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TABLE OF C

1  INTROD

1.1  PURP1.2  BACK1.3  STAT1.4  MINIM1.5  TERM1.6  FUND1.7  CONT1.8  ACQU1.9  SOLIC

2  GENER

2.1  ANTI2.2  QUES2.3  AUTH2.4  CONT2.5  CONT2.6  INCO2.7  INSUR

3  PROPO

3.1  SUBM3.2  PREP3.3  BIDDE

4  EVALU

4.1  OVER4.2  ALLO4.3  EVAL4.4  SELE4.5  NOTI4.6  DEBR4.7  PROT4.8  POST

5  DEFINI

EXHIBIT 1 ..EXHIBIT 2 ..

APPENDIX AAPPENDIX BAPPENDIX C

nt Replacement

CONTENTS

DUCTION .

POSE ............KGROUND .TEMENT OFMUM QUAL

M ..................DING ............TRACTING UISITION ACITATION

RAL INFORM

CIPATED PSTION AND HORIZED CTRACT FORTRACT REQ

ORPORATIORANCE.......

OSAL SUBM

MITTAL INSPARATION O

ER RESPON

UATION AND

RVIEW ........OCATION OLUATION PRCTION OF AFICATION

RIEFING OFTEST PROCT AWARD C

ITIONS .......

.....................

.....................

A .................B ..................C .................

t Bundled Epis

S

.....................

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.....................F WORK ......LIFICATION..........................................WITH CUR

AUTHORITYSTANDARD

MATION ....

PROCUREMANSWER POMMUNIC

RMATION ..QUIREMENON OF DOCU.....................

MITTALS .....

STRUCTIONOF PROPOSNSIVENESS

D AWARD .

.....................OF POINTS ..

ROCESS .....APPARENTOF APPARE

F UNSUCCEEDURES ....ONFERENC

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ode of Care

.....................

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RRENT OR FY ...................DS .................

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MENT SCHEPERIOD .......

CATION ............................TS ................UMENTS IN.....................

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NS .................SALS ............S ....................

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ESSFUL PRO.....................

CE ................

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......................FORMER ST............................................

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DULE ..................................................................................................NTO CONTR......................

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......................FUL PROPOESSFUL PROOPOSERS ................................................

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.....................TATE EMPL..........................................

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.....................OSER(S) ......OPOSER ...................................................................

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Request

HC

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t for Proposa

CA RFP No. 15

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12 12 13 14 14 15 15 15 

15 

17 19 

20 21 22 

Total Join

1 INT

1.1 PU

The Waand/or nTotal JoPlan (UCollabooffered Awarde

a.

b

Section Capitali In this Rreferenc

1.2 BA

“Payingalso knobold couState. Thpassage quality chealth imeffort wyear 201

As the lahealth caaccountaFee-Forvalue, quhealth caextends benefits Medicar

Currentlplan.

nt Replacement

TRODUCT

URPOSE

ashington Statnetwork of proint (Knees an

UMP) Classic orative (Bree Cto Members w

ed Contractor(

. Deliver higbased on Breporting h

. Be financiCare to inc

5, “DEFINITized terms app

Request for Pces to the plur

ACKGROUN

g for Value” isown as the Heurse for transfhe Innovationof E2SHB 25

contracting, amprovement, ill “reduce ex17 to generate

argest purchaare to focus oable-care and-Service (FFSuality, effectiare and 50 pethrough to thto over 350,0

re retirees, an

ly, over 240,0

t Bundled Epis

TION

te Health Carrovider(s) to bnd Hips) Repand ConsumeCollaborativewho receive c

(s) must have

gh-quality, evBree Collaborhealth outcomally and cliniclude physicia

TIONS” can bpearing in thi

roposal, wherral shall inclu

ND

s a core strateealthier Washformative chan Plan was em572, requiringand other paymfor Medicaid

xtraneous mede budget savin

aser of health on value, not vd value-based S) payment miveness and efercent of the che PEBB Prog000 membersd dependents

000 of the 350

ode of Care

re Authority (become contralacement (TKer-Directed He) recommendcare in Washi

e the followin

vidence basedrative recommmes; and

cally accountan and hospit

be found at this RFP will ha

re applicable,ude the singul

egy of HCA’shington Initiatange in the wambraced by thg the HCA, “tment incentiv

d and public edical costs, acngs identified

care services volume. Thropurchasing st

models; align pfficiency. Wcommercial mgram, adminis including sta

s.

0,000 PEBB m

3 of 22

HCA) is solicacted PEBB C

KR/THR) BunHealth Plan (Cdations. The Tington State s

ng capabilities

d TKR/THR Bmendations, in

table for the ctal care.

he end of thisave the same

, references tolar.

s State Healthtive. The Heaay health care

he Washingtonto increase th

ves that promoemployee purccross all medid in the omnib

in Washingtoough a multi-ytrategies stateprovider, payashington Sta

market to valustered by the ate and other p

members are

citing one or Centers of Exndled Episode

CDHP) MembTKR/THR Bustarting on Jan

s:

Bundled Episncluding but n

complete TKR

Response fordefinition as

o the singular

h Care Innovaalthier Washine is delivered n State Legisl

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on State, HCAyear phase apewide in an ef

yer and consumate aims to drue-based paymHCA. The PEpublic emplo

enrolled in U

Req

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more health cxcellence (COe of Care for bers, based onundled Episodnuary 1, 2017

ode of Care anot limited to

R/THR Bund

r Proposals (Rin Section 5.

r shall include

ation Plan (Innngton Initiativand paid for

lature in 2014e based contrfficiency, cose legislature as, when fully ations act.”

A is changingpproach, HCAffort to phasemer incentiverive 80 percenment by 2019EBB Programoyees, pre-Me

UMP, making

quest for Prop

CA RFP No. 15

care provider(OE) to provide

Uniform Medn Dr. Robert Bde of Care wi7.

and Warrantyo producing an

led Episode o

RFP) docume   

e the plural an

novation Planve seeks to chin Washingto

4 through the racting, alternst savings, andanticipates thiphased in by

g how it purchA will drive e out traditiones; and rewardnt of state-fina.This effort al

m provides meedicare retiree

it PEBB’s lar

posals

5-023

(s) e a dical Bree ill be

y nd

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ent.

nd

n), hart a on

native d is fiscal

hases

nal d anced lso edical es,

rgest

Total Join

Joint repin 2017,Excellenalso receof Excel

To accoalternatiWashing(ESHB work tog

In 2013,Warrantpost-opestandardcomplicand finacomplic

The Breare:

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PEBB mmay nee

Awardeall the apayment

nt Replacement

placements ar, Members wince, if the Meeive TKR/THllence instead

mplish its purive payment mgton state, the1311) “…to pgether to imp

, the Bree Colty. The TKR/Terative care fods. The Warraations can be

ancial accountations.

ee Collaborati

tage 1: Disabrior to surgerisability and eighly disablinf conservative

tage 2: Fitnesrior to surgernsure their sahooses to pronformed cons

tage 3: SurgeAn experienceo implanted hvoiding side e

tage 4: Post-OA standard proomplications,nnecessary re

member demoed in developi

d Contractor(dministrativet processing,

t Bundled Epis

re one of the mill be requiredembers want tHR services oud.

rchasing goalmodels develoe Bree Collabprovide a mecrove quality,

llaborative adTHR Bundledor successful anty defines ce attributed to tability for the

ive has define

bility due to Oy, candidatesevidence of ong osteoarthrie therapy is a

ss for Surgeryy, candidatesfety and comceed with TKent, patient en

ery and Repaid surgical teaardware; preveffects; and m

Operative Caocess should b, ensuring rapeadmissions. (

ographic data ing their prop

(s) will be expe tasks includimember care

ode of Care

most commond to receive Tto receive theut of network

l, HCA will imoped by the B

borative was echanism throuhealth outcom

dopted an evidd Episode of TKR/THR su

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ed four distinc

Osteoarthritis for joint repl

osteoarthritis atis is evident

appropriate.

y for joint replmitment to pa

KR/THR surgengagement, in

ir of Osteoartam should usevent infection

manage pre-ex

are and Returnbe in place to pid return to fu(Please see Ex

can be foundposals.

pected to woring provider ee concierge to

4 of 22

n surgical proTKR/THR serv

in-network bk, but will hav

mplement eviBree Collaborestablished inugh which pumes, and cost

dence-based TCare definesurgery and incs and time-frasurgery. The pneeded to diag

ct stages of a

despite Conslacement theraccording to sat the time th

lacement therarticipate actiery on a patiendividual revi

thritic Joint e evidence-ban, venous throxisting medica

n to Functionsupport the g

function, optimxhibit 1 for ad

d in Exhibit 2

rk with HCA’evaluation andols, and perfo

ocedures in thrvices throughbenefit for thove significant

idence-based rative. A multn 2011 by the ublic and privat effectiveness

TKR/THR Buexpected comcluded both c

ames after surpurpose of thgnose, manag

TKR/THR B

servative Therrapy should hstandardized rhe patient first

rapy should mively in returnent who does iew, and prea

ased practicesombosis, and bal problems c

n goals of avoidmizing hospitdditional deta

to provide Pr

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he UMP popuh one of PEBBose services. incentives to

purchasing sti-stakeholderWashington ate health cars of care in W

undled Episomponents of pclinical comporgery during whe Warranty isge and resolve

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rapy have clearly doradiographic t seeks medic

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authorization

s to avoid comblood loss; m

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roposers with

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orting. HCA in

quest for Prop

CA RFP No. 15

ulation. BeginnB’s Centers oMembers ma

o use the Cent

trategies inclur group in State Legislatre stakeholder

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de of Care anpre-operative onents and quwhich those s to track cline those

ode of Care. T

ocumented criteria. Unle

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ning of ay ter(s)

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1.3 ST

The Awarstrategic olimited to

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nt Replacement

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ode of Care

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ents: ntation of disantation of fitnf the osteoarthrative care ans: iateness; turn to functioare experiencafety.

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of the Contrac

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Recommendati

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ng which thosancial accountns. The Warrions.

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nt collaborativevidence-bas

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onvenient acc

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quest for Prop

CA RFP No. 15

R/THR Bundle

erational and including but

and Warrantyluding produced componentotally knee anity standards

servative ther

s, meaning thcations attribuWarranty defion be attributextra care needot include qua

ve through thesed approache

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posals

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ed

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rapy;

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The respo

1. 2.

3.

4.

5. 6.

The HCAto implem

1.4 MI

Propose

1.

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The HCProposeright to

nt Replacement

Awarded CTKR/THRupon timel

Awarded Cto demonsstandards h

Awarded Crecommenappropriat

onsibilities of

HCA will HCA will contractedHCA will the ContraHCA will are met, thHCA will HCA will

A reserves the ment the TKR/

INIMUM QU

rs responding

Must be licenlicensed, Procalendar day

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Must performContract in th

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A intends to ar(s) with the haward up to f

t Bundled Epis

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Contractor(s) trate that the have been me

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the HCA inc

make paymenprovide finan

d Center(s) of provide perfo

act. review the qu

he contract wirequire its TPupdate any P

right to add o/THR Bundle

UALIFICAT

g to this RFP

nsed to conduposer must prs of being sel

ashington In-

m all total knehe state of W

e to offer a TK

he capacity to f the Member

urgeons, whoinimum of fif

award the Cohighest total sfive (5) Contr

ode of Care

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lude, but are

nts to the Awncial incentiveExcellence fo

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manage the vr population;

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ontract(s) resuscore(s) achieract(s) as a res

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bills to the HCe, which will b

onsible for gatorative’s recom

h an exceptionTHR surgery Bree Collabo

not limited to

warded Contraes to the definor total knee antives to the A

mance measurd for another se and educatped materials,

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n the state of mitment that Apparent Suc

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l hip replacem

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orming TKR/her total knee

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thering all of mmendations

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orative’s recom

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te Members., such as the C

meet its oper

minimum qua

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ccessful Propo

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of Care for t

tal knee and/ o

/THR Bundlee or total hip r

is solicitationeview of the bFP.

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arty administrdischarge wit

f the necessarys for clinical a

the cases in wwho does notmmendations

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Certificates of

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ures within sco

total knee and

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ed Episodes oreplacement s

n to the responbids. The HC

quest for Prop

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ator for each thin an agreed

y documentatand quality

which a provit meet s.

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ty does not ree the WashingCA reserves trmine in its s

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hat results froevel of availaRFP is contin

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mitting a Prop

The HCA resehedule prior toed users of theernment Cust

quest for Prop

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ny minimum Authority to is procureme

hrough Decemion for additioto written munsions, shall nequire a partia

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Changesprocurem

HCA res

Date Novem

Novem18, 20NovemDecemDecemJanuarJanuar

Januar2016 Januar2016 Februa2016 June 1

2.2 QU

Proposedates spsubmitteresponse

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Upon rethe Proc

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s to the Procument schedule

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mber 9, 2015

mber 9 – Nove15

mber 24, 2015mber 3, 2015 mber 4, 2015 –ry 15, 2016 ry 18, 2016

ry 20 - Januar

ry 25 – Januar

ary 1 – May 3

, 2016

UESTION AN

r questions anecified in theed in writing tes will be pro

poser(s) that idered unofficand binding.

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12 of 22

contract resultds or services rmance delive

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OPOSERS

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XHIBIT 1

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ICD-10) proc

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PENDIX AAL SUBMITT

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PPENDIX B

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PPENDIX C

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Standard Desubmitted, howrporated into

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