Design and Build a Decision Support and SURS System
Jeff Patterson
State of South Carolina
[email protected]
Intent
It is the intent of the South Carolina Department of Health and Human Services (SCDHHS) to solicit proposals from qualified vendors for the purchase, implementation and support of a Decision Support System (DSS). The DSS system must consist of one integrated system and must also include the functionality to meet the federal requirements of a Surveillance and Utilization Review System (SURS) as well as fulfill the needs of an Executive Information System (EIS) and Decision Support System. The DSS will allow the SCDHHS to have access to an integrated health care database comprised of Medicaid Management Information System (MMIS) and Medicaid Eligibility Determination System (MEDS) data. The new DSS system will replace the current CS-SURS Client/Server PC based system and will have additional functionalities of both a Decision Support and Executive Information System. The result will be a DSS that is user friendly and readily accessible by members of SCDHHS staff with varying degrees of expertise.
RFP Objective
The objective of this RFP is to procure the services of a DSS vendor to install and maintain software to support the following core outcomes of a DSS/SURS system, which are detailed in Section 6.0, the Scope of Work;
Quick retrieval and analysis of information online without the need for computer programming.
Quality measurements
Surveillance and utilization statistics as required by CMS for SURS
Fraud detection
Provider and beneficiary profile reports, including peer group comparisons
Disease and Case Management Analysis
Managed Care and Fee for Service comparisons
Geographic area comparisons, with mapping capabilities; both for claims paid and program eligibility
Benefit program design
Rate setting
Medicaid Eligibility analysis
