ODMR 2425-0006 EQRO Attachment C - Cost Proposal Form.pdf
PDF 71 KB Posted
- Attached to
- External Quality Review Organization State and local contract opportunity
- Solicitation number
- SRC0000026668
- Issued by
- Ohio
About this file
This is a Cost Proposal Form (Attachment C) for the Ohio Department of Medicaid's External Quality Review Organization (EQRO) contract spanning State Fiscal Years 2025-2031. The form requires bidders to provide cost proposals for transition activities in SFY 2025 and detailed annual costs for multiple Scopes of Work (SOWs) from SFY 2026-2031. The SOWs cover extensive healthcare quality review activities including HEDIS measure validation, performance measure reporting, administrative reviews, network adequacy assessments, consumer satisfaction surveys, encounter data validation, and numerous program evaluations for Ohio's Medicaid Managed Care Organizations (MCOs), MyCare Ohio Plans (MCOPs), OhioRISE program, and Single Pharmacy Benefit Manager (SPBM).
The pricing structure requires bidders to break down costs for each SOW activity between MCO/MCOP services and OhioRISE/SPBM services where applicable. The form includes over 35 distinct SOW activities ranging from technical assistance and data validation to program evaluations and monitoring. Bidders must provide annual costs for each activity across six fiscal years (2026-2031) and calculate both annual totals and a comprehensive six-year total. The form uses a standardized format with grey-shaded cells indicating where costs should not be entered.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| ODMR 2425-0006 EQRO Attachment A - Required Offeror Information.pdf | ||
| ODMR 2425-0006 EQRO Attachment B - Tech. Prop. Form.pdf | ||
| ODMR 2425-0006 EQRO Attachment E - Supp. A - State IT Policy S&S Reqs.pdf | ||
| ODMR 2425-0006 EQRO Attachment F - Data Security and Privacy Terms.pdf | ||
| ODMR 2425-0006 EQRO Attachment G - Acknow., Exceptions, and Assumptions.pdf | ||
| 12.10.24 ODMR 2425-0006 EQRO Base.pdf | ||
| ODMR 2425-0006 EQRO Attachment D - Contract Model.pdf | ||
| ODMR 2425-0006 EQRO Attachment H - Cost Point Calculation.pdf |
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Text version
Contract Reference Activity Name SFY 2025
4.3 Transition Activity
Contract Reference Section 4.1 Activity Name SFY 2026 SFY 2027 SFY 2028 SFY 2029 SFY 2030 SFY 2031
SOW A1A HEDIS Performance Measure Validation (Total)
MCO/MCOP
OhioRISE/SBPM
SOW A1B
HEDIS Performance Measure Calculation and Reporting (Total)
MCO/MCOP
OhioRISE/SBPM
SOW A2
Non-HEDIS and Ohio-specific Performance Measures Development, Calculation, and Reporting (Total)
MCO/MCOP
OhioRISE/SBPM
SOW A3
Electronic Health Record (EHR) and Electronic Clinical Data Base Measures (Total)
MCO/MCOP
OhioRISE/SBPM
SOW A4
Technical Assistance for Health Plan Performance Measures - HEDIS, CAHPS, non-HEDIS, and Ohio-specific Measures (Total)
MCO/MCOP
OhioRISE/SBPM
SOW B1 Comprehensive Administrative Reviews (Total)
MCO/MCOP
OhioRISE/SBPM
SOW B2 Targeted Reviews for MyCare
SOW B3
Targeted Reviews for MCOs, OhioRISE, or SPBM (Total)
MCO
OhioRISE/SBPM
SOW B4 Deeming Crosswalk
SOW C1 Medicaid Addenda Audits (Total)
MCO/MCOP
OhioRISE/SBPM
SOW C1B Medicaid Provider Directory Audits (Total)
MCO/MCOP
OhioRISE/SBPM
SOW C2 Appointment Availability and Access Surveys (Total)
MCO/MCOP
OhioRISE
SOW C3 Validation of Network Adequacy Standards (Total)
MCO/MCOP
OhioRISE/SBPM
SOW D
Validation of Performance Improvement Projects (Total)
MCO/MCOP
OhioRISE/SBPM
SOW E1A
Consumer Satisfaction Survey for Ohio Medicaid Managed Care Program
SOW E1B
Consumer Satisfaction Survey for MyCare Ohio Program
SOW E1C Consumer Satisfaction Survey for OhioRISE Program
SOW E2 Care Management Surveys (Total)
MCO/MCOP
OhioRISE
SOW E3
MCO, MyCare, and OhioRISE Provider Satisfaction Surveys (Total)
MCO/MCOP
OhioRISE
SOW F1 Encounter Data Collection and Validation (Total)
MCO/MCOP
OhioRISE/SBPM
SOW F2
Encounter Data Validation Technical Assistance (Total)
MCO/MCOP
OhioRISE/SBPM
SOW F3 Encounter Data Volume Assessments (Total)
MCO/MCOP
OhioRISE
SOW F4
Encounter Data Submission Completeness Assessments (Total)
MCO/MCOP
OhioRISE
SOW G Rating of Managed Care Entities
SOW H Information System Review (Total)
Attachment C: Cost Proposal Form
There are two (2) parts to this Cost Proposal Form that the Offeror must complete: Part 1 for State Fiscal Year (SFY) 2025 costs; and Part 2 for SFYs 2026-2031 costs.
Part 1: The Offeror must provide a total cost for SFY 2025 for performing transition activities as described in Section 4.3.
Part 2: The Offeror must submit a total annual cost for each contract Scope of Work (SOW) described in RFP Section
4.1. When indicated, the Offeror must provide a total cost for each Contract SOW in the first row (labeled "Total") and then delineate the cost for Managed Care Organization (MCO) and MyCare Ohio Plan (MCOP) lines of busines separate from OhioRISE and the Single Pharmacy Benefit Manager (SPBM). Cells with grey shading should have no cost entered.
The Offeror must calculate a grand total for each State Fiscal Year (2026 through 2031) and a grand total for all State Fiscal Years.
MCO/MCOP
OhioRISE/SBPM
SOW I External Quality Review Technical Report (Total)
MCO/MCOP
OhioRISE/SBPM
SOW J Medicaid Managed Care Quality Strategy Evaluation
SOW K
Care Innovation and Community Improvement Program (CICIP) Evaluation
SOW L State Directed Payment Evaluations
SOW M Independent Assessment Report of 1915(b) Waiver
SOW N1 Health Risk Assessment Data
SOW N2 Population Health Management Data Project
SOW N3 OhioRISE Enrollment Data Transmission
SOW O Care Coordination Program Evaluation
SOW P1 Ohio Comprehensive Primary Care (CPC) Evaluation
SOW P2 Ohio Comprehensive Maternal Care (CMC) Evaluation
SOW Q
Comprehensive Primary Care (CPC) and CPC for Kids Activity Monitoring
SOW R CMC Activity Monitoring
General Technical Assistance (Total)
MCO/MCOP
OhioRISE/SBPM
Total Per SFY
Total for SFYs 2026 - 2031
SOW S
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