DA01--RFI for CCR&A Vendor Demonstrations (VA-26-00031811)

Description

PRE-DECISIONAL PRE-DECISIONAL Community Care Referral, Authorization, and Utilization Management and Care Coordination Systems Situation: The Community Care Referral and Authorization (CCRA) system contract ends in August 2027. To align with Community Care Next Generation (CCN NG) processes, VA seeks a modern solution that supports community care requirements, specifically Utilization Management (UM) and Care Coordination, and integrates these capabilities, enhances interoperability, and improves Veteran experience. A summary of the goals and approach for the RFIs are described below: Goals: Align with CCN NG Requirements Incorporate lessons learned and leverage automation and AI for efficiency. Enhance Veteran Experience Enable referral tracking via VA.gov Adopt Industry Standards Ensure compatibility with commercial off-the-shelf (COTS) solutions. Support Seamless Care Enable transitions between direct and community care settings. Methodology/Approach Two-Phase RFI Process RFI #1: Vendor demos of industry-standard systems (see attached draft and market research) RFI #2: Refined requirements based on demo insights Focus Areas for Evaluation: Referral & Authorization Management Utilization Management Care Coordination Clinical Review Integration Interoperability Medical Documentation Reporting & Analytics Member tracking of referrals Proposed Timeline � � �