INTRODUCTION : Defense Health Agency (DHA) is exploring industry best practices, management, and evaluation for Case Management (CM). Intent is to support and promote evidence-based practices and improve the ability to reflect programmatic measures of success specific to effectiveness, outcomes, and cost. The intent of this RFI is to support market research from industry and private sector sources to inform current Military Health System (MHS) program execution in response to National Defense Authorization Act (NDAA) FY20 (Sec 744): Metrics used in determining the effectiveness and cost of case management Review of case management best practices in the private sector, including with respect to: The intervals at which patients should be contacted; The role of the case manager in coordination; The approximate number of patients managed by a case manager; and Any other best practices relating to case management that would improve the experience of care across the military health system Background. The MHS is committed to provide dedicated CM engagement and support. As recognized experts and critical members of care teams, CM personnel promote integration of case management services across various care platforms to support beneficiaries’ ability to attain their highest level of functioning. The Fiscal Year (FY) 2020 National Defense Authorization Act (NDAA), Section 744 authorizes the MHS to evaluate the effectiveness of case management practices. As a result, the DHA is pursing market research in the form of this RFI to better understand industry and private sector care CM practices and evaluation. The DHA currently executes CM within the Direct Care System (DCS) that comprise medical and interdisciplinary team engagement through dedicated Service and DHA policy. In addition, there is a dedicated TRICARE program currently organized into two regions, East and West. Each region has a regional contractor to support the DHA and MTF efforts to provide TRICARE-eligible beneficiaries access to high-quality health care. The regional contractors administer TRICARE benefit plans that encompass CM by providing program management, benefit determinations, medical care management, customer services, provider networks, and claims processing. AUTHORITY : The DHA is issuing this Special Notice Request for Information for the purpose of Market Research as required by the Federal Acquisition Regulation (FAR) 15.201 and FAR 10.002. This notice does not obligate the Government to award a potential contract or otherwise pay for the information provided in response. Responses to this RFI are not offers and cannot be accepted by the Government to form a binding contract. INFORMATION SOUGHT BY THE DHA : The submissions provided should address each of the following questions. Question #1: What is the average caseload or number of patients managed by a CM? What findings have been determined based on a dedicated caseload assignment per CM? Question #2: How is the average caseload per CM determined? Question #3: What are the intervals at which patients are contacted for CM? How were these intervals determined? What has your performance been based on assigned intervals of contact by a CM? Question #4: What is the role of the CM in care coordination? Please provide a definition for care coordination used to answer this question. Question #5: How do you determine or what measures do you use to determine effectiveness of CM? What is your performance based on the identified measures? Question #6: How do you determine the cost and return on investment for CM? What is your performance based on the requirement? Question #7: Do you utilize any other best practices relating to CM? DISCLAIMER AND IMPORTANT NOTES : THIS NOTICE IS NOT A REQUEST FOR PROPOSALS. The Government reserves the right to use results of the communications with industry for any purpose consistent with, and not otherwise prohibited by FAR Part 10. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. As the intent of the Government’s RFI is to support market research, in no case shall responses to this notice be considered either a response to a solicitation or a submission of an unsolicited proposal, as defined by FAR 2.101. CONFIDENTIALITY : No proprietary, classified, confidential, or sensitive information should be included in your response. Industry responses will be shared with DHA staff for the purpose of market research. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s) NEXT STEPS : Submittals should be emailed to the Government team on or before 1700 MDT on 1 May 2020. Responses to this RFI should be no more than 10 pages (including cover page) and should address each of the questions asked by the DHA in the Information Sought portion of this RFI. The Government may not review submissions that fail to address each of the questions in the section title, “Information Sought by the Government.” If companies wish to include a general capability statement, it should be attached separately. All responses will be reviewed by DHA staff. Industry sources may be invited to present additional details regarding their submittals at an in-person meeting with the Government. The POC sending the submission will be notified about this meeting via email. The Government will not reimburse for expenses incurred related to this in-person meeting. RFI responses that fail to address the information sought will not be reviewed by the Government. Each of the responses will be maintained by the DHA as a source of market research information and published on an internal SharePoint site. PRIMARY POINTS OF CONTACT : Submit RFI response and/or questions to: Primary POC: Chelsea Lavelle, Contract Specialist Email:
[email protected] Secondary POC: Evan Zaslow, Contracting Officer Email:
[email protected]