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Consulting Services for Population Selection & Program Monitoring of the Vt's Medicaid CCM & CC Programs
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Request Date: 8/4/2006 12:00:00 AM
Open Date:
Closing Date: 9/22/2006 4:00 PM
Intent To Bid Deadline:
Est. Dollar Value:
RFQ Number:
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Agency of Human Services-Office of Vermont Health Access
312 Hurricane Lane, Suite 201
Williston,
VT
05495
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Locations:
State-Wide
Keywords:
Medical Services, Consultant Services
Bid Description:
The Office of Vermont Health Access is seeking to enter into a contract with a qualified individual or organization that specializes in providing Medicaid population selection, stratification, and program monitoring services. The contractor is expected to produce the following:
I. Selection of Appropriate Intervention and Reference Populations
A. Design and develop a selection methodology to identify intervention and reference populations for Vermont’s Chronic Care Management (CCM) and Care Coordination (CC) Programs. This will include both an initial and ongoing selection strategy. The Programs seek to improve health outcomes and reduce unnecessary expenditures for Medicaid beneficiaries with chronic health conditions.
B. Develop population criteria. Selection criteria will be authorized by the State and will include both eligibility and clinical components. Appropriate data sources in addition to claims history will be identified and a system to integrate all data sources will be developed.
C. Create a study design with appropriate reference groups for comparison to the population receiving intervention services. The intervention and reference populations must be comparable and equivalent, meaning that the criteria used to identify and select the people who will be potentially exposed to intervention must be the same as the criteria used to define the reference group.
D. Establish baseline population trends and risk stratification of the population.
E. Utilize a scientific/epidemiological methodology.
F. Patient-level electronic data files will be developed and prepared for delivery to the Chronic Care Management intervention vendor and the Care Coordination program.
G. Summary data profile reports will be prepared for the State, including state-wide and selected populations
II. Program Monitoring
A. Develop a system of analysis for clinical/epidemiological monitoring of the interventions conducted by the CCM intervention vendor and CC staff. Both the design type and additional methods to control for confounding factors will be selected.
B. Establish a methodology to identify and measure the effectiveness of interventions with co-morbid disease states.
C. Assist in the design, development, and State implementation of a monitoring and quality improvement program that includes benchmarking, data gathering, and reporting.
D. Develop process and outcome metrics based on intervention strategies proposed by the CCM intervention vendor and CC program staff, and relevant HEDIS measures.
E. Develop processes to integrate appropriate data from other state initiatives such as the Vermont Blueprint for Health.
F. Fully disclose evaluation models, metrics, equations, and patient-level results so that our program and findings are transparent and available to all interested stakeholders.
The Bidder will provide on-going selection and monitoring activities for the Chronic Care Management and Care Coordination Programs. The ongoing selection and stratification process will facilitate enrollment of new CC and CCM participants based on program capacity, the addition of newly eligible Medicaid beneficiaries, and changes in clinical profiles and utilization patterns of current Medicaid beneficiaries. The selection process must also allow for movement of participants between the CC and CCM programs and account for previous participation in the CC or CCM programs as appropriate in a scientifically-designed study.
Monitoring activities will result in regular reporting on process and outcome metrics. Reports must show programmatic outcome changes as compared to what would have happened in the absence of the program. Reports will also inform regular Plan Do Study Act (PDSA) cycles in efforts to improve program performance over time.
All Selection and Program Monitoring methodologies will be documented and shared with the State.
Special Instructions:
There will be a bidders’ conference on September 5th, 2006 from 10:00 am to 12:00 pm. All inquiries and questions related to the RFP must be submitted in writing by 4:00 pm EST August 25th, 2006. Written responses to questions will be mailed by September 15th, 2006. Prospective bidders are required to submit a letter of intent to bid by August 18th, 2006, 4:00 pm EST. Proposals must be received by 4:00 pm EST September 22nd, 2006. The RFP has been posted on the Office of Vermont Website
www.ovha.state.vt.us/RFP .
Awardees
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Ctr for Health Policy & Reseach Univ. of Mass Medical School
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10/20/2006 |
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222 Maple Avenue
Shrewsbury, MA
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$944,305.00 |
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