Utilization_report.pdf

This is a utilization report prepared by the City of Phoenix that documents employee health clinic service usage across multiple insurance carriers for the organization's workforce. The report analyzes service utilization patterns across three years (2023-2025), providing baseline data for the city's Employee Health Clinic Services Request for Proposal PS 26-0095. The proposal solicitation targets establishment of a near-site health clinic serving approximately 32,000 eligible city employees and their dependents enrolled in three self-funded medical insurance plans (HDHP, PPO, and HMO). The contractor must establish and operate the clinic at its own cost and expense, including leasing or owning real property, constructing or leasing the building, furnishing the facility with equipment and fixtures, and covering future renovations. The five-year contract will commence January 1, 2027, with implementation beginning no later than June 2026. The contractor must provide same-day or next-day medical appointments, primary care, urgent care, limited pharmaceutical services, preventive health and wellness services, and optional behavioral health services at a clinic location preferably within two city blocks of 1st Avenue and Washington Street, operating Monday through Friday from 7:00 AM to 6:00 PM Arizona Time. The proposal deadline is February 23, 2026, at 2:00 p.m., with written inquiries due by February 6, 2026, and a non-mandatory pre-offer conference scheduled for February 3, 2026.

The utilization report reveals that Blue Cross Blue Shield of Arizona (BCBS) is the primary carrier with 3,492 charges in 2025, followed by Aetna with 2,662 charges in 2025, with total utilization reaching 6,154 encounters across all carriers. Service utilization data shows that 76 percent of 2025 clinic visits were primary wellness and annual care appointments, with 24 percent addressing acute injuries or conditions, compared to 79 percent and 21 percent respectively in 2023-2024. Proposals will be evaluated using weighted criteria of Method of Approach (42.5 percent), Qualifications and Experience (30 percent), and Pricing Proposal (27.5 percent). Qualified offerors must demonstrate a minimum of five consecutive years of experience providing employee health clinic services for comparable-sized organizations. Pricing must be firm and fixed for the entire five-year contract term through December 31, 2031. The contractor must obtain a performance bond equal to 10 percent of the total contract amount within 14 days of award notification and maintain comprehensive insurance coverage including Commercial General Liability ($2,000,000 aggregate), Professional Liability ($1,000,000 per claim), and Network Security and Privacy Liability ($1,000,000 per claim). Additional requirements include compliance with Disadvantaged Business Enterprise (DBE) and Small Business Participation Plan requirements under 49 CFR Part 26, Federal Transit Administration (FTA) certifications, execution of a Business Associate Agreement establishing HIPAA compliance obligations, and adherence to the City of Phoenix's Supplemental Terms and Conditions.