Spreadsheet: 8e8a71e1-016b-49c8-a067-5617a4e80b64
Sheet: Attachment B1

STATE OF ARKANSAS
REQUEST FOR QUALIFICATION FOR PCMH CARE COORDINATION SUPPORT
RFQ NO: SP-13-0162
Attachment B1. Worksheet: Questions for respondents on how goals will be achieved
Instructions
Refer to Section 4.1.4 of the RFQ for an introduction to this attachment.   The entirety of Attachment B will be scored based on the breakdown described in Section 4.1: Technical Proposal Requirements.
C1 | Help the care team to prioritize groups of patients with high risk conditions who warrant increased care coordination support
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | Do you have a standard method or tool or technology platform to identify and prioritize high-risk patients? | 1 | Yes
 |  | 2 | No
6 | For which high-risk populations have you developed and used assessment protocols or tools to help care coordinators prioritize higher-risk patients? | 1 | Diabetes
 |  | 2 | CHF
 |  | 3 | CAD
 |  | 4 | Smoking cessation
 |  | 5 | Obesity
 |  | 6 | Pregnancy
 |  | 7 | Behavioral health (e.g., depressions, substance abuse)
 |  | 8 | Other
7 | For which high-risk clinical settings have you developed and used assessment protocols or tools for care coordinators? | 1 | Life threatening illness, e.g., cancer, advanced chronic disease
 |  | 2 | End of life care
 |  | 3 | Transition to assisted living facility
8 | Do you care coordinators routinely convene practice staff to discuss identification and prioritization of high-risk patients? | 1 | Yes
 |  | 2 | No
9 | Do your care coordinators assess which high-risk patients would benefit from home visits, and then do the home visits in person? | 1 | Yes
 |  | 2 | No
10 | Do you have tools to identify care gaps for high risk patients? | 1 | Yes
 |  | 2 | No
11 | Do you have clinical alert tools that notify the care team of any of the following? (Select all that apply.) | 1 | Hospital admission
 |  | 2 | Hospital discharge
 |  | 3 | ED visit
 |  | 4 | Critical change in clinical status
 |  | 5 | Change in code status
 |  | 6 | Abnormal test results (lab, pathology, radiology)
12 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
C2 | Collaborate with the care team to ensure coordinated care plans by ensuring a holistic point-of-view that incorporates perspectives from providers, family and peer supports and in an evidence-informed manner
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | If your organization uses a care planning tool, with what systems is it integrated? (Select all that apply.) | 1 | Electronic medical record, practice-based
 |  | 2 | Electronic medical record, beyond practice (e.g., health system)
 |  | 3 | Scheduling platform
 |  | 4 | Claims database
 |  | 5 | Not integrated
 |  | 6 | We do not use a care planning tool
6 | What is the format of the care plan? | 1 | Electronic
 |  | 2 | Paper
7 | Who has access to the care plan? (Select all that apply.) | 1 | Patients
 |  | 2 | Providers within the practice
 |  | 3 | Providers outside of the practice
 |  | 4 | Care coordinators only
8 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
[NAME] | Facilitate the execution of care plans by the care team and medical neighborhood
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | Across which settings have your care coordinators managed transitions of care? (Select all that apply.) | 1 | Acute care hospital
 |  | 2 | SNF or LTAC
 |  | 3 | Specialist groups
 |  | 4 | Rehabilitation settings (e.g., physical therapy, occupational therapy)
6 | Do your care coordinators regularly perform medication reconciliation during transitions of care? (Select one answer.) | 1 | Yes
 |  | 2 | No
7 | In your care coordination model, do your care coordinators provide basic clinical service, e.g., recording vital signs, basic administrative duties, in order to shifts tasks so that other providers can perform to the 'top of their license'? | 1 | Yes, the majority of our care coordinators do this
 |  | 2 | Yes, a minority of our care coordinators do this
 |  | 3 | No
8 | Does your organization provide tools to identify care gaps that occur during care transitions? (Select one answer.) | 1 | Yes
 |  | 2 | No
9 | Does your care coordinator document changes in roles, responsibilities, and / or accountability in the medical record? | 1 | Yes
 |  | 2 | No
10 | Does your organization provide and train clinical providers on clinical pathways for any of the following conditions? | 1 | Diabetes
 |  | 2 | CHF
 |  | 3 | CAD
 |  | 4 | Smoking cessation
 |  | 5 | Obesity
 |  | 6 | Pregnancy
 |  | 7 | Behavioral health conditions (e.g., depression, substance abuse, suicidality)
 |  | 8 | Other
11 | For which types of staff does your organization provide training in clinical pathways? | 1 | Physicians and physician extenders
 |  | 2 | Nurses
 |  | 3 | Medical assistants
 |  | 4 | Other
12 | How has your organization measured the impact of clinical pathways? | 1 | Clinical outcomes
 |  | 2 | Process metrics / milestones
 |  | 3 | Staff survey
 |  | 4 | Patient survey
13 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
C4 | Help patients become informed, take accountability in the execution of their care plans, and become responsible health care consumers
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | Does your organization provide education on chronic disease management to high risk patients, either through a care coordinator or another role (e.g., health coach)? | 1 | Yes
 |  | 2 | No
6 | In what settings are patient education performed? | 1 | On-site
 |  | 2 | Patient's home
 |  | 3 | Remote or virtual (telephone, email, websites)
7 | Has your organization coordinate wellness programs in any of the following topics? | 1 | Smoking cessation
 |  | 2 | Substance abuse
 |  | 3 | Healthy diet
 |  | 4 | Physical fitness
 |  | 5 | Depression
 |  | 6 | Medication adherence
8 | Does your organization develop a community resource database that is tailored to the local practice population, and are your care coordinators trained to utilize it? | 1 | Yes
 |  | 2 | No
9 | Do you have a self-management tool or resource for medication adherence in which your care coordinators have been trained and use on a regular basis with patients? | 1 | Yes
 |  | 2 | No
10 | If your organization provides or helps practices build patient portals, what types of functionalities do they provide? | 1 | Personal health records
 |  | 2 | Provider messaging
 |  | 3 | Care plans
 |  | 4 | Medication management (e.g., e-prescribing)
 |  | 5 | Health education materials
 |  | 6 | We do not provide or help build patient portals
11 | Are your care coordinators trained to help or educate patients to determine appropriate channels to access care? | 1 | Yes
 |  | 2 | No
12 | Do your care coordinators proactively follow-up on patients at high risk for noncompliance? | 1 | Yes
 |  | 2 | No
13 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
C5 | Document care coordination activities and track performance to inform quality and process improvement
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | In what form does your care coordinator document the care plan? | 1 | Electronic file linked to the practice [NAME] and/or provider portal
 |  | 2 | Electronic file, stored on secure hard-drive or web-based server
 |  | 3 | Hard copy record in the patient's chart
 |  | 4 | No physical records
6 | What information does the care coordinator document in the care plan? | 1 | List of providers, responsibilities, accountability
 |  | 2 | Major diagnoses and conditions, associated diagnostic and treatment  recommendations
 |  | 3 | Medication list, allergies, and pharmacy contact
 |  | 4 | Transportation and equipment needs
 |  | 5 | Patient priorities and preferences (including health care proxy, code status)
 |  | 6 | Caregiver and psychosocial supports
 |  | 7 | Social history
 |  | 8 | Other
7 | How do your care coordinators facilitate access of providers to the care plan? | 1 | Automatic updates to medical record
 |  | 2 | Triggered alerts to providers
 |  | 3 | [NAME] updates targeted to specific members of the care plan
 |  | 4 | Direct telephone or in-person communication
8 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
C6 | Identify and remedy medical neighborhood barriers to coordinated care
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Does your organization have experience with this capability? (If not 'yes,' then skip the remainder of the multiple choice questions) | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
2 | At what scale has your organization implemented this capability? (Select the answer that reflects the largest scale your organization has done.) | 1 | Statewide scale
 |  | 2 | Set of fragmented practices (>20)
 |  | 3 | Large health system
 |  | 4 | Small scale pilot
3 | Has your organization implemented this capability in Arkansas? (Select one answer.) | 1 | Yes
 |  | 2 | No
4 | In what clinical settings has your organization implemented this capability (Select all that apply.) | 1 | Small independent physician practices
 |  | 2 | Large medical groups -OR- hospital owned or integrated delivery system
 |  | 3 | Home health organization
 |  | 4 | Payer care management program
 |  | 5 | Third party disease management organizations
5 | Have your care coordinators been trained, and have the majority been involved in developing working relationships between practices and the providers and health care institutions within the medical neighborhood? | 1 | Yes
 |  | 2 | No
6 | Have your care coordinators been trained, and have the majority been involved in helping to develop collaborative care agreements? | 1 | Yes
 |  | 2 | No
7 | Have your care coordinators been trained, and have the majority been involved in interpreting reports and data (e.g., practice- or system-level claims and utilization data) to identify and prioritize opportunities to more effectively coordinate care? | 1 | Yes
 |  | 2 | No
8 | Describe in 1000 words or less what your plan is to implement this capability at scale in Arkansas for PCMH practices.  "At scale" refers to the capacity to deliver this statewide and to all PCMH practices.  Consider what will be your operational model for deploying staff, resources, tools, technology and supporting infrastructure, and over what period of time this would occur.  You may refer to past experiences implementing this capability, including topics addressed in the multiple choices questions above.  Where possible, provide evidence of impact. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
S1 | Hire, train, and deploy care coordinators  who will deliver service in-person at least once per week
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Do you have experience with this staffing requirement in your work prior to this Arkansas PCMH program? | 1 | Yes, we currently achieve this requirement
 |  | 2 | No, but we have achieved this in Arkansas within the past 3 years
 |  | 3 | No, but we currently achieve the same requirement in other states where we work
 |  | 4 | No, but we have a plan
2 | In the past two years, how many care coordination staff have you hired, trained, and deployed to deliver once monthly, in-person service? | 1 | Greater than 30
 |  | 2 | 15 to 30
 |  | 3 | 5 to 14
 |  | 4 | Less than five
3 | In your prior work, do you have experience with developing partnerships or subcontracts with local Arkansas companies for the purpose of hiring or recruiting your workforce? | 1 | Yes
 |  | 2 | No
4 | What care coordination-related positions currently comprise your staffing model? | 1 | Care coordinators
 |  | 2 | Health coaches
 |  | 3 | Care navigators
 |  | 4 | Subject matter expert: Pharmacist
 |  | 5 | Subject matter expert: Social worker
 |  | 6 | Subject matter expert: Nutrition
 |  | 7 | Subject matter expert: Behavioral health specialists
 |  | 8 | Other
5 | What will be the staffing ratio of frontline care coordinators to patients? | 1 | Greater than 1:2,500
 |  | 2 | 1:2,500 to 1:5,000 patients
 |  | 3 | 1:5,000 to 1:10,000 patients
 |  | 4 | 1:10,000 to 1:20,000 patients
 |  | 5 | Less than 1:20,000 patients
6 | With your prior work, what have been the primary sources of recruiting workforce?  (Select all that apply.) | 1 | Hire or re-train existing staff within the practices you serve
 |  | 2 | Hire from the local community
 |  | 3 | Hire from outside of the local community
 |  | 4 | Redeploy care coordination staff from other communities that you already employ
 |  | 5 | Train practice staff to do care coordination work; do not directly hire
 |  | 6 | Subcontract to a hiring agency or another care coordination company
7 | What percent of your current care coordination coaches have had previous experience working in a PCMH? | 1 | >75%
 |  | 2 | >50%
 |  | 3 | >25%
 |  | 4 | <=25%
8 | What frequency, on average, have your care coordinators interacted with practices? | 1 | >= 8 hrs per week
 |  | 2 | >= 4 hrs per week
 |  | 3 | >= 2 hrs per week
 |  | 4 | < 2 hrs per week
9 | How many hours per week, on average, do your care coordination coaches spend with each practice? | 1 | 8 hrs / week or more
 |  | 2 | 4 hrs / week or more
 |  | 3 | 2 hrs/ week or more
 |  | 4 | Less than 2 hrs / week
10 | Does your care coordinator staffing approach include routine interaction and collaboration with community health workers? | 1 | Yes
 |  | 2 | No
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
S2 | Service providers in all regions of the state
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Do you have experience with this staffing requirement in another state or region? | 1 | Yes, we currently achieve this requirement
 |  | 2 | No, but we have achieved this in Arkansas within the past 3 years
 |  | 3 | No, but we currently achieve the same requirement in other states where we work
 |  | 4 | No, but we have a plan
2 | Have you served small practices (less than 5 providers)? | 1 | Yes
 |  | 2 | No
3 | Have you served practices in rural areas (greater than 1 hour drive from an urban center)? | 1 | Yes
 |  | 2 | No
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
S3 | Establish in-state management presence
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Do you have experience with this staffing requirement in another state or region? | 1 | Yes, we currently achieve this requirement
 |  | 2 | No, but we have achieved this in Arkansas within the past 3 years
 |  | 3 | No, but we currently achieve the same requirement in other states where we work
 |  | 4 | No, but we have a plan
2 | For your care coordination in the past two years, what has been the ratio of practice-facing / provider-facing care coordination staff to management / administration? | 1 | Less than 5:1
 |  | 2 | Between 5:1 and 15:1
 |  | 3 | Between 15:1 and 30:1
 |  | 4 | Greater than 30:1
3 | What is your current management presence in Arkansas? | 1 | Current management presence in-state
 |  | 2 | Prior management presence in-state
 |  | 3 | No prior presence; but have contracts or letters of intent with local partners
 |  | 4 | No in-state presence and no evidence of future in-state presence
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
S1-S3 | Implementation plan for scalability in staffing
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Describe in 1000 words or less what your implementation plan is for staffing, based on your proposed staffing model and the expected demand of the PCMH practices that you anticipate you will capture.  Specifically, describe your staffing goals for three points in time:  (1) by July 1st, 2013, which is the planned launch of PCMH,  (2) by January 1st, 2014, and by  (3) July 1st, 2014.   Your answer shall address that topics addressed in S1 through S2:  • The extent to which you can hire, train, and deploy staff to deliver once monthly, in-person service;  • How you will ensure that service is statewide; and  • What management support you will build for Arkansas PCMH.   Comment on what you consider to be the most important roles within your staffing approach (e.g., care coordinators, health coaches, care navigators, subject matter experts, and management).   Complete Attachment B2, "Staffing worksheet," which is intended to summarize for DHS/DMS what is your current state of staff development for Arkansas PCMH.   For all of the above, you may refer to past experiences with staffing.   Lastly, identify challenges to staffing in Arkansas and how you plan to address them. | 1 | N/A
 | (Type your free text response to the above question in this space.)
P1 | Offer similar service options to all providers regardless of payer pools
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Will you offer the same level of service to practices regardless of payer mix? | 1 | Yes
 |  | 2 | No
2 | Do you have experience, within the past 5 years, in negotiating service agreements or developing partnerships with multiple payers simultaneously? | 1 | Yes
 |  | 2 | No
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
P2 | Integrate platforms and workflows across multiple payers
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Do you have experience integrating your processes, resources, or technology platforms with systems of multiple payers? | 1 | Yes
 |  | 2 | No
2 | Have you developed platforms or interfaces that support care coordination by integrating with live claims data to do any of the following? | 1 | Identify care gaps
 |  | 2 | Identify high-risk patients
 |  | 3 | Track medication adherence
 |  | 4 | Track care plan adherence
 |  | 5 | Other
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
P3 | Maintain compliance with HIPAA with regard to claims data provided by other contracting payers, as well as confidentiality of information proprietary to participating payers
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Today do you have the expertise and protocols in place to maintain confidentiality of claims data provided by other contracting payers? | 1 | Yes, we do this today
 |  | 2 | No, but we have a detailed development plan
 |  | 3 | No
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
P1-P3 | Summary of approach to payer collaboration
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Describe in 1000 words or less the approach you will take to payer collaboration in Arkansas.  Expand on the topics mentioned in the above questions on payer collaboration.  In addition, detail your vision for what functionality you can bring to the Arkansas PCMH program if your care coordination staff and technology platforms were fully integrated with multi-payer data for the state's population.  Lastly, identify challenges to payer collaboration in Arkansas and how you plan to address them. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Co1 | Align with practice transformation work
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, describe how, in your proposed service model to Arkansas PCMH practices, you will identify synergies and align with practice transformation work.  What do you think are potential synergies and how would your capabilities be suited to capitalizing on them for the betterment of both PCMH and practice transformation work? | 1 | Yes
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
Co2 | Align with Health Homes (when implemented)
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, describe how, in your proposed service model to Arkansas PCMH practices, you will identify synergies and align with Health Homes (when implemented).  What do you think are potential synergies and how would your capabilities be suited to capitalizing on them for the betterment of both PCMH and Health Homes (when implemented)? | 1 | No
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
Co3 | Align with episode-based care
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, describe how, in your proposed service model to Arkansas PCMH practices, you will identify synergies and align with episode-based care.  What do you think are potential synergies and how would your capabilities be suited to capitalizing on them for the betterment of both PCMH and episode-based care? | 1 | Yes
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
Co4 | Align with enabling initiatives (i.e., payment innovation, healthcare workforce development, consumer engagement and personal responsibility, and health information technology adoption)
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, describe how, in your proposed service model to Arkansas PCMH practices, you will identify synergies and align with enabling initiatives (i.e., payment innovation, healthcare workforce development, consumer engagement and personal responsibility, and health information technology adoption).  What do you think are potential synergies and how would your capabilities be suited to capitalizing on them for the betterment of both PCMH and the enabling initiatives? | 1
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
O1 | Commit to, and innovate for, statewide primary care transformation
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | The State of Arkansas is embarking on an unprecedented effort to transform the State’s primary care delivery system.  Given the potentially significant role respondents will play in supporting the transformation of primary care in Arkansas, DMS requires that respondents are willing to invest and collaborate with the State to make this statewide transformation successful.  [NAME] your willingness to join the State of Arkansas as it embarks on this unprecedented effort to transform the State's primary care system.  What about your firm and your proposed plan for capability-building and implementation makes you an ideal partner for the State of Arkansas? | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
I1 | Establish a vision for how to innovate beyond the current goals
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, describe your vision for how you intend to innovate beyond the goals described in this RFQ.  This includes potential innovations to advance PCMH and to support population health in Arkansas. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
I2 | Develop an operational plan for how to innovate beyond the current goals
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | In 1000 words or less, detail your plan to achieve the vision for innovation.  Comment on optional capabilities, tools and technology, and other resources that would be built.  Include  (a) What organizational investments you have made or will make to establish the workforce and infrastructure needed;  (b) How you will leverage technology that you already have today;  (c) How your plan accounts for the evolving landscape of healthcare reform; and  (d) How your plan is tailored to meet the current and future healthcare needs of patients and their providers, in particular issues of the fragmented provider landscape and distribution or urban and rural populations in Arkansas. | 1 | N/A
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)
V1 | Provide comprehensive value through services that are affordable, and with a fair and transparent pricing structure
Question number | Questions | Answer order | Answer choices | Respondent choice  (Place an "X" in the box next to the answer choice you would like to select)
1 | Describe the standard packages of services that you intend to offer to providers.  The standard packages must meet all specific requirements as detailed in the RFQ.  In addition, standard packages shall represent what services you will deliver for a $3 PMPM.  Describe packages – including summaries of the services offered – that you would execute for providers in the following two scenarios (using 1000 words or less for each scenario):  (a) A care coordination package for a mid-sized, suburban practice of 8-10 providers.  Assume that the practice has been using an electronic medical record for 5 years or more.  (b) A care coordination package for a small, rural practice with 2-3 providers.  Assume that the practice does not have an electronic medical record.
 | (Type your free text response to the above question in this space.)
2 | Identify and summarize, in 1000 words or less, the elements or components of the standard packages described above that you would be willing to offer as a la carte, standalone, or piecemeal service offerings.  In addition, any such offerings shall be presumed by DMS to be offered at less than $3 PMPM.
 | (Type your free text response to the above question in this space.)
3 | Identify and summarize, in 1000 words or less, any additional and / or enhanced services that meet RFQ requirements that you intend to offer to PCMH practices.  Fees for these services may exceed $3 PMPM in total.
 | (Type your free text response to the above question in this space.)
4 | Identify and summarize, in 1000 words or less, any additional and / or enhanced services that are beyond RFQ requirements that you intend to offer to PCMH practices.  Fees for these services may exceed $3 PMPM in total.
 | (Type your free text response to the above question in this space.)
5 | Describe, in 1000 words or less, an alternative "shared upside" fee schedule wherein there is a percentage of your fixed fee that you forego in exchange for a percentage of providers’ shared savings payments based on performance improvement.  The fixed fee shall not exceed the total PMPM per provider.  [NAME] of the predefined percentage of providers’ shared savings shall be contingent on the provider also satisfying quality metrics, since eligibility for shared savings mandates that practices must satisfactorily meet these metrics.   That is, describe a contract wherein the provider and you, the vendor, have aligned incentives around the reduction in total cost of care, the resultant shared savings based on performance improvement, and around PCMH program metrics.  We encourage respondents to offer competitive terms that would be reasonable and attractive to providers.  The description of the fee schedule shall include: (a) The percentage of your fixed fee that you would forego in exchange for a shared upside arrangement (b) The percentage of a provider’s shared savings payments that you would accept in exchange for the reduction in fixed fee
 | (Type your free text response to the above question in this space.)
Supporting documentation
Attach documentation that provides evidence to support your above answers. All documentation should be submitted as one Appendix; it will not be considered to be standalone evidence.  Note which Appendix items the evaluator should refer to when reviewing your response to this section.  You may submit no more than eight (8) documents in support of this section.
 | (Type your free text response to the above question in this space.)