TITLE: Health Care Assistance (Navigator) Program for TRICARE Select Beneficiaries INTRODUCTION: Defense Health Agency (DHA) is exploring options as to how it could best implement a Health Care Assistance (Navigator) Program for certain TRICARE Select beneficiaries with complex medical conditions. The program is expected to meet the following requirements: • Assist beneficiaries with complex medical conditions to understand and use the health benefits under the TRICARE program. • Support beneficiaries in accessing and navigating the purchased care health care delivery system. • Provide beneficiaries with information to allow the beneficiaries to make informed decisions regarding the quality, safety, and cost of available health care services. • Improve the health outcomes for such beneficiaries. This RFI solicits industry's feedback on capabilities currently available to meet the DHA requirement described. The intent of this RFI is to gather information from potential industry sources to be utilized by the DHA TRICARE Program to support market research for the above requirement. Background. The program is being considered for certain TRICARE Select beneficiaries with complex medical conditions. For this instance, the DHA considers two or more chronic conditions requiring the coordination of multiple subspecialists to be a complex condition. TRICARE Select is a fee-for-service plan similar to a Preferred Provider Organization (PPO) health plan, available in the United States and requires enrollment. The DHA's TRICARE program is 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 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. 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: Based on the requirements listed in this RFI, provide the Government with an approach toward meeting each of them. Question #2: What economies of scale and other cost savings could the Government expect to achieve by administering this program? Are these economies of scale outweighed by the increased overhead associated with a new contract? Question #3: How have private/commercial healthcare organizations and health plans implemented similar requirements? Question #4: What utilization management or other tools could an organization use to determine eligibility to participate in Health Care Assistance (Navigator) Program? Question #5: What commercial industry resources, contract approach, requirements, and policies could DHA apply to meet the requirements of the Health Care Assistance (Navigator) Program? Question #6: What metrics should be used to measure whether the program improves health outcomes (noting a strong preference for measures that directly impact patients as opposed to process measures)? Question #7: How should this program get marketed to eligible beneficiaries? 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 1600Hrs. EDT on 21 August 2018. Responses to this RFI should be no more than 15 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 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 September 2018. The POC sending the submission will be notified about this meeting via email. RFI responses that fail to address the information sought will not be reviewed by the Government. 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]