RFP_31786-00192_Appendix_7.2_Quest_Analytics_Access_Report_Instructions.docx

Quest Analytics Vision Provider Network Accessibility Analysis RFP # 31786-00192 Data Requirements & File Layouts The State would like to know the potential of your organization’s professional provider network to service the accessibility needs of its members in the vision insurance program. To measure that potential, this RFP requires each Respondent to submit the Quest Analytics Provider Network Accessibility Analysis report.

DEFINITION: For the purpose of this analysis, “Network Provider” shall be defined as any Optometrist or Ophthalmologist licensed and practicing in the State of Tennessee who:

· is currently operating under a fully executed and in force contract with the Proposer as part of the network the Respondent proposes to use for the State of Tennessee vision insurance program as described in this RFP.

Data Items To analyze the accessibility of Proposers’ professional provider network for the State’s population, the Quest Analytics Suite™ program requires both an employee data file and a provider data file.

Respondents must use Quest Version 2025.4 to run this report. Tennessee employee data, listed with tallies by ZIP code and the ZIP code classification are included in a file accompanying the RFP in Appendix 7.4, tab labeled "TN ZIP Codes Geocoded 2025.4". The file is in Microsoft Excel format, and has also been provided to Quest Analytics. Your professional provider files must contain the following:

· Network Provider Name (Last Name, First Name)

· Street Address – NOTE: For Network Providers who have more than one office location, the file should contain a distinct record for each office address.

· City

· State

· Five digit ZIP Code

· Specialty Code – please include the coding scheme used

· Accepting/Not Accepting Patients Practice Indicator (A=Accepting, N=Not Accepting) Data Format If you intend to have Quest Analytics conduct this analysis, you must submit your data to Quest Analytics in one of the following formats: Access, Excel, Text (Fixed Width or Delimited) and send electronically.

If you have the Quest Analytics Suite™ and need technical support on how to utilize the software, the team can be contacted at support@questanalytics.com or 920.739.4552. If you need Quest Analytics to perform the analysis on your behalf, please contact consulting@questanalytics.com.

Standards and Specifications The standards and specifications listed are to be followed by all proposers. This will enable the State to compare, on a consistent basis, the accessibility of each Proposer’s provider network. It is critical that each analysis meet the following data standards and report specifications.

Analysis Requirements

1. Use the Quest Analytics Suite™ Access Analysis Module. If you do not have the Quest Analytics Suite™, call 920.739.4552 or email consulting@questanalytics.com at Quest Analytics to receive a quote for them to perform the analyses for you.

Appendix 7.2

Data Standards

1. Use all employee ZIP codes data contained in APPENDIX 7.4. - Eligibility Counts by Zip Code, tab “TN ZIP Codes Geocoded 2025.4”, to analyze your network relative to the State of Tennessee eligible member population.

2. Your Network Provider addresses should be geocoded at the address level. For any Network Provider’s address that cannot be exactly geocoded, the ZIP-distributive address points can be used, which takes into account the population patterns to distribute locations. Placing providers at ZIP code centroids or randomly within ZIP codes is not permissible.

3. If more than one Network Provider is located at the same address, all providers at that address should have the same geographic coordinates.

4. Providers should be classified based on their primary specialty.

5. Average driving distance should be used not straight-line distances.

6. Analyses should include all providers in your network which are delivering services in the State of Tennessee only. See the State’s boxed and bolded definition of Network Providers on page 1 of this Appendix.

7. Network Providers who are currently contracted, but will not be on January 1, 2023, shall not be included in your analysis.

Report Specifications

1. Prepare a network accessibility analysis for the entire State. The report should closely resemble the Sample Analysis contained in APPENDIX 7.3 - Sample Quest Analytics Access Analysis Report and should include:

· a cover page;

· a table of contents;

· an access detail page by ZIP code classification

· an access overview page;

· an access summary page by county;

· an access detail page, for members who will need to travel outside the standard and their average distance; and

· a report statistics page which details the specifications utilized to conduct the analysis

2. Conduct an independent analysis of EACH of the following provider groups: See the State’s boxed and bolded definition of Network Providers on page 1 of this Appendix.

In-Network Optometrist Urban 2 providers or locations within 10 miles for 95% of Members Suburban 2 providers or locations within 15 miles for 95% of Members Rural 1 provider within 20 miles for 95% of Members

In-Network Ophthalmologist Urban 1 provider within 15 miles for 95% of Members Suburban 1 provider within 20 miles for 95% of Members Rural 1 provider within 30 miles for 75% of Members

3. Analyses should include all Network Providers in your network which are delivering services from offices located physically within the State of Tennessee only and are under a fully executed and in force contract within Tennessee. See the State’s boxed and bolded definition of Network Providers on page 1 of this Appendix.

4. Mileage should be calculated on an estimated driving distance basis.

5. Checks for accuracy: Respondents are responsible for ensuring their Quest Analytics Access report is accurate. The following items should be reviewed for accuracy:

Title Page:

· Company name should appear on the title page.

· The date of the report should appear on the title page.

· Accessibility Summary – Accessibility analysis specifications:

· Provider Groups –

· Total for Network Providers (Optometrist and Ophthalmologist)

· Employee and Dependent Group – The total number of State employees/retirees and dependents MUST MATCH EXACTLY the number contained in Appendix

7.4. – Eligibility Counts by ZIP Code, tab “TN ZIP Codes Geocoded 2025.4”.

· Access Standard – The Analysis report MUST MATCH EXACTLY the standard required by the State (see page 2 of these instructions)

Analyses must include the following pages:

Page Cover 1

Content/Display Report title, Proposing organization’s name, Date Access Detail by Zip Code Classification (for employees/retirees and dependents with and without desired access): Detail the Average Distance to the 1st and 2nd closest In-Network Optometrist location and In-Network Ophthalmologist location for Employees/Retirees/Dependents with Desired Access and without Desired Access Separately.

Access Overview – include the following:

· Overall Access by pie chart the employees/retirees/dependents with and without access.

· Average Distances to the 1st - 5th closest In-Network Optometrist location and In-Network Ophthalmologist location. Standard Comparison graph indicating the percentage of ALL employees/retirees/dependents having access to one, two, three, four, and five In-Network Optometrists or locations for distances up to 20 miles.

Standard Comparison graph indicating the percentage of ALL employees/retirees/dependents having access to one, two, three, four, and five In-Network Ophthalmologists or locations for distances up to 30 miles.

Access Summary by County (for employees with and without desired access): Summarize by key geographic areas with and without desired access the required Access analysis specifications and Average Distance to the 1st and 2nd closest In-Network Optometrist location and In-Network Ophthalmologist location.

Access Detail Page for ZIP codes not meeting the access standard: Report the accessibility detail of all employees/retirees/dependents without desired access at the ZIP code level, including Zip Code Classification, State, City along with employee/retiree/dependent counts without access and the average distance to the 1st and 2nd closest In-Network Optometrist location and In-Network Ophthalmologist location.

Report Statistics Page: This is a summary page detailing, among other things, the report creation date, the software version, analysis inputs, and calculation method.