SOURCES SOUGHT
R -- Development and Evaluation of Exchange Health Plan Quality
- Notice Date
- 6/2/2016
- Notice Type
- Sources Sought
- NAICS
- 541611
— Administrative Management and General Management Consulting 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
- 170472
- Archive Date
- 7/5/2016
- Point of Contact
- Scott Filipovits, Phone: (410) 786-5779
- E-Mail Address
-
scott.filipovits@cms.hhs.gov
(scott.filipovits@cms.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- Development and Evaluation of Exchange Health Plan Quality Activities Contract Centers for Medicare & Medicaid Services This is a SOURCES SOUGHT NOTICE to determine the availability of potential contractors who can demonstrate the ability to provide consensus endorsement of healthcare performance measures, maintenance of performance measures and their data items, efforts to make recommendations on integrated national strategies and priorities for healthcare performance measurement, and convene multi-stakeholder groups and transmit their consensus-based input on national priorities and performance measurement activities. This is NOT a solicitation for proposals, proposal abstracts, or quotations. Background: Based on Section 1311(c) of the Affordable Care Act, Centers for Medicare & Medicaid Services (CMS) developed the Quality Rating System (QRS) to: inform consumer selection of Qualified Health Plans (QHPs) offered through a Health Insurance Market¬place (Marketplace); facilitate regulatory oversight of QHPs; and provide actionable information to QHPs for performance improvement. CMS also developed the Qualified Health Plan Enrollee Experience Survey (QHP Enrollee Survey), which will yield enrollee experience response data, a subset of which will be used in the QRS. In addition to the above mentioned laws and regulations and in keeping with CMS's overall goal to assess the quality of heathcare in ways that are meaningful and patient centered, patients' input must be proactively integrated into the development of measures and measures related work where appropriate. CMS has firmly asserted that listening to patients' voices is a core mission of its 2013 quality strategy. Patient engagement in quality has been defined as a set of behaviors that foster a collaborative partnership between patients (and families) and providers (and provider organizations). CMS Quality contracts now specify that the patient perspective must be explicitly incorporated into tasks (e.g. Technical Expert Panels, etc.). To the greatest extent possible, this participation should involve actual patients and caregivers, not just the organizations who represent them. The patients and their caregivers are uniquely qualified to provide input regarding the measure topics or concepts based on their experience. Patients can help identify issues that are important to them and that they find useful to better understand the quality of their care. The release of the 2011 National Quality Strategy also requires the design, development, testing, implementation and administration of a Marketplace consumer satisfaction survey based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) principles to measure the experience of Health Insurance Marketplace consumers with their Qualified Health Plan (QHP). Requirements Overview: These requirements apply to contractors under the 541611 NAICS code. The Contract will require preparation and completion of the tasks detailed in the Statement of Work (SOW). The Contract will involve work under the following domains: 1. Maintenance of Quality Rating System The contractor will maintain the Quality Rating System and recommend any necessary changes to the measures in the core set, the survey measures, methodology or the IT systems that support the measurement system. The contractor will also calculate ratings and assist in the display of the ratings. 2. Maintenance, Development and Implementation of Survey The contractor shall continue to design, develop, test and implement a QHP Enrollee Experience Survey (QHP Enrollee Survey) and provide results and technical assistance to the States based on analysis of those results. 3. Refinement of the Quality Rating Methodology The Contractor will propose any methodological changes necessary to maintain a reliable and valid scoring and weighting of the measurement system. The contractor will convene Technical Expert Panels to guide them in the development of the appropriate methodological approaches. 4. Development of Quality Rating System for Medicaid The contractor will develop a Quality Rating System for the Medicaid program. Included in this work will be the development of the core set of measures applicable to the Medicaid program and the methodological approach for the calculation of ratings. The contractor will test the calculation of the rating system and include a reasonable method for dissemination of the ratings to the Medicaid programs. 5. Ad Hoc Analysis and Reports The Contractor will complete analysis of the Quality Rating System that may include program implementation issues, analysis using exchange data, and comments or feedback on various public inquiries. 6. Stakeholder Outreach The Contractor will provide appropriate outreach to stakeholders, public and CMS/HHS education, and public dissemination of activities. The contract will include the following requirements (note that although this is an extensive list, it is not meant to be all inclusive): 1. Overall Contract Work Plan. The Contractor must submit to the CMS Contracting Officer's Representative (COR) an Overall Contract Work Plan, in Microsoft Project, that addresses project planning, implementation, management, quality assurance, and evaluation during the contract performance period. At a minimum, the Work Plan must address all methods, processes, procedures, quality assurance, management activities, and protocols necessary for effective and efficient completion of tasks. The Work Plan requirements are further outlined in the SOW. 2. Summary of Work Plan. The Contractor must submit to the CMS COR and Department of Health and Human Services (HHS) Government Task Lead (GTL) a Summary Work Plan which summarizes the project plan for implementation, management, quality assurance, and evaluation that will occur for the Task Order. The Summary Work Plan, at a minimum, must address all methods, processes, procedures, quality assurance, management activities, and protocols necessary for an effective and efficient completion of tasks. The Summary Work Plan requirements are further outlined in the SOW. 3. Education. Prior to initial deliberations for committees and multi-stakeholders review and evaluation of measures and applicable content for endorsement, reports, and input, the Contractor will provide the CMS COR, HHS GTL, and the committees and multi-stakeholders with the appropriate material and education necessary for the review process in a timely fashion. The Education requirements are further outlined in the SOW. 4. Monthly Progress Reports. The Contractor staff will be responsible for e-mailing the CMS COR and HHS GTL a Monthly Progress Report. The Monthly Progress Report requirements are further outlined in the SOW. 5. Weekly Conference Calls. Every Week conference calls must be held between the CMS COR, HHS GTLs, and Contractor staff to go over current activities. 6. Final Report. The final reports that have been endorsed and prepared by the Contractor will be provided to CMS and HHS. Final reports will adhere to the SOW. Capability Statement Information: Contractors must respond to all of the following points, by indicating your experience and ability to provide documentation and/or evidence of meeting each of the following requirements: 1. The Contractor must have experience with: a. Marketplace population health care issues; b. ACA regulations; c. Survey development and analytics; d. Health Care Measures; and e. Health care quality and efficiency and safety issues. 2. With respect to matters related to the contract, the Contractor must conduct its business in an open and transparent manner and include: a. the opportunity for public comment on its activities; b. input from expert technical opinion on the quality of candidate consensus measures - with assurances that such input does not impede the consensus process by prohibiting opportunities for broad membership and public review and comment; c. the inclusion of quality measure developers on technical expert panels when possible; and d. access to the consensus-process by a wide variety of both individual and group healthcare industry stakeholders. 3. The Contractor must have at least four years of experience in establishing quality measures standards. 4. The Contractor must demonstrate the ability to synthesize evidence and convene key stakeholders to make recommendations on Marketplace quality measures, priorities for the quality program in the Marketplace, and health care performance measurement in all applicable settings and input on the selection of performance measures, as defined under Social Security Act Section 1890(b)(7). 5. The Contractor must demonstrate the ability to provide for the endorsement of standardized health care performance measures. The endorsement process under the preceding sentence shall: a. consider whether a measure is evidence-based, reliable, valid, verifiable, relevant to enhanced health outcomes, actionable at the caregiver level, feasible to collect and report, and responsive to variations in patient characteristics, such as health status, language capabilities, race or ethnicity, and income level; b. consider whether a measure is consistent across types of health care providers, including hospitals and physicians; and the Contractor must be familiar with the Affordable Care Act as well as related regulations and other sub-regulatory guidance, focusing on related quality reporting requirements; as well as: c. include an appeals process congruent with a voluntary consensus standards setting organization as defined under the National Technology Transfer and Advancement Act of 1995 (Public Law 104-113) and Office of Management and Budget Revised Circular A-119. The Contractor must provide samples of endorsement and expedited review processes that have taken place. 6. The Contractor must exhibit the ability to validate all data associated with the development of the quality measures. 7. The Contractor must exhibit the ability to establish and implement a process to ensure that endorsed measures are updated (or retired if obsolete), under a maintenance and ad hoc review process, as new evidence is developed and priorities evolve. 8. The Contractor must demonstrate the ability to prepare and finalize reports and measurement frameworks involving topics such as measurement gaps, multiple chronic conditions, and priorities of the National Quality Strategy. 9. The Contractor must provide evidence of convening multi-stakeholders to provide input on national priorities and the HHS selection of quality measures under the Pre-rulemaking Process of the Social Security Act Section 1890(b)(7). The Contractor must also demonstrate the transmission of such input to HHS. 10. The Contractor must provide evidence that they have the ability to maintain the IT system associated with the Marketplace Quality Module. 11. The Contractor shall demonstrate the ability to develop a Quality Rating System (QRS), including a conceptual framework to guide the rating system, and a quality rating methodology that will meet the needs of State and federal regulators and consumers in the Exchange. 12. The Contractor must demonstrate the ability to produce a core set of measures (including technical specifications and a reporting format), identify performance thresholds, and develop a methodology for scoring, weighting and aggregating those measures to produce an overall quality rating score. 13. The Contractor must demonstrate the ability to analyze data that is collected for quality reporting, and for potentially assisting the States in applying the standard methodology to produce quality ratings in each Exchange. 14. The Contractor must demonstrate the ability to develop standards for evaluating health plans' quality improvement strategy (QIS), including a conceptual framework to guide the quality improvement. 15. The Contractor must demonstrate the ability to create QIS standards and a uniform reporting format. 16. The Contractor must demonstrate the ability to analyze data collected for QIS reporting, and for assisting the Exchanges. 17. The Contractor must demonstrate the ability to develop, manage and implement the QHP Enrollee Experience Survey (QHP Enrollee Survey). 18. The Contractor must demonstrate the ability to collect, analyze, and score survey data, and develop descriptive reports of survey results. 19. The Contractor must demonstrate the ability to approve, train and manage the survey vendors for the administration of the survey. Teaming Arrangements: All teaming arrangements shall include the above-cited information and certifications for each entity on the proposed team. Teaming arrangements are encouraged. Additional Information Requested: Interested parties having the capabilities necessary to perform the stated requirements may submit capability statements via email to Scott Filipovits, Scott.Filipovits@cms.hhs.gov. CAPABILITY STATEMENTS MUST DEMONSTRATE THE MINIMUM REQUIREMENTS OUTLINED ABOVE. Please address each in order listed above. Capability statements shall also include the following information: Business information: 1. DUNS Number 2. Tax ID 3. Company Name 4. Company Address 5. Company Point of Contact, phone number and email address 6. Business Size Status (e.g., large business, small business, 8(a), woman owned small business (WOSB/EDWOSB), veteran owned, etc.) as validated via the Central Contractor Registration (CCR) for the applicable NAICS code (i.e. 541611). Additional information on NAICS codes can be found at www.sba.gov. Any potential government contractor must be registered on the CCR located at http://www.ccr.gov/index.asp. 7. Corporate structure (corporation, LLC, sole proprietorship, partnership, limited liability partnership, Professional Corporation, etc.) 8. Current GSA Schedules appropriate to this Sources Sought 9. Current Government Wide Agency Contracts (GWACs) 10. Point of Contact, phone number and email address of individuals who can verify the demonstrated capabilities identified in the responses. 11. Responders should also include a statement about whether or not they have an approved Federal audited accounting system. If the responder has an approved accounting system, please provide the certification in which the accounting system was deemed adequate (e.g. the name of the audit agency and audit number). You may submit as an attachment, which will not count towards the overall page limit. Responses must be submitted no later than Monday, June 20, 2016, 2pm EDT. Capability statements will not be returned and will not be accepted after the due date. This is not an invitation for bid, request for proposal or other solicitation and in no way obligates CMS to award a contract or otherwise pay for the information provided in response. The sole intent of this Sources Sought Notice is to obtain capabilities for set-aside and procurement planning purposes. All capability statements can be submitted via e-mail to the point of contact listed below. Responses shall be limited to no more than 15 pages, with the exception of the SOW questions/comments. CMS software standard is MS Word. Therefore, responses should be submitted in a Word, or Word compatible, document. Page size should be 8.5 by 11 inches with a 1 inch boarder. Responses must be submitted no later than Monday, June 20, 2016, 2pm EDT. Documentation should be sent to: Contracting Officer, Scott Filipovits, Scott.Filipovits@cms.hhs.gov. Caution: In an effort to respond timely, you are hereby notified that the CMS email server does not deliver emails and/or attachments over 5 megabytes to recipients during normal working hours. These large files are released from the CMS server after 5:00pm each business day. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization's qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published in Federal Business Opportunities. However, responses to this notice will not be considered adequate responses to a solicitation. Confidentiality. No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).
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