WCMBP_Section_M_-_Evaluation_Factors_for_Award_AMD_5.doc

United States Department of Labor

(DOL)

Workers’ Compensation Medical Bill Process (WCMBP)

Section M Evaluation Factors for Award Office of Workers’ Compensation Programs (OWCP)

Table of Contents Section

Page 1M.1 Solicitation Provisions Incorporation

1M.2 Basis for Contract Award

1M.3 Proposal Evaluation Procedures

1M.3.1 Solicit Proposals

2M.3.1.1 Publish Solicitation

2M.3.1.2 Respond to Questions

2M.3.2 Evaluate Proposals

4M.4 Evaluation Factors for award

5M.4.1 Technical Factor

6M.4.2 Management Factor

7M.4.3 Prior Experience Factor

9M.4.4 Past Performance Factor

10M.4.5 Price

12M.5

DISCUSSIONS

12M.5.1 Award without Discussion

12M.5.2 Conduct Discussions

12M.6 AWARD Contract

12M.6.1 Proposal Retention

FAR References Reference

Page

1FAR 52.217-5, Evaluation of Options (JUL 1990)

1FAR 15.3, Source Selection

1FAR 15.101-1, TRADEOFF Process

1FAR 2.101 (c) Definitions

2FAR 15.303 (b), Responsibilities

2FAR 15.303 (c), Responsibilities

2FAR 15.305, Proposal evaluation

3FAR 52.215-1, Instructions to Offeror - Competitive Acquisition (Jan 2004), Alternate II (OCT 1997)

4FAR 15.304 (e), Evaluation factors and significant subfactors

12FAR Subpart 4.8, Government Contract Files

M.1 Solicitation Provisions Incorporation The following solicitation provisions pertinent to this section are hereby incorporated by reference in accordance with FAR 52.252-1 provision in Section K of this solicitation.

FAR 52.217-5, Evaluation of Options (JUL 1990) M.2 Basis for Contract Award FAR 15.3, Source Selection In accordance with FAR Part 15.3, an award will be made to that responsible Offeror(s) whose offer, conforming to the solicitation, will be most advantageous to the Government based on technical merit, competitive pricing, and other factors specified in this solicitation.

FAR 15.101-1, TRADEOFF Process

The Government will determine which proposal offers the “best value” to the Government, using a tradeoff among price and non-price factors, allowing the Government to accept other than the lowest price proposal, as per FAR 15.101-1.

FAR 2.101 (c) Definitions

Based on the FAR, “Best value” means the expected outcome of an acquisition that, in the Government’s estimation, provides the greatest overall benefit in response to the requirement.

The Government will evaluate offers received under this Request for Proposal (RFP) to determine the Offeror whose proposal represents the best value to the Government, price and other factors considered. The Government will make an award determination based on the Technical, Management, Prior Experience, Past Performance, and Price factors. The tradeoff will be determined by a process that allows the Government to consider award to other than the lowest priced Offeror or other than the highest technically rated Offeror in accordance with FAR Part 15.101-1, which permits tradeoffs among price and Technical evaluation factors.

M.3 Proposal Evaluation Procedures

The Government will follow the proposal evaluation procedures as outlined below. All activities are conducted as needed, at the discretion of the Government.

M.3.1 Solicit Proposals

The Government will create a Source Selection Board for the evaluation process, publish a solicitation, and respond to questions regarding the solicitation.

FAR 15.303 (b), Responsibilities

The Government has selected a Source Selection Authority who will conduct the Source Selection according to FAR 15.303 (b).

FAR 15.303 (c), Responsibilities

The Government has selected a Contracting Officer, who will perform Source Selection duties according to FAR 15.303 (c).

M.3.1.1 Publish Solicitation

The Government will publicly release the WCMBP solicitation on the Federal Business Opportunities (https://www.fbo.gov) website.

M.3.1.2 Respond to Questions

The Government will analyze, consolidate, prepare and publish (on www.fbo.gov) a unified response to all offerors responding to timely submitted questions to the extent that it can do so.

M.3.2 Evaluate Proposals

FAR 15.305, Proposal evaluation

The Government will assess the acceptability of each proposal, in accordance with the Evaluation Factors of Section M: Technical, Management, Prior Experience, Past Performance, and Price.

The objective of the evaluation process is to provide information to the Source Selection Authority to make an award of a contract. The Government intends to evaluate proposals as per FAR 15.305.

Offerors are notified that non-Government consultants may advise the Government during the Government’s evaluation of proposals.

The Government will assess the relative risks associated with each offeror’s Non-Price and Price Proposals and potential performance and price risks. Risk is defined as the likelihood that the Government will be negatively impacted by the offeror’s failure to meet the negotiated technical, management, and schedule performance and price. Risk is associated with an offeror’s proposed approach in meeting the Government’s needs and requirements. The evaluation team will assess risk and integrate their assessments into the rating of appropriate evaluation factors.

Assessment of risk is an integral component of the evaluation. It will serve to inform the evaluators of the likelihood that the offeror’s proposed solutions would successfully meet the requirements of this solicitation, within reasonable time frames and funding profiles, and without placing unreasonable risk on the Government. In analyzing the risk of the offeror’s proposed solutions, the Government will also consider the offeror’s willingness to share in this risk.

The Government will conduct any communications with the offeror in accordance with FAR 15.306.

All are conducted as needed, at the discretion of the Government. Within each cycle, the Government may apply iterated procedures at their discretion. The following activities may be initiated:

· A competitive range determination

· Documentation and notification of any change in the competitive range (Government)

· Discussions with offerors still in the competitive range (Government and offerors)

· Request for a revised proposal (Government)

· Preparation of a revised proposal (offerors)

· Evaluation of a revised proposal (Government)

At the end of any iteration, the Government may declare the next iteration to be a “Best and Final” revision.

FAR 52.215-1, Instructions to Offeror - Competitive Acquisition (Jan 2004), Alternate II (OCT 1997)

(f)(4)The Government intends to evaluate proposals and award a contract without discussions with offerors (except clarifications as described in FAR 15.306(a)). Therefore, the offeror’s initial proposal should contain the offeror’s best terms from a cost or price and technical standpoint. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals.

FAR 15.304 (e), Evaluation factors and significant subfactors

Offerors are advised that proposals will be evaluated using adjectival ratings with regard to two sets of factors. The Technical, Management, Prior Experience, and Past Performance factors comprise the Technical set. The Price factor comprises the Price set. Each of the factors will be evaluated separately. The following factors, listed in descending order of importance, will be used in the Technical evaluation of proposals:

Technical Factor Management Factor Prior Experience Factor Past Performance Factor Finally, the evaluation of the Technical set will be compared to the evaluation of the Price set to determine the “Best Value” to the Government. The Technical set of factors is approximately equal to the Price set of factors.

Although the Technical factors are approximately equal to cost or price, price is important and should be considered when preparing responsive proposals. In a situation where proposals receive the same technical rating, price will become the determining factor of award.

Although clarity and succinctness is not a specific evaluation factor, the degree to which a proposal effectively presents ideas, concepts, and information is embedded within each factor. It is important that Offerors recognize the Government makes the source selection decision based upon a review of the written offer and any clarifying communications deemed necessary, plus analysis of Prior Experience and Past Performance information. If the Contracting Officer (CO) later determines a competitive range and calls for discussions, any information so obtained will also be used in the source selection decision.

An Offeror should not assume that the CO will independently obtain information necessary to evaluate its proposal and should therefore supply all information required to evaluate its proposal. Failure to provide the information required in order to evaluate a proposal could result in rejection of the proposal as being incomplete, noncompliant, or unacceptable.

M.4 Evaluation Factors for award The Government will evaluate five (5) factors as presented below: Technical Factor, Management Factor, Prior Experience Factor, Past Performance Factor, and Price Factor. There are no subfactors. The Offeror should show that the requirements stated in Section C of the RFP are understood and should offer a logical program for their achievement.

Any offeror who simply proposes to provide supplies and services in accordance with the solicitation document without providing any detail regarding its approach will not be eligible for award. The proposal must include a comprehensive plan for meeting the needs of the Department of Labor (DOL), addressing all of the requirements of the Request for Proposal (RFP), and explaining the proposed technical and managerial approaches to be used. Proposals must clearly demonstrate an understanding of the Government’s requirements and provide a high likelihood for success to be considered for award. The Government will evaluate the Offeror’s proposal for consistency, completeness, and accuracy to determine if the stated approach has a likelihood for success and can be completed in compliance with the planned delivery schedule.

M.4.1 Technical Factor

The Technical Factor is used to evaluate the Offeror’s proposed solution with regard to its approach to meeting the Government’s requirements. The following elements will be considered in evaluating the Technical Factor: Requirements Understanding, Solution Completeness, Suitable Processes, Appropriate Technology, and Minimal Risk. DOL will consider the Offeror’s approach to meet all technical requirements as stated in applicable sections of the RFP. As part of this review, the Government will consider the following:

Requirements Understanding The Government will consider the extent to which the Offeror’s proposal reflects a comprehensive understanding of the WCMBP including: functional, non-functional, operational, and data requirements associated with providing all required capabilities described in this solicitation.

Solution Completeness The Government will consider the extent to which the Offeror’s proposal fully implements a complete WCMBP solution, consistent with the requirements of Section C of this solicitation. The Government will consider the Offeror’s technical approach and capabilities to meet requirements described in this solicitation, including the Offeror’s ability to meet the projected volumes.

Suitable Processes The Government will consider the extent to which the Offeror’s proposal incorporates the use of “best practices”, including government and industry standards, which are advantageous to the Government.

Appropriate Technology The Government will consider the extent to which the Offeror’s proposal incorporates the use of state-of-the-art technologies, which are advantageous to the Government.

Minimal Risk The Government will consider the extent to which the Offeror’s proposal describes a solution that minimizes risk to the Government. The Government will consider the Offeror’s risk containment, mitigation strategy and risk management approach as well as the quality assurance approach that tracks issues to their resolution and alters procedures as required.

M.4.2 Management Factor

The Management Factor is used to evaluate the Offeror’s proposed solution with regard to capabilities (people, facilities, processes, and others) to meet project management requirements, the Offeror’s approach to manage and execute day-to-day program operations, staff qualifications and experience, ability to apply consistent and repeatable processes and ability to manage the project in a coherent and integrated manner. The Offeror’s Project Schedule, Key Personnel, Program Management capabilities, Staffing capabilities, Training capabilities, Quality Assurance/Quality Control capabilities, Risk Management capabilities, and Subcontract Management Plan will be evaluated to determine their compliance with all applicable requirements and the overall soundness of their approach to managing a project of this type, scope and complexity. DOL will evaluate the Offeror’s approach to meet other related requirements as stated in applicable sections of the RFP. The Management volume will be evaluated collectively for compliance with the requirements and to determine if the Offeror’s overall management approach is thorough, including the identification of potential risks, planned corrective measures and assignment of qualified and experienced resources that will maximize the potential for success. DOL will consider the Offeror’s approach to meet all management requirements as stated in applicable sections of the RFP.

This factor also measures Offeror’s approach to:

· adapting to rapidly changing priorities and direction

· manage quality

· managing and staffing the entire team, including approach to retaining and/or replacing employees, including managing subcontractors

· maintaining continuity of staff for Government required key positions during both the Implementation and Operations phases

· successfully plan, control, and manage the WCMBP contract within cost, while meeting the performance characteristics specified in the solicitation

· exercise program control and management and ability to produce deliverables on time and at expected quality levels as defined in the solicitation

· communicate with the DOL about the program execution and its ability/approach to rearrange priorities as requirements change

· training and availability of facilities and resources

· provide hands-on support at the places of performance identified in this solicitation, as well as the availability of technical and management resources

· meet other management requirements as stated in the RFP The Offeror’s relevant key-personnel qualifications information must thoroughly describe the skills, abilities, and experiences of the proposed key-personnel. The Offeror’s Key-Personnel Qualifications documentation must provide sufficient detail to demonstrate that the Offeror will provide the quantity and quality of skilled workforce necessary to successfully meet the technical and managerial requirements described in all applicable requirements. The evaluation of Key-Personnel Qualifications will be based upon the content, completeness and thoroughness of the data submitted, as well as the relevance of the skills, abilities, and experience of the person as relates to the role they are proposed to perform in meeting the requirements of the solicitation.

The eventual contract awardee’s proposed key-personnel qualifications will be incorporated into the contract as material terms of the contract and the Government may consider a key person’s failure to meet the qualifications as a breach of contract.

M.4.3 Prior Experience Factor The Prior Experience factor, as distinguished from Past Performance, is used to evaluate the Offeror’s proposal with regard to the Offeror’s institutional and personnel capabilities as evidenced by recent previous projects having similar relevant requirements with regard to scope (breadth of functions) and processing volumes for Offerors (including their proposed subcontractors). Offerors whose companies and proposed personnel possess more years of similar experience will be viewed more favorably than Offerors with fewer years of similar experience.

The Government will evaluate the Prior Experience of Offerors’ companies and proposed personnel to determine whether it is relevant, similar in complexity, similar in size, and current. The Offeror’s Prior Experience should demonstrate that the Offeror and its proposed staff have the knowledge necessary to perform all of the solicitation requirements. The Offeror shall provide a narrative description of its Prior Experience, as well as the Prior Experience of any proposed subcontractors. The narrative must demonstrate completeness, accuracy, and the strengths and/or weaknesses they possess as relates to the potential for project success.

The government will consider previous or current contracts with Federal, State, or Local Governments and Private organizations as well as take into consideration Prior Experience information regarding predecessor companies, key personnel who have relevant Prior Experience and/or subcontractors. The Government will consider information submitted under this solicitation, as well as information obtained from any other sources, when evaluating the Offeror’s Prior Experience.

An Offeror without a record of relevant Prior Experience or for whom information on Prior Experience is not available, will receive a less favorable rating on the Prior Experience factor than an Offeror with such Prior Experience.

The evaluation of Prior Experience will apply to all business arrangements and relationships including joint ventures, teaming partners and major subcontractors including any subcontractors identified in the Small Business Subcontracting Plan.

The evaluation of Prior Experience will consist of a qualitative assessment of the Offeror’s record of Prior Experience (previous and/or ongoing contracts of similar size, scope, and complexity). The Offeror’s Prior Experience record and evaluation are considered to indicate a probability of success on the proposed contract.

The following elements will be considered as relevant Prior Experience: Bill Processing Experience, Workers’ Compensation Bill Processing Experience, Call Center Experience, and Mailroom/Imaging Experience.

The Government will consider the extent to which the Offeror has experience providing:

· medical bill processing services for projects of similar size (processing volumes) and scope (breadth of functions provided), for all process requirements areas

· workers' compensation program services (e.g., state workers’ compensation programs) for projects of similar size (processing volumes) and scope (breadth of functions provided) for all process requirements area

· Call Center services for projects of similar size (processing volumes) and scope (breadth of functions provided) for all process requirements area

· Mailroom service for projects of similar size (processing volumes) and scope (breadth of functions provided) for all process requirements area

In evaluating Prior Experience in the relevant indicated areas, the Government will consider:

a. Corporate and Key Personnel experience applying industry best practices that include, but aren’t limited to:

1. Performance and quality standards associated with all requirements relating to processing medical bills

2. Incorporating the latest government and industry standards (statutory/regulatory/policy)

3. Incorporating the latest medical coding requirements (for bill processing experience)

4. Number of similar projects supported

b. Project histories, whose descriptions include the:

1. Number and type of customers supported

2. Project timeframe(s). Number of years of experience providing a solution that has demonstrated successful operation

3. Length of project for each client

4. Size of implementation(s) indicating annual bill volume

5. Type of contract (system and/or service)

6. Lifecycle phase involvement (design, develop, test, implementation, operation, maintenance)

7. Level of involvement (lead, subcontractor, major support, minor support)

c. Experiences, similar to the requirements stated in Section C of this solicitation, that include:

1. Similar bill processing volumes (for bill processing experience)

2. Use of diagnosis-to-procedure editing (for bill processing experience)

3. Multiple benefits programs (for bill processing experience)

4. Use of “accepted condition" (for workers’ compensation experience)

5. Call Center operations efficiently employing sophisticated tools for real-time load distribution (for call center experience)

6. Call Center operations efficiently employing sophisticated tools that facilitate easy location of case information (for call center experience)

7. Mailroom operations efficiently employing sophisticated tools for data entry (for mailroom experience)

8. Mailroom operations efficiently employing sophisticated tools for storage of system artifacts (for mailroom experience)

9. Mailroom operations efficiently employing sophisticated tools for tracking documents (for mailroom experience) M.4.4 Past Performance Factor The Past Performance factor, as distinguished from Prior Experience, is used to evaluate the Offeror’s proposal with regard to how well an Offeror performed under previously awarded contracts.

The Government will evaluate the Offeror’s past performance record, considering the currency and relevance of the information, source of the information, context of the data, and general trends in the Offeror’s performance, as available. The government will consider past or current contracts with Federal, State, or Local Governments and Private organizations as well as take into consideration past performance information regarding predecessor companies, and/or subcontractors. The Government will consider information submitted under this solicitation, as well as information obtained from any other sources, when evaluating the Offeror’s past performance.

An Offeror without a record of relevant Past Performance or for whom information on Past Performance is not available, will receive neither a favorable nor an unfavorable rating on Past Performance. The Government may look to sources of information beyond those provided by the Offeror.

The evaluation of past performance will apply to all business arrangements and relationships including joint ventures, teaming partners and major subcontractors including any subcontractors identified in the Small Business Subcontracting Plan.

The evaluation of past performance will consist of a qualitative assessment of the Offeror’s record of past performance (previous and/or ongoing contracts of similar size, scope, and complexity) and success (how well the contractor performed). The Offeror’s past performance record and evaluation will indicate the Offeror’s probability of success on the proposed contract. The following elements will be considered under the past performance factor:

Quality of Deliverables or Service

The Government will consider the extent to which the Offeror complied with the Statement of Work, Performance Work Statement, and/or specifications in performing work on the deliverables or services including, but not limited to:

Meeting the requirements of the contract, including all end-products;

Transforming operational needs into an integrated systems design solution;

Engineering software to meet contract requirements for software development modification and maintenance;

Meeting program quality objectives (Production ability, reliability, maintainability, inspecting ability, testing ability etc);

Recruiting, training and retaining personnel Performance to Schedule

The Government will consider the extent to which the Offeror performed the work within the negotiated period of performance and/or delivered according to the negotiated schedule.

Performance to Price

The Government will consider the extent to which the Offeror performed the work within the contract price, including such factors as the:

d. Amount of any price increase

e. Reasons for price growth

f. Ability to forecast and control price Compliance with Contract The Government will consider the extent to which the Offeror complied with the other terms and conditions of the contract.

Staffing

The Government will consider the extent to which the Offeror provided qualified, cleared (if applicable), and experienced personnel, as required by the contract.

M.4.5 Price

The Price factor is used to evaluate the Offeror’s proposal with regard to the amount to be paid by the Government. The Government will use the analysis techniques defined in FAR 15.404-1.

The Government will evaluate the total price of a proposal by adding the price of all base and option periods of performance, as well as potential award term periods of performance. Evaluation of options and award term prices will not obligate the Government to award the options and award term extensions.

The Government will determine the extent to which proposed pricing is fair and reasonable. A price is fair and reasonable in its nature and amount, if it does not exceed that which would be incurred by a prudent person in the conduct of competitive business.

The Government will also determine the extent to which proposed pricing reflects a clear understanding of the requirements. The Government will compare the Pricing Group definitions in Section B with the proposal’s Basis of Estimate (BOE) narrative to determine if the BOE is consistent with the Government-supplied definitions. The Government will review the proposal’s price build-up for comprehensibility, completeness, and accuracy in explaining the submitted prices.

Price proposals may also be evaluated for price realism to measure an Offeror’s understanding of the technical requirements and/or examine the performance risk of proposals, with particular attention to the risk of low-priced proposals. For example, unrealistically low prices may increase an agency’s risk of performance, since, in an effort to cut losses, a contractor may “cut corners” on quality, deliver late, or default, often requiring additional agency involvement as well as re-procurements, which consequently may increase the agency’s cost of performance. A price proposal which is determined to be unrealistically low in cost(s) and/or price will be assessed as having high proposal risk and/or weaknesses under the Technical and/or Management evaluation factors and will be deemed reflective of an inherent lack of technical competence or failure to comprehend the complexity and risk of the requirements, justifying rejection of the proposal.

Finally, the Government will assess the extent to which the proposal provides prices that are balanced. A proposal containing unbalanced prices, as defined in FAR 15.404-1 (g), may be considered materially unbalanced and not eligible for award.

M.5 DISCUSSIONS

M.5.1 Award without Discussion

The Government intends to award without discussions. If no discussions are warranted or needed in the sole discretion of the Government, the procedures described in Section M.5.2 are skipped and the procedures in M.6 are initiated.

If the Government determines that discussions are required, procedures M.3 and M.5.2 are followed iteratively until an award can be made.

M.5.2 Conduct Discussions

The Government will determine a competitive range among the offerors. The Government will notify unsuccessful offerors that their proposal has been removed from the competitive range.

The Government will notify successful offerors that their proposal is within the competitive range. The Government may invite offerors in the competitive range to a Discussion meeting.

M.6 AWARD Contract

The Government will determine which proposal offers the “best value” to the Government, using a tradeoff among price and Technical factors, allowing the Government to accept other than the lowest priced proposal, as per FAR 15.101.

In determining the award of a contract, the Government will give primary consideration to the offeror that can perform the contract in a manner most advantageous to the Government, price and other factors considered. The Government will compare each offeror’s proposal to the requirements contained in this solicitation, including all compliance documents. The offeror shall accurately and thoroughly demonstrate an understanding of the objectives and scope of the project in its proposal.

The Government will document its contract award decision in a Source Selection Decision Memorandum (SSDM).

M.6.1 Proposal Retention

FAR Subpart 4.8, Government Contract Files

The Government will retain one copy of all unsuccessful proposals. Unless the offeror requests otherwise, the Government will destroy extra copies of such proposals.

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