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UND 46-2015 North Dakota Medicare Rural Hospital Flexibility (Flex) Program ‘15

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UNIVERSITY OF NORTH DAKOTA School of Medicine and Health Sciences

Center for Rural Health

NORTH DAKOTA

Hospital Association

NORTH DAKOTA

Healthcare Review, Inc.

NORTH DAKOTA

EMS Association

REQUEST FOR PROPOSAL (RFP)

for

The North Dakota

Medicare Rural Hospital Flexibility (Flex) Program ‘15

RFP #46-2015

RELEASE DATE: Friday, September 19, 2014

TECHNICAL ASSISTANCE CALL: Thursday, September 25, 2014

(1:00pm CT)

Participants interested in a review of the guidance; question & answer

session should call: 1.866.809.4014 (passcode: 7773294#).

APPLICATION DUE DATE: Thursday, November 20, 2014

(Applications must be received by 5pm CST)

AWARD NOTIFICATION DATE: Monday, December 15, 2014

Prepared by the University of North Dakota Purchasing Department


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PURPOSE

This Request for Proposal (RFP) is released by the University of North Dakota Purchasing Department on

behalf of the North Dakota Medicare Rural Hospital Flexibility (Flex) Program. The North Dakota Flex

Program is administered by the University of North Dakota Center for Rural Health, School of Medicine

and Health Sciences. Its partners include the North Dakota Hospital Association, the North Dakota EMS

Association, and the North Dakota Healthcare Review, Inc. (North Dakota’s quality improvement

organization). The Flex Program’s Steering Committee is comprised of one or more members from each

of the partners. The Steering Committee sets policy, develops guidelines, and reviews and determines the

hospital subcontract awards. The ND Flex CAH Subcontract Program is designed to support the goals of

the Flex Program by supporting rural hospitals in remaining viable to maintain access to care for rural

North Dakotans. The Medicare Rural Hospital Flexibility Program is funded by the federal Office of

Rural Health Policy (ORHP), Department of Health and Human Services.

All North Dakota Critical Access Hospitals (CAH) are eligible to apply for Flex subcontract funding.

A Critical Access Hospital can submit more than one application. A separate application form

must be submitted for each area of focus (comprehensive revenue cycle management analysis and

community health needs assessments strategic implementation activities).

DEFINITIONS

Application ..................................................................................................................... Response to the RFP

CAH ......................................................................................................................... Critical Access Hospital

Contractor ...................................................................................................... Hospital receiving subcontract

Flex ……………………………………………………………..………Rural Hospital Flexibility Program

ORHP .................................................................................................. Federal Office of Rural Health Policy

Proposal ......................................................................................................................... Response to the RFP

RFP ................................................................................................................................ Request for Proposal

Respondent ........................................................................................ Hospital responding to RFP, Applicant

Flex Steering Committee.............. .............................. University of North Dakota, Center for Rural Health

North Dakota Hospital Association

North Dakota EMS Association

North Dakota Healthcare Review, Inc.

UND .................................................................................................................... University of North Dakota


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SECTION 1

STANDARD TERMS AND CONDITIONS

1.1 Please refer to the attached sample subcontract.

1.2 UND subcontract requirements:

In order for the University to meet a federal requirement under the Federal Funding Accountability and

Transparency Act (FFATA), all entities receiving federal flow-through funding are required to obtain a

Dun and Bradstreet number and to be registered on the System for Award Management site prior to

submitting a proposal. Below is a link to the registration site:

1. Must have active registration status with the official U.S. Government System for Award

Management website. https://www.sam.gov

2. Must provide a Dun and Bradstreet number (also called the DUNS number). This is a 9-digit

identification of the physical location of your business.

Please note that there is a good chance your organization is already registered with the SAM and has a

DUNS number. Please check first with your contracting or business office.

https://www.sam.gov/


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SECTION 2

SCOPE OF WORK

Funding is available to support CAHs in identifying potential areas of financial and operational

improvement, as well as supporting CAHs and communities in developing implementation strategies and

programming in response to identification of unmet community health and health service needs.

NOTE: Rural Hospital Flexibility funds cannot be used to purchase or acquire real property or to

improve existing property; for building and/or physical structural improvements; or for the purchase of

food.

A. Critical Access Hospital Subcontract Program

There are two areas that can be addressed through this initiative: comprehensive revenue cycle

management analysis, and community health needs assessments strategic implementation activities. The

following provides a description of each.

2A.1 Comprehensive Revenue Cycle Management Analysis:

This activity will take the form of financial consultation for comprehensive revenue cycle

management analysis/education, with the objective of increasing hospital revenue and

cash flow. The Flex program will cover up to three subcontracts up to $15,000 for

financial assessment performed by a qualified accounting firm with history and

experience in the area of health care finance. The financial analysis must include the

following:

Chargemaster review

Collections

Admissions

Billing & Coding Review

Review of Medicare Cost Report Utilization Operating Departments

Physician Documentation

Ancillary Managers

During the application review process, subcontracts will be determined based on need, as

outlined by data from the Flex Monitoring Team CAH Financial Indicators Reports, and

other sources.

NOTE: All application requests for consultant services must include a minimum of two

bids from different consultants, both including a detailed budget narrative and a

thorough description of what the analysis will include. The applicant must then provide

rationale for using their consultant of choice. The Flex Steering Committee does not

wish to interfere with the hospital’s right to choose their own consultant; however does

want to understand the available options and a detailed description of the benefits that

the analysis will provide to the specific hospital and its community.


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Reporting requirements for 2A.1 Revenue Cycle Management Analysis Subcontracts:

12-month post measure reporting will include, but is not limited to:

• Percent improvement in bad debt as a percent of gross charges and/or net patient revenue

• Improvement in point of service collections as a percent of total revenue

• Percent reduction in claims review and denial rates

• Percent improvement in days in AR, based on gross revenue

- % change in gross revenue captured

- % change in number of clean claims

- % change in reduction of denials

• Number and percent of line items with CPT/HCPCS code changes added, deleted or revised

- # and % of CDM items deleted

- # and % of CDM items added

- # and % of CDM items revised

- # and % of CDM CPT codes deleted

- # and % of CDM CPT codes added

- # and % of CDM CPT codes revised

• # of line items with revenue code changes recommended, and implemented

- # and % of CDM revenue codes revised

• % reduction in CDM errors

• % reduction in cost-report errors

2A.2 Community Health Needs Assessment Strategic Implementation Activities:

The objective of this activity is to satisfy regulatory requirements of the Affordable

Care Act; implement programs which address identified community health needs;

encourage collaboration with other community organizations and stakeholders; and

promote community engagement and healthy behaviors.

Funding will support hospital programming and activities to help address a

significant need as identified by a hospital’s most recent Community Health Needs

Assessment (CHNA). The Flex program will support up to seven subcontracts up

to $15,000.

Note: All application requests for strategic implementation funds must include the

proposed activity which addresses the identified need, both including a detailed

budget narrative and a thorough description of what the activity will include. The

applicant must: (1) describe the collaborative partnerships involved including

specific project roles and responsibilities of each partner identified; (2) define the

anticipated impact the proposed activity will have on the community; (3) state the

duration of the activity; (4) explain how the activity or program will be measured

for effectiveness; and (5) list the other identified significant needs identified by the

CHNA and explain how they are being addressed, or, if they are not being

addressed by the hospital, explain why not.


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Reporting requirements for 2A.2 Community Health Needs Assessment Strategic

Implementation Subcontracts:

12-month post measure reporting will include, but is not limited to:

Number and description of activities or programs implemented as a result of Flex

Community Health Needs Assessment Strategic Implementation funding.

Number of individuals in the target population served by these activities or

programs.


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SECTION 3

RULES FOR APPLICATION

3.1 It is the sole responsibility of the Respondent to be certain that it has received a complete set of

the Proposal Documents when preparing to respond. Upon submission of its Application, the

Respondent shall be deemed conclusively to have been in possession of a complete set of

proposal documents.

Respondents are expected to examine the entire RFP; including all specifications,

requirements, and instructions. Failure to do so will be at the Respondent’s risk.

3.2 UND will not be responsible for any costs incurred by Respondents which may result from

preparation or submission of application to this RFP.

3.3 Proposal Application

Respondents should use the attached application form. An electronic copy is also available at:

http://ruralhealth.und.edu/projects/flex/grants.php

Each page must be identified with the hospital’s name and city, as well as name and telephone

number of primary contact. (For example, left upper header: Mercy Medical Center, Williston;

right upper header: Primary Contact Jim Smith, Telephone (701) XXX-XXXX.)

Please refer to Section 2, Scope of Work, for additional application information.

An electronic copy of the application is required.

APPLICATION SUBMISSION:

E-mail (required) to: [email protected]

Acceptance or denial of application: The Steering Committee reserves the right to accept or deny any or

all applications or parts of the application, and to waive informalities.

The time line for this process is as follows.

RFP release date: Friday, September 19, 2014

Technical assistance: Thursday, September 25, 2014

(1:00pm CT): Dial: 1.866.809.4014/passcode: 7773294#).

Application due date: Thursday, November 20, 2014, 5pm CST

Award notice date: Monday, December 15, 2014

Work completion: August 31, 2015

http://ruralhealth.und.edu/projects/flex/grants.php

mailto:[email protected]


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APPLICATION GUIDELINES

Instructions: The application form is to be completed by hospitals seeking support from the Flex

Subcontract Program. For information on the RFP or application please contact Angie Lockwood at the

UND Center for Rural Health, School of Medicine and Health Sciences:

Angie Lockwood, Project Coordinator

UND Center for Rural Health

School of Medicine and Health Sciences

501 N. Columbia Road, Stop 9037

Grand Forks, ND 58202-9037

701-777-5381 (Phone)

E-mail: [email protected]

Web Address: http://ruralhealth.und.edu/

In completing this application, be as specific as you can be in stating your needs, describing your

situation, and identifying your actions. Maximum application length is eight pages, to include budget,

budget narrative, and summary. If appendices are included, those are not counted against the eight

page limit, but please provide only pertinent information.

http://ruralhealth.und.edu/


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SECTION 4

AWARD

4.1 Applications will be reviewed by the Flex Steering Committee consisting of the following:

University of North Dakota, Center for Rural Health (Lynette Dickson, Jody Ward, Brad

Gibbens, Angie Lockwood)

North Dakota Hospital Association (Tim Blasl)

North Dakota Healthcare Review, Inc. (Barb Groutt)

North Dakota EMS Association (Curt Halmrast)

4.2 The criteria for application evaluation is meeting the requirements as outlined in Section 2, Scope

of Work and address the following in this order:

A. SUMMARY (One page maximum for summary)

1. Provide a brief description of why your facility should be selected to complete a

Revenue Cycle Management Analysis OR Community Health Needs Assessment

Strategic Implementation Project (Choose only one per application.)

2. Provide a brief description of anticipated outcomes, overview of intended use of

information gathered, plan for results and follow-through.

3. State the total dollar amount of funding being requested.

B. BUDGET & BUDGET NARRATIVE

1. The budget section should cover such areas as line item expenses, contractual

costs, as well as in-kind contributions.

2. The budget narrative must follow the order of the budget and is a mechanism to

assist the reviewers in understanding the budget. The budget narrative should

identify line item expenses and explain how the line items are determined and/or

calculated.

3. A sample budget and narrative can be found on the Flex website at:

http://ruralhealth.und.edu/projects/flex/funding-programs

4. Copy of consultant bids (minimum of 2) and rationale for consultant/vendor

choice. Revenue Cycle Management Analysis applicants should use template

letter for consultant bids, found on the Flex website at:


Rural Hospital Flexibility funds cannot be used to purchase or acquire real property or to improve existing

property; for building and/or physical structural improvements; or for the purchase of food.

PLEASE TAKE NOTE: These subcontracts are intended to fund new activities,

not any activity or projects which begin before the Flex subcontract is awarded.

Any expenditures incurred prior to the formal contractual signing by both parties

are the responsibility of the hospital. Prior expenses cannot be submitted for

reimbursement. All project activities must be completed by August 31, 2015.




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C. PROJECT DESCRIPTION

1. Provide a description of why your facility should be selected to complete a

Revenue Cycle Management Analysis OR Community Health Needs Assessment

Strategic Implementation Project (Choose only one per application.)

2. Include the goals, action steps, and specific project deliverables. Make sure that

they are time sensitive and measurable. Include a time line with specific dates.

All project activities must be completed by August 31, 2015.

3. Provide a description of anticipated project outcomes. What is the intended plan

for using the information/resources obtained through this project? Explain the

plan for results and follow-through.

4. State the total dollar amount of funding being requested.

5. For Revenue Cycle Management Analysis applications only:

a. Does your facility currently have a financial analysis team in place?

i. If so, explain which staff serve on the team, as well as frequency

of financial analysis meetings.

ii. If not, please explain your facility’s plans for establishing a

financial analysis team, including which staff will serve on the

team, as well as frequency of meetings.

OR

5. For Community Health Needs Assessment Strategic Implementation Project

applicants only:

a. What significant needs were identified by your hospital’s Community

Health Needs Assessment?

b. Which need(s) are you seeking to address with this funding application?

c. Explain in detail the proposed activity or program.

d. With respect to the other significant needs identified by the CHNA, how

are those other needs being addressed by the hospital? For identified

needs not being addressed by the hospital, please briefly explain why

they are not being addressed.

e. Will the hospital collaborate with other community organizations or

stakeholders on this proposed program or activity? If yes, please include

information detailing specific project roles and responsibilities of each

partner identified.

f. Will hospital personnel will be involved in carrying out the proposed

activity or program? If yes, explain which personnel will be involved

and what each individual’s role will be.

g. What is the anticipated impact on the community of the proposed activity

or program?

h. What is the duration of the proposed activity or program? (Is it a

continuing program or of limited duration?)

i. How do you plan to measure the effectiveness of the proposed activity or

program?


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D. PROJECT MANAGEMENT

1. Please identify the individual responsible for management and oversight of this

project.

4.3 A subcontract will be provided as the award document. A sample copy of the subcontract is attached

for your information. Hospitals do NOT need to complete the subcontract or return it with your

proposal. It is simply intended to serve as an example.

4.4 Funded projects are required to submit a final report to the Center for Rural Health and participate

in the Flex Program’s evaluation.

4.5 The North Dakota Rural Hospital Flexibility Program will coordinate news release information

following award notification.


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