Analyze and Assess Method, Data and Case Mix Assessment Information for the Monitoring and Refinement of the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS)

INTRODUCTION: The Centers for Medicare & Medicaid Services (CMS) is performing Market Research to determine capabilities in the marketplace to perform the requirements described in the attached draft Statement of Work (SOW) entitled "Analyze and Assess Method, Data and Case Mix Assessment Information for the Monitoring and Refinement of the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS)". PURPOSE: This SOURCES SOUGHT NOTICE is to determine the availability of potential small businesses/small disadvantaged businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, veteran-owned small business, and women-owned small business) that can conduct an aggression analysis for the refinement and monitoring of an inpatient psychiatric facility prospective payment system for CY 2011, and potentially for future years. The information/Capability Statements obtained from this market research will be considered in planning the appropriate acquisition strategy. While the focus of this market research is to identify capable small or small disadvantaged businesses, large businesses are not precluded from submitting capability statements in response to this SSN. However, the Government may not evaluate capability statements submitted by large businesses unless it is unable to identify capable small or small disadvantaged businesses. Please be sure to indicate if you have a GSA schedule contract, a contract on GSA 8(a) STARS, or a contract on GSA VETS GWAC. THIS IS STRICTLY MARKET RESEARCH TO ASSIST IN DETERMINING THE APPROPRIATE ACQUISITION STRATEGY TO OBTAIN CONTRACTOR SUPPORT SERVICES TO PERFORM THE SAME OR SIMILAR REQUIREMENTS TO THOSE DESCRIBED IN THE ATTACHED DRAFT SOW. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) MAY OR MAY NOT ISSUE A REQUEST FOR PROPOSAL. RESPONSES TO THE SOURCES SOUGHT NOTICE BE THE SUBMISSION OF A CAPABILITY STATEMENT. ACCORDINGLY, CMS WILL NOT ENTERTAIN QUESTIONS REGARDING THIS MARKET RESEARCH. BACKGROUND: The Balanced Budget Refinement Act of 1999 (BBRA) required the establishment of a PPS for inpatient hospital services furnished in psychiatric hospitals and psychiatric units of acute care hospitals to replace the reasonable cost based payment system. Please note that the Medicare Modernization Act also allowed critical access hospitals to establish psychiatric units. Section 124 of P.L. 106-113 mandated that the Secretary develop a per diem PPS that includes an adequate patient classification system reflecting the difference in patient resource use and costs among psychiatric facilities. In addition, the Secretary is permitted to require psychiatric hospitals and units to submit information necessary for the development of the PPS. To meet the requirements of the BBRA, CMS prepared a proposed rule (68 FR 66920), which was published on November 28, 2003 and a final rule that was published on November 15, 2004 (69 FR 66922). In the final regulation, CMS indicated that we would continue to complete special studies, expand the research to focus on the impact of the IPF PPS, and analyze the data to make recommendations regarding potential updates and refinements to this system. The first update to the IPF Payment System was proposed in January 2006 (71 FR 3616) and finalized on May 6, 2006 (71 FR 27040). In support of the development and implementation of an inpatient psychiatric facility PPS, a number of research projects were undertaken. The University of Michigan was funded to complete data analysis in support of the regulation and examine the feasibility of developing and pilot testing an instrument to collect additional patient specific data. This instrument, The Case Mix Assessment Tool (CMAT), was tested on a small number of facilities. Results were generated in the fall of 2006. Another project was funded with the Research Triangle Institute to examine variations in cost including, analysis of cost variation by day of stay, and collection of an expanded list of patient specific data. A third study was funded following the publication of the November 15, 2004 final rule (69 FR 66922).This study was funded with the Urban Institute to replicate and update the data base used for the final rule and to begin to make recommendations to CMS regarding refinements focusing on the available administrative data, and the increase in the reporting of DRGs and co-morbid conditions. To ensure that the IPF PPS was able to account adequately for each IPF's case mix, we performed an extensive regression analysis of the relationship between the per diem costs and certain patient and facility characteristics to determine if those characteristics associated with statistically significant cost differences occurred on a per diem basis. For characteristics with statistically significant cost differences, we used the regression coefficients of those variables to determine the size of the corresponding payment adjustments. In that final rule, we explained that we believe it was important to delay updating the adjustment factors derived from the regression analysis until we have IPF PPS data that includes as much information as possible regarding the patient-level characteristics of the population that each IPF serves. Therefore, we indicated that we did not intend to update the regression analysis and recalculate the Federal per diem base rate and the patient- and facility level adjustments until we completed that analysis. Until that analysis is complete, we stated our intention to publish a notice in the Federal Register each spring to update the IPF PPS (71 FR 27041). RESPONSE REQUIREMENTS/INFORMATION: In order for CMS to assess a firm's capability, Capability Statements, submitted in response this SSN, shall include written responses that demonstrate the necessary knowledge, experience and ability to meet the SOW requirements. Specifically, Capability Statements (not exceeding 10 pages) shall include sufficient detail that clearly demonstrates your ability to provide the following services: 1. Respondents shall have experience developing prospective payment systems through regression analysis to update a data base, analyze outcomes, and make recommendations on refinement, monitoring and evaluation of the current inpatient psychiatric facility prospective payment systems (IPF PPS). Provide specifics of experience and dates of such experience. (CRITICAL REQUIREMENT). 2. Respondents shall have experience creating and manipulating large data files, and conducting research, analysis, and special studies on MS-DRGs, co-morbid conditions, and severity indexes to incorporate measures into a case mix methodology. (CRITICAL REQUIREMENT). 3. Respondents shall have experience analyzing specialized Medicare claims and cost report data from CMS data systems using nontechnical specifications developed by policy analysts. Provide specifics of experience and dates of such experience. (CRITICAL REQUIREMENT). 4. Respondents shall have experience completing preliminary analysis involving complex data analysis, research and special studies within a three month period. (CRITICAL REQUIREMENT). 5. Respondents shall have a working knowledge of mental health issues and clinical practice. (CRITICAL REQUIREMENT). 6. Respondents shall have experience with the CMS and other governmental rules and regulations concerning privacy and use of confidential data. Note: Please refer to the draft SOW for additional information. Please include the following in your response: Business Information - a. DUNS: b. Company Name c. Company Address d. Current GSA Schedules appropriate to Sources Sought (MOBIS) e. Type of Company (i.e., small business, 8(a) woman owned, veteran owned, etc.) as validated via the Central Contractor Registration (CCR). All offerors must register on the CCR located at http://www.ccr.gov/index.asp f. Company Point of Contact, Phone and Email address g. Please provide three professional references to include type of work performed and dates. Teaming Arrangements: All teaming arrangements should also include the above-cited information and certifications for each entity on the proposed team. Responses must be submitted not later than 2:00 PM on April 15, 2010 via email to the Contract Specialist at Jessica.Sanders@cms.hhs.gov Capability statements will not be returned and will not be accepted after the due date. The maximum number of pages for submission is 10 pages. The Sources Sought Notice is for information and planning purposes only and is not to be construed as a commitment by the Government. This is not a solicitation for proposals and no contract will be awarded from this Notice. No reimbursement will be made for any costs associated with providing information in response to this Notice. Respondents will not be notified of the results of this evaluation.