A -- UPDATING THE CONDITION CATEGORY CLASSIFICATION SYSTEM

The Centers for Medicare and Medicaid Services (CMS) intends to award on a sole source basis, under the Simplified Acquisition Procedures in accordance with FAR Part 13 (Dollar Threshold of $100,000) a firm-fixed purchase order to the Research Triangle Institute, PO Box 12194, Research Triangle Park, NC 27709-2194 to acquire services from the Research Triangle Institute (RTI) to assist the Centers for Medicare & Medicaid Services (CMS) with updating the condition category (CC) classification system as well as provide technical consultation on the updated CC system required for maintaining CMS outcome measures; and conducting ad hoc analyses. The Quality Measurement and Health Assessment Group (QMHAG) uses the189 clinically relevant CC as the grouper for grouping the risk factors for the mortality risk adjustment models used to calculate the mortality and readmission measures reported on Hospital Compare (HC) as required by the Deficit Reduction Act (DRA) of 2005. Under the DRA - which requires hospitals to submit data for specific quality measures for health conditions common among people with Medicare, and which typically result in hospitalization - CMS implemented the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) initiative. This initiative requires hospitals to continuously submit data regarding quality measures for the mortality and readmission rates for Acute Myocardial Infarction (AMI) and Heart Failure (HF) patients for all acute care hospitals in the nation to be publicly reported on the HC Web site, located at www.medicare.gov. The goal of this initiative is to equip consumers with quality of care information to make more informed decisions about their health care, while encouraging hospitals and clinicians to improve the quality of inpatient care provided to all patients. CMS will align its CC maintenance priorities which are required for the risk adjustment methodology used for reporting the outcome measures on HC with the RTI expertise to facilitate an efficient strategy for updating the CC for the mortality risk adjustment models. CMS is required by statute (Section 4001 of the Balanced Budget Act [BBA] of 1997) to implement and maintain a risk adjustment methodology that accounts for variations in per capita costs based on health status and other demographic factors. The RTI developed the CC methodology as required by the Balance Budget Act (BBA) of 1997 and continued to be intimately involved in CMS's maintenance requirements related to this classification system. QMHAG, the primary CMS resource for the development, implementation, and management of healthcare quality measures and healthcare assessment instruments, also uses the189 clinically relevant CC as the grouper for grouping the risk factors for the mortality risk adjustment models used to calculate the mortality and readmission measures reported on Hospital Compare as required by the DRA. The RTI is the sole organization contracted by CMS to develop and maintain the CC classification system since its development. The RTI played a leading role in the development of the CC methodology and continues to lend its expertise to CMS in updating and maintaining this classification system as new codes are implemented each year. The process is set up to continuously review and update the classification system as new codes or requirements become known. To our knowledge, RTI is the only organization that has demonstrated extensive knowledge in this capacity. Continuing to align our processes with RTI expertise in this capacity is of benefit to CMS. For example, selecting a new contractor for this work will be detrimental to CMS since the new contractor will have a steep learning curve. While with RTI, they have many years of experience doing this type of work for the Center for Beneficiary Choice (CBC). In addition, doing this type of work with RTI is advantageous since it requires modification of similar work they've already done for CBC. All responsible sources may submit capability statements in consideration to the Agency at the above address and must be registered in the Central Contractor Registration (CCR) System. CMS program officer shall make the determination of what would constitute equivalent expertise. The period of performance is for 1 year. NAICS CODE IS 541690.