RFP 2025-06 ESRD Management Clarifying Questions 3.pdf

This document is a Clarifying Questions Response #3 from CareOregon, a nonprofit health plan in Oregon, regarding Request for Proposals #2025-06 for End Stage Renal Disease (ESRD) Population Risk-Based Management Services. CareOregon seeks a risk-bearing entity to provide comprehensive population health management services for approximately 200-250 ESRD members enrolled in CareOregon Advantage, a Dual Eligible Special Needs Plan (D-SNP), with additional members in CKD Stages 4 and 5. The scope of work includes designing and delivering kidney care programming, ensuring members receive all entitled benefits, and implementing population health management for early-stage chronic kidney disease through ESRD. The initial contract term runs for three years (February 2026 through December 31, 2028), with options for two additional one-year renewals. Proposals are evaluated on four criteria: General Background and Qualifications (0-30 points), Scope of Work (0-35 points), Equity, Diversity, and Inclusion Efforts (0-10 points), and Fees (0-25 points), with a maximum 15-page response requirement and a submission deadline of January 6, 2026, at 2:00 PM Pacific Time.

The clarifying questions document addresses key contractual requirements, confirming that CareOregon requires a non-negotiable 90-day termination for convenience clause without any delay periods. CareOregon was unable to provide specific member counts for CKD Stage 4 and Stage 5 populations separately, noting only that CKD Stages 4 through ESRD are in scope. The fee structure remains flexible, accommodating various arrangements including full capitation, fixed fees, time and materials pricing, or contingency fees based on savings. Proposers must be risk-bearing entities capable of assuming medical expenses and demonstrate substantial experience with Medicaid, Medicare Advantage, CKD, and ESRD populations, along with expertise in CMS Kidney Care Choices Models and HEDIS data utilization. Insurance requirements include Commercial General Liability ($1,000,000 per occurrence/$2,000,000 aggregate), Professional Liability ($1,000,000 per occurrence/$2,000,000 aggregate), and Cyber Liability ($1,000,000 per occurrence), with strict compliance required for HIPAA regulations and CareOregon's Data Security Requirements.