Department of Vermont Health Access

The buyer seeks a qualified vendor to assist in maintaining a Medicaid nursing facility reimbursement methodology. The vendor will provide expertise and methodology development for Vermont Medicaid's Patient Driven Payment Model (PDPM) and nursing home rate setting. Key services include calculating case-mix scores, maintaining data systems, conducting audits, and supporting ongoing implementation and refinement of the PDPM methodology.

• 1/20/2024 - Proposal Due Date
• 1/6/2025 - Questions Due
• 4/1/2025 - Anticipated Contract Start Date

• Expertise in nursing facility Medicaid rate development
• Fiscal analysis and modeling experience
• Federal and state regulatory analysis skills
• MDS programming and clinical expertise
• Proven performance in nursing facility rate setting

• Calculate quarterly case-mix scores for nursing homes
• Maintain secure data collection system for case mix data
• Maintain provider portals for data accuracy checks
• Provide Help Desk support for case mix data questions
• Support implementation and refinement of Vermont Medicaid PDPM
• Conduct MDS data validation audits for nursing homes
• Provide ad hoc support for nursing home rate setting processes