Exhibit B Performance Requirements Summary.pdf
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- Solicitation number
- HT001524R0030
- Issued by
-
Defense Health Agency
About this file
This document outlines key performance requirements and standards for a contract providing ambulatory care services at the Augusta Military Medical Center. Services include primary care for assigned beneficiaries with requirements for appointment access and screening metrics. Specialty care is expected to meet MGMA productivity standards. Key personnel must be approved within five days of award and changes reported three days prior. DMHRSi staffing data and timekeeping separation must meet standards. Encounters must be documented within three days and secure messages responded to within one. Remedies include past performance documentation and payment withholds for deficiencies.
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Exhibit B – Performance Requirement Summary (PRS)
Performance Objectives
Standards Acceptable Quality Level
(AQL)
Method of Assessment Remedies
Key Personnel
PWS para 1.18
Contractor Key Personnel required on this contract meet the experience and qualifications stated in the
PWS.
Key Personnel names are submitted to COR NLT five (5) business days after contract award.
Key personnel qualifications are met 100% of the time.
COR review of CVs for Key Personnel and date submitted.
Past Performance Documentation
(CPARS)
Changes to Key Personnel
PWS para 1.18
Changes to Key Personnel are reported to COR.
Key personnel changes reported to COR NLT three (3) business days before the change is made.
Review staffing report submitted monthly
Past Performance Documentation
(CPARS)
Manpower Data
PWS para 1.19
DMHRSi information on 100% of all contracted employees shall be submitted and approved NLT COB second business day after the end of the government pay period.
On-time reporting 81% of the time.
Random inspection for training and clinical DMHRSi coding compliance
Past Performance Documentation
(CPARS)
Contractor Timekeepers
PWS para 1.19
Contractor Timekeepers cannot be Timecard Approvers per DHA PM 6010.13-M Vol 1 & Vol 2
Meets standard 95% of the time.
DMHRSi report to inspect names of submitted and approved timecards.
Past Performance Documentation
(CPARS)
Patient Encounter Notes
PWS para 5.13.2.1.5.4
All MHS Genesis patient encounters are to be completed and closed by Provider.
All encounters are documented and closed within three (3) business days.
Observation & random sampling
Past Performance Documentation
(CPARS)
Primary care manager empanelment
PWS para 5.7
All beneficiaries are assigned to a Primary Care Manager (PCM), no ghost empanelment exists.
No more than 1300 enrolled beneficiaries empaneled to one (1) full-time PCM.
No fewer than 650 enrolled beneficiaries empaneled to one (1) part-time PCM.
Zero enrollees ghost empaneled.
The Contractor shall provide a report on the last business day of each month detailing each Provider and number of empaneled beneficiaries.
75% payment per member per month rate for each enrollee ghost empaneled on last business day of month.
ATAMMC PWS Exhibit B Performance Requirements Summary
Medical Group Management Association (MGMA) Standards
PWS para 5.9.3
Specialty care will meet or exceed productivity standards when compared to MGMA standards.
All ACC locations together meet an average of 50th percentile for RVU productivity.
Monthly report submitted by contractor;
COR Surveillance and Performance Monitoring module in Procurement Integrated Enterprise Environment
(PIEE).
Past Performance Documentation
(CPARS)
MHS Genesis Portal Secure Messaging
PWS Para 5.13.2.1.5.9.1
Timely response to beneficiary messages submitted and received through MHS Genesis Portal Secure Messaging.
100% of messages received from beneficiaries through the MHS Genesis Portal Messaging System shall be responded to within one business day of submission.
Observation & random sampling
Past Performance Documentation
(CPARS)
Healthcare Effectiveness Data and Information Set (HEDIS) measures
PWS para 5.13.2.20.1
Primary Care screening metrics.
-Breast Cancer Screening
Meets standard at a minimum of 75% for the month.
Monthly report for all enrolled beneficiaries who meet the metric requirement.
Past Performance Documentation
(CPARS)
Healthcare Effectiveness Data and Information Set (HEDIS) measures
PWS para 5.13.2.20.1
Primary Care screening metrics.
-Cervical Cancer Screening
Meets standard at a minimum of 75% for the month.
Monthly report for all enrolled beneficiaries who meet the metric requirement.
Past Performance Documentation
(CPARS)
Healthcare Effectiveness Data and Information Set (HEDIS) measures
PWS para 5.13.2.20.1
Primary Care screening metrics.
-Colorectal Cancer Screening
Meets standard at a minimum of 75% for the month.
Monthly report for all enrolled beneficiaries who meet the metric requirement.
Past Performance Documentation
(CPARS)
Primary Care Access (acute appt)
PWS para 5.14.1.1
Contractor shall meet TRICARE access standard for primary care ACCs, and acute appointments are scheduled within 24 hours of request.
Patient will be seen within 24 hours 100% of the time for acute appts.
Govt reviews data quality and percentage of patients sent to network.
Past Performance Documentation
(CPARS)
Primary Care Access (routine appt)
PWS para 5.14.1.2
Contractor shall meet TRICARE access standard for primary care ACCs and routine appointments are scheduled within seven (7) days.
Patient is seen within seven
(7) days of appt request 100% of the time.
Govt reviews data quality and percentage of patients sent to network.
Past Performance Documentation
(CPARS)
ATAMMC PWS Exhibit B Performance Requirements Summary
Inspection Metrologies:
M1: Inspection of Reports. All reports shall be reviewed upon receipt. The reviewer will report any flaws in the document and categorize the flaws (Editorial, Format, and/or Substance).
| Exhibit B – Performance Requirement Summary (PRS) |
| Standards |
| Remedies |
File details come from the government source that posted it. Updated .