[The Chartis Group, LLC] Response Document Report.pdf

Mississippi Department of Health

Procurement Dorthy Young, -

570 East Woodrow Wilson Drive, Jackson, MS 39216

[THE CHARTIS GROUP, LLC] RESPONSE DOCUMENT REPORT

IFB No. 3160008132

FLEX FY26: Financial and Operational Improvement for Mississippi's CAHs RESPONSE DEADLINE: July 27, 2026 at 10:30 am Report Generated: Wednesday, July 29, 2026

The Chartis Group, LLC Response

CONTACT INFORMATION

Company:

The Chartis Group, LLC

Email:

wbalfour@chartis.com

Contact:

William Balfour

Address:

220 West Kinzie 3rd Floor Chicago, IL 60654

Phone:

N/A

Website:

www.chartis.com

Submission Date:

Jul 24, 2026 11:29 AM (Central Time) http://www.chartis.com/

FLEX FY26: Financial and Operational Improvement for Mississippi's CAHs

Invitation For Bid - FLEX FY26: Financial and Operational Improvement for Mississippi's CAHs

ADDENDA CONFIRMATION

Addendum #1 Confirmed Jul 21, 2026 10:45 AM by William Balfour

Addendum #2 Confirmed Jul 21, 2026 10:45 AM by William Balfour

QUESTIONNAIRE

1. Bidder Representative - Name* Michael Topchik

2. Bidder Representative - Title* Executive Director, The Chartis Center for Rural Health

3. Bidder Representative - Complete Mailing Address* 220 West Kinzie StreetChicago, IL 60654

4. Bidder Representative - Telephone Number* 207-939-4816

5. Bidder Representative - Email Address* mtopchik@chartis.com

6. MAGIC Vendor ID Number* Enter your MAGIC Vendor Number here. This is a ten (10) digit number that begins with 310. This information must be submitted accurately.

Please see below for additional guidance:

• If you ARE registered with the MAGIC eProcurement system and do not know your MAGIC Vendor number, you may contact the MAGIC helpdesk by calling (601) 359-1343 or by emailing mash@dfa.gov for assistance. Webpage Call Center. (Do NOT create a new vendor number)

• If you are NOT registered, please visit the registration page here: MAGIC eProcurement system. If you require assistance, you may access the Call Center page for both a phone number and email as well as business hours for assistance.

Maximum response length: 10 characters

3102092773

7. Paymode* Is Offeror currently registered with PayMode?

Yes

8. Authorized Business in Mississippi* Is Offeror in compliance with Mississippi Code Annotated § 79-4-15.01 regarding authorization to transact business in Mississippi?

Yes

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

Choose one:

mailto:mash@dfa.gov https://www.dfa.ms.gov/mmrs-call-center https://www.dfa.ms.gov/vendors https://www.dfa.ms.gov/mmrs-call-center

Bidder hereby certifies that the complete unredacted copy of its bid may be released as a public record by MSDH at any time without notice to bidder. Bidder 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). The bid contains no information bidder 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. A bidder who selects this option but submits a redacted copy of its bid may be deemed nonresponsive.

10. Confirmation of Non-Collusion* Offeror hereby certifies that the fees submitted in response to this IFB have been arrived at independently and without, for the purpose of restricting competition, any consultation, communication, or agreement with any other Offeror or competitor relating to those fees, the intention to submit a bid, or the methods or factors used to calculate the fees proposed. In submitting a bid, we certifies that the price submitted was independently arrived at without collusion.

Confirmed

11. Contingent Arrangements* Offeror hereby certifies that they _____ retained any person or agency on a percentage, commission, or other contingent arrangement to secure this contract.

have not

12. Audited Financial Statements* Please submit Independently Audited Financial Statements as part of your submittal to this IFB.

MS_Flex_Audited_Statement_Response_FINAL_07_2026.pdf

13. Additional Information For any additional information requested or required by any of your previously provided answers or as stated within this IFB please upload the additional documentation here.

This includes but is not limited to a redacted copy (if applicable) of the Offeror's submittal in which all information deemed to be confidential commercial and financial and/or trade secrets is redacted in black.

Chartis_MS_DOH_3160008132_Flex_FinOp_Improvement_RFP_07.24.26_FNL.pdf

14. IFB Confirmation* Offeror confirms and acknowledges that they have read this IFB in its entirety and fully understands all requirements. Submitting party further confirms that they are authorized on behalf of the vendor to submit such a bid.

Confirmed

PRICE TABLES

FLEX FY26

***For additional information, please refer back to the scope of work. ***

Line Item Description Quantity Unit of Measure

Unit Cost Total

1 Statewide Needs Assessment 2 Assessment $70,000.00 $140,000.00

2 Revenue Cycle Management Roundtable 4 Roundtable Sessions

$7,500.00 $30,000.00

3 Outmigration Assesment 6 Analysis $9,500.00 $57,000.00

4 Billing and coding trainings 4 Trainings $5,000.00 $20,000.00

5 Chargemaster reviews for CAHs (6 Hospitals) twice per year 24 Reviews $13,500.00 $324,000.00

TOTAL $571,000.00

IFB RFx Number: 3160008132 FLEX FY26: Financial and Operational Improvement for Mississippi's CAHs

Response regarding Audited Financial Statements

Chartis is a privately held, national healthcare consulting firm with more than 1,000 professionals that operates in all 50 states with offices in San Francisco, Chicago, Minneapolis, New York and Boston. We follow generally acceptable accounting practices and have our financials audited by the certified public accounting firm. As a privately held firm, we do not publicly disclose our financials.

Chartis

220 West Kinzie Street

Chicago, IL 60654

Hannah Wright

Bid Coordinator

Mississippi Department of Health

570 East Woodrow Wilson Drive

Jackson, MS 39216

Re: IFB RFx Number: 3160008132

Dear Kristen, We are delighted to participate in this Invitation for Bids. Our relationship with the Mississippi

Department of Health is a source of immense pride within The Chartis Center for Rural Health team and Chartis. In this bid response, we will detail our plan for the continued support of the

Mississippi Department of Health and all the state’s Critical Access Hospitals through the

Medicare Flex Program.

Since 2015, we have successfully partnered with the Mississippi Department of Health to deliver

Flex grant-funded performance improvement programming to the state’s Critical Access

Hospitals. The powerful combination of our analytics and rural-relevant benchmarks, expertise and insights have delivered significant value to these hospitals in the form of Financial &

Operational Assessments, MBQIP Quality Improvement, Population Health Assessments, Value-based Purchasing, hospital leadership and Board education and industry-leading research on the stability of the rural health safety net.

We maintain strong, productive relationships with Critical Access Hospital leadership teams across Mississippi, and we believe our analytics methodology, reporting, expertise and perspective is unique and delivers compelling results. The requirements of this bid dovetail with our Flex-funded Quality Improvement engagement and it is our belief that no other organization is better positioned to fulfill the requirements of this bid request than The Chartis

Center for Rural Health. We know Mississippi’s rural hospital landscape and are prepared to help the state’s Critical Access Hospitals continue to improve performance and the delivery of care in their communities.

Sole-source Provider Focused on Building Successful Flex-Funded Networks

The Chartis Center for Rural Health is exclusively focused on serving as a consistent, reinforcing advisor to rural health organizations. Our sole source programming, curriculum, expertise and benchmarking technology delivers a common, rural-relevant framework through which leadership teams and frontline decision makers can establish a deeper understanding of hospital performance and initiate further performance improvement.

Today, our expertise and services are utilized by State Offices of Rural Health (e.g., Colorado, Iowa, Maine, Nebraska, Ohio, etc.), Rural Health Associations, health systems with rural affiliates and individual rural hospitals. These engagements encompass more than 300 rural hospitals.

Additionally, our INDEX framework is the foundation for some of rural healthcare’s most prestigious awards (e.g., Top 100 Critical Access Hospitals) and our data analysis and research is leveraged by rural healthcare advocates such as the National Rural Health Association in support of legislative initiatives in Washington, D.C., and across the nation.

Historically, our Flex (and SHIP) grant-funded programming has been used by State Offices of

Rural Health, Departments of Health and Universities in more than 30 states, including:

• Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Louisiana, Maine, Massachusetts, Michigan, Missouri, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont and Wisconsin.

Across all our state engagements, we work closely with State Office of Rural Health/Department of Health leadership and grant program coordinators and actively engage hospital leadership teams through on-site hospital visits, network-wide in-person meetings, one-on-one conference calls and Webinars.

Helping Critical Access Hospitals Navigate a Historic Moment

The rural health safety net has been under considerable pressure for more than 15 years.

Approximately 200 rural hospitals have closed (or converted to a model no longer supporting inpatient care) and our research indicates that more than 430 are vulnerable to closure. Yet the presence of the Rural Health Transformation Program presents rural healthcare with a unique opportunity.

Rural hospital leadership teams must devise a new set of key considerations to navigate the continued uncertainty and seize opportunities as they emerge. Hospitals, particularly independent rural hospitals, must prepare to maximize their participation in RHT-funded initiatives. We believe we can play a vital role in helping the state’s Critical Access Hospitals capitalize on new strategies maximizing this moment.

We have based this bid response on our experience supporting other departments of health and their efforts to improve hospital operations and finance at Critical Access Hospitals, and the information provided in the bid response. To that end, as you review the proposal, if questions or concerns arise, please do not hesitate to contact us directly for any clarifications or requests for modifications.

Best Regards, Michael Topchik

Executive Director

The Chartis Center for Rural Health mtopchik@chartis.com

(207) 518-6705

Mississippi's CAHs

Organizational Overview The Chartis Center for Rural Health is focused on improving the delivery of care in America’s rural communities. A sole source partner to Departments of Health and State Offices of Rural

Health around the country, the Chartis Center for Rural Health provides expanded visibility into the performance of rural hospitals. Through our rural-relevant benchmarks and comparative analytics, knowledge and expertise, we have developed unique, sole source programming and deliverables designed to address multiple Flex and SHIP grant-funded program areas.

As a national leader in providing research for rural health policy, our team is uniquely positioned to provide analytic-based consulting services to rural health stakeholders. The combination of our extensive data sets and benchmarks of rural healthcare, research and solution portfolio with the broader expertise and resources of Chartis, The Chartis Center for

Rural Health delivers the leadership expertise needed to help rural providers, health systems, associations and state networks develop and implement performance improvement initiatives.

Whether the objective is to best understand market forces and patient outmigration, to deliver higher quality care at lower cost, measure and report for public reporting or to better understand and support population health disparities, The Chartis Center for Rural

Health provides an accountable resource focused on helping rural providers fulfill their mission.

The Chartis Center for Rural Health works with the rural healthcare community through:

• Network Collaboration: Tailored programming and guidance to support peer collaboration and learning in priority areas such as value-based payment models, quality improvement (MPQIP), rural health clinic benchmarking, EDTC benchmarking, revenue cycle optimization and population health management.

• Strategic and Operational Advisory: Expert guidance on the internal operational and external market factors which impact the health and growth of a rural organization and create a data-driven foundation for achieving strategic goals.

• Quality Improvement: Technical assistance in the development of quality improvement initiatives including Value-based Purchasing-related improvement in areas of Process of Care, Outcomes of Care, Patient Satisfaction (HCAHPS), and

Efficiency.

• Advanced Analytics: Rural-relevant analytics and benchmarks for detailed assessment and identification of improvement opportunities across finance, operations, quality and population health.

Our unique approach, portfolio of solutions and expertise has helped more than 750 rural and Critical Access Hospitals, state-wide rural hospital networks (in more than 30 states) and health systems with rural footprints leverage sophisticated analytics for benchmarking performance to inform strategic and operational decisions.

At the core of our benchmarking and data analysis is the Chartis Rural Hospital

Performance INDEX®. Now in its 15th year, the INDEX is the industry’s most comprehensive and objective framework for assessing rural provider performance. INDEX data is the basis of many of rural healthcare’s most prominent awards such as the annual

Top 100 Critical Access Hospitals and Top 20 Critical Access Hospitals programs and is used by organizations such as the National Rural Health Association in support of legislative initiatives.

CORE COMPETENCIES

Our primary areas of expertise include:

- Working with governmental and non-governmental partners to support public reporting programs

- Establishing state-wide hospital networks to facilitate performance improvement

- Analyzing data for network benchmark reporting

- Applying Balanced Scorecard methodology for quality improvement

- Providing performance management tools for acute care hospitals, physician practices, and long-term care operations

- Facilitating collaboration and peer-to-peer best practice exchanges for rural healthcare

- Developing innovative, custom reporting solutions

- Consulting with leadership teams to interpret benchmarking data and recommending initiatives to improve performance in healthcare organizations.

A Market-Leading Firm with Extensive Resources

Our analytics, rural-relevant benchmarking and research are backed by the full breadth of expertise and resources of Chartis. Founded more than 20 years ago, Chartis is one of the nation’s largest healthcare advisory firms. With more than 1,000 professionals, Chartis is committed to helping providers, payers, technology innovators, retail companies, and investors create and embrace solutions that tangibly and materially reshape healthcare for the better.

Today, our firm serves clients across the health spectrum, including 40% of all U.S. hospitals, providing expertise and services for Strategic Transformation, Financial Transformation, Clinical Transformation, and Digital & Technology Transformation.

Chartis is a privately held, national healthcare consulting firm that operates in all 50 states with offices in San Francisco, Chicago, Minneapolis, New York and Boston. We follow generally acceptable accounting practices and have our financials audited by the certified public accounting firm. As a privately held firm, we do not publicly disclose our financials.

Federal Grants Experience

At The Chartis Center for Rural Health, our team is uniquely focused on serving as a consistent, reinforcing advisor to state offices of rural health, departments of health, rural hospitals and health systems and rural affiliates. We offer a programming curriculum that brings leadership teams and frontline decision makers together under a common, rural-relevant framework to establish a deeper understanding of hospital performance and initiate further performance improvement.

Today, the Chartis Center for Rural Health’s expertise and grant programming are relied upon by state offices of rural health and departments of health in states such as Colorado, Iowa, Maine, Mississippi, Nebraska and Ohio. In these states, our grant-funded programming reaches leadership teams and frontline decision makers at over 300 rural hospitals. Historically, The

Chartis Center for Rural Health has facilitated state-wide networks in more than 30 states, and.

These states include:

• Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Louisiana, Maine, Massachusetts, Michigan, Missouri, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont and Wisconsin.

Since 2015, The Chartis Center for Rural Health has provided rural hospitals in Mississippi with access to a broad range of performance benchmarks, analytics, analysis and expertise in support of Flex and SHIP grant funded programs. We maintain a close working relationship with healthcare professionals across the Mississippi rural hospital community, from frontline decision makers (e.g., Quality Improvement) to CEOs, CFOs and other C-Suite members.

Encompassing all Critical Access Hospitals in the state and more than a dozen rural and community hospitals, this grant-funded program offers analysis, expertise and advisory guidance across Financial and Operational Improvement (e.g., benchmarking, managed care contract optimization), Quality Improvement, and Value-based Purchasing. In addition to rural-relevant benchmarks and analytics utilizing the Chartis Rural Hospital Performance

INDEX, this program also features customized assessments for Mississippi Critical Access

Hospitals focused on areas such as Medicare Patient Outmigration, Population Health and

Market Share which help support strategic planning.

Additionally, our Value-based Purchasing consortium, which was coordinated in collaboration with the Mississippi Hospital Association through the SHIP grant, leveraged our proprietary VBP modeling and enabled hospital leadership teams to explore performance across four domains (Clinical Care, Safety, Patient Experience and Efficiency) and the financial impact of performance deficiencies.

Hospital engagement is the foundation of our state network initiatives and a hallmark of all our client relationships. As part of our Flex and SHIP grant funded engagements with clients such as the Mississippi Department of Health, we conduct data review sessions in one-on-one webinars with hospital leadership and hold network-wide webinars that help to inform and direct strategic decisions. Over the course of these engagements, our programming enables us to nurture relationships with hospital leaders and create success across the entire network.

Programmatic Experience Historically, our Flex grant-funded programming has been used by State Offices of Rural Health, Departments of Health and Universities in more than 30 states. Across all our state engagements, we work closely with State Office of Rural Health and Department of Health leadership and grant program coordinators and actively engage hospital leadership teams through on-site hospital visits, network-wide in-person meetings, one-on-one conference calls and Webinars.

Our approach, commitment to client service, and the value of our programming are the principal reasons why so many of our state-level engagements are active for extended periods of time. In addition to our long-standing engagement in Mississippi, our team has been supporting Flex-funded engagements, for example, in Ohio since 2008, Maine since 2008, and Colorado since

2014. Some of the components of these engagements echo our work in Mississippi but also demonstrate our ability to tailor grant programming to the specific needs of states and their rural hospitals. Consider the following:

- Ohio Department of Health - For more than 15 years, we have successfully partnered with the Ohio Department of Health to deliver Flex and SHIP grant-funded performance improvement programming to Ohio’s 32 Critical Access Hospitals.

The foundation of this engagement is the Chartis Rural Hospital Performance INDEX, which provides each Critical Access Hospital with comprehensive and objective performance monitoring and benchmarking analytics. For this engagement, we have developed 2 specific tracks – MBQIP Quality Improvement and Financial & Operational Improvement.

This unique structure allows us to leverage the power of network collaboration to use better understand performance, identify opportunities for improvement and develop performance improvement initiatives that dovetail with federal grant guidance.

Additionally, our Value-based Purchasing consortium in Ohio complements these performance improvement initiatives helping Critical Access Hospital leadership teams better understand the correlation between performance and reimbursement through sophisticated VBP modeling and identifying performance opportunities based on state and national benchmarks of performance.

- Maine Office of Rural Health and Primary Care – Chartis works directly with the Maine

Office of Rural Health and Primary Care to provide sophisticated benchmarking data, analysis, education and quality improvement focused on Patient Satisfaction with

HCAHPS. Since 2008, CCRH has led a longitudinal, grant-funded quality improvement initiative with the Maine State Office of Rural Health and played a significant role in helping

Maine’s Critical Access Hospitals achieve the second-best quality and patient satisfaction in the nation.

This very successful initiative involves 16 Critical Access Hospitals. Our work with the Maine

Office of Rural Health has not only delivered measurable results (i.e., among the nation’s best for Quality) – but played a vital role in enabling the Maine Office of Rural Health and

Primary Care to establish a collaborative network through which hospital leadership teams can use performance analytics as a springboard to solve problems and exchange best practices.

- The Colorado Rural Health Center – Since 2014, we have maintained a long-standing relationship with the Colorado Rural Health Center. This Flex-funded program encompasses both Critical Access and Rural & Community facilities and is one of the largest state network engagements managed by The Chartis Center for Rural Health with 34 hospitals.

At the core of the program is the Chartis Rural Hospital Performance INDEX, which provides each participating hospitals with comprehensive and objective performance monitoring and benchmarking analytics for financial and operational improvement.

As part of this program, we convene regular meetings for network participants, have established C-level work groups and present at the annual Colorado Rural Health conference. Our ability to meet annually, in-person with senior leadership from the network hospitals serves as a powerful mechanism for sharing insight into Colorado rural hospital performance and fostering collaboration among frontline decision makers and leadership teams.

Program Management and Organizational Experience A sole source partner to State Offices of Rural Health around the country, the Chartis Center for

Rural Health provides expanded visibility into the performance of rural hospitals. Through our rural-relevant benchmarks and comparative analytics, knowledge and expertise, The Chartis

Center for Rural Health has developed unique, sole source programming and deliverables designed to successfully address multiple Flex program Areas. These program areas include:

• Flex Program Areas Supported: Program Area 1: Critical Access Hospital Quality

Improvement (MBQIP), Program Area 2: Critical Access Hospital Financial and Operational

Improvement, Program Area 3: Critical Access Hospital Population Health Management, Program Area 5: Critical Access Hospital Designation

Our network programming combines advisory services, rural-relevant research, and comparative analytics to help state offices of rural health, departments of health, hospital associations and universities measure rural hospital performance and implement sustainable improvement initiatives. Whether the objective is to better understand market forces and leakage, to deliver higher quality care at lower cost, measure and report for public reporting or to better understand and support population health disparities, The Chartis Center for Rural

Health provides an accountable resource focused on helping rural hospitals fulfill their mission.

Across all our state network engagements, The Chartis Center for Rural Health works closely with State Office of Rural Health and Department of Health leadership and grant program coordinators. We actively engage hospital leadership teams through a variety of program components such as on-site hospital visits, network-wide in-person meetings, one-on-one conference calls and data review and education Webinars. We track and measure program progress and provide regular back regularly to our state grant program coordinators.

The Chartis Center for Rural Health works with state partners to develop programming, develop agenda, and execute the delivery of technology and consulting solutions that aid hospitals and networks or systems of hospitals to work toward common performance improvement objectives. In support of this work, we employ:

- Principals and Senior Consultants who are former hospital or multi-hospital CXOs, assuring strategic, quality, financial, and operational relevance to hospital leadership and networks.

- Consultants with experience working with rural hospitals across the country. Consultants offer perspective to participants when mining data for performance improvement opportunities. Consultants further develop network focus on initiatives such as public reporting, quality improvement, and benchmarking.

- Analysts assist participating hospitals and other network partners in transferring data, developing indicators, providing advanced benchmarks and analytics, and providing a high level of individual customer support.

- Engineers/Programmers work with analysts and consultants and assure data sets are updated and accurately reflect the ever-changing algorithms used in public reporting as these change on a weekly basis.

Through our experience working collaboratively with the Mississippi Department of Health as well as with other state offices of rural health on Flex grant funded programming, we understand how to manage all aspects of the engagement to ensure the optimal results for our state partners and the individual rural hospitals that participate in the network. The regular cadence with which we communicate with Flex Program Coordinators and hospital leadership teams helps to ensure that our programming is engaging, delivers value and adheres to the state’s budgetary requirements.

Work Plan

1. Financial and Operational Assessment:

The Chartis Center for Rural Health will facilitate a collaborative, statewide ‘network’ for measuring and monitoring financial and operational performance through a series of advanced analytics and benchmarks. At the core of the programming is The Chartis Rural Hospital

Performance INDEX, a sole source framework of rural-relevant benchmarks and research for more than 2,100 rural hospitals in the country across 36 indicators spanning 8 pillars.

Access to INDEX data for financial and operational improvement as well as other analytics such as

Flex Financials will provide every Critical Access Hospital in the state with a market-leading performance assessment at 3 intervals during the grant year (Winter, Summer and Fall).

With data refreshed 3 times annually, this sole source technology and analytic solution supports the rural hospital flexibility program with a comprehensive and objective view of performance indicators for inpatient market share, outpatient market share, quality, outcomes, patient perspective, cost, charge and financial efficiency. The robust technology, data science, and advanced algorithms that support INDEX are unique. We are committed to working actively to ensure the INDEX remains in-step with rural-relevant measures as they are retired/introduced by

CMS.

Now in its 16th year, the INDEX is a comprehensive and objective assessment of rural hospital performance. Featuring a methodology that utilizes publicly available data, the INDEX is leveraged nationwide by rural hospitals, health systems with rural affiliates, hospital associations, and state offices of rural health to measure and monitor performance across a variety of areas impacting hospital operations and finance. In addition to the INDEX metrics, our programming also provides access to an expanded view of financial and operational performance through 22

Flex financial indicators (updated annually), and detailed Cost & Charge comparative analysis for specific DRGs/procedures.

• A collaborative, statewide network utilizing the INDEX supports Flex Strategy Area 1 and 2 simultaneously.

• Use of INDEX for financial and operational improvement dovetails with Chartis’ existing engagement with the Flex program in Mississippi to support Critical Access Hospitals through MBQIP improvement.

Chartis will work collaboratively with the state’s Flex coordinator to help provide onboarding education and guidance on public reporting to ensure ‘network’ hospitals are correctly reporting metrics that are integrated into the INDEX. With each of INDEX’s 3 annual data releases, Chartis will deliver the following to each Mississippi CAH:

• INDEX Hospital-level Analytics – Hospital-specific benchmarks providing Overall

Rank and a percentile rank for each of the 8 INDEX Performance Pillars.

• INDEX Statewide Pillar Analytics – Benchmarks for all CAHs containing Overall

Rank and Pillar-level metrics, including median benchmarks for state CAHs/Rural PPS and all U.S. CAHs/Rural PPS.

• INDEX Indicator Analytics – Indicator level performance across 36 INDEX metrics.

Metrics provided for state CAHs/Rural PPS and all U.S. CAHs/Rural PPS.

• Enhanced Analytics – Flex Financial data (22 metrics) and Cost/Charge comparison for specific DRGs provide additional insight into rural hospital performance.

• Networkwide INDEX Webinars – Conducted with each INDEX release, the webinars help increase engagement by providing participating hospitals with an in-depth review of INDEX metrics.

• Individual Data Review Sessions – Conducted via Zoom, these sessions provide individual hospitals with the opportunity to dive deep into their INDEX metrics to identify opportunities for improvement.

As noted, INDEX analytics will be provided through this engagement to each of the state’s

Critical Access Hospitals. Chartis will use the INDEX data, as well as additional financial metrics and Chartis’ own data regarding rural hospital vulnerability, to determine the 12 Critical Access

Hospitals in need of chargemaster reviews as part of the statement of work.

2. Specialized Leadership and Front-line Decision Maker Learning

• Revenue Cycle Roundtable (2 sessions – 1 in-person and 1 remote)

• Billing & Coding Course (2 sessions – 1 in-person and 1 remote)

As part of this program, Chartis will convene financial and revenue-cycle leaders from the state’s

Critical Access Hospitals for learning and collaboration.

For this component of the programming, Chartis will be partnering with MHA and its Rural

Hospital Alliance and Center for Rural Health. The Mississippi Hospital Association (MHA) is the statewide agency for health care representation and service to all hospitals and health care networks, as well as the patients and communities they serve. Founded in 1931, MHA provides representation and support to members through advocacy activities that address an array of concerns, perspectives and needs at both federal and state levels. MHA debates health policies from development through legislative, regulatory, and judicial processes. This agency also provides quality educational offerings and information on health care issues and trends.

The MHA has a long history of partnering with others to execute grants that benefit hospitals and the communities they serve. This partnership lends expertise and access to the project. MHA has worked with Chartis in previous grants and maintains a solid working relationship with them.

The Rural Hospital Alliance (RHA) was formed as a 501 (c) 3 in 2011. RHA continues to attract membership from rural hospitals across Mississippi and has grown to a total of 42 members. The

RHA meets monthly. The Mission of the RHA is to assist member hospitals in being successful healthcare providers in their unique rural setting by helping them to achieve collectively what they could not achieve individually, in the areas of:

1. Sharing ideas that can contribute to more effective management of member hospitals;

2. Using the purchasing power of a network for the benefit of member hospitals;

3. Providing a venue through which member hospitals can band together to promote their common goals and agenda.

4. Work together with one united voice to promote advocacy with both federal and state legislation to maintain and improve rural healthcare.

While networking is considered one of the primary benefits of this organization, the programs and services available to members are also very important and continue to evolve as the needs of the organization and membership evolves with the ever-changing healthcare delivery environment.

The RHA in collaboration with MHA has partnered with MSDH to successfully execute both FLEX and SHIP grant objectives for over 25 years. Vast experience with federal and state grants has led to expertise in managing grants. As a trusted partner with Chartis, RHA and MHA will be able to provide credibility and access to rural hospitals.

As an organization, Chartis possesses a tremendous amount of expertise in revenue cycle operations, and hospital billing and coding processes. Our education sessions are designed to help meet rural hospital leaders (executives and frontline decision makers) where they are and provide them with the tools and knowledge to seize improvement. Our roundtable sessions, for example, will help Mississippi’s CAHs better understand how to:

▪ Align revenue cycle operating models to support strategic priorities.

▪ Maximize technology investments.

▪ Enable the realization of full revenue potential at the lowest possible cost to collect.

▪ Create a consistent, equitable, and predictable patient financial experience

Scheduling off these sessions (e.g., day, time and location) will be coordinated with the state’s

Flex coordinator and also leverage – when possible – existing rural meetings occurring within the state (e.g. planned events hosted by the Mississippi Hospital Association). Session agenda will be determined collaboratively by the Flex coordinator and Chartis.

3. Chargemaster Reviews (Programming for 6 Critical Access Hospitals)

Once the 12 Critical Access Hospitals have been identified, Chartis will work in collaboration with the Flex coordinator to determine which 6 will receive 2 reviews in year 1 and which 6 will receive 2 reviews in year 2 of the engagement.

During years 1 and 2, Chartis will work with 6 of the identified Critical Access Hospitals to assess and adjust the facility chargemaster. For this program component, Chartis will leverage its extensive expertise supporting hospital financial operations and utilize data from a variety of sources, cost and charge variance data and individual hospital data to help these facilities identify errors and develop go-forward plans for implementing changes.

For this component of the programming, we will leverage a combination of online sessions for all 6 CAHs as well as 1-on-1 data review calls with each of the 6 individual CAHs. Scheduling of each online session (e.g., day, time and location) will be coordinated with the state’s Flex coordinator and also leverage – when possible – existing rural meetings occurring within the state (e.g. planned events hosted by the Mississippi Hospital Association).

4. Outmigration Assessments (6): Medicare Patient Outmigration Assessments shed new light on market factors and identify key service line “Keepage” and “Leakage” opportunities in both inpatient and outpatient domains. This assessment leverages a unique approach and results in a sole source deliverable unique among firms supporting rural healthcare.

Within every rural hospital’s service area are patients who bypass their local facility and seek treatment elsewhere. Providing detail into patient leakage volumes, associated service lines and expected revenue impact, these assessments offer rapid insight into key strategic service lines for potential development and recruitment imperatives.

As part of this engagement, Chartis will produce outmigration assessments for 6 Critical Access

Hospitals. We will work collaboratively with the Flex coordinator to determine which hospitals receive the assessments. Once each assessment has been delivered, Chartis will coordinate and conduct a data review with hospital leadership.

Programming Approach:

For more than a decade, Chartis’ research has helped quantify the uncertainty endangering rural hospitals and inform the efforts of those working to preserve care in rural communities as well as our client engagements. The combination of this expansive research program and our internal expertise and sophisticated, rural-relevant analytics provide us with a unique lens into the challenges facing rural hospitals and a platform from which we can help improve the delivery of care.

Our programming focuses on helping hospital leadership teams and frontline decision makers to identify opportunities for improvement across hospital operations and finance. Our emphasis on

Performance Improvement is always consistent with themes from the Patient Safety and

Affordable Care Act (ACA) and the Triple Aim of healthcare.

Measure: As an organization, we utilize data as a resource to generate and ask questions through the lens of measurement. Through this program, we’ll work actively with the

Department of Health to leverage all existing data resources (e.g., Flex Monitoring team), along with our own database of proprietary and publicly available data such as INDEX to provide a comprehensive and objective view of CAH performance spanning areas such as Market Share, Cost, Charge and Financial Efficiency. The breadth and depth of our data also allows us to not only provide CAHs with a lens into their own performance, and that of their in-state peers but other like-hospitals from around the country.

We render these rural-relevant metrics into ‘views’ that represent industry standards or have been developed by policy makers and dynamically update and deploy new data as it becomes available (often up to a year in advance of other sources). This approach enables our hospital and network clients to utilize our tools and reporting as a tool to consistently measure and monitor performance progress.

Results: As a team, we employ a “Network Collaborative” model to facilitate a coordinated approach to the development of targeted performance improvement initiatives to achieve

Results. While performance improvement initiatives may be unique to each facility, there will be instances where initiatives can be developed across the entire network of CAHs.

Sustain: Monitoring performance progress is foundational for creating improvement cycles that generate consistent results. We strongly believe in the power of performance improvement monitoring as a catalyst for identifying new opportunities for improvement. Measurable results is an important driver for supporting the Department of Health in its reporting to the FORHP regarding the efficacy of the Flex program.

Perspective: As the rural health landscape continues to shift, our understanding of the impact of these factors at the state- and local-level is vital. Sophisticated research into these factors can expand and deepen our ability to identify factors contributing to hospital vulnerability, and to develop strategies and devise action aimed at stabilizing the rural health safety net in

Mississippi.

Programming Method:

For this engagement, we will provide quality and performance-related benchmarks to the relevant hospital “leads” as a means of framing the project and to set the stage for continuing the strong collaboration across the network. With data, there are a few key considerations:

• Data - Acquisition: There is no requirement for data entry on the part of any CAH. We utilize public data sources for our INDEX reporting.

• Data - Processing: We will rely on CMS processing of relevant measures, and we will create intramural and intermural cohort analysis between and among the CAHs as well as nationally.

• Data - Reporting: Stakeholders will have access to multiple layers of reporting including network aggregate reporting, hospital-by-hospital reporting and measure-by-measure reporting.

• Data - Benchmarking: We possess extensive experience supporting rural health networks across the country and have developed standard system/network-level analytics to include aggregated network-level reporting, hospital-by-hospital level reporting, and measure by measure reporting. A hallmark of the network analytic approach continues to be intramural comparisons between all participants, identifying top performers to facilitate

“best practice exchanges” and to highlight areas of challenge in need of technical assistance.

• Data - Utilization: As a firm, we have always recognized the importance of context and expertise needed to extract actionable insights from data. Our team possess extensive expertise facilitating network meetings and webinars and the provision of one-on-one hospital technical assistance.

Our data-driven approach provides the foundational frame for understanding financial and operation performance. This “assessment” meets federal grant guidance, and leverages a network collaborative, benchmark approach to identification of opportunities.

1 Evaluate: Our team will produce trended financial and operation metrics for each CAH utilizing the context of intramural and intermural benchmarks to establish a baseline of current performance.

2 Identify Opportunity: Individual measures above a 65% percentile will be identified as opportunities for quality improvement. This standard analytic approach will support the

Department of Health in developing targeted grant activities and provide a standard for reporting progress to FORHP. This approach will also develop a standard perspective for each participating CAH. It is important to note that not all measures above the 65% percentile represent actionable opportunities, however this approach supports a consistent analytic approach in the identification of opportunity for improvement.

3 Target Action: Our expert clinical consultants will provide an executive summary to target action.

4 Results: Our benchmarking data serves as a road map, highlighting areas of opportunity through comprehensive assessments, while consultants support a process of performance improvement. They will:

• Develop network meetings and present benchmarking data

• Help facilitate the development of Performance Improvement Plans (PIPs) as needed

• Provide feedback/reporting to the Department of Health

The timeline included with this RFP response includes prospective dates for network-wide webinars. Access to team members for 1-v-1 data reviews and Performance Improvement Plan progress will be offered on an as-needed basis. Access to our team members for individual data reviews is a key driver for maintaining strong engagement among network participants, and ultimately generating meaningful results.

5 Sustain (Measure): CCRH is uniquely situated to provide consistent, objective, trended, benchmarked reporting on targeted metrics to monitor and sustain improvement

6 Understand: CCRH is at the forefront of conducting research into the stability of the rural health safety net. Our findings into rural hospital vulnerability, and declining access to care, for example, are helping inform and guide hospital leadership, rural healthcare leaders and advocates, and shape government policy. As part of this program, we will provide the

Department of Health with visibility into rural hospital vulnerability in the state so that the department can explore opportunities to assist these facilities and better understand the potential implications at the community level. Please note that due to the sensitivity of the vulnerability data, we will collaborate with the Department of Health to share any vulnerability data which may identify specific hospitals to safeguard privacy.

Mississippi's CAHs

Project Team Overview

The Chartis Center for Rural Health has developed an experienced project team to facilitate hospital and network performance Improvement initiatives. Our team members possess tremendous healthcare and analytics experience and have worked closely with rural and Critical

Access providers on strategic initiatives to improve Quality, Patient Satisfaction, Outcomes and

Financial performance including Value-based Processing.

Project Manager: Michael Topchik, MA, Executive Director

As the executive director of the Chartis Center for Rural Health, Michael Topchik has been focused exclusively on rural communities and their healthcare for 20 years. In this role, Michael advises the nation’s largest health systems and their rural affiliates, state offices of rural health, and independent rural hospitals to assess operational and financial performance and develop strategies for improving the delivery of care.

Michael directs Chartis’ rural health safety net research analysis, which is used widely by rural healthcare organizations in support of public policy initiatives. Michael is a frequent speaker at national and regional conferences on a variety of topics, such as rural hospital vulnerability; rural health disparities and inequity; declining access to services such as obstetrics, oncology and general surgery; nursing and workforce shortages; and the new CMS Rural Emergency Hospital

(REH) designation. He regularly shares his expertise with leading news outlets such as CNN, USA

Today, The New York Times, PBS NewsHour, National Public Radio, KFF Health News and Modern

Healthcare.

Functional/Technical Lead: Troy Brown, Network Consultant and Performance

Improvement Specialist

Troy spent 10 years in administration at Charles A. Dean Memorial Hospital, a critical access hospital in Maine, serving in a variety of roles including: Director of Business Services, with oversight in areas of Registration, Patient Accounts, HIM, IT and Materials Management. He also led C.A. Dean performance improvement and community relations and development. Troy has built upon this foundation at The Chartis Center for Rural Health, facilitating strategic performance improvement projects with rural hospitals, statewide networks of hospitals and health system networks across the country, including the Ohio Critical Access Hospital network for both Flex and SHIP-funded programs. Troy will support the Flex-related programming, including data review and assessment, and performance improvement planning.

Network Data Analyst: Ana Wiesse

In her role as data analyst, Ana works closely with rural hospital leadership teams to help them better understand and assess performance through the lens of the Chartis Rural Hospital

Performance INDEX. Ana is actively involved in the development of sophisticated analytic-based assessments for The Chartis Center for Rural Health’s network clients that provide greater visibility into dynamic factors impacting market share, patient volumes, population health, quality and the delivery of care.

Marketing & Communications: Billy Balfour

Billy leads The Chartis Center for Rural Health’s marketing initiatives. In his role, he works closely with state offices of rural health to promote and coordinate various network initiatives designed to engage, educate and help participating hospitals optimize their use of INDEX-related benchmarks. As part of his role, Billy also oversees development and marketing of CCRH’s thought leadership activities, including executive-level presentations at national conferences and ongoing research into the rural health safety net.

Network Support/Analysts/Client Service: The Chartis Center for Rural Health has dedicated resources will support consortium activities and initiatives, including data analysis, reporting and promotion of network events to build and nurture collaboration among the Critical Access

Hospitals.

September October Provide Vulnerability Analysis Monthly Correspondance with Flex Coordinator INDEX Distribution #1 (Financial/Operational Assessment) Network Webinar 1v1 Data Reviews Outmigration Assessment Development Outmigration Assessment Distribution Outmigration…