Government Contract | South Dakota
Medicaid Data Analytics Solution

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Bid Information

Bid Alert No: 00000412102

Bid Title: Medicaid Data Analytics Solution

Agency Bid No. Title: 462

Received Date: 11/10/2015

Close Date: 12/18/2015

Purchase Type: Not Stated

Delivery Point: Yankton, South Dakota

Delivery Date: Not Stated

Special Notices: L.O.I. Due By Optional 11/12/2015, Questions Due By Optional 11/18/2015, Bidder Preregistration


Specifications include, but are not limited to:Proposals must provide a description for each of the following requirements of how the requirements will be met. 3.1 The State of South Dakota is requesting that respondents provide a solution that supports rapid reporting and data visualization and customizable reports using Medicaid eligibility data and Medicaid claims payment data. Proposed solutions must include predictive modeling, risk scoring, and the ability to quickly develop real time analytics analysis of State Medicaid claims data. The following are some examples of expected types of reports; 3.1.1 Service or drug utilization with the ability to drill down multiple levels and with various attributes (including region, provider, recipient, etc.). 3.1.2 Predictive modeling of service costs. 3.1.3 Predictive modeling of utilization changes 3.1.4 Predictive modeling capability relative to various financial impacts including federal match rate changes. 3.1.5 Predictive modeling of the impact of program/eligibility changes 3.1.6 Prospective budget analysis with the ability to drill down multiple levels and with various attributes. 3.1.7 Retrospective budget analysis with the ability to drill down multiple levels and with various attributes. 3.1.8 Predictive modeling with regard to cost center budgets and spend rates. 3.1.9 Ability to data mine common billing errors to support program integrity and quality control monitoring. An example of this would be to show spikes in different data elements such as codes or provider payments. Another example is to determine incorrect use of indicators on certain claim types. 3.1.10 Operational and policy management analysis. An example of this is to determine which providers may be switching to paper filing vs. an electronic claims history. Another example is to research third-party payer data and how to better management claims unit functions. 3.2 Data elements expected to be included are claim data, provider data and recipient data. A subset of the data dictionaries will be provided upon request. Additionally, financial cost center data elements (BA Codes) will need to be used to generate reports specific to those cost centers. A list of some of those cost centers is included in Attachment C

Product Codes: 20911, 20810

Agency Information

Issuing Agency: South Dakota Human Services Center

State: South Dakota

Agency Type: State and Local

Contact: 523 East Capitol Avenue, Pierre, South Dakota



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