SPECIAL NOTICE
Q -- Health Information Exchange (Interoperability) for the Defense Health Agency (DHA) managed care support - RFI Questions
- Notice Date
- 7/18/2014
- Notice Type
- Special Notice
- NAICS
- 524114
— Direct Health and Medical Insurance Carriers
- Contracting Office
- Other Defense Agencies, Defense Health Agency, Contract Operations Division - Aurora, 16401 E. CenterTech Pkwy., Aurora, Colorado, 80011, United States
- ZIP Code
- 80011
- Solicitation Number
- T2107{Interoperability_EHRs}
- Archive Date
- 8/31/2014
- Point of Contact
- Charles Hargett, Phone: 3036763508
- E-Mail Address
-
charles.hargett@dha.mil
(charles.hargett@dha.mil)
- Small Business Set-Aside
- N/A
- Description
- List of questions for industry response. PURPOSE: The DHA, is seeking targeted feedback from industry regarding interoperability of healthcare data between the Direct Care System (DCS) and network providers (NP) through the Managed Care Support Contractors (MCSC). This RFI solicits industry's feedback on capabilities currently available in the private sector to meet the later described Military Health System (MHS) requirements. The intent of this RFI is to gather information from industry healthcare vendors to be utilized by the MHS TRICARE Program as support in our continuous market research for upcoming contract requirements. The information will not be utilized for any purpose other than market research to achieve the overall objectives to improve healthcare data interoperability under the TRICARE Program. PROGRAM BACKGROUND: One of DHA's goals is to achieve greater integration of our direct and purchased healthcare delivery systems to accomplish the Department's Quadruple Aim: achieve medical readiness, improve the health of our people, enhance the experience of care, and lower our healthcare costs. TRICARE is comprised of three health care options: Prime, Standard, and Extra. TRICARE Prime is similar to a Health Maintenance Organization (HMO) with a Point of Service Option and requires beneficiary enrollment. All ADSMs are TRICARE Prime enrollees, although they are required to receive all of their care either in the MTF or under special rules that apply to Active Duty health care, further explained in the TRICARE Operations Manual, Chapter 17. ADFMs may elect to enroll and are not required to pay an annual enrollment fee; other eligible beneficiaries pay an annual enrollment fee to enroll in TRICARE Prime. TRICARE Extra, which requires no enrollment, is an option in which the beneficiary may choose to use a provider in a TRICARE contractor-developed network, at a reduced cost-share for a particular instance of care, but is not restricted to use of the provider network. TRICARE Standard is a fee-for-service option, essentially the program formerly called the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), in which the beneficiary is free to use any authorized provider. The three options of TRICARE are described fully in 32 Code of Federal Regulations (CFR) Parts 199.17 and 199.18. INTEROPERABILITY BACKGROUND: The use of electronic health record systems (EHRS) has grown dramatically under the Accountable Care Act (ACA) and under Meaningful Use (MU). For example, the Health Information and Management Systems Society (HIMSS) reports that 91.2% of hospitals now have EHRSs that are Health Information Exchange (HIE) capable. The Center for Disease Control (CDC) reports that 78% of office-based physician practices have EHRSs (2013). This explosion of EHRSs in the United States (U.S.) describes an environment that was not available before, and it suggests that healthcare data could be exchanged among healthcare providers at ever increasing levels of interoperability in the future. The Health and Human Services (HHS) Office of the National Coordinator (ONC) defines healthcare interoperability as the exchange and use of healthcare data. Interoperability is supported by a five-tier framework that includes the following: 1. Vocabulary and code sets (MU Stage 1), 2. Content structure (MU Stage 1), 3. Security (MU Stage 1), 4. Transport (MU Stage 2), and 5. Services (MU Stage 2). This ONC definition of interoperability is based on the definitions provided by the Institute of Electrical and Electronics Engineers (IEEE) and HIMSS. The government is interested in achieving interoperability of healthcare data between the Direct Care System (DCS) and the Network Providers (NP) for scenarios including, but not limited to, the following: • Service members and/or all beneficiaries who are referred to the private sector for care, which supports continuity of care as well as readiness; • TRICARE Prime members enrolled in the DSC who are referred to the private sector for care; • Prime members enrolled to the private sector who might reasonably receive future care in the DCS; and • Other scenarios in which it would be beneficial for the DCS providers to have knowledge of healthcare records created by NPs. Interoperability of healthcare data should support the Referral Management Process (RMP) which includes DCS sending referral requests and NP returning the documentation of care. Interoperability should also include care provided by the private sector for patients who could reasonably be seen by the DCS in the future to ensure continuity of care. Interoperability should similarly address the optimization of use of the DCS for TRICARE Prime members enrolled in the private sector and referred for specialty care where that care could be provided by the DCS. These example scenarios are not considered to be exhaustive of the appropriate use of interoperability. Given this interest in achieving interoperability, the maturity and expansion of the EHRS's in the U.S. and the supporting national infrastructure, the government is interested in industry's perspective in using machine-to-machine (M2M) interoperability in future managed care contract(s). This exchange includes national level health information exchange using ONC interoperability standards. REQUEST FOR INFORMATION (RFI): Within the attached document there are a list of questions for which the Government is seeking additional information from industry. Interested vendors are invited to respond to as many of the questions as are applicable to its line of business and/or expertise. Vendors are not expected to provide answers to all questions in order to submit a response to the Government. Responses to this RFI should be no more than a total of 50 pages (including cover page). Please submit responses electronically to charles.hargett@dha.mil no later than August 4, 2014, 1500 MST. Please include reference data for a designated point of contact (name, title, address, phone/fax, email). Responses should be packaged in a Word document. Other electronic attachments can be submitted if the total page count does not exceed 50 pages. No verbal responses will be accepted. Proprietary information may be submitted; however, RFI respondents are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response. All submissions will be protected from disclosure outside of the TRICARE Program Office. In addition, RFI respondents should be aware that the TRICARE Program Office may utilize contractor support personnel under existing contracts to review responses and information submitted. These companies and individual employees are bound contractually by Organizational Conflict of Interest and disclosure clauses with respect to proprietary information, and they will take all reasonable action necessary to preclude unauthorized use or disclosure of an RFI respondent's proprietary data. RFI responses MUST clearly state whether permission is granted allowing the program office support contractors access to any proprietary information. This RFI is not a solicitation. This RFI is for planning purposes only. It does not constitute a RFP or a promise to issue an RFP in the future. This RFI does not commit the Government to contract for any supply or service whatsoever. Further, TRICARE Program Office is not seeking proposals at this time, and will not accept unsolicited proposals. Respondents are advised that the Government will not pay for any information or administrative costs incurred in response to this RFI. All costs associated with responding to this RFI will be solely at the responding party's expense. Participation is not mandatory or required; participation or response to this RFI is not a prerequisite for any future procurement activities.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/notices/ee054bee6ebf87bf8ae8c3e0a2581de7)
- Place of Performance
- Address: Defense Health Agency, Contract Operations Division-Aurora Branch, 16401 East CentreTech Parkway, Aurora, Colorado 80011-9066, Aurora, Colorado, 80011, United States
- Zip Code: 80011
- Zip Code: 80011
- Record
- SN03430334-W 20140720/140718234834-ee054bee6ebf87bf8ae8c3e0a2581de7 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
| FSG Index | This Issue's Index | Today's FBO Daily Index Page |