ESBD_515779_1779845512435_TAMH-26-284 Addendum 1.pdf

THE TEXAS A&M UNIVERSITY SYSTEM

Office of Procurement & Business Services

ADDENDUM NO. 1

Date: May 26, 2026

RFP Due Date: June 2, 2026

RE: RFP-01-TAMH-26-284 Healthcare System Consulting Services

Respondents shall acknowledge receipt of addendum(s) on the Execution of Offer (Exhibit A).

Additional Information:

As part of the response to Section 4, Respondents shall include an Executive Summary that outlines and provides a concise, overall summary of your proposal response. This summary may be included as part of a cover letter.

Questions/Responses:

1. To support development of an appropriately scoped and tailored proposal, can the A&M System provide additional context on the healthcare system under consideration, including:

a. Approximate size (e.g., number of hospitals, licensed beds, or revenue range);

b. Whether the opportunity reflects a single entity, multi-site system, or potential carve-out from a larger health system that will have transition service implications;

c. Whether the A&M System is the initiating party or responding to an inbound competitive opportunity; and

d. Current stage of discussions (e.g., exploratory vs. active engagement)?

Response: No, due to the nature and timing of this RFP, this information will be provided to the awarded Respondent.

2. Can the A&M System provide additional detail on the decision-making and governance structure for this engagement, including key stakeholders across Texas A&M Health, the College of Medicine, and University-level leadership, their respective roles, and the process for review and final approval across project phases?

Response: This project is an A&M System and Texas A&M Health led exploration/opportunity assessment. Executive leadership within the A&M System, Texas A&M and Texas A&M Health will be involved in the governance structure and decision-making process. This leadership team will share with the A&M System Board of Regents.

3. Is there a specific decision that you expect to make at the conclusion of this effort? If so, what stakeholders will be involved in that decision-making process?

Response: Texas A&M Health and the A&M System will determine next steps once the opportunity is assessed at a high level and potential models of affiliation are shared as part of the deliverables by the awarded Respondent.

4. Do you have an ingoing perspective on internal stakeholder engagement (e.g., who to include, decision-making forums)?

Response: Refer to question #2 above.

5. Is there a specific health system that you are focusing this effort on or are you considering options with multiple potential health systems?

Response: Yes, this engagement is focused on a specific healthcare system.

If you are focusing the effort on a single health system:

a. Will Texas A&M have access to a data room with key information about the health system (e.g., financials, strategic documents)?

Response: Only what is available publicly online at this time. We will not have a “data room”. Data gathering would be part of the consultant’s responsibilities.

b. Do you anticipate engagement with the health system (e.g., interviews, working sessions)?

Response: Yes, but timing is to be determined since the management team is not involved in the discussion at this time.

c. Have any Agreements been signed (e.g., exclusivity, LOI, NDA) that impact this effort?

Response: Not yet.

6. Do you have an anticipated budget for this effort?

Response: This information is not available at this time.

7. The solicitation notes that final proposals should be in PDF format. Does Texas A&M have preference for a narrative response built in Word, or a slide-based response built in PowerPoint?

Response: Respondents shall provide their proposal response documents in PDF format, however, may submit a Word or PowerPoint in addition to the PDF. This shall apply to any narrative included as well. Refer to the Additional Information section on page 1 of this addendum to clarify inclusion on a narrative (Executive Summary).

8. What are the drivers for seeking this new partnership model relative to the current model of faculty practice affiliation with multiple systems? Is the expectation that any future partnership would be exclusive for Texas A&M, the potential partner, or both?

Response: Model to be determined based on consultant’s model recommendations. The College of Medicine will continue to have multiple health system partners throughout the state.

9. What are Texas A&M’s goals for the partnership beyond serving as an undergraduate/graduate training site (for example, revenue or margin, greater control over strategy/operations, clinical research sites)? Would defining these goals be part of the scope?

Response: The College of Medicine wants to expand its clinical footprint by adding an acute care hospital to its portfolio. This will expand clinical revenues, research opportunities, UME and GME along with clinical research. An acute care hospital will add support to the expansion of the College of Medicine clinical departmental infrastructure.

10. What range of deal structures, in addition to acquisition, is under consideration? Could the partnership be structured as a traditional contractual affiliation agreement, or must it be an equity partnership with joint ownership?

Response: We have a basic Master Affiliation Agreement already and the desire is to move to a management and branding opportunity.

11. Is there an expected range or ceiling for capital deployment that you can share now, or that may be available after award to the selected vendor?

Response: No, not at this time.

12. How extensively do you anticipate involving leadership and other stakeholders, such as department chairs or the faculty senate, in the evaluation process?

Response: We no longer have a faculty senate. This initial evaluation will include the leaders identified as above until we know what the potential opportunity will be.

13. Should we assume this first phase is intended to be a smaller, leadership-focused exercise?

Response: It will be leadership focused but desire an overview of opportunity and thoughts on potential models.

14. Would you like us to recommend a preferred stakeholder engagement approach?

Response: Yes, engagement approach recommendations may be included for our consideration.

15. Will the selected consultant have access to a data room with target information and/or interviews with target management, or should the analysis be conducted on an outside-in basis?

Response: The data TAMU has is only what is available publicly online at this time. We will not have a “data room”. Data gathering would be part of the consultant engagement expectations.

16. Is there a budget range allocated for the consulting effort as outlined in the RFP? If so, please share.

Response: Refer to question #6 above.

17. Application of Section 4.1.I.e (Comparable Projects). Section 4.1.I.e requires Respondents to “highlight at least three comparable projects completed in the past three years and provide a client reference from each project (include contact information).” Respondents respectfully request clarification of the A&M System’s intended application of this provision in three respects:

a. Where a Respondent (including its named team members or principal officers) can demonstrate substantively comparable engagements — i.e., advisory, operational, or executive engagements concerning the acquisition, governance, operating-model design, financial restructuring, or implementation of a multi-facility healthcare system — that were completed outside the three-year window but for which a current, willing client reference remains available, will such engagements be considered in satisfaction of Section 4.1.I.e, either in lieu of or in combination with engagements completed within the three-year window?

Response: Yes

b. May Section 4.1.I.e be satisfied, in whole or in part, through engagements completed by named team members, principal officers, key personnel, or identified subcontractors, including engagements performed in the individual’s professional capacity prior to formation of the current Respondent entity?

Response: Yes

c. Where two or more firms submit a joint proposal or operate under a teaming arrangement, will the combined record of the participating firms be considered collectively in satisfaction of Section 4.1.I.e?

Response: Yes

18. Joint Submissions and Teaming Arrangements. The RFP does not expressly address joint submissions, prime-and-subcontractor structures, or formal teaming arrangements. Respondents respectfully request clarification on the following:

a. Does the A&M System permit two or more firms to submit a single joint proposal as co- Respondents, and if so, by whom (prime alone, or all participating parties) should Exhibit A (Execution of Offer) and Exhibit B (Non-Collusion Affidavit) be executed?

Response: Yes. Unless you are forming a partnership as a single legal entity, the prime respondent shall respond and complete all exhibits. The other firm would be included as a partner within the proposal response.

b. Where a Respondent identifies subcontractors as named team members performing defined scope elements, must each named subcontractor execute any of the Forms required under Section 2.4, or is the prime’s execution alone sufficient?

Response: Subcontractors do not need to execute any of the required forms.

19. Texas Resident Bidder Status (Exhibit A). Exhibit A requires Respondents to certify their status as a Texas resident bidder. Respondents respectfully request clarification of (i) the specific weight, if any, that the A&M System assigns to Texas resident bidder status in the best-value evaluation; and

(ii) whether that status is determined by the location of the prime Respondent’s principal place of business, or whether it may be satisfied based on the location of subcontractors or named team members performing the work.

Response: (i) There is not a specific weight assigned to this status. (ii) It is determined by the prime Respondent’s principal place of business.

20. VetHUB Subcontracting Plan (Attachment A; Section 4.3). Attachment A and Section 4.3 of the RFP establish a two-percent (2%) VetHUB subcontracting goal. Respondents respectfully request clarification on the following:

a. Where the precise scope of subcontracted work cannot be finalized prior to award, will the A&M System accept a documented good-faith-effort demonstration, supported by outreach evidence to certified VetHUB businesses, in satisfaction of Section 4.3 at the time of proposal submission?

Response: Yes

b. Attachment A instructions reference courtesy review of a draft Subcontracting Plan submitted to SO-HUBProgram@tamus.edu at least ten (10) business days before the proposal deadline. Is such a courtesy review available to Respondents whose Subcontracting Plan may be amended or finalized after the courtesy-review draft is submitted?

Response: Yes

21. Scope of “Operate and Manage” (Section 3.3). Section 3.3 describes the engagement as advising the A&M System on a potential opportunity to “operate and manage a healthcare system (hospital and community clinics) for Texas A&M Health.” Respondents respectfully request clarification of whether the consulting scope is intended to encompass evaluation of:

a. A self-operated model, in which Texas A&M Health (or an A&M System affiliate) is the operating entity;

b. A third-party managed-services or contract-management model, in which an external operator manages the system under contract;

c. An affiliation, joint-venture, or partnership model with an existing health system; or

d. Some combination of the foregoing.

The answer to this inquiry materially affects the level of effort required for the Analysis Report (Deliverable 3) and the High-Level Roadmap (Deliverable 4) and informs the cost proposal.

mailto:SO-HUBProgram@tamus.edu

Response: Ideally, Texas A&M Health would like to have a close partnership with an acute care hospital/system. We are open to the above models but would favor a scenario in which Texas A&M Health has major management responsibilities for the hospital/system to drive the operations and strategic direction of the entity ensuring alignment with the missions of the college of medicine for clinical, education and research priorities while ensuring access to care for the community as we train the providers of tomorrow and grow our clinical faculty.

22. Cost Proposal Structure (Section 4.2). Section 4.2 requires Respondents to provide “total aggregate cost for completion of the project as outlined in Section 3.” Respondents respectfully request clarification as to whether the A&M System has a preferred pricing structure — specifically, fixed fee, time-and-materials, milestone-based payment tied to the four deliverables enumerated in Section 3.4, or some hybrid — and whether the A&M System will entertain alternate pricing proposals so long as a total aggregate cost is also provided.

Response: Given the unknown nature of the scope and possible phases, Respondents are encouraged to recommend pricing structure and any alternate pricing proposal(s) that may be beneficial to both parties.

23. Page Limits and Proposal Formatting (Section 4.1). Section 4.1 enumerates the required elements of the Technical Proposal but does not expressly state page limits, font, margin, or other formatting requirements. Respondents respectfully request confirmation that no page limit applies, or, if a page limit applies, that the A&M System specify the applicable limit and any associated formatting requirements (font, font size, line spacing, margins) by addendum.

Response: There are no page limits or any other formatting requirements beyond what is stated in Section 4.1.

24. Pre-Submission Meeting or Pre-Proposal Conference. Given the breadth of the scope described in Section 3 and the significance of the potential engagement to Texas A&M Health, Respondents respectfully inquire whether the A&M System is willing to convene a pre-submission meeting, pre-proposal conference, or site visit — in person or by teleconference — for prospective Respondents to facilitate a more complete understanding of the A&M System’s objectives and the Healthcare System target.

Response: The A&M System will not be scheduling a pre-proposal conference as part of this RFP.

25. What is the A&M System’s main organizational aspiration or goal(s) of potentially acquiring or partnering with a healthcare System?

Response: Ideally, Texas A&M Health would like to have a close partnership with an acute care hospital/system. We are open to the above models but would favor a scenario in which Texas A&M Health has major management responsibilities for the hospital/system to drive the operations and strategic direction of the entity ensuring alignment with the missions of the college of medicine for clinical, education and research priorities while ensuring access to care for the community as we train the providers of tomorrow and grow our clinical faculty. We have been asked to consider potential management, partnership or ownership of this hospital entity.

26. If the A&M System were to move forward with operating and managing a healthcare system, what does success look like in 3–5 years from the A&M System’s perspective?

Response: Success may include but is not limited to the following examples. Growth of our clinical educational platform to educate students. Growth in our graduate medical education programs.

Growth in clinical service delivery to include inpatient services that would lead to growth in clinical research platforms and ultimately growth and diversification in our clinical faculty to include additional clinical departments within the College of Medicine.

27. Does the A&M System have a potential acquisition/partnership health system target in mind, or is the A&M System seeking the third-party partner engaged through this RFP to identify possible acquisition/partnership targets?

Response: Yes, the A&M System has a potential target in mind.

28. If the A&M System has a target health system in mind per #27 above, can you please share the following information: number of hospitals within the health system; number of clinic locations within the health system; number of clinicians within the health system (delineated by hospital versus clinic, if possible), electronic health record(s) and patient accounting system(s) this health is system using today; and Annual Net Patient Revenue of this health system.

Response: This information will be provided to the awarded Respondent.

29. How much access would the third-party partner engaged through this RFP have to senior team members and data resources of the external healthcare system being considered for acquisition/partnership to support completion of the desired support?

Response: Unable to answer at this time.

30. Does the desired scope of an operational assessment include IT?

Response: Not at this point.

31. Does the desired scope of an operational assessment include clinical operations performance (i.e.

length of stay, case mix index, etc.)?

Response: Case mix would be included and payor percentages at a high level at this time with the initial phase. There would be a deeper dive with the next phase.

32. Given the RFP states this RFP pertains to the College of Medicine in particular, is pharmacy / PBM realignment in scope or out of scope?

Response: Only College of Medicine at this time.

33. Given the desire for support regarding a proposed future state organization model, can the A&M System provide its current organizational structure?

Response: Not necessary during this first phase evaluation. That would be reviewed and revisions would be forthcoming in future phase evaluation.

34. Our approach in consulting services is to stand up a mirror structure for our team and our client partner’s team. Who does the A&M System anticipate would serve as the senior Executive Sponsor for this work? Who will serve as the day-to-day main point of contact for driving this work forward (what we call the Project Lead)?

Response: Executive Leadership of the College of Medicine. Day-to-day point will be a project lead that will be identified in the near future.

35. Are employee/HR transitions anticipated as part of the health system partnership?

Response: It is possible.

36. What are the main objectives for TAMH / the College of Medicine in entering into this opportunity to manage and operate a Healthcare system – e.g., securing clinical training sites, building a research platform, capturing GME/facility revenue or all three?

Response: Refer to question #25.

37. Has university leadership (Board of Regents, President, Provost) already aligned on pursuing ownership/operation, or is this assessment meant to inform the go/no-go decision?

Response: The Board of Regents are aware of this early evaluation process that will lead to a go/no-go decision.

38. What does success look like for this engagement specifically – a go/no-go recommendation, market scanning with a target shortlist, full business plan or all of the above?

Response: Refer to question #26 above.

39. How much operational control does A&M want over this healthcare system, full ownership, joint venture or management services arrangements?

Response: Will entertain any of those models. We would like to have this acute care facility to be branded and managed as an “Aggie-owned acute care facility” but will entertain a tightly integrated partnership/relationship.

40. Can you tell us any more about the hospital and community clinics in scope for the assessment – i.e., size of hospital, no. of clinics, current clinical service model, geographic focus areas, whether it is an independent system or a carve-out from a larger Health system?

Response: No additional information is available or will be provided at this time.

41. If there is no specific target, will A&M Health consider option to build a health system, if yes, are there any geography options in consideration?

Response: This is a specific market opportunity in a geographic region Texas A&M Health would like to have a hospital/health system management opportunity within this market.

42. In addition to facilities, what numbers and types of staff (e.g., physicians, advanced practice clinicians, nurses, administrative staff, etc.) would be conveyed as part of the transaction?

Are there other ancillary facilities like ambulatory surgery centers, imaging centers, laboratories, or others that are within the deal perimeter?

Response: No additional information is available or will be provided at this time.

43. What work has been completed to date by TAMH to identify potential targets / partners which will be the focus of the assessment in this project?

Response: Only high-level discussions and a decision to have a consultant conduct a deeper dive into potential opportunity.

44. (Assuming this is an existing system) As part of the work, how much access would we have to the management team of the health system you are assessing?

Response: Unknown at this time during the initial phase but likely limited.

45. Has due diligence been conducted on facilities and capital equipment to identify and size any obligate replacement, renovation, and/or investment outlays?

Response: No.

46. What’s the nature of those current 220 clinic partnerships -affiliation agreements, professional services agreements, owned practices, or a mix?

Response: Cannot answer this at this time. Once consultant is engaged will give further details. This information, however, is not relevant to the initial phase since the other partnerships are clinical training agreements.

47. How stable are those relationships? Are those clinics providing adequate training volume and case mix for the college of medicine, or are there documented gaps this initiative is meant to solve?

Response: Stable but interested in a deeper integrated relationship with a hospital/health system partner.

48. Is there any growth target on the college of Medicine enrollment that will significantly increase the class size and clinical capacity?

Response: The College of Medicine is hoping to expand class size to 250 students, and the current rate-limiting factor are the clinical rotation sites available to do so.

49. Is there any specific LCME-driven requirements creating pressure that drives this initiative?

Has the college of Medicine received any LCME citations, findings or areas of concern related to clinical training in recent accreditation reviews?

Response: No citations that impact this growth strategy.

50. Does A&M currently sponsor residency programs, if so, who is the sponsoring institution of record – A&M or Baylor Scott & White?

Response: Yes. Will share this with the selected consultant.

51. Is the leadership aware that federal GME funding (Direct GME and IME payments) flows to the hospital where residents train, not the sponsoring university – and has that informed the financial case for ownership?

Response: Yes, we are well versed in the GME funds flow process.

52. Will a TAMH Project SteerCo or similar oversight / governance group be established to oversee this project? How often would you like it to meet and who would you imagine being members?

Response: Yes, Texas A&M Health will establish a steering team to guide this project. Specific members are still to be determined as well as frequency of meetings.

53. What involvement with the Board of TAMH have in this process (e.g., bi-weekly meetings, monthly updates, final approval)?

Response: The Board of Regents will be advised on the progress through the Medical & Health Affairs subcommittee of the Board of Regents. The steering team will keep this committee well informed throughout the process.

END OF ADDENDUM NO. 1