RFP_14-233-SOL-00119.pdf

14-233-SOL-00119

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

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C. E-MAIL ADDRESS

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B. TELEPHONE (NO COLLECT CALLS)A. NAME

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INFORMATION

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CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

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CONTRACT ADMINISTRATION DATA

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and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

06/30/2014 X

DAM

DHHS/PSC/AMS/DAM

Twinbrook Place, Suite 400 12501 Ardennes Avenue Rockville MD 20857

1200 ET 08/28/2014

SHANELLE ( JACKSON

Shanelle.Jackson@psc.hhs.

gov

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STANDARD FORM 33 (Rev. 9-97)

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CONTINUATION SHEET

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14-233-SOL-00119

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AHRQ IDIQ Task Order Solicitation

OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

NSN 7540-01-152-8067

RFP: 14-233-SOL-00119

Proposals Due: August 28, 2014

Section B – Supplies or Services/Prices

B.1. BRIEF DESCRIPTION OF SERVICES

This is an Indefinite Delivery/Indefinite Quantity (IDIQ) Task Order Contract which sets forth the conditions and clauses under which further acquisitions between the parties shall be governed. Individual task orders may include additional clauses as may be appropriate for the particular requirement and task order type. This contract will be used as a means of providing service to the Agency for Healthcare Research and Quality (AHRQ) in an effort to help it achieve its mission in a timely manner.

AHRQ’s mission is to produce evidence to make health care safer, higher quality, more accessible, and more affordable, and to work with the Department of Health and Human Services (HHS) and other partners to make sure that the evidence is understood and used.

Keys to achieving this mission is support for research that advances the development, implementation and spread of initiatives, programs, interventions, and strategies (hereafter all referred to as “interventions”) that address the most pressing challenges of those who deliver, manage or pay for health care services.

This solicitation is designed to procure the expertise, resources and capacities necessary to successfully undertake rapid-cycle research through expeditious competition and awards of task orders to a pre-competed set of highly qualified contractors representing broad-based, and highly-resourced Partnerships. Accelerating Change and Transformation in Organizations and Networks III (ACTION III) task orders will reflect one or more of AHRQ’s four priorities:

• Improve the quality of health care and care delivery

• Make health care safer

• Increase accessibility

• Improve health care affordability, efficiency and cost transparency

B.2. TYPE OF ORDERS (IDIQ)

Task or delivery orders issued under this IDIQ contract shall be: Firm Fixed-priced orders, or Cost-Plus-Fixed Fee orders.

B.3. MINIMUM AND MAXIMUM QUANTITIES

The Government shall place orders totaling a minimum of $30,000 to be distributed to each awardee/contract. This reflects the contract minimum for the entire period of performance. The contract maximum for the entire period of performance shall be for the placement of orders totaling a maximum of $175,000,000.

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B.4. TASK ORDER LABOR RATES (Cost Reimbursement)

The Contractor shall not exceed the maximum, unloaded hourly direct labor rates for each category listed below.

B.4.1 Indirect Costs

Pursuant to the General Provisions of this contract, and FAR Clause 52.216-7, Allowable Cost and Payment (JUN 2011), the following provisional and ceiling rates are established:

*In addition, it is hereby agreed that the above ceiling rates are to be used for the life of the contract.

For Contractors that have an approved Negotiated Indirect Cost Rate Agreement: The Contractor shall use the organization's current negotiated provisional indirect cost rates for billing purposes unless lower ceiling rates have been negotiated and established under the contract.

For Contractors that do not have a Negotiated Indirect Cost Rate Agreement:

The Contractor shall submit an indirect cost rate proposal to its cognizant Federal agency within 90 days of contract award for the review and negotiation of provisional rates. The indirect cost rate proposal shall be submitted to the Contract’s cognizant Federal agency.

If HHS is the cognizant Federal agency, the office responsible for the negotiation of indirect cost rates for HHS profit-making contractors is:

Unloaded Rates Labor Categories Base Period –

Year 1 (dates to be indicated upon award)

Base Period - Year 2 (dates to be indicated upon award)

Base Period - Year 3 (dates to be indicated upon award)

Base Period - Year 4 (dates to be indicated upon award)

Base Period - Year 5 (dates to be indicated upon award)

Class I – Senior $ $ $ $ $ Class II – Associate $ $ $ $ $ Class III – Intermediate $ $ $ $ $ Class IV – Junior $ $ $ $ $ Class V – Other Technical $ $ $ $ $ Class VI – Clerical $ $ $ $ $

Type Provisional Rate

Ceiling Rate*

Base

Fringe Overhead G&A javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','')

Director, Division of Financial Advisory Services Office of Acquisition Management and Policy National Institutes of Health 6100 Building, Room 6B05 6100 Executive Blvd MSC-7540 Bethesda, MD 20892-7540

The cognizant Federal office responsible for the negotiation of indirect cost rates for nonprofit organizations where HHS has cognizance is:

Program Support Center (PSC) Division of Cost Allocation (DCA)

The PSC DCA is comprised of four field offices and a DCA Director's office. The contractor's specific DCA location is based on the location of the contractor. For example, if the contractor is located in Maryland, Virginia or DC, the Mid- Atlantic Field Office of the DCA located in Bethesda, Maryland would be the cognizant office. (Refer to the DHHS, PSC FMS website at https://rates.psc.gov/, and click on Contact Information and Office Locations, for the specific office location to determine the office responsible for a specific contractor. A DCA point of contact for questions is Brian Caudill and he can be reached on 301-492-4857.

The Contractor shall submit its final indirect cost rate proposal to its cognizant Federal agency within 180 days of the completion of each Contractor fiscal year for the review and negotiation of final indirect cost rates. A proposal shall be submitted for each year the contractor has Government contracts. In the event the rates determined by the cognizant negotiated indirect cost official on the basis of actual allowable costs are less than the provisional and ceiling rates agreed to herein, then the lower rates as established by such cognizant official shall apply. Notwithstanding the foregoing, the Contractor shall, in the case of an adjustment of the provisional rates, comply with the requirements of FAR 52.232-20 - Limitation of Cost.

B.4.2 Fee

The Contractor shall not exceed the following ceiling rates:

Fixed Fee Ceiling for Prime Contractor/Subcontractors (%)___

Fixed Fee Ceiling applied by Prime Contractor on Subcontracts (%)___

While ceiling rates are established, a fixed fee will be negotiated at the task order level.

B.5. TASK ORDER LABOR RATES (FFP)

The Contractor shall not exceed the maximum, fully loaded hourly rates for each category listed below.

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Fully Loaded Rates Labor Categories Base Period -

Year 1 (dates to be indicated upon award)

Base Period - Year 2 (dates to be indicated upon award)

Base Period - Year 3 (dates to be indicated upon award)

Base Period - Year 4 (dates to be indicated upon award)

Base Period - Year 5 (dates to be indicated upon award)

Class I – Senior $ $ $ $ $ Class II – Associate $ $ $ $ $ Class III – Intermediate $ $ $ $ $ Class IV – Junior $ $ $ $ $ Class V – Other Technical $ $ $ $ $ Class VI –Clerical $ $ $ $ $ javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','')

Section C – Description/Specifications

C.1. BACKGROUND

The onset of health reform has intensified interest in research on changing how care is designed, paid for, and reported. The Patient Protection and Affordable Care Act is creating unprecedented opportunities and challenges for care providers, payers, and policy makers to enhance care access, quality, and affordability. Expansion of value-based payments and new care models in both the public and private sectors creates a fertile and dynamic environment for experimentation in care delivery improvement and for increasing knowledge about how promising improvements can best be implemented and spread.

Experience has shown that research in real-world settings is critical to successfully developing, testing, adapting, implementing, and spreading interventions that can improve care delivery while meeting the complex challenges faced by our delivery system. In particular, such field-based research is essential for answering questions about how, why, and when particular interventions do or do not work. This requirement is designed to enable AHRQ to secure the necessary resources, capacities and expertise needed to conduct field-based research and to support the spread of findings to promote broad impact. ACTION III builds upon AHRQ’s earlier and current programs that commission field-based research.

Definitions

• Interventions: sets of behaviors, routines, and ways of working that are introduced in an effort to improve health care delivery, organizations, payment, and practice (referred to hereafter as “health care delivery”) with the ultimate purpose of improving care quality and health outcomes. Interventions are implemented by planned and coordinated actions, and can include, but are not limited to: changes in care organization, work processes or staffing; changes in or payment; introduction of quality improvement tools, guides, or other products; application of new assessment-measures and methods; public or private reporting of costs or quality data.

• Pilot Test: introducing on a small scale in a real world setting a previously untested or inadequately tested intervention in order to assess its feasibility for addressing an identified health care problem.

• Implementation: active and planned efforts to mainstream an intervention in one or more real world settings.

• Dissemination: sharing information or knowledge about a particular product or intervention e.g., through publications or web postings; also known as Knowledge Transfer or Knowledge Communication.

• Spread ( Dissemination + Implementation): active, planned – and sometimes externally supported – efforts to engage, persuade and enable target groups to adopt and implement an intervention through use of diverse vehicles and approaches of varying degrees of intensity to change awareness, culture and behavior (e.g., training programs, learning collaborative, practice facilitation, coaching, peer to peer learning, javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') academic detailing).

• Sustainability: making an intervention routine until it reaches obsolescence.

• AHRQ Priority Populations: AHRQ’s priority populations, specified by Congress in the Healthcare Research and Quality Act of 1999 (Public Law 106-129) include:

women, children, racial and ethnic minorities, populations with special health care needs (chronic illness, disabilities, and end of life care needs), the elderly, low-income, inner-city, and rural populations.

• Target Audiences: decision-makers within the arena of health care delivery, including but not limited to clinicians and other health care providers, consumers/patients, insurers, purchasers/employers and policymakers.

Principles for Delivery System Research

Delivery System Research under ACTION III is expected to focus on broad set of interventions aimed at behavior change among patients and care providers; care design and organization; payment regulation; and reporting of quality and/or cost metrics.

Research across this broad spectrum of interventions would be expected to be guided by the following five principles underlying delivery system research:

1. Delivery system improvements may involve applying or modifying existing interventions or developing new tools or approaches. Development begins with syntheses of available evidence and experience, followed by creation and trials of prototypes. Development can benefit from testing in diverse settings and input from diverse stakeholder, including implementers, patients, care givers, and other stakeholders (Bate and Glenn 2006; Bechtel and Ness 2010). Feedback from stakeholders can help to refine the intervention, identify core elements of the intervention that are essential for replication, and inform measures of success.

2. When internal or external change agents seek to make structural or process changes in an effort to improve care delivery, they are introducing new elements into an already complex and dynamic system (Plsek 2001). Many interventions are themselves complex, incorporating multiple, interacting, and sometimes interdependent components (Mittman et al. 2013). Introducing complex interventions into complex systems produces a dynamic set of interactions within the elements of the intervention and among these elements and the organizational context, which are hard to manage and predict (Alexander and Hearld 2013; Carayon 2006).

3. Planning and research on complex improvement initiatives can be expected to encompass several distinct components, including:

• Identification of objectives and sought-for outcomes

• Specification of a logic model or a conceptual model (i.e., program theory) explaining how the intervention is expected to bring about the desired results (Shekelle et al. 2010).

• Attention to context: social, organizational, community, market, regulatory, and other settings into which the intervention is being introduced (Taylor et.

Al. 2011; Tomoaia-Cotisel 2013)

4. Research on delivery system improvement often needs to take into account adaptations and other changes that occur over time in the intervention itself, as well javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') as in the internal/organizational and broader environmental contexts within which it was introduced (Alexander and Herald 2012).

5. The conditions influencing the routinization and sustainability of changes introduced through interventions may differ substantially form the factors and forces affecting initial uptake (Buchanan, Fitzgerald, and Ketley 2007).

Methods for Delivery System Research

To capture dynamic relationships within and among the elements in an improvement initiative, researchers may need to use research designs that explicitly a) examine how interventions interact with the contexts in which they occur and b) examine processes that are intended to facilitate adoption of new behavior or practices. Research designs meeting these two requirements contrast with traditional experimental designs that seek to eliminate or control for effects of context and implementation processes in order to identify invariant relationships between an intervention and an outcome (Berwick 2008).

The conduct of research that reflects these principles requires the application of mixed methods and a wide range of designs and analysis techniques (Creswell et al. 2011, Fetters, Curry and Cresswell, 2013, Miller et al, 2013). Where the randomized control trial (RCT) remains the gold standard in clinical research, research methods designed to answer questions about delivery system improvement are likely to include quasi-experimental designs and observational studies that draw on a diverse set of both qualitative and quantitative analytic tools and approaches (and software supporting these methods). These include, for example: comparative case studies, focus groups and key informant interviews, surveys, critical incident analyses, content analyses, process mapping, work flow analyses, interrupted time-series analyses and stepped-wedge designs, fuzzy set analyses, sequence analyses and others (e.g. (AHRQ 2013)). Where appropriate, research and analytic designs for pilot testing or implementation will need to ensure sufficient power for statistically valid detection of change.

Principles and Methods for Spread of Findings or Interventions

Efforts to support actual uptake of research findings or of proven interventions can range from passive sharing of information (“dissemination” or “knowledge transfer” – e.g., through publications or web postings) to more active, targeted and supported endeavors (“spread”). Experience has shown that passive knowledge transfer is generally insufficient to induce widespread, tangible change in care delivery. Instead, successful implementation and sustained uptake of a new process or product will often require culture change and/or behavior change, for which active engagement and involvement of the primary target audience and other impacted stakeholders have been shown to be essential. Alignment of incentives can also be an important element underpinning successful spread of interventions.

Successful spread initiatives can thus be expected to be comprised of an underlying logic and a set of plans for active outreach, followed by the execution of those plans. At a more granular level, spread activities could be expected to include leveraging relevant javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') partnering organizations to enhance outreach to the target audience; use of diverse vehicles or mechanisms, including but not limited to use of measurement and performance benchmarking; training programs, facilitation, coaching, peer to peer learning, and academic detailing (Perla, Bradbury, and Gunther-Murphy 2013).

ACTION III Precursors: Implementation Research under ACTION and ACTION II

AHRQ has an extensive track record of research on development, implementation and spread of delivery system improvements that embodies these principles, most recently through the “ACTION II” IDIQ Contract mechanism, which followed an earlier “ACTION” IDIQ. Task Orders issued under the ACTION and ACTION II Master Contracts have supported direct collaborations of researchers and providers in conducting research in diverse health care settings aimed at exploring questions of both content and context in the development and spread of interventions.

Under ACTION II, 17 Partnerships have competed for over 30 task orders since 2011.

The Partnerships include a total of over 200 collaborating Member Organizations which provide care to more than 100 million people nationwide and represent a broad demographic and payer mix. Collectively, these Member Organizations include: diverse health care provider organizations (e.g., hospital systems; ambulatory care practices);

long-term care providers; Integrated Delivery Systems, academic institutions (schools of medicine, nursing, public health, health policy, and management); health services research organizations; and organizations representing other diverse stakeholders who play central roles in shaping care delivery through payment, advocacy, or other means (e.g. professional or trade organizations). Each Partnership includes care delivery organizations or systems with large healthcare databases, clinical and research expertise, and the authority to implement health care interventions. (A complete list of the ACTION II Partnerships can be found at:

http://www.ahrq.gov/research/findings/factsheets/translating/action2/index.html).

Since 2011, ACTION II Partnerships have committed their resources, capacities and expertise to the challenging tasks of conducing field-based delivery system research and supporting the spread and uptake of proven interventions. Some examples of ACTION II projects aimed at making safer, higher quality, more affordable and more accessible include:

Research/Development

• Project to develop a conceptual framework that describes the relationship between the built environment of healthcare facilities and the acquisition and prevention of Healthcare-Associated Infections (HAIs), for use in guiding and assessing future research.

• Project to design and test a High Value and Efficiency Culture Survey, as well as a “Communicating about Value” checklist for physicians.

• Project to develop strategies (or modify existing ones) to specifically address the unique challenges of caring for Medicaid patients.

javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') http://www.ahrq.gov/research/findings/factsheets/translating/action2/index.html

• Project to develop a web-based resource guide/toolkit to assist hospitals with varying levels of sophistication in implementing a complex system intervention for preventing falls.

Implementation/Testing

• Project to implement the On-Time Falls Prevention Program in a large nursing home chain to evaluate the extent to which the program reduces incidence rates, emergency room visits and hospitalizations associated with patient falls.

Spread

• Series of projects to promote uptake of comprehensive unit-based safety programs for the reduction of surgical site infections, ventilator acquired pneumonia, catheter-associated urinary tract infections in hospitals, ambulatory surgery sites, and long term care facilities across all 50 states.

• Projects to study the scale up of efficiency-enhancing interventions and develop and disseminate knowledge and lessons learned about what factors facilitate or impede success.

The current procurement is designed to enable AHRQ to continue to support similar efforts over the next years.

References

AHRQ. 2013. “PCMH Research Methods Series” [accessed on 2013]. Available at http://pcmh.ahrq.gov/page/evidence-and-evaluation, accessed Nov. 19, 2013.

Alexander, J.A. and L.R. Hearld. 2012. “Methods and metrics challenges of delivery-system research.” Implementation Science: 7(1):15.

Bate, P. and R. Glenn. 2006. “Experience-based design: from redesigning the systems around the patient to co-designing services with the patient.” Qual Saf Health Care. 15:

307-10.

Bechtel, C. and D. L. Ness. 2010. “If you build it, will they come? Designing truly patient-centered health care.” Health affairs 29(5): 914-20.

Berwick, D. M. 2008. “The science of improvement.” JAMA 299(10): 1182-4.

Buchanan, D.A., L. Fitzgerald, and D. Ketley. 2007. “The Sustainability and Spread of Organizational Change.” London: Routledge.

Carayon, P. 2006. “Human factors of complex social systems.” Applied Ergonomics 37 525-35.

Creswell, J., A. Klassen, V. Plano Clark, and K. Smith. 2011. “Best practices for mixed methods research in the health sciences” [accessed on 2011]. Available at:

http://obssr.od.nih.gov/mixed_methods_research, retrieved Oct 29, 2013.

Fetters, M.D., Curry, L.A., & Creswell, J.W. 2013. Achieving integration in mixed methods designs-principles and practices. Health Services Research, 48 (6 Pt 2): 2134- 2156.

Miller, W.L, Crabtree, B.F., Harrison, M.I., & Fennel, M.L. 2013. Integrating mixed javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') http://pcmh.ahrq.gov/page/evidence-and-evaluation http://obssr.od.nih.gov/mixed_methods_research methods in health services and delivery system research. Health Services Research, 48 (6 Pt 2): 2125-2133.

Mittman, B.S., J. Overtveit, P. Plesk, and S. Salem-Schatz. 2013. “How To Think About Evidence When Deciding Whether To Adopt and Innovation.”

Perla, R.J., E. Bradbury, and C. Gunther-Murphy. 2013. “Large-scale improvement initiatives in healthcare: a scan of the literature.” Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality 35(1): 30-40.

Plsek, P. 2001. “Redesigning health care with insights from the science of complex adaptive systems.” In Crossing the Quality Chasm: a new health system for the 21st century, edited by Institute of Medicine. Washington: National Academy of Sciences.

Shekelle, P., P. Pronovost, R. Wachter, S. Taylor, S. Dy, R. Foy, S. Hempel, K.

McDonald, J. Ovretveit, L. Rubenstein, afety, and P. D. Criteria. 2010. “The Importance of Theory.” Assessing the Evidence for Context-Sensitive Effectiveness and Safety of Patient Safety Practices: Developing Criteria pp. 31-36: Agency for Healthcare Research Taylor, S. L., S. Dy, R. Foy, S. Hempel, K. M. McDonald, J. Ovretveit, P. J. Pronovost, L. V. Rubenstein, R. M. Wachter, and P. G. Shekelle. 2011. “What context features might be important determinants of the effectiveness of patient safety practice interventions?”

BMJ quality & safety 20(7): 611-7.

Tomoaia-Cotisel. 2013. “Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change.” Annals of Family Medicine.

Zhang, W. and J. Cresswell. 2013. “The Use of “Mixing” Procedure of Mixed Methods in Health Services Research.” Medical Care Research and Review 51(8).

C.2. STATEMENT OF WORK

The Contractor shall furnish all of the necessary personnel, materials, services and facilities incident to the performance of the work as stated in each individual task order that may be issued under this contract. ACTION III Task Orders will focus on practical, applied topics of high interest to AHRQ and the Department of Health and Human Services more broadly, as well as to those at the front lines of care delivery and to the patients they serve. ACTION III Task Orders may be local to national in scope.

Broadly speaking, ACTION III research will focus on one or more of AHRQ’s four priorities:

∗ Improve the quality of health care and care delivery ∗ Make health care safer ∗ Increase accessibility to health care ∗ Improve health care affordability, efficiency and cost transparency

It is expected that there will be a wide array of topics explored through ACTION III.

Specific topics may include, for example: reduction of Healthcare Acquired Infections (HAIs) and other threats to patient safety; the structure, organization and processes of care (including issues of workforce design and care coordination); changes in insurance javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') coverage, new models of care and other developments resulting from health care reform;

use and impacts of health information technology; payment; quality and accessibility of care; affordability and efficiency; effectiveness of system design and change strategies;

and health care for priority populations.

ACTION III research can be expected to target all health care settings (including, but not limited to, hospitals, integrated delivery systems, diverse ambulatory care settings including Primary Care practices, Long Term Care Settings) as well as on transitions between them. No health care setting, type of provider, type of recipient, payer, or health condition will be excluded from consideration with respect to research topics that may be undertaken under ACTION III, although individual Request For Task Orders (RFTOs) may focus on particular types of settings, providers, or patients.

The size, scope and topics of ACTION III Task Orders are determined by AHRQ in response to annual appropriations and Agency priorities. Thus, important topics or areas of interest that are unknown or not funded at the launch of ACTION III may emerge over time. It is also possible that, as occurred in the past, other federal partners may collaborate with AHRQ to use the ACTION III mechanism to support research that is of joint interest. ACTION III Partnerships will thus be expected to flexibly respond to changing agency-level needs, interests, concerns, and budgets. This flexibility is likely to result from a combination of the existing capacities of the Partnership Members, as well as from an ability to nimbly reach out for new partners and capacities as needs arise.

C.3. SERVICES TO BE PROVIDED

The services and activities contemplated under this contract are described below. An individual task order may require services associated with one or more of the categories listed here:

a. Development of Interventions

Task Orders focused on development are expected to result in plans or recommendations for interventions to improve or positively impact some aspect or system feature of health care delivery, and/or in recommended action steps for AHRQ, other federal agencies, or other interested parties. These plans or recommendations can focus on a new approach for improving care delivery; a modification of an existing approach or intervention; or a modification of an intervention that has been successful in another industry. This type of Task Order may call for analysis of original or available data on the scope of a current challenge and examination of critical factors underlying it; scans of the environment and literature and syntheses of available evidence and experience; consultation with experts;

observation of promising practices in natural settings; simulations; creation and trials of prototypes and/or other design activities. Development of interventions may also flow from comparative analyses of health system or provider performance (using available data bases) to distinguish performance variations, followed by a drill down to account for differences. Some Task Orders may focus entirely on such syntheses or data analyses as necessary steps toward developing interventions or action recommendations.

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b. Pilot Testing

Some Task Orders may call for testing on a small scale in a real world setting a previously untested or inadequately tested intervention or tool in order to preliminarily evaluate feasibility for addressing an identified health care problem and learn about what is involved in integrating it into the settings for which it is intended. Pilot Testing may be used to assess the logic model underlying the intervention; document whether and how well it worked, and why; examine effects of the contexts in which the intervention was introduced and the approaches used to facilitate uptake; identify modifications needed to increase the likelihood of successful implementation and desired outcomes; examine the return on investment (ROI)/business case for organizations to adapt such models and identify changes that could improve the business case.

Successful execution of Task Orders aimed at Pilot Testing of one or more interventions commonly requires recruitment of appropriate real world sites; engagement of onsite champions or operational leaders; appropriate application of diverse qualitative and quantitative methodologies to preliminarily measure the impact on safety, quality, access, and cost or efficiency; and synthesis of findings.

c. Implementation

Implementation Task Orders will be used to generate findings about ways that context, intervention characteristics, and implementation approach interact to influence uptake of the intervention and success in achieving desired outcomes for patients (e.g., quality, safety, access, affordability). Examination of financial or business impacts (e.g. business case, ROI) for providers and for payers (shared savings or potential cost reductions) will also be of interest. These Task Orders will involve actual implementation of a complex system intervention in multiple sites in order to analyze and evaluate its feasibility, utility and impacts. In most cases, the intervention that will be implemented will have already been tested in a limited number (or type) of settings. Key components of this type of work include identification of core features that remain constant across settings and those that can readily be changed; investigation, documentation and analysis of adaptations of the intervention in response to local conditions; and the roles and responses of diverse stakeholder groups during implementation.

Successful execution of an implementation Task Order requires development of a change package; recruitment of appropriate real world implementation sites (ideally from a cadre of sites or a network with whom the contractor has an existing relationship); engagement of onsite champions or operational leaders and appropriate application of diverse qualitative and quantitative methodologies. Task Orders of this kind will also typically require syntheses of findings and spread of knowledge to appropriate decision-makers and other audiences (“knowledge communication/knowledge transfer”), which may be expected to extend beyond publication in peer-reviewed journals to targeted outreach to audiences of interest (e.g. presentations, webinars).

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d. Spread of Evidence-based Interventions

Task Orders aimed at spreading evidence-based interventions will involve working with HHS and/or other partners to promote widespread uptake of one or more complex system interventions that have proven successful in improving health outcomes or on-the-ground care delivery. Such projects are likely to call for design and execution of a spread approach based on an underlying logic and comprised of plans for active outreach and engagement of members of the target audience and use of diverse vehicles or mechanisms of varying degrees of intensity for changing awareness, culture and behavior, such as those included in the above definition of “Spread”. Spread projects are likely also to call for development of print and web based educational and training materials, provisions of technical support and monitoring and assessment of progress.

Some Task Orders aimed at supporting this objective may also call for the evaluation of the effectiveness of different strategies or approaches for spread in order to develop guidance on how to maximize the likelihood of success of similar endeavors in the future.

e. Analysis and Assessment

Some Task Orders may be focused on analysis and/or assessment of outcomes, impacts, spread and sustainability of efforts to improve the quality, safety, affordability, or accessibility or care delivery. Such Task Orders might, for example, explore: the degree to which interventions designed to improve care delivery achieved their intended objectives and were sustained and adapted over time; the internal (e.g. organizational) and external factors (policy, market or other environmental causes) that can trigger and shape efforts to change how care is delivered; the factors that can drive the success or failure of those efforts.

Some investigations may be triggered by a desire to better understand the contexts and processes that underlie patterns observed in studies of large system-level data. For instance, an ACTION III Task Order might use field-based research to uncover the underlying explanations for observed variations in quality and cost among providers with similar patient and payer mixes, in an effort to identify recommendations for improving care delivery by underperforming providers.

Other investigations may be motivated by a desire to identify factors that enhance or impede the chances of sustainability of specific interventions (including integration into every day practice in the long term) or of the depth or breadth of usage (e.g., proportion of patient visits in which e-prescribing is used; proportion of practitioners using e-prescribing). Here again, analysis of large data sets may identify occurrences of sustained improvements in outcomes, while field-based investigations can help uncover the factors that explain them.

C.4. LABOR CLASS DEFINITIONS

Class I: Senior management personnel, normally holding an advanced degree, with a javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') minimum of ten (10) years’ experience in conducting healthcare delivery, implementation and quality improvement research, policy/program research, data analysis, evaluation studies and/or providing technical assistance to clients of which at least five (5) years’ experience has been in a senior management position or the administration of Healthcare Delivery, Implementation and Quality Improvement Research; Policy Assessments/Analysis; Program Assessments; Evaluation Design Studies And Data Collection; Performance Measurements; Technical Assistance/Expertise; Data Analysis; Auxiliary/Support Services as appropriate;

corporate level management experience that reflects an ability to command organizational resources and direct staff within the broader organization.

Class II: Associate management or technical personnel, normally holding an advanced degree, with a minimum of five years’ experience in conducting healthcare delivery, implementation and quality improvement research, Healthcare Delivery, Implementation and Quality Improvement Research, Policy Assessments/Analysis;

Program Assessments; Evaluation Design Studies And Data Collection;

Performance Measurements; Technical Assistance/Expertise; Data Analysis;

Auxiliary/Support Services, as appropriate.

Class III: Intermediate technical personnel, normally holding a BS or BA degree and at least three years’ experience in technical activities related to Healthcare Delivery, Implementation and Quality Improvement Research, Policy Assessments/Analysis;

Program Assessments; Evaluation Design Studies And Data Collection;

Performance Measurements; Technical Assistance/Expertise; Data Analysis;

Auxiliary/Support Services, as appropriate. The individual is capable of carrying out independent assignments with minimum supervision or acting as leader of small projects.

Includes specialists in computer programming, survey design, etc.

Class IV: Junior analysts, normally holding a BS or BA degree, with three years or less experience in technical areas. Includes research assistants and junior personnel who regularly assist analysts and specialists on routine technical work, such as data collection.

Class V: Other technical staff such as editors, etc.

Class VI: Clerical/Administrative

C.5. GOVERNMENT FURNISHED PROPERTY

The Contractor shall provide all equipment necessary for performance of this contract;

however, in some instances, an exception may be granted to furnish Government-owned property or to authorize purchase with contract funds (see Section G.7 – EQUIPMENT).

Property purchased with Government funds will become the property of the Government at the end of the contract.

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Section D – Packaging and Marking

D.1. PACKAGING AND MARKING

Marking for task orders issued under this contract will be contained in the individual task orders.

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Section E – Inspection and Acceptance

E.1. INSPECTION AND ACCEPTANCE (IDIQ)

All work described in individual orders under this IDIQ contract is subject to final inspection and acceptance by an authorized representative of the Government. The authorized representative of the Government is the Government's COR, who is responsible for inspection and acceptance of all the services to be provided under individual orders.

E.2. FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/

FAR Clause No.

Title and Date Fixed Price Cost Reimbursement

52.246-7 Inspection of Research and Development—Fixed Price.

X

52.246-8 Inspection of Research and Development—Cost Reimbursement

X javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') http://www.acquisition.gov/far/

Section F – Deliveries or Performance

F.1. PERIOD OF PERFORMANCE

The period of performance shall be for a base period of sixty (60) months.

F.2. REPORT(S)/DELIVERABLES AND DELIVERY SCHEDULE (IDIQ)

The contractor shall submit all required report(s)/deliverables in accordance with the schedule established in each individual task order. Report(s) submitted under each individual task order shall reference and cite the contract number and the specific task order number.

F.3. FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/

FAR Clause No.

Title and Date Fixed Price R&D

Cost Reimbursement R&D

52.242-15 Stop-Work Order (Aug 1989) X X javascript:__doPostBack('ctl00$ctl00$body$homebody$RecentDocuments$C$RecentDocumentsControl$RecentDocumentResults$ctl00$DocumentNumberLink','') http://www.acquisition.gov/far/

Section G – Contract Administration Data

G.1. AUTHORITIES OF GOVERNMENT PERSONNEL

Notwithstanding the Contractor's responsibility for total management during the performance of this contract, the administration of this IDIQ will require maximum coordination between the Government and the Contractor. The following individuals will be the Government's points of contact during the performance of this IDIQ:

G.1.1 Contracting Officer

The Contracting Officer for this IDIQ, also referred to as “IDIQ CO” is Rosanna Browning. All communications pertaining to contractual and/or administrative matters under the IDIQ shall be addressed to Rosanna Browning, 12501 Ardennes Avenue; Suite 400, Rockville, MD 20852; Rosanna.Browning@psc.hhs.gov 301-443-6931.

G.2. OMBUDSMAN

The agency task order ombudsman Darryl Grant, Acquisition Management, Suite 400, 12501 Ardennes Avenue, Rockville, MD 20857.

G.3. INVOICE SUBMISSION – NONCOMMERCIAL

The Contractor shall submit invoices once per month. A complete invoice with all required back-up documentation shall be sent electronically, via email, to:

1. Contract Specialist via DAM mailbox: pscsas.invoices@psc.hhs.gov.

2. Contracting Officer's Representative (COR): TBD

3. Financial Management Service (FMS): psc_invoices@psc.hhs.gov.

* No other non-invoice related documents (i.e. deliverables, reports, balance statements) shall be sent to the DAM and FMS mailboxes. Invoices Only.

The subject line of your email invoice submission shall contain the contract number, contract line item number, the order number, if applicable, and the number of invoices.

The Contractor shall send one email per contract per month. The email may have multiple invoices for the contract. Invoices must be in the following formats: PDF, TIFF, or Word. No Excel formats will be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF or TIFF or Word).

Invoices shall be submitted in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

All calls concerning contract payment shall be directed to the COR.

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In accordance with FAR 52.232-25 Prompt Payment, a proper invoice must include the following items:

(i) Name and address of the contractor.

(ii) Invoice date and invoice number. (Contractors should date invoices as close as possible to the date of mailing or transmission.)

(iii) Contract number or other authorization for supplies delivered or services performed (including order number and contract line item number).

(iv) Description, quantity, unit of measure, unit price, and extended price of supplies delivered or services performed.

(v) Shipping and payment terms (e.g., shipment number and date of shipment, discount for prompt payment terms). Bill of lading number and weight of shipment will be shown for shipments on Government bills of lading.

(vi) Name and address of contractor official to whom payment is to be sent (must be the same as that in the contract or in a proper notice of assignment).

(vii) Name (where practicable), title, phone number, and mailing address of person to notify in the event of a defective invoice.

(viii) Taxpayer Identification Number (TIN) and Dun & Bradstreet Number (DUNS).

The contractor must include its TIN and DUNS on the invoice.

(ix) Electronic funds transfer (EFT) banking information.

(A) The contractor must include EFT banking information on the invoice only if required by agency procedures.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the contractor must have submitted correct EFT banking information in accordance with the applicable solicitation provision (e.g., 52.232-38, Submission of Electronic Funds Transfer Information with Offer), contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer- Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(x) Any other information or documentation required by the contract (e.g., evidence of shipment).

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty.

Interest penalties, as prescribed by the Prompt Payment Act, remain…