ONSITE MEDICAL CLINIC RFI #2008000273 RANKING



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ONSITE MEDICAL CLINIC RFI #2008000273 RANKING The following formula was used in ranking the firms: Proposal Perfect Score 100 (based on evaluation criteria furnished with proposal) 50 % of total score Presentations Perfect Score 100 (based on presentation and questions/answers) 50 % of total score Ranking Proposal Score Presentation Score Grand Total 1 st Care Here 90 X 50% = 45.0 87 X 50% = 43.5 88.5 2 nd Care ATC 85 X 50% = 42.5 80 X 50% = 40.0 82.5 3 rd WeCare TLC 75 X 50% = 37.5 78 X 50% = 39.0 76.5 4 th HealthStat 85 X 50% = 42.5 43 X 50% = 21.5 64.0 5 th First Onsite 50 X 50% = 25.0 68 X 50% = 34.0 59.0 6 th Solantic 70 X 50% = 35.0 35 X 50% = 17.5 52.5

FINALIST QUESTIONNAIRE 1 Medical Staff a Minimum Qualifications/Experience (See attachment for full listing) CareATC CareHere First Onsite (Fawcett/HCA) HealthStat Solantic WeCare Properly licensed and credentialed in the State of Florida. Minimum experience will reflect those of the existing medical network. Board certified in Emergency Medicine, Family Medicine, or Internal Medicine 3 Years minimum current practicing experience in family practice, internal medicine, or emergency care. 1 Year minimum experience in acute/urgent care, family practice, or ER setting. General medicine, occupational and workers comp experience. 2 Single or Multiple Doctors? Single Single or Multiple Providers Single Single Single Single or Multiple Providers. WeCare prefers one provider to build relationships, but two is possible. 3 Medical staff hours billed as a fixed price or pass through cost? 4 Medical Staff Rates Guaranteed for Contract Term? Fixed Price Pass Through Fixed Price Pass Through Fixed Price Pass Through Rates are guaranteed for the first 3 years, with adjustments in year 4 based on US Labor Medical Services Index. Guaranteed for 1 year, with subsequent 3% COLA increases Guaranteed for 1 year, with subsequent increases of up to 5% at a pass through to the County Guaranteed for 1 year, with subsequent 4% COLA increases No, periodically adjusted to remain competitive. Solantic will work with County to determine a not to exceed. Guaranteed for 1 year, with subsequent 3% COLA increases 5 How will you handle vacations? CareATC provides alternate staffing if CareHere provides alternate staffing if Staff will be provide through the hospital or 48 Week Clinic is proposed. In order to have Based on staff coverage this should not be WeCare provides alternate staffing if needed. needed. Multiple doctors provides more local physicians as a backup. 52 week coverage the operating schedule necessary, but a local service may be used needed. flexibility. would need to be increased to 60 hours per as necessary. (48 week clinic proposed) week. 6 Procedure for Adding Future Clinic Hours Data will be provided to the County on a monthly and quarterly basis from CareATC and the medical team. CareATC and the County will determine if hours are to be added. Each half day is added at a rate of $1,731 with a 3 year rate guarantee. CareHere will monitor weekly reports provided to the County. Upon hitting certain utilization levels, discussions about adding more hours will be initiated with the County. Hours would be increased based on written mutual agreement between County and First Onsite. Costs of increased hours (personnel/office expenses) would be charged as a pass through cost to the County. If HealthStat and the County agree more hours are needed based on utilization, discussion will begin with the County and HealthStat will begin recruiting additional providers. Within 90 days (typically) additional hours will be added. Solantic will work with the County if additional hours are needed. As utilization reaches 85%, WeCare will evaluate the medical staffing need with the County to assess what areas need additional coverage. Does the administrative cost change with addition of hours? Yes No No No Yes No 7 Medical Staff - Employees or Subcontractors? Employees 8 Medical Staff Selection Process CareATC staff selects and interviews candidates based on local MD's that have experience within the county. 9 County/Committee involvement in Selection Process Employees or subcontractors, based on needs of the County. Comprehensive 25 Step Plan (see full response) Physician - subcontractor ARNP - employee First Onsite will recruit and profile candidates and conduct credentialing/reference check. First Onsite has final selection of candidate. Either, MD is generally a subcontractor. HealthStat may also subcontract with a local group for employees. Recruiting team will search from the local community. The County/Committee will be involved in the process, but CareATC reserves the final right to approve/deny a candidate. The Committee can be involved as little or as much as possible. The County has final decision right on candidate(s). ( County officials can be involved in making recommendations (heavily weighted) and the interviewing of candidates. The County/Committee will be given the opportunity to review the selection. The County is encouraged to select the candidate unless there is a compelling reason otherwise. Employees Solantic will recruit, screen, interview, and select candidates. Solantic will allow the County input into the selection process at the appropriate point of recruitment and selection. Employees (Full Time Only) Once candidates are indentified, the WeCare recruitment panel will interview them individually. All candidates will have credentials verified prior to hire. The County can make provider recommendations and will be the given opportunity to meet selected candidates. The following is a summary of responses provided prior to finalist interviews for discussion purposes. Page 1 of 3 G:\Gehring Group\clients\Charlotte County BOCC\Employee Benefits\2008 Charlotte Files\OnSite Medical Clinic\081308 - Charlotte Clinic Questionnaire Responses REVISED

FINALIST QUESTIONNAIRE 10 Procedure for handling walk-ins? Time slots are kept open in schedule to allow accommodation. CareATC CareHere First Onsite (Fawcett/HCA) HealthStat Solantic WeCare Walk-ins are worked into the existing schedule as need. All workers comp, urgent care, and primary care patients would be accommodated on a timely basis. Time slots are kept open in schedule to allow accommodation. HealthStat recommends that these time slots represent approximately 35% of the schedule. Standard triage protocol is followed and appointment times may be pushed back for an immediate care issue. Time slots are kept open in schedule to allow accommodation. 11 Items Included in Administrative Fee Communication Clinic Monitoring Logistics (Set up) Medical Staff Support OSHA Compliance Liability Firewall Pharm D Services Population/Health Management Disease/Case Management Remote RN for Case Management HRA's Self Education Tools Outreach Programs Comprehensive Health Education Training Physician Seminars 800 Customer Support Online Scheduling Systems Online Medical Management & Tracking Physician/Staff Recruitment Analysis, Trends, Report, Survey Results Program Scorecard Provided list of CPT Codes (see attached) Clinic Provider / Recruitment Credentialing / Contracting General Oversight Purchasing Inventory High Risk Participant Identification Ongoing Reporting EMR System Predictive Modeling Staff Scheduling Payroll and Benefits Quality Assurance and Peer Review Medical Supplies & Pharmaceutical Purchasing Patient Satisfaction Tracking MRO Services Workers Comp Reporting Clinic Implementation Clinic Management Total Lifestyle Counseling HRA's (labs not included) Electronic Tools 12 Contract Opt Out 30 Day, With or Without Cause in First Year 90 Day, With or Without Cause 30 days if either side fails to resolve issues after 30 days notice of breach. 60 days written notice required. County pays for unamortized build out cost. 60 Days, With or Without Cause during initial term County if charged for amortized construction costs if the contract is cancelled in first 4 years. 30 Days, With Cause 13 Implementation Time 12 Weeks 12 Weeks 120 days 28 Weeks 28-36 Weeks 13 Weeks 14 HRA Implementation Time 3-4 Weeks prior to opening Ongoing, beginning at "soft opening" Within 120 day timeframe 7-10 days minimum, based on County needs 28 Weeks 2 Weeks prior to Clinic Opening The following is a summary of responses provided prior to finalist interviews for discussion purposes. Page 2 of 3 G:\Gehring Group\clients\Charlotte County BOCC\Employee Benefits\2008 Charlotte Files\OnSite Medical Clinic\081308 - Charlotte Clinic Questionnaire Responses REVISED

FINALIST QUESTIONNAIRE CareATC CareHere First Onsite (Fawcett/HCA) HealthStat Solantic WeCare 18 Lab Provider LabCorp LabCorp Fawcett or Quest Quest LabCorp LabCorp 17 Labs run through medical plan? No No No No Yes No 16 Lab Costs Cholesterol $4.20 $0.00 $10.00 $13.70 $30.00 $3.50 Blood Sugar $4.20 $0.00 $10.00 $16.25 $10.00 $6.35 Lab Processing Fees $0.00 $0.00 $0.00 $0.00 Varies by Test $0.00 Strep test $2.56 $1.34 $10.00 $2.28 $25.00 $8.00 Flu Test $15.15 $14.72 $10.00 $11.44 $15.00 $80.40 Flu Shot $12.50 $10.00 $25.00 $12.00 $25.00 $15.00 Standard X-Ray Contract with Local Provider $0.00 $60 + $30 film read + $25/hour tech Not Provided $35.00 $10.00 Chest X-Ray Contract with Local Provider $0.00 $75+ $30 film read + $25/hour tech Not Provided $70.00 $10.00 Drug Screening (Qualitative) Not Suggested in Clinic $10.00 $50.00 No Response $25.00 $15.00 Random Drug Screening Not Suggested in Clinic $0.00 Did not respond Not Suggested in Clinic $25.00 $15.00 EKG $0.00 $0.00 $25.00 EKG machine not proposed $40.00 $0.00 DOT Physical $0.00 $0.00 $50.00 $0.00 $50.00 $0.00 19 Lab Rates Guaranteed for Contract Term? No Yes Yes No, adjusted annually Yes No, adjusted annually 20 Lab Turn Around Time 1-2 Days 1-2 Days 8-72 hours 1-2 Days 1-2 Days 1-2 Days 21 X-Ray Cost $80,000 - $100,000 $70,000 - $80,000 $176,000 with build out $75,000 $100,000 Approximately $100,000 Contract Required for X-Ray? If Leased No If Leased If Leased If Leased 22 Set Formulary? Yes No Yes Yes Yes Yes Ability to add drugs? Yes Yes Yes Yes No Yes 23 Additional charges Workers Compensation or PreHire/Fit for Duty Physicals? No First report of injury included in pricing. Additional fees would be charged if full work comp case management is desired. No Based on volume, there may be an additional admin and supply cost. Additional hours will also increase costs. Yes, $75 to $150 based on personnel and test required. $5.00 PEPM for Work Comp for employees not on the health plan. 24 Does EMR allow you track and report on Work Comp separately to the County? Yes Yes Yes Yes Yes Yes What Frequency? Monthly or On Request Any Monthly Monthly, Quarterly, Annually Any Any 25 Ongoing Care to Maximum Improvement? Yes, if requested Yes Yes No, minor work comp injuries only Yes Yes 26 Additional Services a School Physicals Yes Yes Yes, $50 Yes $35 / $50 Sport Yes b Pediatric Care Yes, Limited Yes, but additional staff normally required Age 2+, $50 Yes, but additional staff and costs may be Yes, Age 6 months + Limited - Age 11+ required. c Immunizations Physician has decision to provide Yes Yes Yes Yes Yes The following is a summary of responses provided prior to finalist interviews for discussion purposes. Page 3 of 3 G:\Gehring Group\clients\Charlotte County BOCC\Employee Benefits\2008 Charlotte Files\OnSite Medical Clinic\081308 - Charlotte Clinic Questionnaire Responses REVISED

COST EVALUATION CareATC CareHere LLC First OnSite HealthStat Solantic WeCare TLC HCA Hospitals Proposed Service Hours 40 Hours (5 Days) 55 Hours 40 Hours per week 40 Hours 40 Hours 40 Hours Administrative Costs Hourly $23 per employee per month $11 PMPM by monthly usage Fixed Rate $17 per employee per month Total Administrative Costs $900,000 $401,856 18% of all pass through charges $205,920 $432,000 $295,596 Proposed Medical Staff 1 RN 1 Medical Technician ($1,731 half day rate for entire clinic) 1 M.D. ($125 / hour) 1 Nurse Practitioner ($80 / hour) 1 LPN ($25 / hour) 1 Physician ($100/hour) - 20 Hours 1 ARNP - ($45/hour) - 40 hours 1 Medical Assistant ($16.83 / hour) * ($110 / hour) 1 Medical Office Assistant ($15 / hour) (Medical Staff is subcontracted, must maintain own Liability Insurance, etc.) ($70 - $80 / hour) 1 ARNP ($40 / hour) 1 Medical Assistant ($11 - $14.73 / hour) 1 Front Desk Registrar ($8 - $14 / hour) 1 Center Manager 1 M.D. ($115 / hour) - 40 Hours 1 Nurse Practitioner ($65 / hour) - 24 Hours 1 RN ($35 / hour) - 40 Hours 3 Medical Assistants ($19 / hour) - 40 Hours each County is charged for actual rate and hours only Medical Staff Billing Based on 40 hour week County is charged for actual rate and hours Fixed, County pays COLA Increases County is charged for actual rate and hours Based on 40 hour week only only Medical Staff Cost Included in Hourly cost $349,680 $308,125 $240,000 $579,600 $511,680 Build Out & Start Up Costs Build Out First $10,000 paid by CareATC, any County Responsibility $128,700 + 18% management fee County Responsibility $196,000 County Responsibility Start Up (Estimated) additional is County Responsibility $17,000 ($23,166) - Included over 36 month contract term $6,500 $63,656 Includes first 2 months Supplies and Rx Initial HRA Cost Included in Hourly cost Included in Lab & Supplies Not provided $54,400 Included in total cost $34,398 Supplies (Facility, Lab, misc) $85,500 $37,035 Not provided $43,080 Not Included $188,370 Prescription Drugs Drugs Supplied CareATC formulary, with additional drugs added based on usage data Based on Medical Plan Utilization. Drugs are only supplied if the cost is less than medical plan. Proposed forumalary with the ability to add drugs based utilization HealthStat Formulary Solantic Formulary WeCare Formulary Estimated Rx Costs Included in Supplies $279,195 Not provided $9,600 $15 per generic drug $79,700 Workers Compensation Included First Report of Injury Included Included Minor injuries only Included $39,600 New Hire/Ongoing Physicals Included Included Included Not Included Included Included Contract Required 3 Years, includes 30 day opt out Typically 3-5 years, includes 90 day opt out 3 Years, 90 Day opt out after Year 1 Not Provided 4 Years 3 Years, includes 30 day opt out Estimated Annual Cost $985,500 $1,084,766 $459,991 $559,500 $1,207,600 $1,213,000 Excludes Build out over $10,000 Build Out Rx, Labs, HRA's, 18% Mang. Fee Build Out, Work Comp, Physicals Rx and Lab Costs Build Out References City of Muskogee, OK City of Ocoee City of Lakeland Piper Aircraft Port St. Lucie (Terminating) City of Springfield, MO Utilities City of Palm Bay Winn Dixie (Work Comp Only) Gilmer County Port St. Lucie (Pending) G:\Gehring Group\clients\Charlotte County BOCC\Employee Benefits\2008 Charlotte Files\OnSite Medical Clinic\080108 - Charlotte County BCC On Site Clinic Evaluation for FINALIST PRESENTATIONS

SERVICES EVALUATION CareATC CareHere LLC First OnSite HealthStat Solantic WeCare TLC HCA Hospitals Proposed Service Hours 40 Hours 55 Hours 40 Hours per week 40 Hours 40 Hours 40 Hours Weeks per year 52 Weeks 52 Weeks 48 Weeks 52 Weeks 52 Weeks Proposed Medical Staff 1 RN 1 Medical Technician 1 M.D. 1 Nurse Practitioner 1 LPN 1 M.D. (20 hours) 1 ARNP 1 Office Assistant 1 Medical Office Assistant 1 Medical Assistant 1 Front Desk Registrar 1 Office Manager Exclusive to County Employees 1 M.D. 1 Nurse Practitioner 1 RN 3 Medical Assistants Services Provided Primary Care Services Online Scheduling (Current) X X 24 Hour Resources (After hours) NtI Not Included, lddbt but available ilbl X X X Electronic Medical Records X Health Risk Assessments Online HRA's Labs (Blood Draws, etc) Prescription Drugs Drugs Supplied CareATC formulary, with additional drugs added based on usage data Based on Medical Plan Utilization. Set Formulary HealthStat Formulary Solantic Formulary WeCare Formulary Online Administrative Reports X X X Worker Comp (First Report) X New Hire/Annual Physicals X Drugs Tests X Contract Required 3 Years 3-5 Years 3 Years Suggested 3 Years 2-4 Years 3 Years Contract Opt Out 30 Days 90 Days 90 Days after Year 1 60 Days during intial period Not Proposed 30 Days Estimated Annual Cost $985,500 $1,084,766 $459,991 $559,500 $991,600 $1,213,000 Excludes Build out over $10,000 Build Out Rx, Labs, HRA's, 18% Mang. Fee Build Out, Work Comp, Physicals Rx and Lab Costs Build Out References City of Muskogee, OK City of Ocoee City of Lakeland Piper Aircraft Port St. Lucie (Terminating) included in pricing X not included in pricing City of Springfield, MO Utilities City of Palm Bay Winn Dixie (Work Comp Only) Gilmer County Port St. Lucie (Pending) Rutherford County, TN (5,000 EE's) G:\Gehring Group\clients\Charlotte County BOCC\Employee Benefits\2008 Charlotte Files\OnSite Medical Clinic\080108 - Charlotte County BCC On Site Clinic Evaluation for FINALIST PRESENTATIONS