Medicare Advantage Quality Improvement Organizations

This is a SOURCES SOUGHT (SS) NOTICE to determine the availability of potential small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) that can provide essential technical assistance in evaluating the design, development, implementation and outcomes of the Medicare Advantage Organizations (MAO) Quality Improvement (QI) projects, utilize a consistent and approved protocol for the evaluation of the MAO QI projects, maintain and update any guidance documents as specified by The Centers for Medicare & Medicaid Services (CMS), and maintain a record for tracking all QI projects by MAO, by region, focus areas, and the targeted diseases. The contractor will provide technical assistance and training on the use of the materials and manuals that will be used to the target MAOs. The objective of this effort will be the provision of expert guidance in the ongoing review of QI projects consistent with regulatory requirements. Background: Medicare Advantage Organizations are required by CMS regulations at 42 CFR 422.152(a)(1), (2) and (3) to implement quality improvement projects and chronic care improvement programs, and to encourage its providers to participate in CMS and The Department of Health and Human Services (DHHS) quality improvement initiatives. Currently, MAOs are implementing projects of their own choosing and using their own inclusion criteria and quantitative indicators to measure improvement over time. This special study aims to improve reliability and validity of the MAOs quality improvement projects through the development of standardized project implementation guides including the use of existing consensus-based Health Employer Data Information Set (HEDIS) measures for the topic areas indicated above. The projects and programs will then be evaluated for demonstrable improvement at the MAO contractor level and for the Medicare Advantage (MA) program overall. CMS annually evaluates the quality submissions from MAOs, including their HEDIS, Consumer Assessment of Health Plan Satisfaction (CAHPS), and Health Outcomes Survey (HOS) data as well as their quality improvement and chronic care improvement projects. Additionally, starting in 2008 CMS will work with those health plans that are the lowest performing in specific areas including breast cancer, colorectal cancer, influenza vaccine and pneumonia vaccine. CMS will require MAOs to focus on one specific clinical area in which they should improve their overall performance, thereby improving the delivery of preventative services to beneficiaries. CMS intends to employ contractors to assist health plans to design a quality improvement project focused on improving clinical performance. Contractors will work with the plans to formulate interventions that will be most effective in achieving the desired effect. Moreover, throughout the course of the quality improvement project, the Quality Improvement Organizations (QIO) will provide valuable technical assistance to the health plans and ultimately assist with the evaluation of the project. Instructions/Requirements for Submitting SS Responses to CMS: Questions and Answers: CMS requests that respondents specifically address each question identified below. In general, while this SS is not a request for a technical proposal, respondents shall provide enough information for CMS to make a determination that the offeror has a capability to perform the same or similar type of work identified in this SS. To respond to this notice, contractors must be able to indicate experience and/or the ability to provide all of the information requested below. Please provide your experience, knowledge and ability so that your response clearly indicates that you can provide the following: 1. Knowledge of the principles, concepts and theories regarding clinical quality improvement activities. 2. Knowledge of CMS quality requirements for Medicare Advantage health Plans. 3. Knowledge of HEDIS, CAHPS and HOS data sets. 4. Skill in evaluating clinical quality improvement activities. 5. Experience working with managed care and Medicare populations. 6. Teaming Arrangements - All teaming arrangements shall include the above-cited information and certifications for each entity on the proposed team. Teaming arrangements are encouraged. Responses shall include the information identified in the above questions and at a minimum address each of the following questions: Business Information: a. Company Name b. Company Address c. D&B DUNS Number d. Current GSA contract(s) and/or schedule(s) that you possess which are appropriate to this SS. Specifically, e. Does your organization have a Government approved accounting system? If so, please identify the agency that approved the system. f. Type of Company (i.e., small business, 8(a), woman owned, veteran owned, etc.) as validated via the Central Contractor Registration (CCR). Note: All offerors who wish to be awarded a Government contract must register on the CCR located at http://www.ccr.gov/index.asp . g. Company Point of Contact - Name, Phone and Email address h. Point of Contact, Phone and Email address of individuals who can corroborate the demonstrated capabilities identified in the responses. Please submit completed SS responses in the following manner: 1. When/Where/How: Email responses to both of the following recipients by 11:00AM (Eastern Standard Time) July 28, 2008: a. Contract Specialist - Sandy Bennett, Sandra.bennett@cms.hhs.gov, (410) 786-5143. b. Contracting Officer - Brian Hebbel, brian.hebbel@cms.hhs.gov, (410) 786-5159. Caution: In an effort to respond timely, you are hereby notified that the CMS email server does not deliver emails and/or attachments over 5 megabytes to recipients during normal working hours. These large files are released from the CMS server after 5:00PM each business day. 2. Page Limitation: Please limit responses to no more than 10 pages. Capability statements will not be returned and will not be accepted after the due date. Other Information: 1. Proprietary Information and Disclaimers: All transmitted information marked proprietary shall be treated as such. Therefore, respondents should identify any proprietary information in its SS response. Information submitted in response to this SS will be used at the discretion of the Government. Proprietary materials will neither be distributed, nor discussed with any organizations or business. Further, the information submitted will remain confidential insofar as permitted by law, including the Freedom of Information and Privacy Acts. CMS reserves the right to utilize any non-proprietary technical information in the anticipated Statement of Work (SOW) or solicitation. Respondents should be aware that the SS is for marketing purposes only and any responses submitted do not constitute a commitment by CMS to treat any offeror more or less favorably in the anticipated forthcoming solicitation and/or ultimate award. Responses to this SS are not offers and cannot be accepted by CMS to form a binding contract. CMS does not intend to award a contract on the basis of this SS or to otherwise pay for the information solicited. 2. SS Response Feedback: CMS will not respond directly to organizations submitting information in response to this SS. The information received will be used solely to make informed decisions regarding a potential procurement and to address Draft SOW issues.