Description
The State of Vermont is seeking a qualified vendor to design, develop, test, and implement a statewide commercial‑sector reference‑based pricing (RBP) program for all Vermont hospitals. The effort covers methodological development, enforcement and monitoring mechanisms, and financial‑impact analysis, with deliverables spread over a 12‑month initial contract term and up to four renewal options. The vendor must handle large health‑care data sets (VHCURES, VUHHDS), produce transparent, reproducible models, and provide training and technical assistance to the GMCB staff. Preference is given to Vermont‑based firms and those demonstrating clean‑energy or climate‑change practices.
• Develop a comprehensive RBP rate‑setting methodology, including service definitions, code mappings, weighting, case‑mix adjustment, and quality‑outcome measures.
• Build enforcement, compliance, and monitoring tools to detect provider behavior such as up‑coding or site‑of‑care shifting, and define corrective‑action protocols.
• Conduct detailed financial‑impact modeling linking hospital‑level savings to premium and out‑of‑pocket cost effects, with sensitivity and scenario analysis.
• Deliver all final price schedules, machine‑readable data, methodological appendices, and provide training to state staff; ensure all deliverables meet WCAG 2.1 A & AA accessibility standards and state cybersecurity requirements.