R -- Collection and Management of HEDIS Data Submission

The Centers for Medicare & Medicaid (CMS) intends to procure the services of a contractor to assist CMS in the collection and management of the annual Health Employer Data & Information Set (HEDIS)data submission for Medicare Advantage. It is critical to CMS's mission that we continue to collect and disseminate information that will help beneficiaries choose among health plans (consumer information); information that contributes to better health care through the identification of quality improvement opportunities (quality assurance); and provides for proper oversight and management of the Medicare Program (program oversight). CMS is firmly committed to the use of health care quality assessment and improvement strategies in the Medicare Advantage program. Since January 1997 Medicare managed care organizations have been required to annually report performance measures from HEDIS. HEDIS is a widely used set of health plan performance measures employed by both private and public health care purchasers to promote accountability and to assess the quality of care provided by managed care organizations. Originally designed for private employers need as purchasers of healthcare, HEDIS has been adapted for use by public purchasers, government compliance monitors, and managed care consumers. Annually, CMS collects a subset of the HEDIS measure set, including the Medicare Health Outcomes Survey (HoS) measure. CMS makes the health plan level data available to the public through media that is consumer-oriented. CMS requires an experienced contractor to provide and maintain an information system and IT infrastructure to collect and support submission of HEDIS measures data for Medicare Advantage (MA) plans and generate a database on Medicare plans. In addition to providing MA plans with data submission tools and instructions with detailed technical specifications for submitting HEDIS measures, the contractor must facilitate and provide technical support and assistance to individual MA plans as they submit data according to Medicare requirements. This contractor shall have the capabilities of creating a system that is designed to develop new measures that will benefit the Medicare geriatric beneficiaries and accommodating the new Medicare Advantage PPO health plans and other program changes in the Medicare Modernization Act. The period of performance for this effort is base year with two optional years. All responsible sources may submit a capability statement that will be considered by the agency. The statement must demonstrate that the firm(s) has capability to perform the required work. All capability statements must be submitted via email to Joanne Day at: Joanne.Day@cms.hhs.gov on or before May 26, 2006. Capability statements shall not exceed 10 pages. A determination by the Government not to compete this proposed action based upon responses to this notice is solely within the discretion of the Government. Information received will be considered soley for the purpose of determining whether to conduct a competitive procurement. CMS will not reimburse costs for submission of capability information. The NAICS code for this action is 541710.