RFP 2022-27 Response to Clarifying Questions - Publish Version.pdf

REQUEST FOR PROPOSALS #2022-27 SOFTWARE PLATFORM FOR CARE COORDINATION

RESPONSE TO CLARIFYING QUESTIONS

December 22, 2022

Note that these are questions submitted by interested firms to the above referenced solicitation. The below answers are for clarification purposes only and in no way alter or amend the RFP as published.

# Document/Template RFP Reference Specific RFP Language Question Answer

1 CareOregon RFP 2022-27 Care Coordination Software Platform

3.3 SCOPE OF WORK Hosting

We understand you already have QNXT in On Prim, please confirm where do you want to host the care coordination (On prim or vendor hosting) Could you please confirm if you are looking for SaaS or hosting solution. If you are open with hosting , please suggest a preferred cloud platform?

CareOregon is seeking the best solution that supports integration with our on prem and hosted solutions but has a preference for a SaaS-based solution. If you are offering a proposal for on prem, we would request clarity on the benefits and/or disadvantages of an on prem solution versus SaaS.

2 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 Membership Could you please provide total membership and breakdown of your membership by LOBs?

3 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 n/a Please confirm the number of covered lives.

4 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 n/a How many active patients are in care coordination?

5 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 1.What is the total CareOregon membership to be covered by the solution?

2. What is your expected membership growth over the next year, 3 years, 5 years?

3. How many years of historical data do you wish to be migrated to the new system?

6 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 Please confirm current membership by line of business. AIS last shared that you have 476,085 Medicaid and 13,716 Oregonians as customers.

7 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, page 5, Section 3.2 Our fee will be based on membership. Can you provide the total membership that CareOregon intends to manage with the system selected in this procurement?

8 CareOregon RFP 2022-27 Care Coordination Software Platform

Background, SubsectionB, C In the “B.Key data sets in EDW for possible integration’ and “C. Business Context Diagram for EDW”

We understood EDW is Enterprise Data Warehouse. Please confirm it. Does this EDW already exist or does the vendor need to do the design & develop it?

CareOregon has developed and implemented a robust Enterprise Data Warehouse (EDW) and is not seeking a replacement.

9 CareOregon RFP 2022-27 Care Coordination Software Platform Page: 1, Section: Schedule Deadline to Submit Clarifying Questions - December 19, 2022, 5:00 PM, Pacific Time

Is it fair to assume that responses to questions from all proposers will be shared back with all of them?

All questions and answers are being shared with all vendors.

10 CareOregon RFP 2022-27 Care Coordination Software Platform Page: 1, Section: Schedule

The full team identified to support CareOregon should participate in the demonstration and in subsequent executive and functional interviews, to be scheduled after the demonstrations. Demonstrations will be recorded.

Will virtual meeting access be provided?

Meeting logistics and links will be shared with vendors as part of the invitation to demonstrate.

11 CareOregon RFP 2022-27 Care Coordination Software Platform

Page: 5, Section: Background

“The current number of critical or “super users” of the system is approximately ~150 meanwhile users total of the current system is around 440.”

What exactly is the super user role and what privileges will it require? Are they equivalent to an admin role?

Super Users use the full range of the care management and care coordination functionality and are badged CareOregon staff. They should have some admin privileges and more broad access of the system to support the other end users as needed.

12 CareOregon RFP 2022-27 Care Coordination Software Platform Page: 5, Section: Background

“The ideal vendor will provide a solution that eliminates current process duplication, staff inefficiencies, integration challenges, and lack of data transparency and alignment.”

What is the current IT Landscape? Can you please provide us with IT architecture diagram and process flow diagram?

CareOregon will provide any additional, required information to the successful vendor. A high-level environment diagram has been provided in the RFP.

13 CareOregon RFP 2022-27 Care Coordination Software Platform

Page: 7, Section: 3.2.1 -Term of Contract

The initial term of the contract shall be for five (5) years, with the option of annual or multi-year renewals thereafter subject to the mutual agreement of the parties.

Please let us know your overall budget or a ballpark figure for the implementation and support for 4 years.

CareOregon requires vendors to complete Exhibit B - Pricing Workbook with all costs associated with meeting the requirements outlined in this RFP.

14 Exhibit A - Question Template Vendor demo date preference Are these dates staying intact or moving out in conjunction with due date extension to January 12th, 2023

Addendum #1 provides the adjusted demonstration dates.

15 Exhibit B – Pricing Workbook Cost Assumptions Is data migration part of the scope? Can you indicate approximate volume of records?

In Exhibit D - Technical - NonFunctional Response Workbook, vendors are asked to describe their data migration process as well as the approach and any recommended phasing. In Exhibit B - Pricing Workbook, vendors are asked to provide the cost for the data migration proposed to be performed by the vendor as well as any assumptions made in the pricing.

16 Exhibit B – Pricing Workbook Cost Assumptions

We understand that there are a significant set of requirements, spanned across 4 different areas as mentioned in the RFP - 1. Care Management 2.

Analytics,Insights,Reporting 3. Consumer Engagement 4. Pharmacy & Transportation Will you accept partial bids only for the 'Care Management' requirements if integration to the other sections are provided as needed? Will you be supporting best of breed vendors in this RFP ie) you will support multiple vendors to deliver the complete solution?

CareOregon is seeking a full solution to meet all of the requirements outlined in this RFP. Vendors are encouraged to partner, if necessary. However, CareOregon expects a single prime vendor to submit the proposal on behalf of the partnership.

17 Exhibit C- Business Requirements Response Workbook

Analytics, Insights & Reporting, Subcategory: General

A Deploy machine learning techniques on outcomes and attribution data to automate optimization of a small number of operational variables (like channel optimization)

Do you mean in this context that attribution is related to the payment method for healthcare services?

Yes within this context it means that attribution is related to the payment method for health services among other things.

18 Exhibit C- Business Requirements Response Workbook

Analytics, Insights, Reporting Care Gap Analysis Do you currently have a HEDIS, STARS, ACO reporting application? If yes, are you looking to replace this application? If no, is implementing a Quality Reporting application part of the scope of this project?

We use Cotiviti and Tableau Desktop connected to our Enterprise Data Warehouse and CareOregon is not looking to replace the current application and use of the EDW.

19 Exhibit C- Business Requirements Response Workbook

Analytics, Insights, Reporting, Care Gap Analysis

Ability to support Integrated Health Economic Model that puts a dollar amount to gaps in care (and value to closing them)

Please define Integrated Health Economic Model. Is the workflow in reporting or front end user?

20 Exhibit C- Business Requirements Response Workbook

Analytics, Insights, Reporting, Care Gap Analysis

Ability to support Integrated Health Economic Model that puts a dollar amount to gaps in care (and value to closing them)

What is the Integrated Economic Model?

21 Exhibit C- Business Requirements Response Workbook

Analytics, Insights, Reporting, General

Ability to integrate PHM operational data, cost and health outcomes (including patient-reported) data to view PHM activities against KPIs

Please clarify if you are looking to integrate this data into our system or import our systems data out to another system.

CareOregon's intention to import a vendor's system data into their system with near real time flow.

As of 12-20-2022

An Integrated Economic Model provides insight into the potential cost savings of providing a service. In this example, what is the potential cost to closing a gap in care in comparison to what is gained by closing them?

December 22, 2022

# Document/Template RFP Reference Specific RFP Language Question Answer

22 Exhibit C- Business Requirements Response Workbook

Analytics, Insights, Reporting, Subcategory: Dashboards and Visualization Tools

Ability to support dashboard widgets to pinpoint visualization for data to determine trends

Are you using any Data Visualization tool to determine the trends? If yes, please specify?

CareOregon currently uses Tableau dashboards.

23 Exhibit C- Business Requirements Response Workbook

Analytics,Insights,Reporting Line 54

Ability to support a risk model that includes the following data sources:

Demographics data, claims data, Prescription drug information, self-reported health status, lab and other clinical data, prior year expenditures: Are you looking for one overall risk score? Please provide an example.

CareOregon is looking for the vendor's ability to utilize multiple data sources in determination of a member's risk score.

24 Exhibit C- Business Requirements Response Workbook

Analytics,Insights,Reporting Line 6 Are you using AI today, if so, which vendor is providing this solution? CareOregon does not currently use AI.

25 Exhibit C- Business Requirements Response Workbook

Analytics,Insights,Reporting, Data & Infrastructure

Ability to have self-service capabilities to pull population health level data Please provide additional detail on desired self-service capabilities to pull population health level data for which personnas (e.g. Primary Care Provider, Specialist, Member, Caregiver?)

Vendors are asked to detail which personas their application allows CareOregon to extract data and the scope of the data available for extraction.

26 Exhibit C- Business Requirements Response Workbook

Analytics,Insights,Reporting, General n/a Please provide define existing & desired Analytical/Insights/Reporting KPIs, metrics, index, and comparative analyses

This information will be shared, if required, with the successful vendor. CareOregon is asking vendors to describe the range of analytics and reporting in their solution.

27 Exhibit C- Business Requirements Response Workbook

Care Management Home Health monitoring Is there a vendor/Vendors in place and integrations established for home monitoring?

There is no vendor for home monitoring.

28 Exhibit C- Business Requirements Response Workbook

Care Management Line 105 Are there incentive management systems currently in use? CareOregon does not have any member incentive systems.

29 Exhibit C- Business Requirements Response Workbook

Care Management Line 149 Can you name the Medical Record Systems used by your providers in your network when you are discussing integration of medical records?

CareOregon is seeking information from the vendors about which medical records systems your solution can integrate. The network has a wide variety in place today.

30 Exhibit C- Business Requirements Response Workbook

Care Management Line 29 What is your prevelance of use of OCR for assessment questions? Example settings CareOregon receives a large volume of Assessments via mail. We utilize OCR software to create data files to import into platform. Ideal would be if solution had built in OCR software or capability to read scanned assessments and populate the UI

31 Exhibit C- Business Requirements Response Workbook

Care Management Line 62

Ability to support multi-language capabilities for assessments. Do you have a list of common languages required? Are you looking for bilingual assessment capabilities, i.e., user would engage a member in another language or delivering alternative languages to the member?

UI only need to be in English. Ability to ingest scanned documents in other languages (answers correspond to the english versions)

32 Exhibit C- Business Requirements Response Workbook

Care Management Line151 Which systems are involved when you are discussing "Integrated Order Entry"?

Incoming Data from our Enterprise Data Warehouse, Assessment driven care plan, Care Gaps and HEDIS Measures, Vendor to Vendor Integration (Point Click Care for ADT (Admit Discharge Transfer) data feeds, etc.

33 Exhibit C- Business Requirements Response Workbook

Care Management Telehealth Are there telehealth systems currently in use?

34 Exhibit C- Business Requirements Response Workbook

Care Management 169- Telehealth Is there a telehealth vendor in place? Is the expectation to integrate into a vendor or supply telehealth?

35 Exhibit C- Business Requirements Response Workbook

Care Management-Behavioral Health

Ability to use tools to support behavioral health including emotions, behaviors and biology relating to a person’s mental well-being, their ability to function in every day life and their concept of self.

Please provide additional detail on desired tools CareOregon desires to leverage tools to improve the behavioral health outcomes of its members. Including reporting on various populations, the ability to drill down into that data, and leverage outreach capabilities for those members

36 Exhibit C- Business Requirements Response Workbook

Care Management-Behavioral Health, 100

Ability to easily view recent clinical notes or visits of clients. What is the source of the clinical notes?

Clinical notes may be received through integration or captured in the vendor's solution.

37 Exhibit C- Business Requirements Response Workbook

Care Management-Behavioral Health, 91

Ability to support Behavioral Health Utilization Management Capability Is the expectation to do UM in the new system? Where is the UM activity being done today Do you plan on continuing UM in the current system?

Utilization Management functions and features are not in scope for this procurement.

38 Exhibit C- Business Requirements Response Workbook

Care Management-Care path enablement, care coordination and documentation

Ability for medical management staff to access outcome measures of cost, health and experience (individually and blended in indexes)

Please provide details on the type of information that is required for outcome measures of cost, health and experience (individually and blended in indexes).

Vendors are asked to provide information about outcome measures supported by their solution.

39 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

“Ability to initiate cases based on broad segmentation by authorization requests, retrospective cost analysis, claims-based condition validation, and utilization (Admit, Discharge, Transfer) data”

Will the care management application need to directly connect to these datasets (authorization, claims, etc), or do we need to bring these datasets into the datastore (like Data Lake & EDW) and on top of the care management application will connect to this datastore?

In order to successfully perform risk segmentation and case creation, the vendor's solution will need to utilize the data sources mentioned. Vendors are asked to describe how their solution will accomplish this.

40 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability for Evidence Based Medicine (EBM) information and other notes to display in assessment with applicable question, messages could be client specific

Please provide an example of a client specific message that would display in assessments with applicable questions.

41 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability for the system to queue users to go deeper on specific questions and not skip questions

Please provide a use case scenario for this requirement

42 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to build interactive care plans with Providers What is meant by “interactive”?

This describes the ability to provide real time "interactive" sessions with doctors so that care plans can be customized with providers if necessary.

43 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to distinguish between "Screening" and "Assessment" tools” By this do you mean you are using any Screening and Assessment Tools in the current System? If yes, please specify the tools name?

No. CareOregon is seeking information about how the vendor differentiates between assessments and screenings in the vendor solution.

44 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to integrate with pharmacy authorization platform What are the different pharmacy authorization platforms being used currently?

What are the services being used to integrate with Pharmacy authorization platform (API,Webservices etc. ). Please provide use case for the same.

CareOregon currently uses Agadia and their PAHub platform for pharmacy authorizations. Future integration questions can be discussed during contracting phase.

There is no telehealth vendor in place at CareOregon and there is no integration expectation for the vendor solution

CareOregon is seeking functionality to support answer-driven assessments that sequence the required questions based on a specific member's answers or data. This may include generating alerts and messages based on the answers to assessment questions.

December 22, 2022

# Document/Template RFP Reference Specific RFP Language Question Answer

45 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to load clinical guidelines into the tool What clinical guidelines are currently used?

The vendor should describe any limitations that their solution may have and any specific guidelines that are supported.

46 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to support Assessments that can be updated manually or via data feed. Data feed should be able to update existing assessment with new information, store and display answer history

What are the different data sources that need to be integrated to update the assessment?

Data sources/sets are outlined in the written RFP

47 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to support assessments to be updated manually or via data feed, data feed should be able to update existing assessment with new information, store and display answer history

Do we need to load the incremental /real-time data through the data pipeline /ETL etc?

Vendors are asked to describe if their solution supports incremental updates and how this would be accomplished using their solution.

48 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM)

Ability to support multi-language capabilities for assessments Other than English, which other set of languages do you require the front UI of the solution to be in? Please let us know a use case for the same.

UI only need to be in English. Ability to ingest scanned documents in other languages (answers correspond to the english versions)

49 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM) #23

Ability to load clinical guidelines into the tool What guidelines do you leverage?

The vendor should describe any limitations that their solution may have and any specific guidelines that are supported.

50 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM) #29

Ability to support assessments to be updated manually or via data feed, data feed should be able to update existing assessment with new information, store, and display answer history

What data feed (s)? the data feed(s) would need to be declared as an integration point and included in the Implementation costs

Data sources/sets are outlined in the written RFP

51 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM) 33

Ability to generate alerts from emergency department and A/D/T data feeds What is the source of Emergency Department alert "feed"? Is/are the incoming feed(s) standardized?

CareOregon is seeking a solution that can integrate with Collective. (Current solution for real-time event notification)

52 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM), 72

Ability to integrate with Oregon's POLST registry What is the integration expectation, what is the data, data flow predicted?

Information about the Oregon POLST program can be found here:

https://orpolstregistry.wordpress.com/

53 Exhibit C- Business Requirements Response Workbook

Care Management-Case Management (CM) & Disease Management (DM), 74

Ability to integrate with pharmacy authorization platform What system is leveraged for pharma AUTH’s? We could offer a click "to" the platform, question rationale for "integration"

CareOregon uses Agadia and their PAHub platform for our pharmacy authorizations.

54 Exhibit C- Business Requirements Response Workbook

Care Management-Gaps-in-care prevention

“Ability to use analytics to look for and close missed care protocols” & “Ability to use predictive analytics for proactive intervention and to identify things like patients at risk of missing a clinical protocol or an appointment, or needing special services.”

Is there any AI Analytics implementation required based on DW/Data Mart data? There are no AI Analytics implementation required.

55 Exhibit C- Business Requirements Response Workbook

Care Management-Gaps-in-care prevention

Ability to use analytics to look for and close missed care protocols Please define missed care protocols? A missed care protocol is a previously identified gap-in-care.

56 Exhibit C- Business Requirements Response Workbook

Care Management-Gaps-in-care prevention, 128 &129

Ability to use analytics to look for and close missed care protocols & Ability to use predictive analytics for proactive intervention and to identify things like patients at risk of missing a clinical protocol or an appointment or needing special services.

What analytics and or predictive tools are in place? Do you plan to continue using? A list of current tools was provided in the RFP

57 Exhibit C- Business Requirements Response Workbook

Care Management-General Ability for a talk to text feature Please provide a use case of how this will be used with in the care management platform

CareOregon is seeking information about how clinicians/staff might use talk-to-text within the vendor's solution.

58 Exhibit C- Business Requirements Response Workbook

Care Management-General Ability to have call tracking capabilities within the platform and other platforms like

QNXT

Please clarify requirements for call tracking relative to other platforms such as QNXT CareOregon is seeking visibility to all call tracked within QNXT as well as the vendor solution in order to have a full view of member contacts.

59 Exhibit C- Business Requirements Response Workbook

Care Management-general #15 Ability to fax from the platform Who is the fax vendor? CareOregon uses an email to fax system

60 Exhibit C- Business Requirements Response Workbook

Care Management-Home Health Monitoring

Ability to identify and deploy home health monitoring to patients with high-cost conditions such as chronic heart failure, chronic obstructive pulmonary disease (COPD), diabetes, depression and post-traumatic stress disorder

Please provide the projected number of patients that will require these devices and supply the expected acquisition cost for each condition / category of device and requested deployment & support services to be rendered

CareOregon has requested this capability but is not required for immediate needs

61 Exhibit C- Business Requirements Response Workbook

Care Management-Medication adherence

Ability to deliver targeted messaging every time member picks up a prescription at a pharmacy, including medication adherence, cash monitoring, and immunization messaging. Messaging can be delivered through Pharmacist or direct patient messaging channels

What is the data load like with your PBM?? What type of messaging triggers and can you provide details on where the messages would source to?

CareOregon exchanges eligibility/enrollment with our PBM via SFTP file transfer. PBM sends claims and other data back for eligible members.

CareOregon is looking into triggers around gaps in vaccinations, recent pharmacy activity, etc and source to the Pharmacy team

62 Exhibit C- Business Requirements Response Workbook

Care Management-Medication Adherence

Do you plan on continuing the use of Optum and you would like integration to the new system with Optum?

CareOregon will continue to use Optum

63 Exhibit C- Business Requirements Response Workbook

Care Management-Medication Adherence

Does your RX team currently work in another CM system? The current CareOregon RX team does not work in another CM system

64 Exhibit C- Business Requirements Response Workbook

Care Management-Member Incentives

“Ability to pull in information from employers on a daily basis, that includes wellness and incentive programs”

Please provide some use case/examples. What are you trying to achieve? What type of information are you pulling from employers on a daily basis? How the information relates to an employee’s wellness and incentive programs?

Vendors are asked to describe their capabilities to use data from employer wellness programs, if available.

65 Exhibit C- Business Requirements Response Workbook

Care Management-Member Incentives

Ability to analyze incentives, establish best practices, identify both successes and failures, and present findings

Do you have an incentives vendor that you have or are currently working with? CareOregon does not have any member incentive systems.

66 Exhibit C- Business Requirements Response Workbook

Care Management-Pharmacy & Transportation, Integration Process

Ability to capture written notes and identify specific words to pull reports Can the "specific words" be in a pull-down menu/limited data set choice, or are reports required to track free-text/Natural Language Processing?

Vendors are asked to describe how their solution supports reporting from notes fields.

67 Exhibit C- Business Requirements Response Workbook

Care Management-Pharmacy & Transportation, Integration Process

Ability to provide reporting for proactive monitoring and disease management Please clarify what type of data is required.

CareOregon is looking to analyze trends in its data to confirm medication adherence gaps, etc. The data required for this typically by member

December 22, 2022

# Document/Template RFP Reference Specific RFP Language Question Answer

68 Exhibit C- Business Requirements Response Workbook

Care Management-Pharmacy & Transportation, Integration Process

Ability to support integration with MTM vendor data (eligibility, patient takeaway) Please define patient takeaway?

69 Exhibit C- Business Requirements Response Workbook

Care Management-Pharmacy & Transportation, Integration Process

Ability to support integration with VBID vendor data (eligibility, patient takeaway) Please define patient takeaway?

70 Exhibit C- Business Requirements Response Workbook

Care Management-Readmission Monitoring

Ability to process re-admission information through BI rules to identify prospective patterns, causes, addressable issues

Is BI report creation included in the scope? Could you please provide the details around the expected number of reports and Dashboards and what is the source for reports and for Dashboard data ie) existing DW/Data marts, or from new DW/Data Marts?

Please replace the requirement with: Ability to process re-admission information to identify prospective patterns, causes, addressable issues

71 Exhibit C- Business Requirements Response Workbook

Consumer Engagement Line 68 What IVR system are you using? CareOregon uses NICE

72 Exhibit C- Business Requirements Response Workbook

Consumer Engagement line 74 Please expand on your interpretation/meaning of .... communications expands to include the platform of "things"

Please replace the requirement with: Ability to support communications to include information from the "Internet of Things"

73 Exhibit C- Business Requirements Response Workbook

Consumer Engagement- Member/Patient Portal

Ability for members to check on the status of their care through the Population Health program through the member portal.

Please provide two examples of a care status for a PH program and what determines this

Vendors are asked to describe what types of information and statuses would be available to members.

74 Exhibit C- Business Requirements Response Workbook

Consumer Engagement- Member/Patient Portal

Ability to allow members to obtain cost estimates of healthcare services through the member portal.

CareOregon needing a TiC and No Surprises Act Solution? Or are you looking for integration to an existing solution? If yes, what existing solution vendor is in place?

Or homegrown?

CareOregon currently does not have a solution in place for this functionality

75 Exhibit C- Business Requirements Response Workbook

Consumer Engagement- Member/Patient Portal

Ability to integrate with Health Trio.

What is the use case that is being requested? What HealthTrio functionality will be retained for Member?

76 Exhibit C- Business Requirements Response Workbook

Consumer Engagement- Member/Patient Portal and Provider Portal

Ability to integrate with Health Trio

Please clarify integration with Health Trio and other portal requirements. Will the selected vendor be required to provide a portal in addition to Health Trio portals to meet requirements in these sections? If so, what requirements will be met by Health Trio vs the vendor supplied portals?

77 Exhibit C- Business Requirements Response Workbook

Consumer Engagement- Member/Patient Portal and Provider Portal

What is the use case that is being requested? What HealthTrio functionality will be retained for Provider?

What is the use case that is being requested? What HealthTrio functionality will be retained for Provider?

78 Exhibit C- Business Requirements Response Workbook

Consumer Engagement-Provider Portal

Ability for the portal to send communications via secure email, fax, and generate letters please share more details; a use case would be helpful Vendors are asked to describe how the listed communication channels would be trigged by a member using the portal.

79 Exhibit C- Business Requirements Response Workbook

Consumer Engagement-Provider Portal

Ability to interface with an automated rule driven system-based review process through which providers have 24x7x365 access to submit both initial and concurrent requests and clinical information and obtain real-time approvals.

Is this in relation to the Authorization / Referral submission process: Please clarify the use case.

Vendors are asked to provide information about the integration supported with CareOregon's Authorization solution

80 Exhibit C- Business Requirements Response Workbook

Consumer Engagement-Provider Portal

Ability to take a direct message in a standard format from Provider Portal (To support future integration with EHRs) please share more detail on this Vendors are asked to provide information about messaging supported within their portal solution.

81 Exhibit C- Business Requirements Response Workbook

Pharmacy & Transportation Ability to provide support in self service capabilities for members Please provide additional detail on desired self-service capabilities for members The desired abilities are for self service capabilities include but are not limited to requests for RX refills, transportation request for specific services for members, etc.

82 Exhibit D - Technical - NonFunctional Response Workbook

Implementation Risk Will the Vendor offer any contractual or other cost protections? Please clarify request and/or provide specific examples. Is this SLAs or warranty?

Vendors are asked to identify those vehicles (bonds, SLAs, and warranties are examples) which could be incorporated into the contract to protect CareOregon against non-performance.

83 Exhibit D - Technical - NonFunctional Response Workbook

Page: 2, Section: Database, Files and import/export

“What limitations exist around uploading data into development, test, and training environments?”

What are the Various Environments (Testing, Prod...) required for the application support?

Vendors are asked to define the recommended environments for CareOregon during implementation and ongoing operations, and are also asked to specify the costs in the pricing workbook.

84 Exhibit G - Contracting Addendum Are you expecting an initial redline of the CareOregon Addendum?

85 Exhibit G - Contracting Addendum Are you expecting an initial redline of the CareOregon Addendum?

86 General How will the Scan potential merger affect this project, if at all?

It is too early in the process to know however, consideration should be given for potential additional population growth

As outlined in the RFP, the Contracting Addendum outlines terms that generally will be required. If your firm has exceptions, redline edits should be included with your proposal and will be considered during the evaluation.

This can be found via CMS- Technical Instructions for Standardized Format for Part D Medication Therapy Management Program Comprehensive Medication Review Summary Form CMS-10396

CareOregon currently uses HealthTrio for our Provider and Member portal. The requirement is to be able to integrate activities that take place within the care management tool within these portals to be transparent with both the Providers and Members. In turn, we would want communication from Provider/Member regarding activities, tasks, etc. to be visible in the Care Management Tool.

CareOregon is open to proposals of solutions within platforms but are not seeking to replace the HealthTrio portals.

Use Case: As a care coordinator I am creating a care plan with a member and this care plan needs to be shared with the Active Provider and Member within the

CareOregon Vendor Q&A