SOLICITATION NOTICE
R -- Healthcare Quality Information Systems (HCQIS) Adhoc Reports, Analytics, and Data Management
- Notice Date
- 4/24/2009
- Notice Type
- Presolicitation
- NAICS
- 541519
— Other Computer Related Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd., C2-21-15, Baltimore, Maryland, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- RFP-CMS-2009-SB-RAD-03
- Point of Contact
- Christina F Heller,, Phone: 410-786-1896, Jaime Galvez,, Phone: 410-786-5701
- E-Mail Address
-
christina.heller@cms.hhs.gov, jaime.galvez@cms.hhs.gov
- Small Business Set-Aside
- Total Small Business
- Description
- Phase 3: HCQIS Adhoc Reports, Analytics, and Data Management The HealthCare Quality Information System (HCQIS) is a major application environment that uses application groups, shared servers, and WAN to monitor and improve utilization and quality of care for Medicare and Medicaid beneficiaries. HCQIS is composed of 5 application groups: • Standard Data Processing System (SDPS) for Quality Improvement Organizations (QIOs), including the Clinical Data Abstraction Center (CDAC); • Value Based Purchasing (VBP) IT Infrastructure for Physician Quality Reporting Initiative (PQRI) and Hospital Outpatient; • Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb); • Quality Improvement and Evaluation System (QIES) for states and CMS; • Quality Improvement Initiatives (QII) This statement of work is related to Adhoc Reports, Analytics, and Data Management for the SDPS and VBP application groups and is phase 3, of a 4-phase process. The other phases will be issued as separate solicitations with their specific SOW, requirements, evaluation criteria, etc. The Government estimates that it will issue these separate solicitations during 2008-2009. This information is being provided as informational only and it does not obligate the Government to issue a solicitation or award a contract. The four Phases that currently being developed are: Phase 1 - Program Management and Business Requirement Contract (PMBR) Phase 2 - Infrastructure Contract Phase 3 - Adhoc Reports, Analytics, and Data Management Contract (Current Solicitation) Phase 4 - Development Contract Background The Standard Data Processing System (SDPS), implemented in 1997, supports the Quality Improvement Organization (QIO) program and Centers for Medicare & Medicaid Services (CMS) community. Prior to SDPS, each QIO was responsible for developing solutions to meet the management and reporting requirements of the Statement of Work (SoW). Besides the obvious inefficiencies of redundant systems and costs, each QIO had different competencies during that period. Since the inception of SDPS, its functions have encompassed support, standardization and development of data, software and standards for the QIO community. SDPS continues to rapidly evolve with innovative technology to meet the challenges of supporting and interfacing directly with the QIO community and surrounding healthcare industry. Quality Improvement Organizations (QIO) are under contract by Centers for Medicare and Medicaid Services (CMS) to • Improve quality of care for beneficiaries; • Protect the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and medically necessary and that are provided in the most appropriate setting; and • Protect beneficiaries by expeditiously addressing individual complaints, notices, and appeals, such as beneficiary complaints; provider-issued notices of non-coverage (Hospital-Issued Notice of Non-Coverage [HINN], Notice of Discharge and Medicare Appeal Rights [NODMAR], and Medicare Advantage appeal); Emergency Medical Treatment and Labor Act (EMTALA) violations; and other related statutory QIO responsibilities. The statutory authority for the QIO Statement of Work is found in Part B of Title XI of the Social Security Act (hereinafter referred to as the Act), as amended by the Peer Review Improvement Act of 1982. The Act established the Utilization and Quality Control Peer Review Organization Program, now known as the Quality Improvement Organization (QIO) Program. The statutory mission of the Program, as set forth in Section 1862(g) of the Act, is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. In support of the QIO program, CMS authorized the design and implementation of a SDPS for the User Community. SDPS is an information system solution that provides a common platform for users to share applications and data to promote efficiency and increase productivity. SDPS is the QIO Information Technology and data support infrastructure. The SDPS User Community, for purposes of this contract, refers to the QIOs, the State Agencies, CMS Central and Regional Offices, the Clinical Data Abstraction Center (CDAC), and other organizations/partners that may be incorporated in support of CMS initiatives. This system services the daily, ongoing support that the SDPS User Community needs to fulfill their contractual requirements in a manner supportive of an ongoing quality improvement program. The VBP application group utilizes SDPS applications and warehouses in addition to other VBP specific products. These applications and warehouses support two provisions of the Tax Relief and Health Care Act of 2006 (TRHCA) Division B, Title 1: 1. Section 101, Physician Payment and Quality Improvement, includes The Physician Quality Reporting Initiative (PQRI). This law authorizes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals, who choose to participate and successfully report on a designated set of quality measures for services paid under the Medicare Physician Fee Schedule and provided between July 1 and December 31, 2007 to Medicare beneficiaries under the traditional fee-for-service program, may earn a bonus payment of 1.5% of their charges during that period, subject to a cap. On December 29, 2007, the President signed Public Law 110-173, the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), which authorized the continuation of the Physician Quality Reporting Initiative (PQRI) for 2008. The 2008 PQRI reporting period is January 1-December 31, 2008. The Extension Act also provides new authorities for enhancing PQRI that CMS will be implementing during 2008. MMSEA requires CMS to establish alternative reporting periods and alternative criteria for satisfactorily reporting groups of measures via claims for 2008. It also requires CMS to establish alternative reporting periods and alternative criteria for satisfactorily reporting measures via registries to enable professionals to earn the 1.5% incentive for participation in PQRI based on data submitted via these mechanisms. 2. Section 109, requires the development of measures for the evaluation of the quality of care of services provided by hospitals in outpatient settings. An Outpatient Prospective Payment System (OPPS) Hospital Outpatient Quality Data Reporting Program modeled after the current Inpatient Prospective Payment System (IPPS) Reporting Hospital Quality Data Annual Payment Update (RHQDAPU) program will be established. Section 109, which applies to hospitals as defined under section 1886(d)(1(B) of the Act, also requires that hospital outpatient departments (HOPD) that fail to report data required for the quality measures selected by the Secretary will incur a reduction in their annual OPD fee schedule increase factor by 2.0 percentage points. OPPS payments beginning in CY 2009 will be based on hospital reporting of OPD data beginning in CY 2008. The purpose of this Statement of Work (SoW) is to obtain adhoc report, analytic, and data management services to support the Healthcare Quality Information Systems Value Based Purchasing (VBP) and Standard Data Processing System (SDPS) application groups. The contractor shall provide an adhoc report analytics team that will assist CMS in supporting the SDPS and VBP analytic reporting efforts; identify and report to CMS any potential risk factors that may inhibit or impede the performance of any task; evaluate, develop and apply validation strategies/methodologies used for analytic reporting efforts; assist the HCQIS PMBR contractor with facilitating the completion of report business requirements; assist CMS with the management of each analytic product; manage timelines and ensure project plans are developed in MS Project or other CMS SDLC approved packages for all products; assist in the preparation of white papers, presentations, position papers, etc. to enable CMS to make appropriate, efficient, effective decisions/options. The contract will include the following scope of services: • provide adhoc analytic reporting functions to support program management, contract evaluation, research and development, and education and outreach programs • maintain a solid knowledge base of the data sources; typically, data is stored in CMS OCSQ/ISG application databases • assist the HCQIS PMBR contractor with facilitating the development and maintenance of business requirements definition by working to define, review and clarify requirements from CMS Program Staff, Government Task Leaders (GTL) and Measure Owner entities • gather and write requirements such that they are correct, complete, clear, consistent, testable, traceable, feasible, modular, and design-independent • develop and maintain process and analytic flows for each analytic report, which illustrates the technical design and approach of the analytic team • extract datasets as prescribed by requestors and approved by CMS • identify, prescribe and assist in the management of a System Development Life Cycle (SDLC) approach advantageous to each analytic report • coordinate Joint Application Development (JAD) meetings and manage all administrative tasks for these meetings including facilitation, agendas, minutes, action items, etc The following qualifications are necessary on this project: • Experience with quality measure specification development and analysis specific to the following programs o Quality Improvement Program  9th SoW QIO Beneficiary Protection  9th SoW QIO Prevention  9th SoW QIO Patient Safety  9th SoW QIO Care Transitions o Physician Quality Reporting Initiative o Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) o Hospital Outpatient Quality Data Reporting Program (HOP QDRP) • Experience with national pay for reporting programs. • An understanding of project management principles as it relates to integration into a master plan. • The ability to evaluate, develop, and apply validation strategies used for analytical reporting • Experience with high level sample design • Experience with Applied Research Process (i.e., from receiving policy questions to final synthesized policy/statistical written report), Hypothesis Testing, Univariate and Multivariate Statistics, Analysis of Complex Sample Data, Statistical Programming utilizing very large national databases, • Experience with Presenting Technical Material to a Non-Technical Audience • Experience with Standards and code development (i.e. ICD9, ICD10, SNOMED, LOINC, CPT, HL7etc) • Knowledge and experience with System Development Life Cycle. Tasks The contractor should have experience supporting adhoc analytic reporting and validation analyses on multiple large multi million dollar complex programs and developing or facilitating the development of analytic report artifacts (e.g., analytic reports/files, business requirements, datasets, technical design, process/analytic flows, report specifications, programming code, etc.). General Requirements The minimum contractor requirement is written proof of a CMMI Level II Certification (SCAMPI Report), at time of contract award. All efforts shall be performed in accordance with Centers for Medicare & Medicaid Services (CMS) requirements and shall meet the objectives of increasing efficiency and effectiveness of operations and timely implementation of statutory and regulatory requirements. This is a small business solicitation. The estimated level of effort for the contract is approximately 44,500 hours per year (Base + 6). CMS anticipates awarding this contract in fiscal year 2009. The Period of Performance will be a 12-month Base, plus 6 12-month option years. Teaming arrangements are encouraged.
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