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Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Integrated Veteran Care (IVC) Request for Information (RFI) Performance Oversight and Access Reporting (POAR) Software as a Ser... Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Integrated Veteran Care (IVC) Request for Information (RFI) Performance Oversight and Access Reporting (POAR) Software as a Service (SaaS) THIS IS A REQUEST FOR INFORMATION (RFI) ONLY (as defined in Federal Acquisition Regulation (FAR) 15.201(e)), and shall not be considered an Invitation for Bids, Request for Quotations, or a Request for Proposal. Do not submit a proposal or quote. This market research is issued for information and planning purposes only and does not constitute a solicitation nor does it restrict the Government as to the ultimate acquisition approach. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Additionally, there is no obligation on the part of the Government to acquire any products or services described in this RFI. You will not be entitled to payment for direct or indirect costs that you incur in responding to this RFI. Any contract that might be awarded based on information received or derived from this market research will be the outcome of a competitive process. Interested parties are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response. The Government does not intend to pay for the information submitted in response to this RFI. Be advised that set-aside decisions may be made based on the information provided in response to this RFI. Responses should be as complete and informative as possible. The North American Industry Classification System (NAICS) for this requirement is 541519 with a size standard of 150 employees. A company that is a Service-Disabled Veteran-Owned Small Business (SDVOSB) or a Veteran-Owned Small Business (VOSB) must be VetCert registered and verified (https://veterans.certify.sba.gov). The purpose of this RFI is to conduct market research to obtain information pertaining to industry capabilities and commercially available solutions for Performance Oversight and Access Reporting (POAR) Software as a Service (SaaS). VA is seeking input on potential solutions and requesting the capabilities and experience from industry partners interested in contributing to the solution or providing these services for VA. Businesses of all sizes are encouraged to respond. The Government requests that contractors respond to the specific questions provided in this Request for Information. Responses should demonstrate capability, not just confirm the company s belief that the capability exists. The agency does not intend to award a contract as a result of this RFI, but rather gather capabilities and market information pertinent for project and acquisition planning. The responses to this RFI will be captured as market research and may contribute to the development of an acquisition strategy. Information provided may be used to assess tradeoffs and alternatives available for the potential requirement and may lead to the development of a solicitation. All submissions become Government property and will not be returned. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. The information provided in the RFI is subject to change and is not binding on the Government. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed. PURPOSE This Request for Information (RFI) is for Market Research Only. BACKGROUND The Department of Veterans Affairs (VA) is the largest clinically integrated health system in the Nation, providing access to medical care for approximately nine million enrolled Veterans. The Veteran Health Administration (VHA) Integrated Veteran Care (IVC) leads operational functions to ensure the care provided to Veterans by community providers is scheduled, accessed, and paid for in a timely manner. To ensure that all patients have adequate access to timely, high-quality, specialized care, VA continues to deploy modernization efforts and clinical care innovations to maximize care efficiency without jeopardizing quality or access. VA is seeking services to configure a Software as a Service (SaaS) tool to provide VHA IVC a comprehensive resource for automated analytical reporting leveraged across multiple levels of the VA organization, to improve the monitoring, management, and oversight of health care purchased outside of VA Medical Centers (VAMC) through the Veterans Community Care Programs (VCCP). EXISTING APPLICATIONS VA has multiple data sources to include, (but not limited to) EDI Claims (837I, 837P, 837D, 835), Corporate Data Warehouse, Financial Service Center and Electronic Claims Administration and Management System (eCAMS), which will need to continue to be utilized as sources for data gathering/mining. DESIRED END STATE VA is seeking a dashboard and reporting system that has the capacity to configured and subsequently maintained which will contain categorized reports aligning to the following dashboard titles: Network Management (NM) and Administrative Fees Oversight (Admin Fee). Network Management dashboard reports consist of key elements to monitor Network Adequacy, Veteran Access, and Provider Utilization. Administrative Fee Oversight dashboard reports focus on Contract Performance Monitoring, monitoring Per Member Per Month (PMPM) fees and utilization as well as contract Incentive/Disincentive Factors (IDF) for the Community Care Network (CCN) Contracts. Reports developed shall include multiple data sources, as defined by VA during report development, and shall include retroactive reporting ensuring at least six (6) rolling years of reporting is housed within the dashboards. Reports developed shall provide various filtering and sorting abilities and shall also allow for geographic mapping display, when applicable as defined by VA. Reports developed as a part of the creation of the dashboard shall meet, but not be limited to, the following minimum requirements:  Allow VHA IVC to monitor and analyze the access to care within the CCN (Community Care Network) in relation to the calculated timeframes between various date stamped data elements. Wait time calculations will be processed utilizing CC referral and claims data with the resulting outputs extracted into custom Network Management reports that allow end users to analyze CCN coverage at various granularities, including VA Medical Center (VAMC), Veterans Integrated Service Network (VISN), and VA Enterprise level. Allow VHA IVC to monitor and analyze the physical coverage of the CCN (Community Care Network) in proximity to Veteran locations and across medical specialties. Drive time calculations will be processed utilizing CC provider and Veteran location with the resulting outputs extracted into custom Network Management reports that allow end users to analyze and visualize CCN coverage at various granularities including at a Medical Center, VISN & Enterprise level. This capability shall also include National Council for Prescription Drugs Programs (NCPDP) transactions to calculate pharmacy drive times and identifying the closest Immediate Need Pharmacy. Drive time calculations will be processed utilizing CC provider and Veteran location with the resulting outputs extracted into custom Network Management reports that allow end users to analyze CCN coverage at various granularities, including Medical Center, VISN & Enterprise level.  Allow VHA IVC to monitor and analyze the utilization of providers across VCCP through the analysis of network status and referral volumes. Utilization will be displayed including percentage comparisons and visuals that allow end users to analyze CCN coverage at various granularities, including Medical Center, VISN & Enterprise level. Allow VHA IVC to monitor and analyze a visual representation of approved network waivers (Deviations) across multiple provider specialties and categories of care spatially compared to approved counties and zip codes. Allow VHA IVC to analyze and monitor Quality Assurance Surveillance Plan (QASP) Performance Objective (PO) calculations of the CCN contracts. These reports incorporate Network Dashboard calculations for wait time and drive time as well as analysis of claims processing, scheduling times, as well as other quality metrics. Allow VHA IVC to monitor and analyze up to a full year of CCN Per Member Per Month (PMPM)/Per Member Per Case (PMPC) budgetary requirements across the unique Veteran and total expenditure measure selection. Data incorporated into this include Invoice Payment Processing System (IPPS) data when it is available and admin fee projections (leveraging historical claims and referral data) when actual information is not available. The resulting outputs extracted into custom Admin Fee reports will allow end users to drill-down and analyze raw data by respective PMPM/PMPC category, CCN region, and fiscal year. Allow VHA IVC to monitor and analyze detailed information on the Incentives (or disincentives) that are paid (or billed) to the CCN Third Party Administrators (TPAs) for their performance in supporting CCN and its various initiatives. This report shall project the feasible range of outcomes for any given IDF, region, and future fiscal year, it also incorporates actual Quality Assurance Surveillance Plan (QASP) Performance Objective (PO), TPA 837/835 Electronic Data Interchange (EDI), Provider Profile Management System (PPMS), and TPA improper payment audit deliverable data to calculate the specific outcomes and cost impacts for IDFs 1 5 by region and fiscal year.  The underlying and supporting system housing and displaying these reports shall meet the following minimum requirements: Be FEDRAMP MODERATE authorization and validation through FEDRAMP Marketplace with the ability to move to the High Impact Level should the need arise. This shall apply to both the SaaS and any cloud hosting service/infrastructure. Shall be FIPS 140- 2, NIST 800, HIPAA, and 508 Compliant. Run on a secure cloud infrastructure and shall be accessible from various client devices through either a thin client interface, such as a web browser (e.g., web-based email) or a program interface. Not require download of software to VA computers. Not require VA to manage or control the underlying cloud infrastructure including network, servers, operating systems, storage, or individual application capabilities. Be accessible to multiple simultaneous VA users at any given time. The number of user accounts that could be accessed simultaneously by users of this software is estimated at 500 users.  Be able to support the estimated up to 50 million claims per year with storage capacity that includes the current fiscal year as well as six (6) prior fiscal years. Include data objects that shall be editable with the support of Data Authoring and Versioning (DAV) control.  The Contractor shall ensure the POAR SaaS tool is available and operational for users 24/7.  System shall have or achieve an Enterprise-wide (VA-wide) Authority to Operate System shall support VA trusted internet connection (TIC) System shall be accessible both within VA facilities and remotely System shall be a configurable Commercial-off-the-shelf (COTS) SaaS product System shall enable direct Single-Sign-On (SSO) through integration with VA s SSOe System shall have adaptable integration options to support integrations with future VA systems System shall allow for integration with current and future COTS software and analytical tools utilized by VA, including but not limited to Tableau, MS Power BI, Service Now VA Users shall be able to appropriately export information from the system, consistent with VA security and privacy requirements (User Role access or other solutions to restrict access to protect PII) System shall facilitate role-based user access and authorization System shall be able to provide continuous release capability System shall be able to offer Application Program Interfaces (APIs) that can be consumed by VA systems, e.g., VA.GOV System shall maintain capacity to have data refreshed and validated monthly Provide unlimited end user access to POAR SaaS solution via a secure website. INSTRUCTIONS FOR RESPONDING TO THIS RFI CONFIDENTIALITY: No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s). Response Format/Page Limitations: The overall total page limit for responses to this RFI is five (5) pages. Responses should be submitted in Microsoft Word format with Times New Roman font, 12 pt. minimum that addresses the above information. Interested parties should limit marketing material to allow sufficient space for adequately, directly, and substantively responding with the information of most interest to the Government. In all correspondence relevant to this RFI please identify it as a response to the VA-25-00012049 POAR SaaS (Response and Subject Line of email) Any organization responding to this notice should ensure that its response is complete and sufficiently detailed. Respondents are requested to limit responses to the information, and in the format provided below. A - GENERAL INFORMATION Organization Name and the year in which the company was established / founded (please list any previous names used). Unique Entity ID: Address: Point of Contact: Phone Number: Fax Number: Email Address: Any applicable schedules (General Services Administration (GSA), Mission Oriented Business Integrated Services (MOBIS), Veterans Technology Services (VETS) Government wide Acquisition Contract (GWAC), etc.): Business size status based upon the applicable NAICS code of 541519 Other Computer Related Services. (For more information refer to http://www.sba.gov/): If SDVOSB/VOSB, is your business verified in the VetCert database (https://veterans.certify.sba.gov) Company ownership (public, private, joint venture). B APPROACH, CAPABILITY, AND EXPERIENCE INFORMATION Describe how your company, partner or sub-contractor s solution qualifies as a VA Software as a Service (SaaS) and describe its hosting environment. How does/will your company, partner or sub-contractor s solution meet requirements for VA FedRamp approval at the software and hosting level? **************************************************************************** Submission: Responses to this RFI shall be submitted to the following points of contact via email to Erica.Wortman@va.gov and Michael.Marone@va.gov no later than at 1:00PM ET on Wednesday, October 16, 2024. Questions: Questions related to this RFI and/or the draft PD shall be submitted on, or before 1:00PM ET on Thursday, October 11, 2024. Submit questions, in writing, regarding this RFI to Erica.Wortman@va.gov and Michael.Marone@va.gov. See attached documents: Draft PWS Performance Oversight and Access Reporting (POAR) Software as a Service (SaaS)