UNIVERSITY OF NORTH DAKOTA

1 UND 36-2014 NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 1 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 for The NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 RFP #36-2014 RELEASE DATE: September 16, 2013 TECHNICAL ASSISTANCE CALL: September 24, 2013 (4:00pm CT) Participants interested in a review of the guidance; question & answer session should call: (passcode: 7776782#) APPLICATION DUE DATE: October 18, 2013 (Applications must be received by 5pm CST) AWARD NOTIFICATION DATE: November 4th, 2013 Prepared by the UNIVERSITY of NORTH DAKOTA Purchasing Department UND 36-2014 NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 2 PURPOSE This Request for Proposal is released by the UNIVERSITY of NORTH DAKOTA Purchasing Department on behalf of the NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program.

2 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 grant awards. The ND Flex Grant Program is designed to support the goals of the Flex Program at the local level by supporting rural hospitals in remaining viable while maintaining access to care for rural NORTH Dakotans.

3 The Medicare Rural Hospital Flexibility Program is funded by the federal Office of Rural Health Policy (ORHP), Department of Health and Human Services. NORTH DAKOTA Critical Access Hospitals (CAH) are eligible to apply for Flex Grant funding. Flex Grant funding is available specifically to support the measurable financial improvement of NORTH DAKOTA Critical Access Hospitals. A Critical Access Hospitals can apply for more than one grant. A separate application form must be used for each area of focus. The Medicare Rural Hospital Flexibility Program is funded by the federal Office of Rural Health Policy (ORHP), Department of Health and Human Services. DEFINITIONS Application .. Response to the RFP CAH.

4 Critical Access Hospital Contractor .. Hospital receiving contract award 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 .. 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 UND 36-2014 NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 3 SECTION 1 STANDARD TERMS AND CONDITIONS Please refer to the attached sample subcontract. 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.

5 Below is a link to the registration site: 1. Must have active registration status with the official Government System for Award Management website. 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 good chance your organization is already registered with the SAM and has a DUNS number. Please check first with your contracting or business office. UND 36-2014 NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 4 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.

6 NOTE: Rural Hospital Flexibility funds cannot be used to purchase or acquire real property or to improve existing property. The funds cannot be used for building and/or physical structural improvements. A. Critical Access Hospital Program Grant There are two areas that can be addressed through this grant initiative: comprehensive revenue cycle management analysis, and community health needs assessments strategic implementation activities. The following provides a description of each. 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.

7 The CAH program grant will cover three awards of 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, awards 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.

8 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, but does wish to understand the available options and a detailed description of the benefits that the analysis will provide to the specific hospital and its community. UND 36-2014 NORTH DAKOTA Medicare Rural Hospital Flexibility (Flex) Program 14 5 Reporting requirements for Revenue Cycle Management Analysis Grants: 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.

9 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 Community Health Needs Assessment Strategic Implementation Activities: The objective of this grant 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.

10 This award will take the form of funding programming activities to help address the significant needs as identified by a hospital s most recent Community Health Needs Assessment (CHNA). The CAH program grant will cover up to seven awards of up to $15,000 for Strategic Implementation activities. 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, (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.