DHA Industry Partnership Network (IPN) Request For Information (RFI) - Special Notice Title: Innovative Health Benefit Delivery and Management INTRODUCTION: The Department of Defense seeks information from knowledgeable sources regarding the next generation TRICARE programs. The Department's goal is to understand Industry's perspectives, risks and costs associated with providing the TRICARE benefit to eligible beneficiaries in order to maximize the number of available suppliers. The DHA seeks to garner lessons learned from implementations of Government health benefits to include state and national programs, consultants, education and others. Background. The TRICARE Program is available in the United States and requires enrollment by eligible beneficiaries. The TRICARE contractors create and manage the provider networks, process claims and provide administrative functions in support of the program. The DHA's delivery of the TRICARE program 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 by providing program management, benefit determinations, medical care management, customer services, provider networks, and claims processing. See the breakout at https://tricare.mil/About/Regions. The TRICARE benefit is not insurance, but rather a benefit, established by law and regulation that is consistently applied through health plans such as TRICARE Prime, TRICARE Prime Remote, etc. which assign patients to military or civilian primary care managers and pay associated claims. The contractors also manage TRICARE Select, a personally managed PPO plan. The Military Health System is undergoing significant operational changes as the DHA operationalizes the 2017 National Defense Authorization Act, Section 702. The Agency will be responsible for both Direct and Purchased care which includes the optimization of military medical treatment facilities (MTFs) to provide an integrated training platform to support military readiness. The TRICARE support contractors may be leveraged to support this optimization. AUTHORITY: The DHA Component Acquisition Executive J-4 is issuing this Special Notice Request for Information (RFI) 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. GENERAL INDUSTRY PARTNERSHIP NETWORK (IPN) PURPOSE: The DHA IPN Program, within the Component Acquisition Executive (CAE) (J-4) Directorate at the DHA, intends to use industry responses and communications from this notice as market research for subsequent acquisition strategies. DHA seeks information on availabilities, capabilities, and other pertinent marketplace data to strengthen the DHA's understanding of the current and future marketplace to enhance its ability to obtain quality services economically and to efficiently and lawfully establish potential vendor source files, listings and requirements. The DHA will not award any contracts under this notice. INFORMATION SOUGHT BY THE DHA: The submissions provided should address each of the following questions. Question #1: Describe how a health benefit plan is innovatively managed or delivered to beneficiaries on behalf of a payer. Question #2: What data or system requirements limit more commercial participation in participating in the TRICARE program? Question #3: How can Industry, Government, Academia or health plans implement similar requirements in a novel or innovative way? Question #4: What commercial industry resources, contract approaches, requirements, or policies could DHA apply to meet the requirements of the TRICARE Program? Question #5: How can the TRICARE Program be best utilized to facilitate military readiness? Question #6: What mechanisms or risk reduction initiatives can be applied to reduce the administrative costs of health benefits? DISCLAIMER AND IMPORTANT NOTES: THIS NOTICE IS NOT A REQUEST FOR PROPOSALS. This notice constitutes solely a market research effort as described under FAR 10.002. This notice does not obligate the Government to award a potential contract or otherwise pay for the information provided in response. The Government may invite certain respondents to an in-person meeting as a follow-up to this RFI. The Government will not pay for expenses related to this in-person meeting. 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. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published in Federal Business Opportunities. However, 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's IPN team on or before 4:00 PM. Eastern Time on 24 October 2018. Responses to this RFI should be no more than 6 pages 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 and assessed by DHA staff. Several potential industry sources may subsequently be invited to present additional details regarding their submittals at an in-person meeting with the Government in 8-9 November at La Cantera, San Antonio, Texas. In your response, please indicate the priority for a one on one meeting time: a) 8 Nov morning b) 8 Nov afternoon c) 9 Nov morning d) 9 Nov afternoon The point of contact sending the submission will be notified about this meeting via email. We greatly appreciate your time and look forward to learning from the submission. 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 DHA IPN Team email:
[email protected]