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Medicaid Long Term Care Case Mix Methodology Transition Consulting Services
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Request Date: 1/2/2020 11:14:36 AM
Open Date: 1/2/2020
Closing Date: 1/22/2020 3:00 PM
Intent To Bid Deadline:
Est. Dollar Value: $0.00
RFQ Number:
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Agency of Human Services, Dept of Vermont Health Access
312 Hurricane Lane
Williston,
VT
05495
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Locations:
Washington
Keywords:
Health Care Services
Bid Description:
The Centers for Medicare and Medicaid Services (CMS) is transitioning from its current case-mix model, Resource Utilization Groups, Version IV (RUG-IV), to the Patient Driven Payment Model (PDPM). The State of Vermont, Department of Vermont Health Access (State) relies on RUG-IV data to set nursing facility per diem rates for the 35 Vermont nursing facilities that accept Medicaid. In recognition of this transition, State intends to retain a qualified vendor (Bidder) with fiscal and clinical expertise to assist in developing a Medicaid nursing facility reimbursement methodology that meets the unique needs to the state’s residents and providers. Bidder will provide expertise, advice, and methodology development to transition from RUG-IV. This will include evaluating and modeling the transition from RUG-IV to PDPM, and innovative alternatives that may include prospective acuity-based case-mix payment systems. Qualified Bidders will have expertise in the following areas:
• Nursing Facility Medicaid rate development;
• Fiscal analysis and modeling;
• Federal and state regulatory analyses;
• Minimum Data Set (MDS) programming and clinical expertise; and
• Proven performance in the field of nursing facility rate setting.
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