Special Notice – HEDIS Data Collection Services

Notice Type: Special Notice

Posted Date: 29-AUG-16

Office Address: Office of Personnel Management; Office of Procurement Operations; Contracting; 1900 E Street, N.W., Room 1342 Washington DC 20415-7710

Subject: HEDIS Data Collection Services

Classification Code: R - Professional, administrative, and management support services

Solicitation Number: OPM3516N0001

Contact: Cheryl D Allen, Contracting Officer, Phone 202.606.2054 , Fax 202.606.1464, Email [email protected]

Description: Office of Personnel Management

Office of Procurement Operations

Contracting

This is a NOTICE OF INTENT that the United States Office of Personnel Management (OPM) plans TO AWARD A NON-COMPETITIVE CONTRACT for Healthcare Effectiveness Data and Information Set (HEDIS) Data Collection Services to National Committee for Quality Assurance (NCQA), 1100 13th Street, NW, Suite 1000, Washington, DC 20005. We will conduct this acquisition in accordance with Federal Acquisition Regulation (FAR) Part 12. The statutory authority permitting other than full and open competition is FAR 6.302-1 - Only one responsible source and no other supplies or services will satisfy agency requirements. We intend to issue a request for proposals (RFP) to NCQA for HEDIS Data Collection Services and award a resultant contract no later than October 1, 2016. The resultant contract will be firm-fixed-price. The period of performance is expected to be five years: a one-year base period and four one-year options. THE PURPOSE OF THIS NOTICE OF INTENT IS TO SATISFY THE REQUIREMENTS OF FAR SUBPART 5.2. THIS NOTICE OF INTENT IS NOT A REQUEST FOR COMPETITIVE PROPOSALS. However, all responsible sources may submit a capability statement, proposal, or quotation, which we will consider. All responsible sources must submit their capability statements, proposals, or quotations in writing via e-mail to Cheryl D. Allen, Contracting Officer, at [email protected] no later than eight days, 3:00 P.M. Eastern Time, of the published date of this notice. We will not consider responses received after this date and time. Verification of receipt of electronic transmissions is the sole responsibility of the respondent. The Government will not be responsible for any costs incurred for capability statements, proposals, quotations, or any other documents prepared in response to this notice. We will not issue an RFP. We will consider any requests for an RFP as non-responsive. A determination not to compete this action based upon responses received is the sole discretion of the Government. All contractors must be registered in System for Award Management prior to execution of a contract award. If we do not receive any viable responses, we intend to award a contract to NCQA without further notice.

BACKGROUND:

OPM manages the Federal Employees Health Benefits (FEHB) Program. Federal Employee Insurance Operations (FEIO) is responsible for providing Federal employees, retirees and their families with insurance products that offer choice, value and quality to help maintain the Government's position as a competitive employer. More than 200 FEHB participating health plans provide health insurance to the more than 8 million Federal enrollees and family members covered by the Program.

For over a decade OPM has promoted quality initiatives in the FEHB Program. In continuing our efforts to provide information about the quality of health plans participating in the FEHB Program, OPM collects HEDIS data from health maintenance organization, fee-for-service, and point of service health plans. HEDIS measures how well a plan designs its benefits and manages its network in order to prevent and treat common conditions.

HEDIS measures are used to evaluate the clinical effectiveness of a health plan's provider network on a range of important healthcare topics such as breast cancer screening, control of diabetes, the overuse of antibiotics, and pre-natal and post-natal care. We post individual health plan results to the FEHB website to assist Federal employees and annuitants in choosing a health plan. We also indicate whether the health plan result is lower than, higher than, or equal to NCQA's published benchmarks of performance on HEDIS measures, which is known as the "Quality Compass." This benchmark data is published annually.

The measures assess health plans' performances by looking at the structures and processes of care delivered to their enrollees. HEDIS measures have been increasingly adopted by both public and private purchasers in an effort to establish accountability in managed care. OPM is accountable to Federal Employees and the American taxpayers for the overall cost of health benefits. Ensuring timely preventive care and effective treatment helps limit cost growth.

REQUIRED SERVICES:

In support of its mission, FEIO/Healthcare and Insurance requires a contractor to administer the HEDIS data collection project; ensure uniform collection, reportage, and auditing of the data; conduct an annual survey using a healthcare organization questionnaire; provide distributive results for a broad range of measures for each FEHB plan; and provide OPM with a HEDIS data extract and the Quality Compass benchmark data to be used by OPM and the health insurance groups in assessing plan performance.

The contractor is required to provide HEDIS data collection services to include, but not limited to, the following:

* Collect HEDIS data electronically from health plans using NCQA's proprietary data submission portal, the Interactive Data Submission System (IDSS). Health plans' data submissions to the IDSS portal must be audited by an NCQA certified auditor in order to be accepted by NCQA. Unless OPM utilizes NCQA's IDSS reporting portal and methodology, there will not be any assurance of the validity of the carrier's data and OPM will not have access to national benchmarking data. This will irreparably damage OPM's ability to provide comparable data on health plan performance to federal employees, which has been a long-standing responsibility on the part of OPM.

* Maintain current information on all plans participating in HEDIS. Health plans must be surveyed annually, using a healthcare organization questionnaire, which requires plans to submit or update contact names and addresses as well as information on service areas and product lines. The questionnaire also requests all health plans to indicate their FEHB sub code. The information collected in the survey will be used to create a crosswalk that links FEHB codes to the contractor assigned identifiers. The contractor provides this crosswalk to OPM to check for accuracy and completeness.

* Provide OPM with Quality Compass benchmark data so that OPM can compare and assess plans based on industry benchmarks. NCQA is the only entity that can create national benchmarks based on HEDIS data because they hold copyright to the individual measures as well as to the proprietary database and methodology used to collect and analyze the measures.

* Provide OPM with HEDIS data extracts for each clinical measure that each plan reports. OPM aggregates the data to the plan contract level and compares and assesses plans based on Quality Compass benchmarks. The resulting data is then used to flag the health plan's performance on public websites that federal employees utilize to review plan performance.

Link/URL: https://www.fbo.gov/spg/OPM/OCAS/CD/OPM3516N0001/listing.html