Federal Employees Health Benefits Program Plan Performance Assessment Services
Added: Mar 05, 2018 4:01 pm
The Office of Personnel Management (OPM) Federal Employee Insurance Operations (FEIO) administers the Federal Employees Health Benefits (FEHB) Program for eligible Federal employees and annuitants, other statutorily eligible individuals, and their eligible family members. The FEHB Program covers approximately 8.3 million lives and provides about $53 billion a year in healthcare benefits.OPM aims to improve the health of the populations we serve, ensure the delivery of high quality consumer focused health care, and provide Federal employees, annuitants, and other statutorily eligible individuals with affordable insurance benefits. To reward quality care, OPM evaluates FEHB carriers on key parameters of clinical quality, customer service, resource use, and contract oversight through the FEHB Program Plan Performance Assessment. Many aspects of the FEHB Program Plan Performance Assessment framework rely on measures from the Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS).Scoring measures against national benchmarks helps OPM recognize top plans in the program, inform enrollee choice, and link objective performance to profit factors. In addition, the FEHB Program Plan Performance Assessment aligns OPM required health plan measures with other major systems of measurement, without creating a disparate set of measures unique to the FEHB Program.OPM has collected FEHB Carrier HEDIS and CAHPS measures for many years. The first year of FEHB Program Plan Performance Assessment scoring was in 2016. For 2017, we added an Improvement Increment to the Clinical Quality, Customer Service and Resource Use (QCR) score. FEHB Program Plan Performance Assessment guidance and instructions are issued to FEHB Carriers via Carrier Letters which are available on the OPM website at https://www.opm.gov/healthcare-insurance/healthcare/carriers/#url=Archive.OPM seeks technical expertise and data systems capabilities to collect, calculate, aggregate, and report measurement data related to the FEHB Program Plan Performance Assessment. The additional services provided under the proposed contract will streamline data reporting and analyses, expand the capacity of OPM to utilize a broader range of relevant measures along with appropriate benchmarks or reference ranges, and strengthen the integrity of the performance calculation process. The required expertise to perform these specific services includes healthcare analytical system proficiencies, as well as subject matter expertise in healthcare measure development, evaluation, and reporting. The successful offeror must demonstrate detailed evidence of their experience in the areas of clinical quality, customer service, resource use, and quality assurance evaluation, as well as health plan efficiency measurement. Due to the technical nature of this project, extensive experience in the details of measure auditing and reporting is required, including but not limited to the NCQA HEDIS Audit and the CAHPS Survey. Having provided a similar scope of data evaluation and aggregation services to large commercial or government entities is highly desirable. In addition to the technical expertise described above, OPM is seeking a collaborator with the vision and capability to help refine the FEHB Program Plan Performance Assessment methodology as new measures are added and trends are elucidated.OPM has published the FEHB Program Plan Performance Assessment methodology and reporting instructions through a series of Carrier Letters. The offeror is expected to be familiar with published OPM materials, including material provided at https://www.opm.gov/healthcare-insurance/healthcare/carriers/#url=Performance-Assessment.We will procure the proposed acquisition using full and open competition procedures in accordance with FAR Part 12 in conjunction with FAR Part 15. All responsible sources may submit a proposal, which we will consider.The proposed contract will be firm-fixed-price. The performance period for the proposed contract is expected to be five years: a one-year base period and four one-year options.OPM intends to issue a request for proposals (RFP) on or about March 12, 2018. The RFP and all documents relating to this requirement will only be available on the Federal Business Opportunities (FBO) website at https://www.fbo.gov. Interested parties are responsible for monitoring the FBO website for release of the RFP and all other documents relating to this requirement. We encourage interested parties to register on the FBO website for e-mail notification of all actions relating to the RFP and for the interested vendors list. After we release the RFP, we will give interested parties the opportunity to ask questions. We will include all questions and answers in an amendment to the RFP and post the amendment on the FBO web site.Proposals will be due on or about April 11, 2018. We anticipate awarding the proposed contract by July 31, 2018.This is a new requirement. Therefore, there is no incumbent.
24322618R0013 Office of Personnel Management
3/5/18, 4:01 PM