Most on-site clinic RFPs ask “what’s your PMPM?” and stop there. Vendors have winning PMPM answers ready. The questions in this template are designed to surface what the PMPM doesn’t tell you.
This RFP is structured into 10 sections. Each has a list of questions to send vendors, a short note on what to listen for in their answer, and where applicable the answer that should disqualify a vendor. Cut what doesn’t apply. Add what’s specific to your workforce. The goal isn’t to mail it verbatim — it’s to ask better questions than the vendors are used to.
Section 1 — Vendor profile
Questions: How many years has your company been operating on-site clinics? How many active clinics do you currently operate? Median employer size you serve? Smallest and largest employer? Three references from employers in our industry and size range (within 2× our employee count), with permission to contact.
What to listen for: “Median employer size” tells you who they’re actually built for. A vendor whose median is 8,000 employees serving you at 350 will treat you as a small account. “Smallest employer” tells you if they have a working model below 1,000 employees, or if they’ll be inventing one for you. If they can’t provide references in your industry, they don’t have industry experience.
Disqualifier: Median employer size > 2,500 employees AND you have <1,000 employees. The economics don’t match.
Section 2 — Clinical model
Questions: Who provides care — NP, PA, MD, rotating staff? Will the same provider see our members every visit? What’s your provider’s average tenure? How do you handle coverage during vacations / sick days / turnover? What’s your scope of practice — what’s handled on-site vs. referred out? Do you offer behavioral health on-site? Do you operate an on-site pharmacy?
What to listen for: “Rotating providers” or “we’ll see who’s available” is a red flag. Continuity of care is the single strongest engagement driver. Provider tenure under 18 months suggests churn. “Limited scope, mostly refer out” defeats the purpose of on-site care — the whole model is built on reducing downstream referrals.
Disqualifier: No commitment to a dedicated provider for your clinic. No coverage plan when the primary NP is out.
Section 3 — Economics
Questions: What’s your PMPM fee structure? Is the PMPM all-inclusive, or are there additional per-visit charges, utilization fees, or supply-and-pharmacy mark-ups? What’s the typical break-even month for an employer our size? What’s the typical 12-month ROI you’ve observed? Will you commit to a specific savings target with downside if missed? Are setup / build-out costs separate from PMPM? Contract term and renewal terms?
What to listen for: An “all-inclusive PMPM” with per-visit fees on top isn’t all-inclusive. Ask for an example monthly invoice from a real similar-size employer (with the employer name redacted). “We don’t commit to a savings target” is a hedge. Reputable vendors will commit to a guaranteed savings number with a rebate clause. Setup costs over $200K for a mid-size clinic deserve scrutiny.
Disqualifier: No transparency on additional fees beyond PMPM. Refuses to put any savings commitment in writing. Contract term >3 years (locks you in before you’ve validated outcomes).
Section 4 — Engagement
Questions: What’s the average verification rate (members claiming their account) at 90 days across your employer book? What’s the average engagement rate (one or more visits) at 12 months? What do you do specifically to drive these — what’s your communications playbook? How do you handle the workforce segment that doesn’t verify or doesn’t engage?
What to listen for: Verification rate at 90 days should be 50%+. Below that, the launch motion is weak. Engagement rate at 12 months should be 60%+. “We send launch emails” is the bare minimum.
Disqualifier: 12-month engagement rate <50% across their book of business.
Section 5 — Technology
Questions: What EHR do you use? Do members have a portal / app to book, view records, message the provider? Is the portal available in languages other than English? Do you offer telehealth between in-person visits — same provider, or a separate telehealth team? What’s the member experience for prescription refills, lab results, or appointments outside business hours?
What to listen for: The EHR matters because it determines whether records port to a future vendor if you switch. Common EHRs (Elation, Athena, eClinical) are portable. Proprietary EHRs are not. A separate telehealth team breaks continuity. “Members have an app” is a low bar — ask for a 2-minute walk-through video. If they can’t produce one, the app is probably not what they’re claiming.
Disqualifier: Proprietary, non-portable EHR. Telehealth is a separate team / vendor.
Section 6 — Privacy + employer data access
Questions: What clinical data does our company see about individual employees? What aggregate / de-identified data do we see? How is HIPAA compliance documented and audited? If we decide to switch vendors at end of contract, what happens to our members’ clinical records? Do you share data with third parties (broker, TPA, research firms)?
What to listen for: The correct answer to question 1 is “nothing about individuals.” Any vendor that offers to share individual-employee clinical data with the employer is creating a legal liability for both of you. Aggregate reporting should include: visit volume, engagement rate, cost per encounter, top 5 conditions managed — no individual-level detail. Records should remain accessible to the member regardless of contract status.
Disqualifier: Vendor offers individual-level clinical data to the employer. Refuses to commit to records portability at contract end.
Section 7 — HSA compatibility
Questions: We have [X] HSA-eligible HDHP participants. How do you charge for non-preventive visits to maintain HSA compliance? Are charges per-visit, per-CPT-code, or flat fee? Does the member see a clear payment path, or do you surprise-charge a card on file? Do you provide HSA-qualified receipts for member reimbursement? How do you handle the IRS Section 223 boundary between “free preventive care” and “charged non-preventive care”?
What to listen for: “We don’t charge HSA members” is wrong — IRS Section 223 requires fair-market-value charging for non-preventive care on HDHPs, or the member’s HSA can be disqualified. Flat-fee charging is simpler and easier to defend than per-CPT FMV. Both are compliant; flat-fee creates fewer disputes. The vendor should walk through the legal reasoning without prompting.
Disqualifier: Vendor doesn’t have an HSA-compliant billing structure (this WILL disqualify members’ HSAs).
Section 8 — Implementation
Questions: From signed contract to clinic open, what’s your typical timeline? Who manages implementation on our side (HR, IT, vendor PM)? What’s our workload during implementation — estimate hours? What’s your roster / eligibility file format requirement? Who’s responsible for build-out, equipment, IT setup?
What to listen for: A 6-week timeline is fast. A 4-month timeline is slow but realistic for a built-from-scratch clinic. Beyond 6 months suggests the vendor doesn’t have repeatable launch processes. “Custom file format” for eligibility = bad. Standard HRIS exports (Workday, ADP, Paylocity, BambooHR) should work out of the box. “HR provides build-out” is a red flag.
Disqualifier: >6 month implementation timeline. Requires custom eligibility file format your HRIS can’t export.
Section 9 — Reporting
Questions: What reports do we receive — and at what cadence? Can you provide a sample report from a real (anonymized) employer? Do you provide claims-data reconciliation showing actual avoided spend? What’s your method for attributing reduced PCP / outpatient / specialist spend to the on-site program? Are your reports auditable by our finance team or third-party actuary?
What to listen for: Sample reports tell you everything. If they can’t produce one, they don’t have one. Claims-data reconciliation is the gold standard for ROI proof. Vendors that only report “visit volume” can’t prove ROI. “Auditable” should be a yes — reports that are vendor-internal-only are marketing, not evidence.
Disqualifier: No sample reports available. No claims-data reconciliation methodology.
Section 10 — Exit terms
Questions: What’s the termination clause — notice period, cause vs. without-cause? What happens to our employees’ clinical records if we terminate? What’s the wind-down period for the clinic itself? Are there any exit fees or penalties?
What to listen for: 90-day termination without cause is reasonable. Longer is a lock-in. Members should retain access to their own clinical records via the EHR’s standard patient-portal export. “No exit fees” is the right answer.
Disqualifier: Termination without cause requires >180 days notice. Exit fees exceed remaining contract value.
How to score responses
Score on four axes:
- Clinical model fit (30%) — dedicated provider, real continuity, right scope
- Economics + transparency (25%) — honest PMPM, committed outcomes in writing
- Engagement track record (25%) — will their model actually drive usage?
- Implementation + exit terms (20%) — can they launch on time and can you leave?
Anything below 70% overall is a no. 70-85% is a maybe — worth a second conversation. Above 85% is a finalist worth the time of customer reference calls + site visits.
What to do with this
- Adapt the template to your specific situation
- Send to 3-5 vendors (don’t waste your time with more — diminishing returns)
- Give them 2-3 weeks to respond
- Score answers, shortlist 2 finalists
- Reference-check by phone (phone reveals more than email)
- Site visit if practical
- Decide
If you’d like a second pair of eyes on the responses, or you want us to walk through how Archer would answer each section before you include us in your RFP — happy to help.