RFX 3160007100 PROCUREMENT FILE PART 2 OF 3.pdf

State of Mississippi Decision Support and Related Health Care Analysis Consulting Services IFB #3160007100– Due Date February 28, 2025

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4.1.26 Must have the ability to support the following components of the managed care program evaluation:

4.1.26.a Cost and use performance of specified physicians and hospitals. The system should allow for the adjustment of case-mix in providing accurate comparisons among providers.

Explain the methods for case-mix adjusting.

Yes, we confirm. We have built-in, at-the-ready capabilities to analyze cost and use performance of specified physicians and hospitals. Additionally, the variety of physician contract arrangements (i.e., POS, PPO, HMO, and Indemnity) in use today can present challenges from a profiling perspective. Specifically, members may not be “assigned” to primary care physicians to manage their care, making it difficult to profile the care delivered, and, in turn, the physicians rendering the care. To address this issue, our solution includes a feature called Primary Care Physician Imputation to designate a managing physician for the patient. We based this imputation upon an examination of the pattern of care delivered to patients during a 12 month period of time, specifically by identifying the physician with whom the patient has had the most Evaluation and Management (E&M) visits. Additionally, both a managing physician and an episode primary physician is assigned to each episode of care. We based the episode managing physician assignment upon the pattern of E&M visits within each episode of care and the episode primary physician assignment upon the identifying the physician with the highest RVU count within the episode. This two-pronged solution gives you the ability to choose which method suits your organization's profiling goals.

4.1.26.b Use of in-network and out-of-network services by participants

Yes, we confirm. If the vendors provide data on whether claims were paid in-network, then the system can report on in- and out-of-network experience, another important plan management and evaluation function. For example, you can create a report examining the following:

• Percent charges and services in-network.

• Rates of use (inpatient and outpatient).

• Price per service (inpatient and outpatient).

• Employee out-of-pocket payments (in-network and out-of-network).

• Quality of care measures (e.g., rate of preventive care services).

• Provider discounts by type of provider.

You can control inpatient admission payments for DRG, and severity mix to measure true performance of network providers. You can evaluate physician discounts, controlling for service mix, by reviewing payments for specific procedures or using the Relative Value Unit (RVU) methodology. You can also compare network price per RVU to out-of-network and relevant norms, and network discounts to expected levels, monitoring on a quarterly basis with a more rigorous analysis of price annually.

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4.1.26.c Specific negotiated payment discount arrangements

Yes, we confirm. The ability to analyze, report, and compare providers by networks, groups, hospitals, or individuals is key to any clinical analysis system. Our solution provides users with the capability to compare utilization, cost, discount, access and quality of care by network, as long as adequate network indicators are provided in the source data. You can compare and contrast network performance with user-defined norms and benchmarks, such as best practice norms and centers of excellence. If the vendors provide data on whether claims were paid in-network, then you can report on in- and out-of-network experience, including provider discounts by type of provider.

You can evaluate physician discounts by controlling for service-mix by reviewing payments for specific procedures on a risk-adjusted basis. Further, you can compare network discounts to expected levels and monitored on a monthly basis, with a more rigorous analysis of price annually. By understanding differences in utilization, practice patterns, levels of quality, and costs, you can work with providers to offer feedback and help improve their performance. By retaining bill/pay line detail and/or encounter line item detail, users can “drill down” and “get behind” any provider profile to examine the details about the healthcare rendered.

See below for a sample of the drill down and drill up capabilities.

Figure 10. Drill Down Capabilities

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4.1.26.d Accessibility of network providers

Yes, we confirm. The ability to analyze, report, and compare providers by networks, groups, hospitals, or individuals is key to any clinical analysis system. By understanding differences in utilization, practice patterns, levels of quality, and costs, you will be able to work with providers to offer feedback and help improve their performance. By retaining bill/pay line detail and/or encounter line item detail, our solution allows users to “drill down” and “get behind” any provider profile to examine the details about the healthcare rendered. We can make all provider data available from the data vendors available for reporting.

In addition, you can compare network provider participation within your own data. Reporting could include specialty availability by geography and patient access, as well as referral pattern analysis. You can use our solution to compare utilization, cost, access and quality of care by network, as long as adequate network indicators are provided in the source data. For example, a user can create a report examining the following:

• Percent charges and services in-network.

• Rates of use (inpatient and outpatient).

• Price per service (inpatient and outpatient).

• Quality of care measures (for example, rate of preventive care services).

• Provider discounts by type of provider.

You can evaluate physician discounts by controlling for service-mix by reviewing payments for specific procedures on a risk-adjusted basis. Further, you can compare network discounts to expected levels and monitor them on a monthly basis, with a more rigorous analysis of price annually.

Our solution allows for providers to be assessed on several clinical metrics including specific procedures, relevant clinical quality rules, cost, and efficiency. We also facilitate tiering by assessing providers’ practice pattern, cost, and performance. It provides the insights necessary to help develop your network tiers by answering evaluating criteria like the examples below:

• Demographics and risk of attributed population.

• Access by geographic region.

• Features that are driving cost.

• Year-over-year scores and trending.

• Most cost-effective providers, considering patient risk.

• Adherence to evidence-based care for chronic conditions.

• Adherence to recommended screenings.

We have worked closely with clients in the past to help leverage our solution to develop their own tiered networks and look forward to discussing your goals in additional detail.

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4.1.26.e Performance by specific provider

Yes, we confirm. Our integrated data model and transparent approach to analytics allows for easy drill down from the aggregate down to the claim level detail to support you in producing insights and detail about your providers. With the solution, you will have the ability to create reports to evaluate productivity of your providers as well as creating visual dashboards and drill-throughs specific to your provider reporting needs.

To aid in reporting at a provider specific level, you can also compile your own best practice norms and define comparative reference groups using dynamic benchmarks. Custom norms and benchmarks, called “dynamic benchmarks,” allow you to compare one segment of your population (provider specialty, based on your book of business, other user-defined population, particular region, etc.) to a custom-defined benchmark while controlling for differences in disease severity, age/sex differences, and geographical price variation. By using a dynamic benchmark within our system, you can directly compare two data views on a single report. This functionality is powerful, intuitive and heavily leveraged in provider profiling and assessment.

In addition, there are multiple robust physician attribution models available within the solution based on patients, episodes and admissions.

Our Medical Episode Grouper (MEG) assigns the following physicians to each episode:

• Episode Managing Physician: The physician with the largest number of Evaluation and Management visits during the course of the episode.

• Episode Primary Physician: The physician with the highest sum of total RVUs, excluding anesthesiologists, radiologists, and pathologists.

Imputed PCP assigns a primary care provider to each member based on that member's utilization pattern. For primary care physician attribution, we designate a managing physician based on the highest number of Evaluation and Management (E&M) visits (based on CPT procedure coding) during the previous 12 months.

Admission Primary Physician attribution assigns a provider who is responsible for the overall admission, based upon the Relative Value Units for professional services included in each admission (again, specifically, members may not be “assigned” to primary care physicians to manage their care, making it difficult to profile the care delivered and, in turn, the physicians rendering the care).

Client assigned attribution as well as physician hierarchies (for example: physician, group, ACO, Health System, etc.) can be incorporated in our Health Insight’s solution. We will work closely with you during implementation to understand your preferred methods of attribution to ensure the database is optimally designed to meet your reporting needs, should you have your own physician attribution that you would like to include for reporting.

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4.1.26.f Disease management program

Yes, we confirm. Our solution can track disease management programs including enrollment, retention, and results. It can easily quantify the cost and utilization experience of a defined population for all diseases and compare these measures to normative data. These capabilities help you to assess the:

• Illness burden of a given population or community health cluster.

• Prevailing treatment practices as reflected in the claims for those members.

• Potential for cost and quality improvements through targeted disease management programs.

We help our clients quantify the potential return on investment of launching or subcontracting case management, disease intervention, nurse on call, and other programs for managing demand and improving outcomes. Our solution also provides a set of disease management reports that show changes in patient care from one year to the next. Depending on the criteria, a user can use the reports to determine whether patients are getting better or worse in specific areas.

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Figure 11. Condition Management Dashboard

4.1.26.g Future benefits changes such as deductible/co-pay, adding or deleting coverage, etc., to facilitate estimating the financial impact to the Plan. The model should be based on actual claims experience and eligibility data and provide detail on the ability of the user to specify factors for inflation, change in use patterns, population changes, fourth quarter carryover, and retention rates.

Yes, we confirm. You can perform plan design modeling using several different approaches.

First, we use our standard solution modeling capability, based on your historical experience, to enable you to project as precisely as possible the impact of specific plan design changes, as they apply to the number of individuals affected and the level of increase or decrease in

©2025 Merative US L.P. Merative Confidential 61 employee and employer costs. You can use custom subsets created from running reports that isolate members who meet the needed plan design criteria.

Our highly flexible and intuitive ad hoc reporting tool lets you model the cost impact of benefit design changes through an advanced measure creation. You can summarize cost experience and then model proposed plan design changes with “what if” logic. For example, to model the cost impact of moving from a $5 co-payment for retail prescription drugs to 20% co-insurance, you would first create measures to specify the co-insurance factor and calculate the cost savings of the proposed design. On a single report, you could then summarize by Therapeutic Class (or any other field) allowed charges, co-payment amount, modeled co-insurance amount, and the potential cost savings of the design change. You could add another “group by” field to this report to summarize the same information by plan option.

You can also use our standard distribution reports to model the out-of-pocket cost impact of plan design changes on individuals. For example, our clients with union-represented workforces have successfully used distribution reports to demonstrate to the union that a proposed plan design change will impact relatively few individuals.

Additionally, our Benefit Modeler, which we are providing at no cost to you, is a web-based actuarial model for estimating the cost impact of proposed healthcare benefit plan design changes. Modeler is a powerful and flexible proprietary tool that supplements the modeling applications included in our solution. We developed it using normative data in our MarketScan database. Benefit Modeler uses your own claims cost experience (or MarketScan data), industry group, enrollee age and gender, and geographic distribution to tailor results to your healthcare experience. Using Benefit Modeler, you can establish a reliable baseline from which alternative plan designs and reimbursement methods can be modeled using “what if” logic.

You can model up to five alternative plan designs in a single session. The cost impact of each scenario for the company and its employees can be determined in minutes. Even complex interactions that would result from multiple plan design changes can be simultaneously assessed with Benefit Modeler.

Figure 12. Sample Benefit Modeler Report

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4.1.27 Must have the ability to provide reports for monitoring the following areas:

4.1.27.a Third party claims administrators and/or insurers

Yes, we confirm. Our standard measure Third Party Amount allows you to track third party payments whether made by Medicare or other insurers. Our solution also allows you to configure eligibility and claim-level fields to identify and track members eligible for other coverage.

4.1.27.b Medical management firms

Yes, we confirm. Many clients leverage our solution to monitor and evaluate medical management firms, identify where programs are needed, details on program participation and outcomes, as well as ROI studies to support ongoing program investment ranging from out-of-the-box, readily available analysis to customizable and complex depending on the level of rigor needed.

We include a host of quality, evidence-based measures that address outcomes, including avoidable admissions, readmissions, complications, mortality, and disease progression. We also provide a wealth of quality measures that address evidence-based care processes. We have over 3,000 available measures that cover cost, utilization, and quality integrated within our solution to support outcomes analysis. Our integrated methods and measures support establishing population health risk baselines using a broad spectrum of metrics and tracking change over time.

Where possible, will report on an intervention cohort and a counterfactual (non-participant) cohort for program evaluation analytics. The purpose of the counterfactual cohort is to determine what trends, if any, the intervention group experiences versus what is experienced by a group not exposed to the intervention. Our solution includes features to make the design of the intervention cohort and the counterfactual cohort straightforward, while also providing flexibility to account for multiple population characteristics. We have a proven track record of integrating non-standard health and wellness information, including participation data, that you can use to assess the impact of programs.

Our clients most often focus program effectiveness evaluations on improving “traditional” KPIs of health and healthcare as it relates to cost, use, compliance behaviors, quality metrics, and population health. These outcomes may vary based on individual programs but, generally, these outcomes are readily available among the algorithms in our solution and just need to be pulled into a report. With these metrics and information, you can evaluate program effectiveness to validate and support ongoing program investment. This sort of analysis is available out-of-the-box via built-in key performance indicators (KPIs) and outcomes (or you can tap into our healthcare analytics team to conduct a tailored analysis, depending on the level of rigor you need).

Below is a link to a client example of how our advanced analytic methodologies and insights put programs and actions in place and then measure a strong ROI. We report real results and outcomes to both internal and external stakeholders and the positive impact on the lives of the members they serve.

https://www.merative.com/blog/healthcare-analytics-trane-eaton

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4.1.27.c Providers such as physicians, hospitals, other health care providers, and provider networks

Yes, we confirm. We commonly support value-based initiatives between health plans and providers to present information reflective of both cost efficiency and clinical effectiveness and have extensive experience working with clients to leverage episode value-based analytics within our solution. Our solution allows flexibility and customization in evaluating providers for value-based care initiatives allowing users to examine managing or primary providers at the episode level, with built-in adjustment for both episode severity and underlying patient illness burden. You can also use dynamic benchmarking to examine providers at the procedure code level, with performance ratios and variance statistics built into the solution.

We can report on the episode managing physician or episode primary physician. We impute the episode managing physician managing care for the episode based upon the pattern of care within the episode. The episode primary physician is assigned based on provider utilization within the episode. our solution helps you accurately and fairly compare cost efficiency (and cost of treatment) between provider groups/physicians by taking into account differences in population risk and disease severity. Risk Adjusted Episodes are the methodology we use to create risk adjusted expected cost based on a combination of the disease and severity from the Medical Episode Grouper (MEG) with population-based risk adjustment power of the Diagnostic Code Group (DCG) grouper from Cotiviti (formerly DxCG).

We apply risk adjustment to derive expected costs, or what the benchmark value would have been if the benchmark population had the same episode severity and patient risk as the study population. Once we have our expected costs, we create performance ratios, savings opportunities and overall cost efficiency scores to compare a physician to a group of peers.

We can then break down those cost efficiency ratios by a variety of service costs and clinical conditions to show and guide providers where they can be more cost efficient.

In addition to cost efficiency, we produce scores on clinical effectiveness. Our Quality Rules Engine has built in attribution models to assign the responsible physician to the rule being measured. Below are the integrated rules engine measures within our solution our clients use for value-based care initiatives.

HEDIS Certified Physician and Health Plan: This Physician and Health Plan focused package is an Allowable Adjustment NCQA Certified rule set, as defined within the HEDIS health plan specifications, addressing preventive services, chronic disease management, behavioral health care, and appropriateness/overuse of service and value.

Medication Management Focus: These Medication Management focus rules are medication adherence measures defined by the Pharmacy Quality Alliance that measure patient compliance for the same drug or same therapeutic class within the measurement year.

Low Value Care Measures: These Low Value Care measures identify services performed, which research indicates do not provide positive insights or results and potentially have negative effects on patients. The measure set is based on Watson Health Research and the Choosing Wisely campaigns.

By using our large set of industry defined quality measures, you can identify providers who are delivering appropriate care. Our solution includes an integrated Quality Rules Engine to identify opportunities to close gaps in care by comparing services rendered against evidence-based

©2025 Merative US L.P. Merative Confidential 64 medicine and clinical content. We have standard clinical effectiveness scores defined by the percentage of care criteria delivered as well as percent of patients with all recommended care as attributed to each physician. We also provide compliance rates for each measure and peer group comparisons for additional provider insight.

We have worked with clients to develop profiles that measure physician performance using a variety of efficiency and effectiveness measures. We have designed and customized a number of scores in addition to our standard measures that stratify physicians by both cost and quality scores, enabling alternative pricing models such as multi-tier pricing based on how effectively and efficiently a physician is delivering care.

These types of analyses are a great example of how clients using our advanced analytic methodologies and insights put programs and actions in place and then measure a strong ROI.

Below is a link to a recent article showcasing how Blue Cross of Idaho (BCI) uses our analytic models as a foundation to create a VBC pay for performance system that have 3,100 providers and 635 clinics participating and delivering high quality care while saving BCI over 6.5 million dollars annually.

Blue Cross of Idaho’s Predictive Analytics Breakthrough | Healthcare Innovation

4.1.27.d Cost containment programs: drugs, dental, variable deductibles, outpatient, etc.

Yes, we confirm. Our solution provides standard and ad hoc analytic reporting capabilities to help you understand cost and use trends related to all claim types – medical, drug, dental, variable deductibles and outpatient, based on the availability of data from your vendors

– and their key drivers, such as changes in eligibility, enrollee demographics and health status, plan design, etc.

Period-over-period trend reports can be used for before-and-after comparisons. In addition, normative benchmarks can help users analyze the effectiveness of cost containment programs.

Also, standard cost and use report templates can provide information on specific subsets of the population or for claims involving utilization review. Where necessary, ad hoc cost and use reports can be specifically created, or the standard report templates can be easily modified.

4.1.27.e Wellness program benefits to the Plan

Yes, we confirm. As the leading independent health informatics organization, our software and consultative support services provide the premier platform for all wellness and disease management programs’ implementation and evaluation. Our solution provides extensive capabilities to support identification and evaluation of your wellness and health promotion programs, as well as determining how the benefit design can influence their success. It can track each program’s enrollment, retention, and results. It can easily quantify the cost and utilization experience of a defined population for all diseases and compare these measures to normative data. These capabilities enable the assessment of the illness burden of a given population or community health cluster; the prevailing treatment practices as reflected in the claims for those members; and the potential for cost and quality improvements through targeted disease management programs. We help you quantify the potential return on

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Our solution includes pre-defined population subsets that contain candidates for preventive services or populations likely to use healthcare services more intensely than the population at large. This makes it extremely easy to analyze compliance to preventive service standards (for example, the number of colon cancer screens that are delivered to members 50 and older, and the number of well child visits provided for children age 3 through 6, as well as the care provided for diabetics, hypertensives, or asthmatics.

4.1.27.f Pharmacy benefit manager

Monitoring your pharmacy benefit manager (PBM) is an important piece of managing your overall healthcare benefit. By utilizing our solution, you are able to track pharmacy claims and ensure your PBM is meeting your expectations. You can track pharmacy costs and utilization, identify members utilizing GLP-1s, monitor specialty drug spend, assess formulary utilization, and much more. See below for our standard Pharmacy Rates and Trends dashboard.

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Figure 13. Pharmacy Rates and Trends Dashboard

4.1.27.g HEDIS reports across a broad range of variables

Yes, we confirm. We incorporate NCQA allowable adjustment certified HEDIS metrics in our solution. NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the healthcare system for quality improvement initiatives. The rules provide flexibility for evaluating different populations without

©2025 Merative US L.P. Merative Confidential 67 altering measures’ clinical intent (e.g., removal of continuous enrollment or product-line criteria).

We offer pre-created metrics for each measure with and without continuous enrollment, as well as summary metrics to evaluate overall compliance. In addition, we have built-in physician attribution, and several reporting fields related to quality, such as summary fields, as well as fields that indicate the last event date related to a particular measure to surface relevant information for care management purposes.

See below for our standard Quality of Care dashboard which utilizes many HEDIS measures to give you a quick view of quality metrics by the variables you choose using the included filters.

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Figure 14. Quality of Care Dashboard

4.1.27.h Disease management program

Yes, we confirm. Care management analytics and reporting are our core capabilities. Our solution provides extensive capabilities to support identification and evaluation of your care management and health promotion programs to help you ensure they are both effective and managed efficiently. With our solution, you can track each program’s enrollment, engagement, ©2025 Merative US L.P. Merative Confidential 69 retention, and results. We also support longitudinal comparisons of risk, cost, utilization, and care quality, as well as member engagement experience for multiple population cohorts.

We define cohorts most frequently by level and duration of program participation and adjust for the original health risk of the group, derived from claims data, health survey, or biometrics. This approach allows for fair assessment of program interventions.

We can help you select the right diseases to manage. Knowing which disease conditions offer your organization the best opportunities for return on investment (ROI) in both cost and quality is the first step in establishing an effective disease management program. Using our robust reporting capability, you can readily identify the costliest and most prevalent diseases among your membership. Our reporting capability enables you to assess the clinical severity of a particular disease within your population; it also informs you about the diseases that, by applying evidence-based guidelines, are likely to result in quality improvement.

Our solution helps you identify and risk-stratify patients that are appropriate candidates for care management, disease management, and population management, allowing for both retrospective outcomes and prospective risk analysis. Leveraging our Medical Episode Grouper (MEG), Cotiviti DCGs, and our risk stratification methodologies, we can work with you to identify patients for specific programs or diseases.

For disease management, for example, we identify qualifying populations or members as “complex”—having multiple expensive conditions—or with select chronic conditions, based on the MEG information. Additionally, you can “flag” members using input from your own criteria/methods (for example, prior authorizations, health risk assessments, third-party disease management registries).

After initial identification of individuals with a chronic condition, additional information is available to further segment populations or members for various disease management programs and interventions. A predictive risk patient component identifies which individuals are more likely to experience high future disease/condition risk. Used in conjunction with clinical severity information from MEG and information on individual patient compliance with evidence-based condition guidelines, you can target individuals for disease management programs and provide individual-specific interventions. If a patient has multiple conditions, we can work with your organization to appropriately target these sub-segments of patients and ensure that they are routed to the appropriate care management processes.

You can also identify gaps in care at the individual level and join this data with system-generated utilization, demographic, and geographic information, so you can focus member outreach efforts on members who would derive the greatest benefit. Clients can also “close the information loop” by incorporating intervention information back into the database, such as care management participation and outcomes. We can either do this on an ad hoc basis or be permanently integrate it into the database via supplementary tables. Regardless of how you integrate the data, you can use it to evaluate the effectiveness of member engagement programs and inform future efforts.

After targeting the desired population, you can assign members to user-defined disease management programs as participants. You can store this program participation enrollment/disenrollment information in your database and use it for various program effectiveness studies.

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In addition to new patient targeting and program participation analysis reports, we can provide a variety of flexible, simple-to-use report views that enable you to interact with your disease management information in powerful new ways. You can slice and dice the information by various data views or cohorts on the fly, as well as interactively drill down into specific measures. We also provide return on investment ROI reports for financial analysis of disease management programs.

4.1.28 Comply with mutually agreed service performance guarantees. Refer to IFB Section 6.6, Performance Standards, and Exhibit B, Performance Standards and Discount Guarantees, of the proposed contract.

Yes, we confirm. We take pride in our history of service excellence and our commitment to our clients. Our goal is to establish a strong bond between our organizations so that both parties are equally committed to creating a successful decision support system for you. We are fully prepared to discuss performance guarantees with you as part of the contract negotiation process. Once the scope, risk, and objectives of the project are more fully understood and agreed upon and the terms of the Services and License Agreement defined, we can decide on the exact amount of money to be put at risk.

Our general approach to establishing performance guarantees is based on a three-pronged process: 1) defining terms to the mutual satisfaction of both parties; 2) using objective and quantifiable measurement; and 3) establishing a cap on the penalty, where appropriate, based on a percentage or other factor related to total contract value. In cases where client actions can affect the success of a project (such as timely signoffs on implementation deliverables), we may request that those dependencies be included as a condition of the guarantee. We also request that “cure” periods and other provisions for corrective action be considered in the agreement. Our performance guarantees fall within one or more of the following areas:

Implementation Timeframe/ Data Acquisition/ Data Integrity/Data Issue Resolution/ Database Update/ Product Support & System Availability.

4.2.1 Assign a Vendor Account Representative to work directly with the MDFA Representative.

Yes, we confirm. Tim Bragg will be your Vendor Account Representative and will work directly with the MDFA Representative.

4.2.2 Perform all services provided in the contract between the vendor and MDFA in accordance with customary and reasonable industry standards as well as in strict conformance to all laws, statutes, and ordinances and the applicable rules, regulations, methods and procedures of all government boards, bureaus, offices, and other agents. The vendor shall be responsible for the complete performance of all work; for the methods, means, and equipment used; and for furnishing all materials, tools, apparatus, and property of every description used in connection therewith. No statement within this IFB shall negate compliance with any applicable governing regulation. The absence of detail specifications or the omission of detail description shall be recognized as meaning that only the best commercial practices are to prevail and that only first quality materials and workmanship are to be used.

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Yes, we confirm.

Compliance with Healthcare Industry Standards

We meticulously designed our solution to comply with all healthcare industry standards. This commitment ensures that our system remains up-to-date and aligns with the latest regulations and guidelines.

Timely Updates and CMS Content Integration

We prioritize maintaining our system with timely updates to recognize and incorporate changes in the Centers for Medicare and Medicaid Services (CMS) content. This includes:

• Monthly Code Releases: We update our content, including diagnosis, procedure, and related codes, on a scheduled monthly basis. This ensures that our system reflects the most current information and standards.

Adherence to Statutory Regulations

Our dedication to industry standards extends to all aspects of healthcare requirements, including:

• Health Insurance Portability and Accountability Act (HIPAA) of 1996: We ensure that our solution complies with HIPAA regulations, safeguarding patient privacy and securing health information.

LOINC Value Maps Maintenance

We maintain our Logical Observation Identifiers Names and Codes (LOINC) value maps to ensure accuracy and compliance. Specifically, we:

• Avoid Federally Restricted Data: We do not include federally restricted genetic and HIV lab tests into our databases, maintaining compliance with federal regulations.

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7.1.1 Bid Cover Sheet (Attachment A)

Attachment A

BID COVER SHEET

Bids are to be submitted as listed below, on or before 2:00 PM CST, February 28, 2025.

PLEASE MARK YOUR ENVELOPE:

IFB RFx Number 3160007100 for Decision Support and Related Health Care Analysis Consulting Services

Opening Date: 3:00 PM CST, February 28, 2025

Mississippi Department of Finance & Administration, Office of Insurance

Attention: Alicia Coleman, MDFA OI Procurement & Contracts Director

P.O. Box 24208 (Mailing Address)

Jackson, Mississippi 39225-4208

501 North West Street, Suite 1201-C Woolfolk Building (Hand Delivery Address)

Jackson, Mississippi 39201

SEALED BID – DO NOT OPEN

Name of Company: Merative US L.P.

Name, title, phone number, and email address of Company Representative to be contacted by MDFA, if different than person identified above:

Same as above

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1. Does your bid package contain any trade secrets, confidential commercial or financial information?

Yes, we confirm. Our response contains trade secrets, confidential commercial and financial information.

2. Release of Bid as Public Record: Vendor shall acknowledge which of the following statements is applicable regarding release of its bid as a public record. A vendor may be deemed non-responsive if the vendor does not acknowledge either statement, acknowledges both statements, or fails to comply with the requirements of the statement acknowledged. Choose one:

Yes Along with a complete copy of its bid, the vendor has submitted a second copy of the bid in which all information vendor deems to be confidential commercial and financial information and/or trade secrets is redacted in black. The vendor acknowledges that it may be subject to exclusion pursuant to Chapter 15 of the PPRB OPSCR Rules and Regulations if the MDFA or the Public Procurement Review Board determines redactions were made in bad faith in order to prohibit public access to portions of the bid which are not subject to Mississippi Code Annotated §§ 25-61-9, 75-26-1 through 75-26-19, and/or 79-23-1. The vendor acknowledges and agrees that MDFA may release the redacted copy of the bid at any time as a public record without further notice to vendor. A vendor who selects this option but fails to submit a redacted copy of its bid may be deemed non-responsive.

____ The vendor hereby certifies that the complete unredacted copy of its bid may be released as a public record by the MDFA at any time without notice to vendor. The bid contains no information the vendor deems to be confidential commercial and financial information and/or trade secrets in accordance with Mississippi Code Annotated §§ 25-61-9, 75-26-1 through 75- 26-19, and/or 79-23-1. The vendor explicitly waives any right to receive notice of a request to inspect, examine, copy, or reproduce its bid as provided in Mississippi Code Annotated § 25- 61-9(1)(a). A vendor who selects this option but submits a redacted copy of its bid may be deemed non-responsive.

Yes, Merative has provided a redacted copy of our response.

3. Indicate the month and year in which your company was established/started.

We were officially established in 1981 as Medstat. We became Merative on July 1, 2022. We renamed our business unit Truven Health in 2024.

4. How long has the company been providing/performing the equivalent or similar services in requirements and scale to those services described within this IFB?

For nearly 50 years, we have been providing health plans, employers, hospitals and clinicians, state and federal government agencies, life sciences companies, and policymakers with market-leading performance improvement solutions built on data integrity, advanced analytics, and domain expertise. These insights and solutions have been delivering the facts our clients need to make confident decisions directly affecting the health and well-being of people and organizations in the US and around the world.

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5. State the full legal name of your company, and provide the web address, physical location and mailing address of your company’s home office, principal place of business, and place of incorporation.

Full Legal Name: Merative US L.P

Physical and Mailing Address and Principal Place of Business: 100 Phoenix Dr. Ann Arbor, MI 48108

Place of Incorporation: Merative US L.P. is incorporated in Delaware (U.S.) as a limited partnership.

Web Address: www.merative.com

6. List the office that will serve the Board/MDFA. If it is located at a different address than the home office, provide the complete physical location and mailing address, phone number, and facsimile number for this office.

We will provide services for our office in Arbor, MI, USA (100 Phoenix Dr. Ann Arbor, MI 48108) as well as from our data center in Dallas, TX, USA (14901 FAA Boulevard, Building 2, Fort Worth, TX 76155).

7. Describe your organizational structure. Indicate whether your company operates as a corporation, partnership, individual, etc. If it is incorporated, include the state in which it is incorporated, and list the names and occupations of those individuals serving on your company’s Board of Directors. Also, list applicable parent organizations and subsidiaries of your organization.

Merative US L.P. is incorporated in Delaware (U.S.) as a limited partnership. Additional information can be found at www.merative.com.

Merative US L.P. is a private company owned by Merative L.P., of which Francisco Partners private equity funds are the ultimate investor. Francisco Partners private equity funds are managed by Francisco Partners Management, L.P.

Merative US L.P. is the operating entity that will provide the products and services to you under an agreement signed between the parties.

Our officers include Gerry McCarthy, Chief Executive Office; Brian Bonner, Chief Financial Officer and Chief Operating Officer; Troy Bailey, Chief Technology Officer; Katie Coleman, Chief Human Resources Officer; Julie Daughtry, Chief Legal Officer; Pat Gilmore, Chief Revenue Officer.

Additional information on our leadership team and team structure can be found here:

https://www.merative.com/leadership.

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8. List the name and principal occupation or business of any person or entity owning five percent (5%) or more of your company.

Not applicable.

9. List the name(s) of any organization(s) of which your company owns or controls five percent (5%) or more.

In alignment with our commitment to transparency and integrity, we confirm that our ownership structure includes entities that are integral to our strategic operations and mission. We consider specific details about ownership percentages to be proprietary and disclose them only under mutually agreed terms that preserve the strategic interests of both our partners and our company.

10. Is your company currently for sale or involved in any transaction to expand or to become acquired by another business entity? If the answer is yes, please discuss the impact both in organizational and directional terms.

As a forward-looking organization, we continuously evaluate opportunities that align with our strategic goals and enhance value to our clients and stakeholders. We make decisions or conduct discussions regarding potential sales or acquisitions with careful consideration of their impact on our organizational direction and client commitments. While we maintain confidentiality on specific transactions or discussions, we assure all stakeholders that we will manage any future changes with a focus on continuity, enhancement of service capabilities, and alignment with industry best practices.

11. Describe any ownership or name changes your company has been through in the past three (3) years. Are any ownership or name changes planned?

On June 30, 2022, Francisco Partners, a leading global investment firm that specializes in partnering with technology businesses, completed the acquisition of healthcare data and analytics assets that were part of IBM’s Watson Health business. Under the ownership of Francisco Partners, the new standalone company is called Merative. Additional information can be found here: https://www.franciscopartners.com/media/merative and here:

https://merative.com/.

We do not make the details of possible or pending mergers and acquisitions or divestitures publicly available. However, we represent that there is no past or pending merger, acquisition or divestiture activity that would prevent us from discharging its obligations under a contract finally awarded to us.

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12. Describe any changes in the organizational structure that have occurred within your company over the past twenty-four (24) months or are anticipated during the next twenty-four (24) months including, but not limited to, addition or elimination of product or business lines, mergers, acquisitions, etc.

Over the past twenty-four months, our organizational structure has evolved to better align with market needs and our strategic vision. This includes optimizing our operations and potentially expanding our service offerings. We anticipate that our organizational structure may continue to evolve as we remain responsive to the healthcare industry's demands and technological advancements. Specific changes are made with a vision to strengthen our core capabilities and ensure we are well-positioned to serve our clients effectively. We share detailed information about such changes as appropriate within the framework of our client and partner relationships.

13. What was the average number of employees of your firm during the calendar year 2024? Please list the net change in the number of employees in your firm from December 2023 to December 2024, with an explanation if change is significant.

We employed approximately 2,030 employees in December 2024 and 2,124 employees in December 2023.

14. Has your company ever been involved in a lawsuit involving any area covered by this IFB? If the answer is yes, please provide details including dates and outcomes.

No, we may, as a matter of course, from time to time, be a party to a lawsuit. We are not, however, currently (nor in the years since it being established as a standalone company) a party to any lawsuit that will affect its ability to perform the services outlined in this RFP response. To the best of the submitter's knowledge, we represent that there is nothing in this area that precludes us from providing products and services to you under an agreement signed between the parties.

15. Has your company been cited or threatened with citation within the last three (3) years by federal or state regulators for violations of any federal, state, or local law or federal, state, or local regulation? If the answer is yes, please describe the circumstances in detail.

No, we have not been cited or threatened with citation within the last three (3) years by federal or state regulators for violations of any federal, state, or local law or federal, state, or local regulation.

16. Has your company had any HIPAA breaches or incidents determined to be reportable to the U.S. Department of Health and Human Services (DHHS) within the last three (3) years? If the answer is yes, please describe the circumstances and the corrective action in detail.

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No, We have not paid any HIPAA breaches or incidents determined to be reportable to the U.S.

Department of Health and Human Services (DHHS) within the last three (3) years.

17. Confirm your company currently meets all applicable requirements of HIPAA and HITECH including the Administrative Simplification and Security Rule provisions.

Yes, we confirm. We currently meet all applicable requirements of HIPAA and HITECH including the Administrative Simplification and Security Rule provisions.

18. During the past five (5) years, has your company, related entities, principals, or officers ever been a party in any material criminal litigation, whether directly related to this IFB or not? If the answer is yes, please provide details including dates and outcomes.

No, to the best of the submitter's knowledge, we represent that there is nothing in this area that precludes us from providing products and services to you under an agreement signed between the parties.

19. Confirm your bid is valid for one (1) year subsequent to the date of submission.

Yes, we confirm our bid is valid for one (1) year subsequent to the date of submission.

20. The selected vendor must cooperate with the Board, MDFA, and with all other vendors/contractors of the Board/MDFA with respect to ongoing coordination and delivery of services and in any transition of responsibilities. Confirm your company will comply with this requirement.

Yes, we will comply with this requirement.

21. Provide a brief description of any outside vendors or subcontractors that will be involved in providing key services detailed within your bid. Please include the term of your current contract with each vendor or subcontractor. Describe the nature of the relationship with the vendor or subcontractor, including any ownership interest. Please include a copy of the current contract as an appendix to your bid.

Not applicable; there are no outside vendors or subcontractors involved in this engagement.

22. State if the proposed account executive, any officers or principals and/or their immediate families are or have been within the preceding twelve (12) months, employees or elected officials of the State of Mississippi.

Not applicable.

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23. Provide a complete resume for each staff member/consultant who will be assigned to render services to the Board/MDFA, including detailed information on any special or professional training or designations and years of related experience.

The core team will include a Project Manager, Account Executive (Vendor Account Representative), Analytic Consultant and Data Manager.

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7.1.2 Bid Form (Attachment B Pricing)

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Attachmen…