QIO Cost Proposal Template toDHHS.xlsx
XLSX spreadsheet 37 KB Posted
- Solicitation number
- RFP - 10A - 202605096
- Issued by
- Maine
About this file
QIO Cost Proposal Summary
This is a cost proposal template issued by the State of Maine Department of Health and Human Services for RFP #202605096, which seeks to procure Quality Improvement Organization (QIO) Quality Management and Support services. The proposal template is designed for bidders to submit comprehensive pricing for services spanning an eight-year period divided into an initial performance period with startup (months 1-6) and initial operations (months 6-12) phases, followed by three renewal periods. The core service areas include reportable event management, grievance and consumer complaint management, general reporting, and optional activities such as provider technical assistance, data management, surge reviews, and clinical review team staff augmentation.
The cost proposal template requires bidders to populate pricing across multiple service categories with escalating volume thresholds. Reportable event management is structured across three volume ranges: 0-30,000 reports annually, 30,001-40,000 reports annually, and 40,001-50,000 reports annually, each with distinct service line items including event triage, desk-level reviews, routing, trend analysis, and resolution tracking. Grievance and consumer complaint management is similarly tiered across three ranges: 0-1,000, 1,001-2,000, and 2,001-3,000 complaints annually. General reporting requirements include project plans, monthly status reports, performance measures reports, annual reports, and ad hoc reporting. Optional activities allow bidders to propose costs for provider training and technical assistance, data entry services, surge reviews with specified cost-per-review metrics, special projects, and clinical review team augmentation. The template does not specify contract award dates, set-asides, or specific funding amounts but requires detailed cost projections for each service category across the full eight-year contract period to enable the state to evaluate total cost of ownership.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP 202605096 Q | — | |
| RFP 202606104 Public School Electronic Health Record_FINAL.docx | DOCX document | |
| RFP 202605096 QIO Quality Mngmt and Support-FINAL.docx | DOCX document | |
| OADS - LTSS Event Form.pdf | ||
| OADS - Evergreen Reportable Event Form.pdf | ||
| QIO Proposed Services Response Form.docx | DOCX document |
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Text version
BUDGET SUMMARY
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| The information on this tab will auto populate based on information entered into the supporting tabs. |
Total Core Costs for Initial Period of Performance: $ - 0
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | |||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | ||
| Start Up Period | |||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Start Up Costs | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| 2 | Reportable Event Management | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| 3 | Grievance/ Consumer Concern Management | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| 4 | General Reporting | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| 5 | Total Core Costs / Year | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Start Up Costs
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| Bidders are to fill in the orange cells with total projected costs. |
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | |||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | ||
| Start Up Period | |||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Reportable Event Category Rationalization | |||||||||
| 2 | Reportable Event Review Forms | |||||||||
| 3 | Reportable Event Workflows | |||||||||
| 4 | Grievances and Complaint Workflow | |||||||||
| 5 | Routing Business Rules | |||||||||
| 6 | Fixed Operating Costs (Lease, etc.) | |||||||||
| 7 | Capital Costs | |||||||||
| 8 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Reportable Events
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| Bidders are to fill in the orange cells with total projected costs. |
| A | Reportable Event Range 1: 0-30,000 reports per year | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Event Triage (Including Daily Report) | |||||||||
| 2 | Event Desk Level Reviews | |||||||||
| 3 | Event Routing | |||||||||
| 4 | Event Trend Analysis | |||||||||
| 5 | Monthly Event Reporting Trends | |||||||||
| 6 | Quarterly Reportable Event Management | |||||||||
| 7 | Ad Hoc Reporting | |||||||||
| 8 | Event Resolution Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| B | Reportable Event Range 2: 30,001 to 40,000 reports per year | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Event Triage (Including Daily Report) | |||||||||
| 2 | Event Desk Level Reviews | |||||||||
| 3 | Event Routing | |||||||||
| 4 | Event Trend Analysis | |||||||||
| 5 | Monthly Event Reporting Trends | |||||||||
| 6 | Quarterly Reportable Event Management | |||||||||
| 7 | Ad Hoc Reporting | |||||||||
| 8 | Event Resolution Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| C | Reportable Event Range 3: 40,001 to 50,000 reports per year | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Event Triage (Including Daily Report) | |||||||||
| 2 | Event Desk Level Reviews | |||||||||
| 3 | Event Routing | |||||||||
| 4 | Event Trend Analysis | |||||||||
| 5 | Monthly Event Reporting Trends | |||||||||
| 6 | Quarterly Reportable Event Management | |||||||||
| 7 | Ad Hoc Reporting | |||||||||
| 8 | Event Resolution Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Griev & Con. Complaint Mngmt
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| Bidders are to fill in the orange cells with total projected costs. |
| A | Grievance/ Consumer Complaint Range 1: 0-1,000 | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Grievance Intake | |||||||||
| 2 | Grievance Resolution | |||||||||
| 3 | Grievance Routing | |||||||||
| 4 | Complaint Intake | |||||||||
| 5 | Complaint Routing | |||||||||
| 6 | Monthly Grievance/ Complaint Reports | |||||||||
| 7 | Quarterly Grievance/ Complaint Reports | |||||||||
| 8 | Grievance/ Complaint Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| B | Grievance/ Consumer Complaint Range 2: 1,001-2,000 | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Grievance Intake | |||||||||
| 2 | Grievance Resolution | |||||||||
| 3 | Grievance Routing | |||||||||
| 4 | Complaint Intake | |||||||||
| 5 | Complaint Routing | |||||||||
| 6 | Monthly Grievance/ Complaint Reports | |||||||||
| 7 | Quarterly Grievance/ Complaint Reports | |||||||||
| 8 | Grievance/ Complaint Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| C | Grievance/ Consumer Complaint Range 3: 2,001-3,000 | |||||||||
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | ||||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | |||
| Start Up Period | ||||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Grievance Intake | |||||||||
| 2 | Grievance Resolution | |||||||||
| 3 | Grievance Routing | |||||||||
| 4 | Complaint Intake | |||||||||
| 5 | Complaint Routing | |||||||||
| 6 | Monthly Grievance/ Complaint Reports | |||||||||
| 7 | Quarterly Grievance/ Complaint Reports | |||||||||
| 8 | Grievance/ Complaint Tracking | |||||||||
| 9 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
General Reporting
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| Bidders are to fill in the orange cells with total projected costs. |
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | |||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | ||
| Start Up Period | |||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Project Plan | |||||||||
| 2 | Monthly Status Reports | |||||||||
| 3 | Performance Measures Report | |||||||||
| 4 | Annual Report | |||||||||
| 5 | Ad Hoc Reporting | |||||||||
| 6 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Optional Activites
| State of Maine |
| Department of Health and Human Services |
| COST PROPOSAL FORM |
| RFP# 202605096 |
| Quality Improvement Organization (QIO) |
| Quality Management and Support |
| Bidder Name: |
| Bidders are to fill in the orange cells with total projected costs. |
| Total Cost Summary | Initial Period of Performance | Renewal Period 1 | Renewal Period 2 | Renewal Period 3 | |||||
| Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | ||
| Start Up Period | |||||||||
| (M1-M6) | Initial Operations |
(M6-M12)
| 1 | Provider Technical Assisatance (TA and Training) | |||||||||
| 2 | Provider Data Management | |||||||||
| 3 | Surge Reviews - Expected Number of Reviews | |||||||||
| 4 | Surge Reviews - Total Cost | |||||||||
| 5 | Special Projects | |||||||||
| 6 | Data Entry - Expected Number of Hours | |||||||||
| 7 | Data Entry - Total Cost | |||||||||
| 8 | Other Costs Related to Optional Activities | |||||||||
| 9 | Clinical Review Team Staff Augmentation | |||||||||
| 10 | Total Cost Summary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| 11 | Cost per Surge Review |
| 12 | Cost per Hour of Data Entry |
File details come from the government source that posted it. Updated .