B -- ANALYSIS OF MEDICARE + CHOICE PAYMENT ALTERNATIVES

Notice Date

July 10, 2001

Contracting Office

Department of Health and Human Services, Health Care Financing Administration, Acquisition and Grants Group, 7500 Security Blvd. C2-21-15, Central Building, Baltimore, MD, 21244-1850

ZIP Code

21244-1850

Description

The Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration intends to award on a sole source basis, under the Simplified Acquisition Procedure (Dollar Threshold of $100.000) a firm fixed price award to=20 Mr. Chris Hogan, 506 Moorefield Road, SW, Vienna, VA 22180. The purpose of this acquisition is to determine the feasibility of implementing alternative payment approaches for M+C Organizations. The primary objective will be to determine whether CMS can implement an approach that simplifies its systems requirements, eases the reporting burden on the M+C program, etc., while maintaining payment integrity. The contractor should consider the implications of any suggested approaches on CMS?s data collection processes, data validation effort, and future payment model recalibration. The contractor should also consider whether and how changes to the ratebook would be made, and how any payment adjustments (such as retroactive adjustments) would be done. The contractor will perform the following tasks: (1) Develop conceptual alternative payment approaches. The contractor shall prepare a concept paper that outlines several alternative approaches for collecting data from and making payment to M+C organizations. (2) Assess the feasibility of implementing alternative approaches. For each of the above approaches, the contractor shall identify implementation issues and suggest possible solutions. The contractor shall conduct analytic studies as necessary to support the feasibility assessment. The specific analyses and data sources that are needed to support these studies will be determined by the contractor after the alternatives have been identified. Qualified contractors must have experience with risk adjustment models and must have a technical understanding of M+C payments including the calculations required to construct ratebooks for new payment systems. In addition, CMS require that the contractor does not have any involvement with the maintenance of the current PIPDCG risk adjustment model or the development of any of the comprehensive models being considered for future implementation by CMS. We also require that the contractor is not currently consulting for any demonstration project for which payment is (or will be) based on M+C payment. Any such involvement could lead to the perception of a conflict of interest between policy work under progress and the work required under this contract. Mr. Chris Hogan is the only contractor that meets these qualifications. He has a Ph.D. in Economics and has 13 years experience with risk adjustment and payment policy issues. As a policy analyst for 10 years with the Medicare Payment Advisory Committee, he directed and performed research on a wide variety of payment issues, including risk adjustment. For the past 3 years he has been performing statistical analyses to inform Medicare payment policy. In addition, Mr. Hogan is not consulting for any demonstration project nor is he involved with the PIP-DCG or the development of any of the comprehensive risk adjustment models. Mr. Hogan possesses a unique combination of qualifications that make him the only suitable contractor to perform this work. All responsible sources may submit capability statements in consideration to the Agency at the above address.

Web Link

Visit this URL for the latest information about this (http://www.eps.gov/spg/HHS/HCFA/AGG/Reference-Number-743-1-040319/l isting.html)

Record

Loren Data Corp. 20010712/SPMSC013.HTM (D-191 SN50R3G6)