REDUCING PREVENTABLE HOSPITALIZATIONS AMONG NURSING FACILITY RESIDENTS: SOURCES SOUGHT

REDUCING PREVENTABLE HOSPITALIZATIONS AMONG NURSING FACILITY RESIDENTS: SOURCES SOUGHT Purpose of Notice Prior to engaging in a procurement activity to acquire vendors for the testing of interventions to improve the health care situation for nursing home residents (both Medicare and Medicaid recipients), the Center for Medicare & Medicaid Services (CMS) is issuing this sources sought notice. This Sources Sought Notice is to determine the availability of potential small businesses (e.g., 8(a), service-disabled veteran owned small businesses, HUBZONE small businesses, small disadvantaged businesses, veteran-owned small businesses and women-owned small businesses) in accordance with FAR 7.105(b)1. The potential small businesses will need to demonstrate the ability to provide the services defined in this notice under Requirements. Background The Center for Medicare and Medicaid Innovation (CMMI) within CMS is developing an overall initiative to address a widespread and costly problem: nursing facility residents are subject to frequent preventable inpatient hospitalizations. These hospitalizations are expensive, disruptive, disorienting, and often dangerous for frail elders and people with disabilities. CMS research on nursing facility residents eligible for both Medicare and Medicaid in 2005 found 314,000 potentially avoidable hospitalizations, accounting for $2.6 billion in Medicare expenditures. Working with qualified vendors, CMS hopes to achieve the following objectives in each intervention strategy as implemented: - Reduce the frequency of preventable hospital admissions and readmissions - Improve the process of transitioning between inpatient hospitals, long term care facilities, rehabilitation facilities, and the community - Reduce overall health care spending without restricting access to care or choice of providers The primary focus of the clinical interventions would be Medicare-Medicaid enrollees in nursing facilities, but it may also benefit residents who are not yet Medicare-Medicaid enrollees (i.e., Medicare beneficiaries not yet eligible for Medicaid but who represent similar opportunities for inpatient reductions). The interventions should focus on extended-stay residents rather than those who are likely to experience only a brief post-acute stay and then return home. Requirements The work that will be addressed under the future contract will require the vendor to be able to, at a minimum, develop and implement interventions that: Demonstrate strong evidence base; Provide support during transitions to and from inpatient hospitals, rehabilitation facilities, and nursing facilities, including facilitating timely and complete exchange of health information among providers; Provide support for improved communication and coordination among hospital staff (including attending physicians), nursing facility staff, pharmacies...etc; Work in cooperation with existing providers, including residents' primary care providers, nursing facility staff, and families to implement best practices and improve the overall quality of nursing facility care, focusing on quality improvement activities that most directly relate to preventable hospitalizations; Partner with nursing facility staff to implement preventive services, such as care to prevent urinary tract infections, dehydration, and other common causes of preventable hospitalizations; Coordinate and improve management and monitoring of prescription drugs to reduce risk of polypharmacy and adverse drug events for residents; Supplement (rather than replace) existing care provided by nursing facility staff; Demonstrate strong potential for replication in other communities and institutions; Coordinate closely with state health reform efforts, including other CMS demonstrations and waivers; and Allow for participation by nursing facility residents without any need for residents or their families to change providers or enroll in a health plan. Interventions may also include: - Enhanced behavioral health assessments, treatment, and management; - Support for residents and nursing facility staff to facilitate a successful discharge to the community; - Health information technology tools to support sharing of care summaries across transitions in care and maintenance of accurate, up-to-date medication lists; - Person-centered care that improves communication among the health care team and improves care coordination; - Support for resident and family long-term planning and meeting the resident's care preferences (e.g., community living options). The primary focus of the clinical interventions would be Medicare-Medicaid enrollees in nursing facilities, but it may also benefit residents who are not yet Medicare-Medicaid enrollees (i.e., Medicare beneficiaries not yet eligible for Medicaid but who represent similar opportunities for inpatient reductions). The intervention would focus on extended-stay residents rather than those who are likely to experience only a brief post-acute stay and then return home. To fund these interventions, CMS would contract with entities to establish and manage the interventions. We expect these entities would hire staff who would maintain a physical presence at participating nursing facilities. CMS is not planning to permit nursing facilities to act as vendors under the future contract. Anticipated Period of Performance The government expects that the final contract(s) for this body of work will be for a base period of 12 months and three (3) twelve month option periods to be exercised at the discretion of the government. Capability Statements In response to this sources sought notice, CMS is seeking capability statements. Capability statements are NOT proposals and do not address price/cost. The contractor community is merely asked to provide information which may demonstrate that they have expertise and capacity to meet the requirements of this work as a prime contractor, with subcontractors as they deem necessary. For the purposes of responding to this notice, contractors should address the following: 1.Experience partnering with nursing facilities, supporting Medicare and Medicaid beneficiaries during transitions between care settings (including inpatient hospitals, nursing facilities, and home and community-based settings), and working with data relevant to this initiative; 2. Ability to simultaneously implement and manage an intervention that would meet the requirements outlined above in at least 15 nursing facilities; 3. Ability to obtain support from the State Medicaid and survey & certification agencies and at least 15 nursing facility partners; 4. Organizational resources for training, reporting, quality assurance, and back-up staffing sufficient to manage clinical activities at multiple sites simultaneously; 5. Ability to hire staff, train staff, produce policies and procedures, and pass a readiness review process prior to implementing the intervention (prior to receiving any payment from CMS); and 6.Sufficient procedures and facilities to protect proprietary and confidential data and analysis. Response Requested Responses are required no later than July 29, 2011 in the following format to the following electronic address: Melissa.Seeley@cms.hhs.gov: Microsoft Word (or PDF) document with page size 8.5 by 11 inches. Font shall be Times New Roman Size 12 with no less than single spacing between lines. The maximum number of pages for submission is 10 pages. Please be advised that email transmitted files over 5 megabytes are not delivered during standard working hours, are only released from the CMS server after 5:00 PM EST, and may affect the timeliness of your response. Additional Information CMS also requests the following additional information: Business Information: - DUNS - Company Name - Company Address - Current GSA Schedules appropriate to this Sources Sought - Do you have a Government approved accounting system? If so, please identify the agency that approved the system. - Type of company (e.g., small business, 8(a), woman owned, veteran, etc.) as validated via the Central Contractor Registration (CCR). All potential offerors must register on the CCR located at http://www.ccr.gov/index.asp - Company Point of Contact, Phone and Email address Teaming Arrangements: All teaming arrangements should also include the above-cited information and certifications for each entity on the proposed team. Confidentiality: No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s). Disclaimer and Important Notes: This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted.