Medicaid Modernization: Quality Measurement Analysis

CMS is conducting market research to identify firms capable of meeting our needs in the area of providing information for conducting a comprehensive evaluation of health plan performance. Respondents to this notice shall submit no more than a 10 page description of their organization. The response must show that the firm is a leader in health care quality measure development and quality assessment through the usage of HEDIS standardized tools. Firm must have access to the full range of submitted HEDIS data including those that publicly release data and those that do not. Experience working with Medicaid constituency including State Medicaid programs, Medicaid health plans and External Quality Review Organizations (EQROs). This notice does not constitute a request for proposal and no pricing information will be accepted. Organizations responding must also provide the following information in a one-page attachment to the response: (1) DUNS number (2) TIN (3) Confirmation of CCR registration and expiration date (4) Size status (5) Identification of any GSA Schedule contracts in place Responses will be considered in terms of capability of organizations to meet the Agency's needs. Respondents should not anticipate being contacted by the Agency as a result of this notice. Responses must be provided within 15 days of the date of the posting and must be submitted in the following manner (1) one electronic version to the attention of: John Cruse AGENCY'S NEED The contract will provide CMS with audited Medicaid Healthcare Effectiveness Data and Information Set (HEDIS) health plan data and support Medicaid stakeholders in their efforts to establish quality improvement goals through the use of standardized, audited and comparable performance information. The primary data source for this analysis will be HEDIS results already in National Committee for Quality Assurance's (NCQA) HEDIS database that have undergone a HEDIS Compliance Audit. Additionally, the contractor will reach out to those health plans that do not currently report to the HEDIS database. HEDIS is a standardized measurement system that specifies how health plans collect, audit and report data on their performance in care and service areas ranging from child and adolescent immunization status, to helping patients control their cholesterol and enrollee satisfaction. In 1993, NCQA released HEDIS 2.0 that quickly became the - industry standard performance measurement set. NCQA maintains and evolves HEDIS specifications and data collection protocols. Since 1997, Medicare, Medicaid and commercial HEDIS results from health plans have been collected on a nationwide basis by NCQA. Since its inception, NCQA has been a leader in health care quality assessment. NCQA operates as an independent, not-for-profit organization and does not represent the exclusive interests of any single constituency.