Medicare Data Solutions RFP FAQ

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1 Medicare Data Solutions RFP FAQ Updated 7/22/2016 Q: Are client references specific to the Primary vendor or is it open to the whole team as well including subs? A: Include whichever references you feel accurately portray your ability to meet the expectations in the RFP and response. Q: In response to intent to respond, does the Prime have to be the one who submitted their intent, or does it pertain to the actual team? (i.e. we responded with our intent to bid, however if we were to be a sub, and our Prime didn t respond, would our initial response be enough?) A: The intent pertains to the actual team. It does not matter whether one or all parties responded. Q: How can I access the Pricing Spreadsheet? The PDF has an embedded image for Appendix D, Pricing spreadsheet, but it doesn't appear to be a link. A: The pricing spreadsheet can be accessed through crisphealth.org, underneath news and events and the RFP link. There should be a link to a google sheet for the Medicare Data Pricing Template. Updated 7/18/2016 Data Questions Q: What is the expected frequency of Medicare data loads? Daily, weekly, monthly? A: Assume monthly update files for Medicare data. The State of Maryland and CRISP continue to work with CMS both on data delivery and timeline. Q: What is the current format of the Medicare s Chronic Condition Warehouse data? What does CRISP plan to do with this data? Volume of data? Is this an add-on to the RFP? Or covered under RFP scope & pricing already? A: The State of Maryland and CRISP continue to work with CMS both on data delivery and timeline. HSCRC s current CCW work is not included in the scope of this RFP. Q: Our assumption is CMS is the only valid data source. Apart from CMS, are any other source systems anticipated to send data to CRISP? For example, are any other data sources in scope for this project, such as Hospitals, Facilities, Eligibility, Claims, Provider, Patient. A: Medicare data from CMS is the core of this request. However, in the RFP we have asked vendors to provide information and pricing for using a set of X12 files sourced by Maryland providers as an alternative to Medicare data. Other data sources are not within the current scope of the project. Note that the most advantageous solution will be extensible for future incorporation of additional types of data. Q: What are the source system expected data volumes? What is the expected Volume data during history load and delta loads? A: Please base price responses on the scenarios in 4.B. using the vendor s knowledge of Medicare data.

2 Q: Can you describe how data aggregation, data exchange, and care coordination activities would work between CRISP s HIE and the proposed Data Solution/Analytics Engine? A: Under the scope of this engagement, CRISP does not anticipate data aggregation/exchange between CRISP s current HIE efforts and the proposed Medicare Data Solution. Future efforts may include data aggregation/exchange. We anticipate that Medicare data will be a core component of provider s care coordination efforts. Therefore, vendor responses should explain how Medicare data is actionable for providers. CRISP will incorporate the analytics engine products into CRISP training materials. Q: What is the expected data storage size in terms of TBs for the initial load and subsequent incremental loads? A: Please use your knowledge of Medicare data from past experience to provide your best estimates. Q: As mentioned in the RFP, vendor solutions are expected to be able to extend to accommodate clinical and commercial data. Does CRISP also plan to store unstructured data in the near future? A: While this project focuses on Medicare datasets, that the most advantageous solution will be extensible for future incorporation of additional types of data. Vendors experienced with unstructured data may want to highlight their experiences working with these types of data. Q: Current version of CCLF is 9, can we know if CRISP wants to support version 8 as well? A: We are uncertain how CMS will provide Medicare data. Expect to support data from January 1, 2013 going forward. Users Q: How many hospitals that will be participating? I read 46 and then 48 in Maryland with another area of the RFP mentioning more in the District of Columbia. A: While CRISP partners with hospitals in Maryland and the District of Columbia, this scope only includes hospitals within Maryland. For phase one, vendors should plan for users from the 48 acute care hospitals in Maryland. Q: What is the population of users that would need to be interviewed as part of the discovery process? A: While CRISP works closely with representatives from the State, hospitals, other members of the healthcare community, we did not envision the vendor engaging in an extensive discovery process. However, if you feel this is a core component of your solution, please discuss this in your response. Q: What are the different type of users that would be expected to access this system besides system and application maintainers? How many of each type? A: State staff from HSCRC (anticipate 10 users), hospitals (48 acute hospitals in Maryland), ambulatory practices (unknown number), long term care providers (unknown number). Q: Please provide a detailed breakdown on the number of ACOs, Hospitals, Practices, and Providers within CRISP. Is the expected to be a multi-tenanted solution by stakeholder? A: The solution will serve different types of end users. Based on the vendor s experiences providing actionable data to various types of users, the vendor s response should explain if/how analytics engine delivery products will differ based on the end user. 2

3 Connectivity with Providers Q: Is the solution expected to feed data back into their HIE and/or Practice EMRs? How many distinct EMR instances would be connecting to the solution? A: EMR connectivity is not a requirement of this RFP. Q: Are you expecting the Data Solution/Analytics Engine to distribute Medicare data and reports directly to healthcare providers, or are you expecting to use the Data Solution/Analytics Engine to augment the information in your HIE system and use other means to distribute information to healthcare providers? A: We are expecting the solution to provide products outside of our current HIE. Reporting and Analytics Q: What are the CRISP specifics on Quality Measurement can you elaborate on needs here? Importing data only or are you seeking additional calculation/logic surrounding these measures? Are you looking for episode groupers on total cost of care? What methodology are you looking for here, per beneficiary spend or episode grouping? A: The State of Maryland s waiver focuses on population health; therefore, the best solution will provide a range of population health analytics that are actionable for a provider. Vendor responses should describe in their analytic set details quality measures (initially in line with NCQA, AHRQ, or other national standards) that the vendor is able to produce with Medicare data and that the vendor understands are important for providers. Per beneficiary and episode grouping may be important components of a vendor s solution. Again, we are asking for vendors to use experiences and knowledge to provide for us the most advantageous and actionable analytics sets for providers. Q: What are the most important types of reports sought by CRISP? A: The most important types of reports will be actionable for providers. Q: What programs are you looking to support and the associated quality measures? A: CRISP is interested in understanding which quality programs vendors can support using Medicare claims data. We anticipate sharing with hospitals measures aligned with NCQA, AHRQ, or other national standards, and the MSSP ACO claims-based measures. Q: Please list all required reports for this solution. A: In this RFP we seek vendors with substantial Medicare data experience. We are relying upon the vendor s experience to identify the most important reports to deliver to providers. Please describe these analytic sets in Appendix E. Security Q: Our assumption is that all standard security requirements currently in place will apply. Please confirm if there are any unique security/privacy protocols that respondents should be aware of. A: CRISP follows industry best-practices for security and privacy protocols. There are no unique protocols that need to be taken into consideration for this RFP. Q: What are the security compliance levels required or targeted for this environment? FISMA Moderate? A: CRISP is not specifying compliance levels for this RFP, and expects vendors to propose adequate safeguards and protocols commensurate with the sensitivity of data. 3

4 CRISP s current system or Integration with CRISP s current system Q: Will the new Data Solution/Analytics Engine replace your existing data/hie systems or work alongside your existing systems? A: The new solution will work alongside, but independently from CRISP s existing data/hie systems. Extensibility is a plus for future integration, but not required for this RFP. Q: What is the current cloud strategy for our organization? A: CRISP is open to vendor input and recommendations regarding cloud hosting. Q: Are your existing data tools custom developed or out of the box? A: CRISP s current tools are custom developed. Q: What is your organization s stance on Open Source solutions? A: CRISP does not have a preference on Open Source solutions. We are seeking effective solutions that are mutually advantageous for CRISP and our partners. Q: If a vendor proposes an on-premise model and hardware to be procured by CRISP, does CRISP have an expectation that this hardware purchase and setup will be included in Phase 1 of the project? A: CRISP expects any work required to fulfill the deliverables described in Phase 1 to be complete. Vendors may propose prioritization and structured implementation that allows procurement and other steps to be done over time, so long as the deliverables are met. Q: Please provide an existing architecture and/or topology diagram(s) to illustrate the expected integration points among the existing and anticipated systems. A: We received a number of requests for details regarding the current CRISP architecture, services, dedicated private networks, etc. We are not prepared to post detailed information about existing solutions, and ask that vendors use prior experience to indicate where connections with existing systems may be necessary. As we evaluate responses and move through the selection process, we will work with vendors to provide additional detail as required. Q: Does CRISP have a preference for a data hosting strategies, technology platforms, integrations, or data warehouse solutions? A: CRISP will rely on vendor judgment and recommendations, based on the vendor s experience working with Medicare data and other large datasets. Other Q: Section 4 Financial Proposal references multiple environments (Production, Disaster Recovery, Staging, Testing, Development, as well as any separation of servers for Presentation/Web, Application and Database servers). Are all of these environments required? A: The RFP provides assumptions for the environments we expect to see in order to accomplish the objectives. Vendors may describe different configurations they feel would be at least as effective. Q: Are there specific uses of the system which are more mission critical than others (ETL vs MDM vs analytic processing vs end user reporting)? What is the impact of each system if it were to be unavailable for one day? One week? One month? Are there any established or expectations for Recovery Point Objective (RPO)? Are there any established or expectations for Recovery Time Objective (RTO)? 4

5 A: CRISP does not have any stated items which are more important than others or expectations for RPO or RTO. Vendors should feel encouraged to provide their recommendations. Q: Please provide a list of programs and associated measures this project is intended to support. A: As stated earlier in this document, CRISP expects the vendors to list the measures they are able to support and those that have proven most useful to providers during other implementations. Q: Please clarify question 3.C.ii.L, Audit Capabilities. Is the question inquiring about CRISP s ability to audit the vendor s systems? A: The question is inquiring about the ability to audit within the vendor s system. Q: How deeply technical do you want the proposal to be? A: Please provide enough technical detail so we can understand your work plan and solution. Appendix A provides space to provide diagrams to elaborate on your technical proposal. Q: Where do you anticipate the work will be done and can any of it be done remotely? A: Most of the work can be completed at the vendor s site, however some on-site coordination and travel will be required. Updated 7/13/2016 Q: Would CRISP prefer a full end-to-end vendor s solution, or can the respondent answer the analytic engine platform questions and still be considered for next step selection? A: Partial solutions are valid and acceptable. Q: Who are the estimated end-users for the analytics engine and self-service data abstracts? A: In phase one, all 46 acute care hospitals across Maryland will have a number of users of the system. We expect about 10 system users from each hospitals, with about 2-3 power users each. In phase 2, we expect to bring post-acute care providers, long term care providers, and other users onto the system as well. The users for all phases will be geographically dispersed across the state. Q: How much historical data will be loaded initially? A: The State of Maryland and CRISP continue to work with CMS both on data delivery and timeline. Our intent is to receive data going back to January 2013 as that is the baseline year for Maryland s All-Payer Model. Q: Is there a formal delivery schedule of Medicare files? A: The State of Maryland and CRISP continue to work with CMS both on data delivery and timeline. Q: Are population health analytics, such as care coordination and end-user visualizations, part of the intent of this RFP? A: CRISP would like to see a full range of what you intent to provide under the phases of the RFP. The State of Maryland s waiver focuses on population health, thus the best solution will provide a range of population health analytics. Q: Is the vendor responsible for practice transformation in Phase 3? 5

6 A: Provider practice transformation is outside of the scope of this engagement. In phase 3, the vendor will be responsible for refining the solution and providing ongoing support. If CRISP determine CRISP would like to operate the system, the vendor is responsible for conducting training with CRISP staff. Q: Does CRISP have SLAs with the end-user community for transforming the monthly feeds to actionable analytics? A: Practice transformation is outside of the scope of this RFP but the most advantageous solutions will draw clear connection between data and actionability at provider level. Q: If a vendor proposes an on premise model, does CRISP have an expectation / preference that the vendor both procures the hardware and installs the software or that the vendor recommends the hardware and installs the software once the hardware is procured by CRISP? A: CRISP will rely on vendor judgment and recommendations for software/hardware. CRISP does not have a preference on hardware or software. Proposal Format Questions Q: Please clarify where graphics should be provided. A: Graphics can be included within sections of the proposal, or in the appendices as noted in the RFP. The idea is to have a thumbnail-like understanding in the narrative and place any additional details into the appendices. Graphics for 3.c.i can be included as part of 3Ci or as part of Appendix A, and graphics for Section 3ciii can be included as part of 3ciii or as part of Appendix E. Q: Where should graphics for section 3.C.ii be placed? A: There was no corresponding Appendix listed for section 3 c ii in the RFP. Please place graphics within the narrative for this section or create an additional Appendix G, with a 3 page limit. Q: Are graphics included in the page counts for each Appendix? A: Yes. Any diagrams or figures are part of the page count for appendices. Q: Can all graphics be placed in a separate Appendix G? A: For ease of review, please place graphics either within the narrative or in the corresponding Appendix as indicated in the RFP. Q: What is the page count for the Technical Diagrams section? A: The Technical Diagrams section page count is 10 pages, as addressed in the bidders conference. We apologize for the typo in the RFP that erroneously lists the Technical Diagrams section as 3 pages. Q: What is the requested order of the project plan and customer references, as it varies throughout the RFP? A: Apologies for the confusion. Please order the customer references as Appendix B and project plan as Appendix C. While for ease of review we have asked for the proposal in a certain format, the content of your proposal is far more important to us than order of documents. Q: What should vendors use as the implementation start date for the proposed project plan and timeline requested in Section 3.D.iii and Appendix C? 6

7 A: The implementation start date is up to the discretion of the vendor, but should be aligned with the contract start date. Dates are subject to change. Background on CRISP and RFP Q: Please describe CRISP s data-governance activities (data definitions, stewardship, etc.) and strategic alignment with this analytics engine platform. A: CRISP conducts data governance activities tailored to specific data sets and use cases. For this RFP, we are asking that the vendor propose an appropriate governance model keeping in mind extensibility. Q: Please describe CRISP s existing information technology (IT) staff available to support this enterprise activity. A: As this is a large and important solution, CRISP will use a blend of existing resources and newly hired resources to maintain the Medicare data system. During the engagement, CRISP management will deploy resources to oversee the engagement and coordinate with the vendor to review workflow and deliverables, and serve as the primary point of contact for CRISP. As CRISP determines the long term operational strategy for the Medicare data system, CRISP will deploy and hire additional resources as needed. Q: Please describe CRISP s existing relationship with CMMI and partnership plans for the next 1-5 years. A: As the State Designated HIE for Maryland, CRISP is increasingly acting as a provider of state-level infrastructure to support care coordination and care management efforts that are being driven by Maryland s goals for quality improvement and cost control as defined by the State s All-Payer Model contract with the Centers for Medicare and Medicaid Innovation (CMMI). Q: How will CRISP review technology vendors who are world-class in analytic engine platforms with a partner ecosystem that includes multiple end-user visualization options? A: As in all CRISP s vendor partnerships, we seek long-term technology partners that we believe are the best in the business for providing effective and efficient solutions. We seek partnerships that benefit and grow both organizations while delivering excellent value to our users. Updated 7/6/2016 Q: Can qualifications and references from a sub or partner be included as part of the lead bidder s proposal to meet the requirements outlined in the RFP? A: Yes, it is acceptable for bidders who respond collectively to include shared qualifications and references so long as they adequately demonstrated their experience with projects of a similar size/scope. Partners are recommended to demonstrate that they have worked collaboratively on similar projects before. Q: Can vendors submit a brief bio for review to ensure specific Medicare experience meets RFP requirements? A: Yes, vendors may submit a brief bio and we will do our best to determine their eligibility. We are looking for 3 implementations of similar size and scope with Medicare data. 7

8 Q: My firm is potentially interested in partnering with other firms for our response. Can you share any contact information for interested groups? A: CRISP will not release the names or contact information for potential responders without their permission. If any groups are interested in partnering, they may and she will share only the information amongst those groups. 7/1/2016 Procedural Questions Q: Can vendors submit multiple bids? A: Yes, CRISP will consider multiple bids. Q: Is a formal intent to respond letter required for the July 8 th deadline? A: A simple to laura.mandel@crisphealth.org listing your company, contact person, and contact information will suffice. CRISP does not require a formal letter. Q: What is the funding mechanism for this RFP? A: The RFP is funded directly by CRISP. Q: Are there are any funding parameters or guidelines? A: No. Vendors should submit bids based on the cost templates provided. Q: Is there a governmental certification requirement? A: No. Vendor Background Requirements Q: Can you elaborate on the minimum requirement of three Medicare data implementations of similar size and scope? A: Vendors who submit bids for this RFP must have significant experience implementing Medicare data and analytics solutions that are comparable to the one described in the RFP. Because of the nature of the Medicare data, we require vendors to demonstrate significant prior use of Medicare datasets and file formats, such as CCLF (Claim and Claim Line Feed), LDS (Limited Data Set), X12, or other CMS prescribed datasets. Vendors submitting partial responses should demonstrate experience with the aspects of the RFP to which they are responding. Q: Can experience with other government datasets, such as Medicaid, be substituted for the Medicare requirement? A: No. This project requires demonstrated experience with Medicare data. Experience with other datasets is beneficial and definitely a plus, but cannot replace use of Medicare data. System Connections Q: What type of extensibility capabilities do you envision? A: While this project focuses initially on Medicare claims data and requires use of Medicare datasets, we envision being able to incorporate other datasets in the future. This may include Medicaid data, 8

9 commercial data, and clinical data. Organizations may want to highlight experience or data solutions using these types of datasets in conjunction with Medicare data. Q: Should the system be able to run groupers or algorithms, such as case-mix or risk adjustments? A: The data solution should be able to manage complex data, but could achieve this by layering the algorithms on top of the data. Q: Should the system connect with a data visualization software, such as Tableau? A: For this RFP, we are not requiring or intending to connect the analytic set through Tableau; however, respondents may want to describe their experience with visualization software, including but not limited to Tableau. If you have another data visualization tool that you prefer, please let us know we are always looking for the best tools in the industry. Data Questions Q: Where will the Medicare Data System data come from? (Question received via .) A: The Medicare data will come either directly from Medicare or via an organization who is part of a Medicare ACO (or similar initiative). The specific technical approach would depend on the data type (i.e. CCLF or LDS) and we expect the vendors to be familiar with these protocols and automation approaches. For X12, we assume this would come directly from the providers (we picture parallel processing of X12, 837, and 835 files). Q: What is the expected format of the Medicare Claim feeds? Will they come through as csv/flat files or X s? Or something else? (Question received via .) A: We expect either CCLF (Claim and Claim Line Feeds), LDS (Limited Data Set) or X s as described in the RFP. We expect the vendor to be intimately familiar with handling these types of Medicare data. Q: It was mentioned the Medicare Data System will transform the data to industry standards. Can you offer specifics on it please? (Question received via .) A: Regarding transformation, we would like to understand how the vendor solution approaches mastering specific data attributes to industry standards. This may include: Patient mastering to an MPI or Provider mastering to an NPI (and other standard provider taxonomy codes); mastering administrative concepts for Procedures and Diagnoses to industry standard groupers or classifications; and mastering Pharmacy data to industry standard drug classes or categories. Miscellaneous Q: Is this RFP related to the state s All-Payer Claims Database (APCD)? A: No, these RFPs are not related. The work for the APCD was awarded through the Maryland Healthcare Commission s formal procurement process. 9

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