Kern Health System CORE Software Professional Services RFP Responses to Questions/Request for Explanation

Transcription

1 Kern Health System CORE RFP Responses to Questions/Request for Explanation Kern Health Systems (KHS) has prepared the following responses to questions received regarding the CORE Request for Proposal (RFP). Each question is noted in BOLD and starts with Q. All responses are indicated with R. Attachment A. Scope of Services 1.0 Background 1.2 Business Model Q. In 1.2 it is mentioned that KHS currently operates a fee for service model for the majority of its population and contracts. Please provide a complete listing of payment methodologies you currently support or any future payment methodologies you plan to move to (Example): DRG APG APC Fee Schedule Flat Fees Per Diems R. KHS currently supports the following payment methodologies: a. Capitation b. AP c. DRG d. Fee Schedule e. Flat Fees f. Pier Diem g. Discounts Q. Please provide the number of interfaces, by functional area, expected as part of the implementation such as ID card interface, EOB/EOP interface, standard HIPAA X12 transactions, or others. Page 1 R. KHS will either create or interface as part of the migration or interface: ASC ANSI X12 Electronic Data Interchange (EDI): I and P

2 999 NACHA ACH HL7 Laboratory 1.3 Information Technology Environment 3.0 Scope Q. Is it KHS intention to retain their current technology environment as described in Section 1.3? R. KHS intends to retain its current environment and consistently analyzes when and where technology can be retired or processes improved. Q. Can a conference call be scheduled next week to discuss in greater detail? R. Upon selection of Core finalists, conference calls or onsite visits will be scheduled to have discussions in greater detail to refine the final contract and pricing. 3.1 Selection Kern Health System is underway in the selection process. The vendor s involvement will be minimal for this efforts. Kern expects to have selected the migration or replacement system in June Q. Please let us know what progress you have made during the System Selection phase. Have you identified finalists or a vendor of choice? R. KHS will have selected the finalists or vendors of choice by March Presentation will then be made to the KHS Board of Directors in June. Q. Please pass along any pertinent information, as it is key to respondents abilities to propose resources and services tailored to KHS needs. R. KHS will have made the selection of the Core Software Systems platform prior to selection of the Core vendor. Q. Are you currently using an external vendor to help you in the decision criteria? R. KHS will make the decision regarding the Core Software Systems vendor internally and no outside Core Professional Services vendor assistance will be utilized. Q. If so, who? R. Not applicable Page 2

3 Q. What are the decision criteria and factors used in selection? R. KHS is currently developing factors and criteria in house. Q. Weighting? R. Not applicable Q. Priorities? Etc. S. Not applicable Q. What platforms are being considered for the replacement? R. KHS will consider all platforms presented for the Core Software Systems. Q. What phases of the SDLC (System Development Life Cycle) will the vendor be involved in? R. Heavily in the Project Management for the Design and Implementation of the SDLC with configuration and subject matter expertise. Long term; KHS desires a relationship to be leveraged for the Maintenance Q. In reference to 3.1: It is indicated that KHS expects to have a system selection June Does this include just the selection process or the contract negotiations and finalized contract with the Manage Car Software Vendor? We are looking to understand if this is the date that the project will kick off or if there will still be some time waiting for contract negotiations and signature? R. KHS has defined the following timeline: February 3, 2014 RFP release February 14, 2014 Bidders Questions Due (1:00PM), Please . February 19, 2014 KHS will responses to all Bidders February Proposals due (2:00PM) March 21, 2014 Proposal evaluations complete, three finalists selected March 31-April 11, 2014 Three finalists and KHS System Review/Question Period April 21- May 30, 2014 Contracting and legal June 12, 2014 Proposed contract presented to KHS Board for approval June 13, 2014 Award Announcement June 13, 2014 Notwithstanding the approval of the contract by the KHS Governing Board, the contract, its terms and conditions, and the commencement of operations thereunder are subject to regulatory approval and modification Vendor to outline and provide costs for the selection function. Q. Is KHS requesting an outline and cost quote for the entire system selection project? R. KHS is not looking for the Core vendor to be involved in the selection process; however, KHS anticipates the Professional Services vendor to provide Project Management expertise with system implementation and production efforts in Page 3

4 conjunction with the KHS the project management and implementation teams. The KHS Project Management team lacks the experience to fully manage this project. KHS will leverage the Vendor to provide a complementing implementation specialist at key points in the core system project and potentially provide KHS with technical resources; as necessary. KHS will make the Core vendor selection on or about the same time as we select the Core Software Systems vendor. 3.2 Project Management Q. Can you please clarify any requirements around the use of onsite/offsite resources as well as onshore/offshore resources? R. KHS expects that the Project Management component will be in an onsite and offsite manner, and KHS does not believe that offshore resources would be a benefit for the project management component. Implementation or technical resources can be provided in an onsite/offsite or onshore/offshore manner. Q. Is KHS open to a time and materials contract with the vendor? Q. Does KHS desire costs to be presented as Time and Materials or a fixed price plus expenses? R. KHS is open to a Time and Materials contract; while, it is expected that vendors with experience would submit an accurate reasonable estimate range (high-low) for the RFP response. KHS would expect that the estimate list a reasonable maximum hour cap limit to prevent project scope creep where the vendor would incur any undue additional costs. KHS will provide travel and expense (T&E) reimbursements as well and would expect the vendor to provide a reasonable estimate based on previous engagements. Q. Can you please provide any current state business architecture and technical architecture diagrams? R. KHS cannot provide at this time. 3.3 Implementation Q. Does KHS intend to dedicate business and technical staff to the implementation or is KHS looking to outsource the entire implementation? R. KHS will have dedicated resources from each of the organizations disciplines to include business and technical staff. KHS expects that the Professional Services business and technical staff will compliment/assist KHS expertise with their operational experience of Medi-Cal Managed Care core business processing. KHS currently has the capability to perform various platform installations with its internal resources provided ample documentation and configuration guidelines exist with the core system. Page 4

5 KHS would expect if special or specific circumstances surrounding the platform exist; that the Core Software Systems vendor would provide technical assistance as is required or needed. This would also include the installation and configuration of the product. Q. What staff does KHS intend to have participate in the implementation-particularly, what roles will this staff be filling (business subject matter expert, technology subject matter expert, etc.)? R. KHS anticipates assigning the following personnel to assist with the implementation: 2-3 Project Manager s, 2-3 Technical Analysts and a dedicated subject matter expert for each discipline: Finance, Member Services, Claims, Provider Relations, Utilization Management, and Quality Improvement. KHS currently has the capability to perform various platform installations with its internal resources provided ample documentation and configuration guidelines exist with the core system. Q. Does Kern have a target date for the go-live of the new core system? R. KHS is estimating the Go Live Date to be in the first quarter of Q. If so, is it driven by contract conditions with the current vendor, or a business event? R. KHS has established the following timeline: February 3, 2014 RFP release February 14, 2014 Bidders Questions Due (1:00PM), Please . February 19, 2014 KHS will responses to all Bidders February Proposals due (2:00PM) March 21, 2014 Proposal evaluations complete, three finalists selected March 31-April 11, 2014 Three finalists and KHS System Review/Question Period April 21- May 30, 2014 Contracting and legal June 12, 2014 Proposed contract presented to KHS Board for approval June 13, 2014 Award Announcement June 13, 2014 Notwithstanding the approval of the contract by the KHS Governing Board, the contract, its terms and conditions, and the commencement of operations thereunder are subject to regulatory approval and modification. Q. Will the vendor be available to assist in the data conversion/migration? R. Unknown at this time. KHS has a very robust Operational Data Store (ODS) that contains the historical data that would be needed for the conversion/migration. Q. Will there be a historical conversion of data? R. KHS has a very robust Operational Data Store (ODS) that contains the historical data that would be needed to complete the conversion/migration. Page 5

6 Q. Will your existing EDI solution be migrated over to the new solution or will a new one be deployed with the new solution? R. KHS current EDI platform is not coupled within our current core system. KHS expects to continue to keep the EDI platform separate from our new solution for a lighter conversion. KHS processes ASC ANSI X12 Electronic Data Interchange (EDI) transactions through a PenTaho Extract Transfer Load (ETL) tool and the Microsoft Biztalk, HIPAA translation module. Q. Do you have an estimated completion date for the implementation? R. KHS anticipates completion of the implementation in the first quarter of Q How many integration points will be involved with the solution? R. The primary integration with KHS Operational Data Store (ODS) that feeds many of KHS workflow, reporting, and other operational processes. Currently, KHS utilizes one integration point with the current core system with the McKesson ClaimCheck product. Q. What business processes are manual today but intend to be automated in the future state? R. KHS maintains a robust EDI and business process reengineering (BPR) workflow solution within the organization that is coupled with the Operational Data Store (ODS). The conversion approach is to retool the ETL processes that feed the ODS and as KHS identifies processes within the core system, KHS will retire workflow processes; identified as redundant or obsolete. Q. Please provide a complete listing of the products KHS is looking to migrate and new products to be implemented in the future with the new system R. KHS has identified the following products for migration or new products to be implemented in the Core System as follows: KHS SQL Microsoft SQL Operational Data Store (ODS) data feeds. McKesson ClaimCheck software. Care/Case Management solution (TBD in 2015). Cactus Credentialing/Contracting software. Q. Please provide the number of members KHS is planning to migrate to the new system and future growth estimates? R. KHS currently serves about 140,000 members and we are looking to expand to approximately 200,000 in Q. Please provide the number of providers (practitioners versus facilities) KHS is planning to migrate to the new system and please provide any provider network expansion plans. R. KHS currently plans to migrate, approximately 700 providers. Page 6

7 Q. Is KHS planning to migrate the business over as a Big Bang approach or a phased approach by product, LOB or other method? R. KHS currently maintains a single LOB and is open to a parallel migration or Big Bang approach and KHS will collaborate with the expertise of the Professional Services vendor to provide additional guidance. Q. Are there any core functions that will be handled outside of the Managed Care Software System that is selected (i.e., Care Management/Utilization Management will be handled in a surround system and interfaced with the Core Managed Care Software System)? R. KHS maintains a robust EDI and business process reengineering (BPR) workflow solution within the organization that is coupled with the Operational Data Store (ODS). The ODS is coupled with ETL software to provide near real-time data updates from the core system. KHS has identified the following functions that will be implemented in parallel with the Core System leveraging the ODS: KHS custom Care and Case Management. KHS U/M processing KHS BPR Platform KHS Business Object reporting KHS Data Dashboard As KHS identifies processes that can be retired from its BRP platform KHS will retire redundant or obsolete processes. Q. In reference to 3.3.4: Please clarify is KHS is asking for vendor to outline the costs for the vendors professional services including the internal costs for KHS OR to outline the costs for vendors professional services, KHS internal costs and cost of the Managed Care Software vendor. R. KHS is looking for the Professional Services costs that the vendor will incur and costs only as it relates to the project management, implementation experience or subject matter expertise, technical resources, and any other related vendor expense. Q. Our firm is bidding on the Implementation RFP. At the same time, there are vendors who rely on our firm to assist them when they bid on projects, such as your claim system RFP. For example, some firms offer their products on a hosted basis and contract with our firm to provide the hosting. Other firms may contract with us to supplement their implementation staff when they need additional resources. Does KHS object to our firm supporting these firms, as well as providing our own bid for the implementation portion? R. No, KHS does not object. Page 7

8 Q. Please identify the expected system-testing lifecycle phases required for the implementation. This includes unit testing, SIT, UAT, performance, or others, and the expected role of the implementation services vendor during testing. R. KHS is looking for both the core system vendor and the professional services vendor to provide guidance and recommendation regarding the amount of system testing required prior to a production launch. KHS expects that based on the previous implementation engagements the vendor will have an estimated testing iteration time-line that could be provided as the basis for a cost range. KHS understands that implementation delays and issues occurs and that if the testing takes a longer period of time than expected; then, KHS would incur additional expense. KHS expects ample testing to occur within the organization prior to the production go live. Q. Please provide the number of reports, by functional area, expected as part of the implementation. R. KHS leverages an Operation Data Store (ODS) in conjunction with Business Objects for the majority of the organization reporting (approximately 350 reports). Currently there are approximately twenty (20) reports that are utilized actively within our Core System. Q. Please provide the number of letters, by functional area, expected as part of the implementation. R. KHS currently utilizes approximately 10 letters actively within our Core System and leverages the KHS workflow platform to produce the remainder amount of letters. Q. Please provide a list of output collateral expected as part of the implementation. This includes ID card, billing invoice, EOB, or others. R. KHS maintains a robust EDI and business process reengineering (BPR) workflow solution within the organization that is coupled with the Operational Data Store (ODS). The conversion approach is to retool the ETL processes that feed the ODS and as KHS identifies processes within the core system, KHS will retire workflow processes; identified as redundant or obsolete. Q. Are there any known requirements, risks, or assumptions that may impact the overall delivery of the target application by the expected go-live date? R. KHS is not aware of any known requirements, risks or assumptions that may impact the overall delivery of the target application at this time. KHS is flexible on the implementation timeline and has not set any hard deadlines for the production date. Page 8

9 Q. Please provide the number of banking/funding companies, providers, contracts, capitation agreements, and benefit plans. R. KHS has identified the following: Banking- None Provider- Approximately 700 Contracts- Approximately 300 Capitation Agreements- 2 Benefit Plans- 1 Q. Please define the expected responsibilities of the technical and analytic resources as well as any required skill or competencies. This includes the PL/SQL experience or others. R. KHS expects to dedicate the following resources: 2-3 Project Manager s, 2-3 Technical Analysts and a dedicated subject matter expert for each discipline: Finance, Member Services, Claims, Provider Relations, Utilization Management, and Quality Improvement. KHS will have a Database Developer, System Administrator, Data Analyst, and Application Development team assigned to the project as well. Any additional resources that the vendors deem appropriate should be included in the RFP response listed at the Time and Materials rate. Q. Please clarify what is meant by Financial Processing and Technology and Data Management and the role the implementation vendor is expected to play. R. KHS expects the vendors to provide expertise and assistance in the new processes as it relates to provider reimbursements, monthly revenue reconciliation, and overall training and configuration of the core software system as it relates to the financial processing of a Medi-Cal Managed Care Organization. If the vendor has experience in data management of various systems this would complement KHS as well. Q. Please confirm that billing is part of the implementation scope and included as part of the operational areas listed. The vendor would need to have knowledge and expertise in the underlined data set. R. KHS does not currently provide or perform billing as we work solely with Medi-Cal under a single line of business. Q. For each of the following areas, please provide the expected segregation of duties between KHS, the system vendor providing the core application, and the vendor providing implementation service. This includes: R. KHS expects the core software vendor and KHS to be the primaries on implementation and configuration of the core application. The professional services vendor would be expected as stated in the RFP to collaborate and assist KHS with configuration and subject matter expertise in operational processes as necessary, and act as the primary project manager for the project. Page 9

10 The professional services vendor will ensure that the project is effectively managed within KHS in collaboration with the KHS project team. KHS has designated the following employees to the project: 2-3 Project Manager s, 2-3 Technical Analysts and a dedicated subject matter expert for each discipline: Finance, Member Services, Claims, Provider Relations, Utilization Management, and Quality Improvement. KHS will have a Database Developer, System Administrator, Data Analyst, and Application Development team assigned to the project as well. KHS currently has the capability to perform various platform installations in house provided guidance, documentation and configuration with the core system. Page 10 Analysis Identification and documentation of business requirements Identification and documentation of gaps Design Identification and documentation of the future state (high level) Identification of configuration design and gap solutioning Configuration Execution of configuration design Configuration testing Conversion Creation of data mapping and crosswalks from the legacy to target application Creation of data extracts from the legacy application Creation of data loads in the target application format Identification and documentation of data gaps Integration Documentation of integration requirements Third-party vendor engagement and coordination Creation of data mapping and crosswalks from the target application to a third party Development of interfaces to a third party Testing Test strategy, planning, documentation, and management Configuration testing System Integration Testing (SIT) User Acceptance Testing (UAT) Other testing Training Project initiation training (Core team) Creation of training materials Delivery of training for Train-the-Trainer Delivery of training for front-end users Documentation Creation of business process workflows Creation of desk level procedures Go-Live Post-go-live transition and issue resolution

11 3.4 Post Implementation Q. What duration is post implementation support needed? R. KHS is looking to establish a long term relationship with a Professional Services vendor to provide augmented consulting to the Core System vendor. It is expected to be presented as a time and materials response in the RFP. General Questions: Q. Will there be an opportunity for an onsite presentation of the RFP responses? R. KHS will schedule onsite presentations at the request of the finalist vendors, once selected. Page 11