Bidders’ Conference Convened by Dirigo Health Agency June 18, 2012 Solicitation to Select Designated Survey Vendors

Agenda Purpose of Bidders’ Conference Goals of the initiative Expectations of the solicitation Subsidy payments Timelines Q & A

Purpose of Bidders Conference Provide overview of the project’s goal Review expectations of the solicitation Clarify issues NOTE: Presentation not exhaustive of all requirements identified in RFP and its Appendices Answers to questions raised at the Bidders’ Conference are not binding. Bidders should submit all questions in writing following the conference. Final responses to written comments will be posted on the Dirigo Health Agency project website on June 27, 2012

Goals of the Initiative Promote patient experience as a vital component of care quality Expand the number of primary and specialty care practice sites collecting patient experience data Apply a consistent tool and approach for assessing patient experience Compare survey results to regional and national benchmarks Publicly report findings at the practice site level for use by consumers Enhance the use of patient experience survey data by practice sites to improve quality

Why Designate Survey Vendors?  Maximize consistency in survey administration  Ease participation by practice sites  Serve as a vehicle for awarding practice-site subsidies

Eligibility to Submit Bids Minimum requirement  Experience using CAHPS protocol for sampling and administering a CAHPS survey instrument Preference  NCQA-certified vendor, or  Certified by CMS for administration of the H-CAHPS survey or Medicare Advantage and Prescription Drug Plan CAHPS surveys

Review Project Features Target population Practice site Survey instruments Modes of administration Sample frame and size Practice-site subsidy Registration Field Period

Target Population Adult patients (18 and older) of primary care and specialty care practice sites Parents of children (<18) who are patients of pediatric practice sites only

Practice-Site Practice site is the unit of analysis Practice site is defined as the place where one or more clinicians practice together and provide primary or specialty care at a single geographic location, whether single geographic address or separate office suites at the same address.

Survey Instruments Adult Primary Care Practice Sites CG-CAHPS Adult PCMH, version 2.0 Child Pediatric Practice Sites [Note correction] CG-CAHPS Child PCMH, version 2.0 Adult Specialist Practice Sites CG-CAHPS Adult PCMH, version 2.0.  This version is modified and includes all CG-CAHPS core items and a subset of supplemental items.

Modes of Administration Mail only Telephone only Mixed mode of mail with telephone follow-up Mixed mode of with mail follow-up Mixed mode of with telephone follow-up

Practice Recruitment Participation in the survey is voluntary Survey vendors will be responsible for contacting and enlisting practice site participation DHA will conduct outreach activities to promote the survey effort among physicians and practice groups There also will be limited public promotion to increase awareness of the survey effort in general

Sample Frame Sample drawn at single point in time at practice site level Patients who had at least one visit with a provider at the practice site in the 12 months prior to sample selection. “Provider” includes physician, nurse practitioner or physician assistant who independently manages a patient caseload.

Sample Size # Providers at Practice Site* # of Completed Surveys Required** *Provider means physician, nurse practitioner or physician assistant who independently manages a patient caseload ** Based on Agency for Healthcare Research and Quality guidelines for practice site sampling.

Practice-Site Subsidy Available to all participating practice sites that:  Use a Designated Vendor  Follow DHA Survey Guidelines  Submit a signed DUA with CAHPS allowing Dirigo Health access to survey results for public reporting Flat subsidy amount per completed survey Amount of subsidy based on preferred rate established thru RFP solicitation Subsidy level expected to be 60-90% of preferred rate Subsidy paid to the vendor in 2-3 installments Vendor balance bills practice after receipt of subsidy

Registration Vendors must register practice sites in advance of survey administration Registration requirements  Signed Data Use Agreement  Name of participating practice site, number of providers by practice site Data obtained through registration is used to determine initial practice site subsidy payments to vendor

Field Period Survey administration will occur over a three-month period (September 2012 – November 2012 )

Data Submission CAHPS Online Reporting System Maine’s Use of CAHPS Database Data Use Agreements Data Submission

CAHPS On-Line Reporting System National repository of data for selected CAHPS surveys Two major applications  Benchmarking  Benchmarking to evaluate health system performance and support quality improvement  Research  Research on consumer assessments of quality Funded by AHRQ and administered by Westat through the CAHPS User Network

Maine’s Use of CAHPS Database DHA plans to use the CAHPS Database to analyze and aggregate comparative site-level results and national benchmarks for state-level reporting. Benefits –  Minimizes costs of analyzing and aggregating survey data  Streamlines data submission and encourages practices to submit their data to CAHPS Database to view their own practice data for benchmarking.  Composite measures available through CAHPS database for public reporting.

Maine’s Use of CAHPS Database Practice sites will include DHA as a data user in the required data use agreement (DUA) with CAHPS Database. Vendors will submit survey results to the CAHPS Database following submission guidelines. DHA will access results from CAHPS Database to publicly report practice-level findings.

How it will work Signed agreement between practice sites and CAHPS must authorize DHA to have access to site level information for statewide public reporting. Vendors responsible for ensuring DUAs are signed and submitted to CAHPS and DHA to establish subsidy eligibility. Vendors must provide DUA documentation in DHA practice registration system to receive estimated initial subsidy payments. Vendors will submit survey results through the CAHPS PCMH Clinician & Group Survey Data Submission process following CAHPS guidelines and recommendations. Final subsidy payments made to vendors based on CAHPS Database confirmation of surveys submitted.

Public Reporting Practice sites must agree to have practice site level survey results publicly reported as a condition of receiving a subsidy. Practice site level survey data will be publicly reported on the DHA website. Design of public reporting website will be developed with input from stakeholders.

Proposal Contents Section 1 - Organizational Qualifications and Experience  Applicant entity  Sub-contractors  Experience of senior staff responsible for work  Methods for assuring compliance with terms of RFP  Evidence that qualifying criteria are met  Experience with similar survey projects, especially CAHPS and PCMH, with emphasis on experience in Maine  Experience using CAHPS Database  Historical response rate by mode

Proposal Contents Section 2 – Specifications of Work to be Performed  Strategy for practice-site recruitment  Opt in/out for new business  Sampling method  Mode(s) of survey administration  Method for obtaining Data Use Agreement  Adherence to CAHPS Survey Administration guidelines  Understanding of Data Submission requirements  Post survey validation

Proposal Contents Section III – Cost Proposal  Calculated as cost per completed survey  Separate bid for each mode that Vendor plans to use  Identify break breaks based on level of participation

Proposal Contents Section IV – Economic impact within Maine  Activities that have direct and positive impact on Maine  Employment of Maine residents  Subcontracting/partnering with Maine businesses  Payment of Maine taxes or licensing fees

Proposal Contents Section V – Required Proposal Attachments Evidence of NCQA-Certification or CMS Training (if applicable) Resume of person(s) responsible for project oversight Marketing materials

Scoring Organization qualifications & experience (30 points) Approach to work (40 points) Cost proposal (25 points) Economic impact within Maine (5 points)

Timeline ActivityDue Date Receipt of written questionsJune 22, 2012 Responses postedJune 27, 2012 Receipt of proposalsJuly 6, 2012 Estimated start of contractAugust 6, 2012 Estimated contract end dateApril 30, 2013

Questions?? Responses to q uestions addressed during the Bidders’ Conference are not binding. Bidders are advised to submit their questions in writing by 5:00 pm on June 22. Final responses to written comments will be posted on the Dirigo Health Agency project website on June 27, l