The National Academy for State Health Policy (NASHP), a non-profit, nonpartisan forum of policymakers, is issuing this request for proposal (RFP) to identify future contractor(s) to create an online searchable database that shares data from a tool we developed. Proposals are due by 5 p.m. (ET) Tuesday, March 30, 2021.
Through its Center for State Health Care System Costs (the Center), NASHP has developed a hospital cost tool to analyze a hospital’s costs versus its prices. The tool is an Excel workbook that requires manual data entry from a hospital’s annual Medicare Cost Report (MCR) to identify its costs for providing hospital services, the largest portion of health care spending. Formulas are embedded in the tool to calculate several hospital financial metrics. Entering the data can be very time consuming and prone to data-input errors when used by individuals who are unfamiliar with the MCR.
In September 2020, NASHP began working with Vivian Ho, director of the Center for Health and Biosciences at the Baker Institute at Rice University, to auto-populate the MCR data from the national Healthcare Cost Report Information System (HCRIS) using the tool’s formulas. Ho and her team have successfully used Strata software to link NASHP’s tool with HCRIS, creating a data set of about 40 key points from the tool’s calculations. The data set resides in an Excel format, with 10 tabs (each representing a year of data from 2011 – 2020) each containing the 40 data points for each of the approximately 6,500 hospitals nationwide that submit an MCR. The data points include:
- Net income
- Profit margin
- Cost-to-charge ratio
- Uncompensated care costs
- Payer mix and profit/loss from Medicare, Medicaid, and commercial payers
- Break-even financial points
- Comparison to Rand 3.0, and
- Hospital pricing as a multiple of Medicare
NASHP has used the data set to prepare reports, Microsoft PowerPoint presentations, and deeper analyses for states and employer health plans that allow for benchmarking hospitals by bed size, state, national, and other measures. The work is intensive and requires a level of data expertise that not all state policymakers either have access to or the resources for. As a result, to date only a few people are working with the data. However, NASHP intends to make analysis from this data available to all state policymakers who want it.
Next Steps: Share an Online National Database of Hospital Costs
NASHP is interested in sharing (and regularly updating) the data set it created with Rice University on NASHP’s website to make it is accessible to states. To ensure the online database is useful to states and other health care purchasers, it should be searchable and include interactive features that allow users to create customized comparison charts, etc. Further, using the most recent data available (by a certain month, to be determined, in 2021), NASHP wants to create standardized reports for each state and Washington, DC that provide information through charts and graphs on hospital cost trends in their states that include national benchmarks.
While NASHP will continue to work with Rice University to update the data set using its evolving tool and the strata code already developed, the online data set needs to easily allow such updates. NASHP is seeking to contract with one or more entities that can advise NASHP on the best way to present this large data set online and make it as useful as possible to its core audience of state policymakers. NASHP is seeking expertise in organizing and presenting complex data sets online that can be manipulated by users with differing needs without making changes to the original data set. Please consider that NASHP wants flexibility built into the online data set to allow for quarterly updates, which is the frequency that the HCRIS data base is updated. Also, over time NASHP will likely expand the tool with additional data points as states need more information and/or as the MCR evolves. It also anticipates adding information from future resources, e.g., Rand 4.0. NASHP is also seeking help to develop and create easy-to-understand state reports with graphs, charts, and other visual representations of the data to offer a snapshot of hospital costs for each state. NASHP recognizes that the skills needed for this project may require contracting with two different entities – one with expertise in creating large online data sets and another with the graphics knowledge to create informative, visual reports. We are open to contracting with one or multiple parties to complete the work.
To achieve these goals, NASHP is seeking proposals from entities with expertise in creating online searchable online databases that can be routinely updated and/or entities with expertise in developing graphics from complex data. It is NASHP’s intention to begin this work in the late spring or early summer of 2021 so that the online database and individual reports will be available early in 2022 (or before, if possible.) NASHP welcomes interested entities to submit proposals related to the following anticipated deliverables and questions noted below.
- Develop an online, searchable database from the data set that NASHP now has from the HCRIS database using the strata code developed in partnership with Rice University. It must include:
- Accessible display of large data set that includes approximately 40 data points for about 6,500 hospitals over a 10-year-plus period of time (2011 and beyond);
- A search tool that allows users to query the database to access specific data points and to customize analytic reports based on their needs, which may include:
- Access to a single hospital’s cost information across all 40 data points throughout multiple years to understand a specific hospital’s cost trends;
- Access to multiple hospitals in a specific location (city, state, multiple state region, and/or national) to compare single or multiple cost data points; and
- A search that allows users to have options for viewing the data.
- Provide an overview of the data set that includes:
- A brief, written introduction of the resource that includes examples of how it can be used;
- A clear, concise instructions for using the resource; and
- A brief recorded training for users to view.
- Design informative charts, graphs, and other visuals to share critical data points and trends from the NASHP database to be used in state reports and presentations.
- Create standard reports using the data set – both national reports and individualized state reports –with graphics. NASHP will collaborate on the commonly requested information that should be included in the reports.
Request for Proposal
NASHP is seeking proposals from potential contractors with expertise, capabilities, and availability to do the work of presenting our data set online. In reviewing responses to this RFP, NASHP hopes to understand respondents’ experience with large data sets, their ability to create accessible graphics, and learn about their successful work with states. NASHP is also looking for information that will assist it in balancing respondents’ relevant experience with proposed budgets and timelines to complete the type of work we contemplate undertaking.
Please note if your proposal is responding to both areas or work/sets of deliverables (creating the online database and developing graphic reports) or if it is just focused on one of the areas of work and identify which one. Proposals responding to this this RFP will be accepted through 5 p.m. (ET), Tuesday, March 30, 2021.
All proposals should include the following:
- Organization and/or individual name and location(s);
- Description of the organization/company and explanation of the type of services provided, please note your audiences/recipients of your services;
- Please describe the experience you/your organization has with the work NASHP is seeking to do, including:
- Creating searchable, online databases that can be used by individuals with various backgrounds, including those with limited statistical experience (up to two pages), and
- Designing graphic-based reports that share critical information in a digestible manner (up to two pages)
- Describe your/your organization’s approach to the work by briefly explaining how either or both sets of the deliverables will be accomplished, as well as the proposed communication plan with NASHP. Please note the strengths and weaknesses of your approach and how you will assure quality work. (Up to three pages per set of deliverables – the online database and/or the graphical reports).
- Describe the people who would work on this project and a summary of their experience.
- Please provide the timeline you/your organization would need to accomplish the work and finish all deliverables and note how soon you/your organization would be available to do the work (up to two pages).
- Please provide the proposed detailed budget for the work and note if you/your organization would be the sole contractor or if there would be a subcontractor used as well.
- Please disclose any possible conflicts of interest.
- Please provide disclosure of complaints, current or pending actions, legal or otherwise.
*Examples of similar work can be included as an appendix to the proposal.
Proposals will be evaluated based on the respondent’s demonstrated experience with this type of work, the organization’s capacity to take on this assignment, the proposed workplan, and proposed cost. Note that the final award of this contract is contingent upon NASHP securing adequate funding for this initiative.
Point of Contact
Respondents can send questions and responses to this RFP to Maureen Hensley-Quinn at firstname.lastname@example.org.
Q&As about NASHP’s RFP
Will this new online database will be a stand-alone, cloud-based web solution?
The database will most likely need to be housed on a stand-alone, cloud-based solution separate from the NASHP website. However, the user-friendly interface should align with the look and feel of our website.
How many general users will be accessing the system – just searching the database? How many will be administrators – with permission to update/edit the data?
We are seeking a contractor that can take our database content and create a user-friendly interface so that the public can access the information as needed. We expect a small number of NASHP staff will need permissions to update and edit the data on a fairly regular base, e.g., quarterly or annually.
Will general users need to log in to use the database or will it be open for anyone to use?
It will be open.
Will the reports need to be downloaded? If so, what format(s) are needed (ex. PDF, JPEG, etc.)? Will the data for each report also need to be downloaded? If so, what format(s) (ex. CSV, Excel, etc.)?
NASHP is seeking one or two contractors to develop:
1) The user-friendly interface for the large excel database we have created so that the public can access the information from that database. It would be ideal to have an option to download the data accessed from this online database in excel format.
2) Point in time individual state reports with charts and graphs to highlight key data elements for that state.
NASHP is open for contracting with one organization to do both parts of this work, but we are also open to separating the work into two different components and contracting with two different entities.
Is there an existing developer that you work with who will also be bidding?
We know the deadline to submit our proposal is March 30, 2021. After that, when do you anticipate making a decision? When do you estimate that work will begin? When do you want the project to be completed/go live?
NASHP will begin considering all proposals after the submission deadline and will notify the successful bidder as soon as possible, likely by the end of April/early May. As noted in the RFP, we hope to launch the work in “late spring or early summer of 2021 so that the online database and individual reports will be available early in 2022 (or before, if possible.)”
What type of hosting/on-going maintenance will you be needing post-launch?
Ideally, NASHP will host the online interface and database as it does our website, but we are open to advice and input from the successful bidder on the best way to do so. We don’t expect ongoing maintenance will be needed, but we are open to advice and feedback from bidders on that as well.
What is the budget for the initial project development? Budget for long-term support?
NASHP has not specified an established dollar-value range for this contract and will consider price as well as a respondent’s ability to complete quality work within our preferred timeline of spring 2021 until winter 2021.
Would the contractor need to ingest the data NASHP and Rice University has prepared (the Excel tool data), or would the contractor ingest that data directly from HCRIS and merge with additional data produced by Rice University?
The contractor will use the large excel file that NASHP put together with Rice University as the calculations from HCRIS database have already been made.
Would the contractor need to interface or make use of the NASHP/Rice Stata code or would the contractor be building a separate system not linked to this existing code?
It is our expectation that the contractor will be creating an online, user-friendly interface so that users can easily access the critical cost data points within NASHP’s existing large, excel file.
Would we expect to make all deliverables accessible to the public or provide differential access to certain users?
The goal is to make all deliverables accessible to the public.
Are there any constraints on the platform and programming language used by the contractor? For example, are there any constraints on whether the contractor can use cloud computing to work with and host the data and reports?
Ideally this online database will be housed on NASHP’s website. However, we are open to input and feedback about how best to make that happen – whether it live our website’s server or be stored via a cloud-based solution.
The RFP states that “Also, over time NASHP will likely expand the tool with additional datapoints as states need more information and/or as the MCR evolves. It also anticipates adding information from future resources, e.g., Rand4.0.” How does NASHP plan to implement future changes after go-live. Although most tools would provide flexibility to update the input data and refresh existing reports, some changes may require an operations and maintenance support. Should we assume additional support after go-live date or would the continued updates of the evolving Rice University’s tool be scoped under a different maintenance and support contract if needed?
At this point, NASHP seeking a contractor that use flexible tools that our staff would be able to maintain. However, if the database needs significant updates, we would seek assistance through a different contract.