Specifications include, but are not limited to: The South Dakota Department of Human Services Division of Long-Term Services and Supports (LTSS) is seeking to establish a professional services contract with a consultant qualified in the evaluation and design of rate methodologies as related to nursing home re-imbursement.; The consultant will be responsible for the following: Preparation of a workplan for the evaluation and potential re-model of the South Dakota Medicaid Nursing Home Rate Methodology. The workplan will include short-term and long-term activities, project cost projections and a strategy that seeks stakeholder endorsement and LTSS approval.; Work in coordination with LTSS staff to lead a workgroup composed of industry representatives and other stakeholders to evaluate the current methodology, consider relevant variables and make recommendations for changes to the nursing home reimbursement methodology which addresses the unique needs of long term care in a predominantly rural state with a high occupancy rate of individuals supported by SD Medicaid. The final work product will include a recommended rate methodology structure endorsed by stakeholders for implementation.; The offeror should present evidence of proven successful experience related to rate setting methodologies. Offeror should respond to each category below and separately list proven successful experience within the category. Additionally, the offeror should provide evidence of proven success in operationalizing policy or other changes as related to services outlined: 3.1 Medicaid Upper Payment Calculations; 3.2 Rate Setting and Reimbursement Model Development; 3.3 Financial Analysis/Modeling including “what if” scenarios; 3.4 Analytics and forecasting; 3.5 Performance Based Contracting; 3.6 Infographic Creation (dashboards, performance metrics, program outcomes, etc.)
