SPECIAL NOTICE
B -- Study of Duals In Aligned Managed Care - SOW
- Notice Date
- 6/29/2017
- Notice Type
- Special Notice
- NAICS
- 611310
— Colleges, Universities, and Professional Schools
- Contracting Office
- Department of Health and Human Services, Program Support Center, Acquisition Management Services, 7700 Wisconsin Ave, Bethesda, Maryland, 20857, United States
- ZIP Code
- 20857
- Solicitation Number
- 17-233-SOL-00594
- Archive Date
- 7/29/2017
- Point of Contact
- David Wilhelm, Phone: 3014924643
- E-Mail Address
-
david.wilhelm@psc.hhs.gov
(david.wilhelm@psc.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- Statement of Work Notice of Intent: The Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the Department of Health and Human Services intends to negotiate on a sole source basis with Vanderbilt University School of Medicine under the authority of FAR 6.302-1 for the project entitled, " Study of Duals In Aligned Managed Care: Measuring the Impact of Financial Alignment for Dual-Eligible Beneficiaries in Tennessee" under FAR Part 15 procedures. This contract will evaluate the impact of Medicare and Medicaid alignment for individuals eligible for both Medicare and Medicaid (dual eligible beneficiaries or duals) on beneficiary outcomes and utilization of acute care and long-term services and supports. This project will focus on one state (Tennessee) that has implemented Medicare and Medicaid financial alignment for duals through a combination of Medicare Advantage Dual-Eligible Special Needs Plans (D-SNP) contracting and Medicaid managed long-term services and supports. This project will focus on one state (Tennessee) that has implemented Medicare and Medicaid financial alignment for duals through a combination of Medicare Advantage D-SNP contracting and Medicaid managed long-term services and supports. Dual eligible beneficiaries tend to have more chronic conditions, cognitive limitations, and functional limitations than other Medicare beneficiaries. As a result, duals account for a disproportionate share of Medicare and Medicaid spending. In 2011 duals represented 20 percent of all Medicare beneficiaries and 35 percent of Medicare spending. Furthermore, duals account for 14 percent of Medicaid enrollment and 33 percent of Medicaid spending. Because of their significant acute care and LTSS needs, there are numerous federal efforts underway to better integrate care for this uniquely vulnerable and expensive population. A key strategy to address these financial and operational challenges has been establishing managed care plans that provide both Medicare and Medicaid benefits. To date, evidence on the effectiveness of these approaches is limited. One of the more scalable options for integrating care for dual eligible beneficiaries is dual eligible special needs plans (D-SNPs). Because of the requirements for benefit coordination and a formalized relationship with the state, D-SNPs have the potential to deliver a coordinated Medicare and Medicaid benefit package that offers more integrated care than regular MA plans or traditional Medicare fee-for-service. ASPE is interested in building an evidence base to support federal and state policy development around D-SNP based alignment of Medicare and Medicaid for dual eligible beneficiaries. This project will test the hypothesis that the delivery of Medicare and Medicaid funded services to full-benefit duals is associated with improved health status and increased efficiency of health care utilization (e.g. decreased ER utilization, decreased NF utilization, and increased use of home and community based services) among full benefit duals in Tennessee, by evaluating the impact that Tennessee's financial alignment strategy (pairing D-SNPs with MLTSS) has had on beneficiary outcomes and utilization. Vanderbilt University is the uniquely qualified to fulfill this acquisition because they have exclusive access to critical state level administrative managed care claims data that is necessary to complete the proposed study. No other contractor currently has access to this data therefore no other source will satisfy agency requirements, and full and open competition need not be provided. In addition to extensive market research of the relevant peer-reviewed and gray literature on this topic, ASPE also has recent experience conducting studies using Medicare and Medicaid administrative claims data. Past projects that have attempted to study service utilization without special access to state level managed care claims have been significantly delayed or required extensive modifications. Vanderbilt is the only contractor we have identified to have access to the Medicare and Medicaid managed care claims data from the state of Tennessee (through the Tennessee all payer claims database) as well as familiarity with manipulating this data. The scope of work is available and attached. All responsible sources may submit a capability statement or proposal, which shall be considered by the agency, electronically to David Wilhelm at David.Wilhelm@psc.hhs.gov. Responses are due by June 14, 2017 by 12:00 pm EST. Responses will not be accepted after the due date. If no capability statements or proposals are received which specifically demonstrate the ability to perform the requirements above, the Government shall proceed with negotiating a firm fixed price contract with Vanderbilt University.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/PSC/DAM/17-233-SOL-00594/listing.html)
- Record
- SN04562870-W 20170701/170629235507-4dedb26a5e83392c99a2c20322150681 (fbodaily.com)
- Source
-
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