RFP for NCQA-certified HEDIS measurement vendor

The Oregon Health Authority is seeking an NCQA-certified vendor to provide technology-enabled services for the Oregon Health Plan's quality measurement program. The primary objective is the certified production, validation, and reporting of approximately 30 HEDIS and 14 non-HEDIS measures. The selected contractor will be responsible for ingesting structured claims and enrollment data, performing initial and quarterly calculations, and delivering reports to the OHA, Coordinated Care Organizations, and the Centers for Medicare & Medicaid Services. Key deliverables include project management plans, data ingestion reports, and annual HIPAA compliance attestations, with non-HEDIS measures requiring a minimum 97 percent quality match. The solicitation process utilizes a two-round, point-based ranking system. Round 1 evaluates technical responses, solution work requirements, and service level agreements, while Round 2 involves a live product demonstration and a detailed price evaluation. Proposers must be HEDIS certified by the NCQA and comply with strict data security standards, including the protection of Level 3 Information and adherence to HIPAA and State of Oregon security protocols. The contract includes a mandatory pricing structure covering a five-year period, encompassing onboarding, measure production, certification maintenance, and cloud infrastructure. Additionally, vendors must provide a certified disadvantaged business outreach plan and comply with digital accessibility standards.