HSCRC-25-0305 Addendum No. 1 Solicitation Questions and Responses.pdf

The Health Services Cost Review Commission is an independent agency of the State of Maryland

P: 410.764.2605 F: 410.358.6217 4160 Patterson Avenue | Baltimore, MD 21215 hscrc.maryland.gov

Joshua Sharfstein, MD Chairman

Joseph Antos, PhD Vice-Chairman

James N. Elliott, MD

Ricardo R. Johnson

Maulik Joshi, DrPH

Adam Kane, Esq

Nicki McCann, JD

Jonathan Kromm, PhD Executive Director

William Henderson Director Medical Economics & Data Analytics

Allan Pack Director Population-Based Methodologies

Gerard J. Schmith Director Revenue & Regulation Compliance

Claudine Williams Director Healthcare Data Management & Integrity

Solicitation No. HSCRC-25-0305

Financial Policy Review

Addendum No. 1

January 30, 2026

TO ALL OFFERORS: Please see the following for the above-mentioned solicitation.

Important Note: This addendum is to respond to questions received related to this solicitation.

I. Answers to questions received in reference to this solicitation

Below are questions received from potential offerors. Responses to the questions are noted below:

1. The HSCRC indicates an expected average of approximately three Full Rate Reviews per year, with variability.

Answer: Any estimates of actual full rate reviews per year are not worthwhile, as there are several factors, including general industry profitability, that determine the number of rate applications.

2. Can HSCRC provide any additional insight into how work is expected to be distributed across Full Rate Reviews, cost structure assessments, and broader policy or methodology reviews over the contract term?

Answer: No, this contract is ad hoc in nature.

3. Is there historical information for the maximum number of reviews that may require support per year

Answer: No, see answers #1 and #2.

4. For work outside of Full Rate Reviews (e.g., policy analysis or methodology evaluation), does HSCRC anticipate these efforts to be episodic or more continuous in nature?

Answer: We expect them to be continuous in nature, as the Commission has over approximately 10 financial methodologies that routinely are reevaluated every 3-5 years. A cadence that will only increase as the Commission works to align financial policies with the Centers for Medicare and Medicaid

Innovation, who will be administering Medicare global budgets in Maryland in 2028.

5. Are there historical trends or examples from prior contracts that illustrate how tasking has been allocated across these categories?

Answer: Given the structure of this solicitation, which is asking contractors to function as The HSCRC extenders on an ad hoc basis, Commission The

HSCRC do not believe there is any merit in providing prior contract allocations across categories, as past will certainly not serve as prologue.

6. How does HSCRC anticipate prioritizing work when multiple Full Rate Reviews or policy analyses overlap in time?

Answer: Full Rate Reviews will be handled in the sequence in which they are docketed, as the Commission is required to make a determination on a full rate review within 150 days of docketing. Policy/methodology review will try to adhere to Commissioner directed policy calendars but may be postponed if full rate reviews consume The HSCRC bandwidth.

7. Does HSCRC expect tasking to be issued primarily as discrete work orders with defined scopes, or as more open-ended analytical support over defined periods?

Answer: For full-rate reviews, there will be discrete work orders. For policy/methodology review, The HSCRC expect “open-ended analytical support.”

8. To what extent does HSCRC anticipate concurrent tasking versus sequential execution of work efforts?

Answer: See answers #7 and #8.

9. Is HSCRC open to contractors proposing analytical enhancements or refinements to existing methodologies, or should contractors strictly apply HSCRC-defined approaches unless directed otherwise?

Answer: The HSCRC is not only open to proposed enhancements but also encourage contractors to bring forward new methodology considerations, as long as it aligns with contractual requirements with the federal government and the broader aims of the AHEAD Model. In all cases, HSCRC would first need to authorize additional work to consider the proposed enhancements.

10. How does HSCRC envision onboarding or knowledge transfer for contractors who have strong healthcare regulatory analytics experience but have not previously supported HSCRC-specific methodologies?

Answer: The HSCRC have numerous materials, including published policy papers, workgroup slide decks and modelling, and recordings of most workgroup and Commission meetings (all of which are on the HSCRC website). Additionally, HSCRC have multiple experts that can provide greater information on particular policy details.

11. Is HSCRC open to a lean, senior-led The HSCRC model with targeted support roles activated as needed, or does it anticipate a more consistent team composition throughout the contract term?

Answer: The HSCRC are open to a lean model. We believe the most important consideration is the experience of the various resources available through this contract as opposed to the size of the HSCRC complement.

12. Does HSCRC place greater emphasis on institutional continuity or on access to appropriately qualified expertise as needs arise?

Answer: Access to appropriately qualified expertise. However, HSCRC would note that this is a broader statement and will not specify further on the exact weighting of each component in the technical evaluation.

13. Can HSCRC provide additional guidance on preferred deliverable formats for Full

Rate Reviews versus broader policy or methodology analyses (e.g., narrative memoranda, analytical models, dashboards)?

Answer: It depends on the project. But typically, We would require summary slide materials and supporting analytical models. Larger narratives, e.g., policy recommendations, are typically the domain of

HSCRC.

14. Are there expectations regarding the level of standardization versus customization of analytical outputs across different reviews?

Answer: Customization is important, as HSCRC may have additional considerations after asking the contractor for modelling. However, standardization is paramount because models have to be replicable across all hospitals, and divergent formatting makes it more difficult for stakeholders to engage.

15. Does HSCRC anticipate reusability of analytical models and dashboards across engagements, or should contractors assume primarily case-specific analyses?

Answer: Both. It depends on the particular subject. Projections of future uncompensated care impacts from HR1 should be reusable, as assumptions in the modelling will change slightly each year as the legislation is implemented.

16. How are contractor analytical outputs typically used—primarily for internal The

HSCRC analysis, formal Commission presentations, or inclusion in public regulatory records?

Answer: Primarily for internal HSCRC analysis but also can be utilized for formal Commission presentations and recommendations.

17. Should contractors anticipate supporting Commission meetings, hearings, or follow-on analytical questions during deliberations?

Answer: Only in developing supporting materials. The HSCRC does not anticipate requiring this contractor to provide expert testimony.

18. Are there expectations for contractors to provide expert explanations or defense of analytical conclusions during regulatory proceedings?

Answer: See answer #17.

19. Beyond statutory timelines, how does HSCRC define success for contractor support under this engagement?

Answer: Accurate and timely analyses are key. Additionally, any new approaches to modifying or reviewing the accuracy of methodologies/policies is another success.

20. Are there qualitative or performance-based indicators HSCRC uses to evaluate contractor effectiveness over the contract term?

Answer: No.

21. Does HSCRC have preferences or standards for analytical tools or platforms, or is tool selection left to the contractor, provided outputs meet HSCRC requirements?

Answer: No.

22. Are contractors expected to integrate with existing HSCRC analytical tools or data environments, or will this be addressed on a task-by-task basis?

Answer: No, this will be addressed on a task-by-task basis.

23. Are there anticipated regulatory, policy, or healthcare system developments that

HSCRC expects may significantly influence the focus or analytical demands of this contract over the next three years?

Answer: Yes, the implementation of the AHEAD Model in Maryland as well as the national implementation of HR1 will necessitate additional analyses.

24. Are there any lessons learned from prior contracts of this nature that HSCRC believes offerors should consider when proposing HSCRC or delivery approaches?

Answer: No.

25. In section 2.5 Responsibilities and Tasks (pg. 9), should items 2.5.2 Financial

Analysis and Modeling and 2.5.3 Preparation of Full Rate Review Responses be interpreted as components of 2.5.1 Assisting with Full Rate Reviews?

Answer: Yes.

26. In Section 2.7 “Substitution of Personnel” (pg. 13), Key Personnel information is outlined.

a. Are there specific criteria that determines whether an individual should be designated as Key Personnel?

Answer: No. It is at the discretion of the Contractor but must be guided by Section 2.6.

b. Are all subcontractors required to be listed as Key Personnel, or only those who meet certain requirements?

Answer: No.

27. In table A (pg. 30), Attachment F – Offeror Technical Response to RFP

Requirements and Proposed Work Plan, it states that “Offeror shall provide the proposed implementation schedule with its Proposal.” Could you please clarify what is included in the definition of an implementation schedule for this project?

Answer: The proposed implementation schedule should be a detailed, time-bound roadmap outlining how this project will move from plan to action. It must include clearly defined project phases, specific tasks and subtasks, assigned roles and responsibilities, resource allocation, and a timeline for completion.