovered;
	5.9.4	Protocols that ensure no offshoring of or offshore access to any protected data; and
	5.9.5	Security protocols for call center employees, correspondence tracking system and process, and electronic systems that access or store protected data.
	5.10	The Respondent shall describe its current and proposed data submission policies and procedures. Topics include, but are not limited to:
	5.10.1	Description of the current and/or proposed methods for exchanging data files with the Department and its contracted vendors;
	5.10.2	Description of current protocols for secure data submission;
	5.10.3	Monitoring for compliance with established data standards; and
	5.10.4	Identification of, and recommendation of solutions to overcome, any barriers to contract implementation.
	Subtotal			5	0	2	10	0

	6. SUPPORTIVE SERVICES
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	6.1	The Respondent shall provide a sample of an Enrollee communications package proposed for marketing Bundled Services, including how to access and search for Bundled Services arrangements, shared savings, and customer service.		5		3	15	0.0
	6.2	The Respondent shall provide samples of all letter and email communications proposed for use in the provision of Bundled Services.
	6.3	The Respondent shall provide a complete description (including a flowchart) of the Respondent’s proposed shared savings process.
	6.4	The Respondent shall provide the number of written complaints/grievances it received per 1,000 participants during 2024. Include a description of the five most frequent complaints/grievances and how it were resolved.
	6.5	The Respondent shall provide a complete description (including a flowchart) of the Respondent's proposed Member appeals process.
	Subtotal			5	0	3	15	0

	7. CUSTOMER SERVICE
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	7.1	The Respondent shall describe its customer service operations. Topics must include, but are not limited to:		5		3	15	0.0
	7.1.1	Location of call center, hours of operation, and number of representatives.
	7.1.2	Training, minimum qualifications, experience, and turnover of representatives.
	7.1.3	Languages customer service unit can support (other than English) and how that support is provided (i.e., language line or Respondent call center representatives).
	7.1.4	Year-to-date call targets and actual statistics (e.g., abandonment rate, speed to answer).
	7.1.5	Call recording system, documentation of calls, and timeframe and manner to furnish call recordings or notes to the department.
	7.1.6	Online chatting, email capabilities, and other electronic access capabilities.
	7.1.7	Customer satisfaction survey methodology and recent survey with results from a group similar in size and composition to the State.
	7.1.8	Explain whether customer service representatives will be dedicated and exclusive. If not, explain the ratio of representatives to Members.
	7.2.2	The Respondent shall provide a copy of the most current customer satisfaction survey(s) results (both customer service and system related, if available), conducted for the Respondent’s clients.
	7.2.1	The Respondent shall describe:

a. How the survey is conducted and provide a copy of the survey tool.

b. How the sample of survey participants were selected.

c. The methodology used to ensure a statistically valid sample.

d. Options for respondent anonymity.

e. The software and vendor used to conduct the survey.

f. Can survey results be reported on a client-specific basis?

g. A quality improvement activity including its results (i.e., effectiveness) initiated as a result of the Respondent’s satisfaction survey results.

Subtotal 5 0 3 15 0

	8. IMPLEMENTATION
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	8.1	The Respondent shall provide a detailed Implementation Plan that clearly demonstrates the Respondent's ability to meet the Department's requirements to have a fully functioning Bundled Services program in place on January 1, 2026. The Implementation Plan shall provide the following:		5		2	10	0.0
	8.1.1	A list of specific implementation tasks/transition protocols and a timetable for initiation and completion of such tasks, beginning with the Contract award and continuing through the Service Commencement Date (January 1, 2026). The Implementation Plan should be specific about requirements for information transfer as well as any services or assistance required from the State during implementation.
	8.1.2	Any critical dates that must be met to keep the Implementation Plan on schedule. Include the processes that shall be reviewed, including system testing, information required from the Department or its contracted vendor, the Respondent, and historical claims data and format.
	8.1.3	Any anticipated major issues during implementation.
	Subtotal			5	0	2	10	0

	9. AUDITS
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	9.1	The Respondent shall describe the Respondent's policies and procedures for auditing provider bills and claims		5		2	10	0.0
	9.2	The Respondent shall provide the overall percentage of claims that are subject to internal audit.
	9.3	The Respondent shall describe in detail how claims are selected for audit (e.g., random by the system, fixed percent per day, fixed number per day per week, diagnosis, dollar amount).
	9.4	The Respondent shall describe its method of selecting claims for internal quality review.
	Subtotal			5	0	2	10	0

	10. CORPORATE INFORMATION
	Number	Response Questions/Required Information	Portfolio Page Number	Maximum Raw Points Possible	Raw Points Awarded by Evaluator	Weight
(Raw Score multiplied by X)	Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
	10.1	The Respondent shall provide an organizational chart identifying the names, area of expertise, functions, and reporting relationships of key employees directly responsible for implementing and providing support services for the State of Florida account.		5		1	5	0.0
	10.2	The Respondent shall provide a short professional biography about the employee(s) primarily responsible for planning, supervising, and implementing the program for the State. Topics include, but are not limited to:
	10.2.1	Description of other duties, if any, assigned to the employee(s) during implementation. Include the number and size of other accounts assigned to the employee(s) during the implementation phase.
	10.2.2	Include an estimated number of hours the employee(s) will commit to the State per day during implementation.
	10.3	The Respondent shall provide a short professional biography about the employee(s) primarily responsible for planning, supervising, and performing account services for the State.
	10.3.1	Description of other assigned duties, if any, the employee(s) perform. Include the number and size of any other accounts currently assigned to the employee(s) and any accounts the employee(s) anticipate being assigned concurrently as the State of Florida account.
	10.3.2	Include an estimated number of hours the employee(s) will commit to account services for the State per day.
	10.3.3	Describe the role and support provided by the account manager for the annual open enrollment process (e.g., meetings, communications).
	10.4	The Respondent shall complete 10.4 Profile of Bundled Services for the last three calendar years.	See 10.4 Profile of Bundled Services spreadsheet
	Subtotal			5	0	1	5	0
				Maximum Raw Points Possible	Total Raw Points Awarded by Evaluator		Maximum Weighted Points Possible	Total Weighted Points Awarded by Evaluator
			Evaluation Total:	50	0		125	0

&G &"-,Bold"Attachment D - Technical Reply D-2: Technical Reply

Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination &P of &N

4.1 Network-Provider Chart

4.1 Network/Provider Chart
Provider / Facility	Area of Practice / Type of Facility	City, State	Number of Bundled Services claims billed by Provider/Facility	Provider / Facility Quality Rating	Affiliated with Center of Excellence?

(Yes / No)

&G &"-,Bold"Attachment D - Technical Reply

Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination &P of &N

10.4 Profile of Bundled Srvcs

10.4 Profile of Bundled Services
Services	Calendar Year 2022	Calendar Year 2023	Calendar Year 2024
Total number of clients for employer groups
Total number of Enrollees covered
Number of public sector clients
Average size of public sector clients
Average percentage of utilization
Average employer savings
Employer’s return on investment

&G &"-,Bold"Attachment D - Technical Reply

Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination &P of &N image1.png

File details come from the government source that posted it. Updated Jun 2, 2025.