RFP_15-233-SOL-00110.pdf

ID/IQ Task Order Contracts for Technical Services for ASPE, AHRQ, and ONC Solicitation #15-233-SOL-00110

SECTION B - ID/IQ Supplies or Services/Prices

B.1. CONSIDERATION AND PAYMENT

This is an Indefinite Delivery/Indefinite Quantity contract that will be used to provide commercial or noncommercial services to client agencies of the Program Support Center.

Individual task orders may be awarded on a Cost Reimbursement (non-commercial only), Time and Materials, Labor Hours or Firm Fixed Price basis.

During the contract period, the Government shall place orders totaling a minimum of $1,000. 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 $100,000,000. The funding for the minimum guarantee is not currently committed and that awards will only be made when and if funding for the minimum guarantee becomes available.

The costs/prices will be negotiated on a per task order basis using the rates established in this contract as explained in B.2 and B.3.

The Contractor will be reimbursed in accordance with pricing section of each task order for satisfactory performance of the work.

B.2 TASK ORDER LABOR RATES (Cost Reimbursement)

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

NOTE:

For task orders whose period of performance extends beyond the base contract period of five years, the Contractor shall use the rates in Year 5 as adjusted by the Employment Cost Index from the Bureau of Labor Statistics. Rates are listed on the right hand side of the page under “Latest Numbers” on http://www.bls.gov/ncs/ect.

The rates specified above are ceiling rates for the prime contractor and shall not be exceeded (these ceilings do not apply to subcontractors or consultants).

Unloaded Rates Labor Categories Year 1

(dates to be indicated upon award)

Year 2 (dates to be indicated upon award)

Year 3 (dates to be indicated upon award)

Year 4 (dates to be indicated upon award)

Year 5 (dates to be indicated upon award)

Class I - Senior $ $ $ $ $ Class II - Associate $ $ $ $ $ Class III - Intermediate $ $ $ $ $ Class IV - Junior $ $ $ $ $ Class V - Editorial $ $ $ $ $ Class VI - Clerical $ $ $ $ $ http://www.bls.gov/ncs/ect

B.2.1 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 rates are established:

*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. The contractor shall provide the ID/IQ CO with a copy of the contractor’s current NICRA and continue to do so throughout the life of the ID/IQID/IQ contract.

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

The Contractor shall submit an indirect cost rate proposal to their 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 Contractor'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:

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

Type Provisional Rate

Base Used to Calculate

Fringe * Overhead * G&A * 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.2.2 Fee

The Contractor shall not exceed the following ceiling rates for Cost Reimbursement Task Orders types:

Fixed Fee Ceiling for Prime Contractor (%)___

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.3 TASK ORDER LABOR RATES (T&M, Labor Hour)

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

NOTE:

For task orders whose period of performance extends beyond the base contract period of five years, the Contractor shall use the rates in Year 5 as adjusted by the Employment Cost Index from the Bureau of Labor Statistics. Rates are listed on the right hand side of the page under “Latest Numbers” on http://www.bls.gov/ncs/ect.

The rates specified above are ceiling rates for the prime contractor and shall not be exceeded (these ceilings do not apply to subcontractors or consultants).

Fully Loaded Rates Labor Categories Year 1

(dates to be indicated upon award)

Year 2 (dates to be indicated upon award)

Year 3 (dates to be indicated upon award)

Year 4 (dates to be indicated upon award)

Year 5 (dates to be indicated upon award)

Class I - Senior $ $ $ $ $ Class II - Associate $ $ $ $ $ Class III - Intermediate $ $ $ $ $ Class IV - Junior $ $ $ $ $ Class V - Editorial $ $ $ $ $ Class VI - Clerical $ $ $ $ $ http://www.bls.gov/ncs/ect

SECTION C - Descriptions/Specifications/Work Statement

PROJECT TITLE: ID/IQ Task Order Contracts for Technical Services for ASPE, AHRQ, and ONC

C.1 PURPOSE OF THE CONTRACT

This is an Indefinite Delivery/Indefinite Quantity Task Order contract that sets forth the conditions and clauses under which future acquisitions between the parties shall be governed. This contract will be used as a means of providing services primarily, but not exclusively, to the Office of the Assistant Secretary for Planning and Evaluation (ASPE), and specifically to the Office of Disability, Aging, and Long-Term Care Policy within ASPE, the Agency for Healthcare Research and Quality (AHRQ), and the Office of the National Coordinator for Health Information Technology (ONC), in an effort to help achieve Office and HHS missions in a timely manner. This ID/IQ task order contract comprises two technical areas:

1 – Disability, Aging and Long-Term Care Policy and Data Analysis

2 – Health Information Technology, Electronic Health Records, and Health Information Exchange

C.2 BACKGROUND

The Program Support Center (PSC), a fee-for-service Government agency, is currently working to expand the services available to the Department and other agencies through the use of Indefinite-Delivery, Indefinite-Quantity (ID/IQ) Contracts. The PSC intends, through this procurement, to increase the number of Contractors and resources available to provide required services, and to enhance our ability to produce quick-turnaround and “real time” information.

C.3 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.

See Section H.1 for task order procedures.

C.3.1 TECHNICAL AREA 1: DISABILITY, AGING, AND LONG-TERM CARE POLICY

AND DATA ANALYSIS

Work under this technical area will support ASPE, and specifically the planning, policy research, and evaluation activities of the Office of Disability, Aging, and Long-Term Care Policy (DALTCP).

DALTCP is responsible for the development, coordination, research, and evaluation of HHS policies and programs that support the independence, productivity, health and security of people with disabilities, including children, working age adults, and older persons. DALTCP is also the lead office within HHS/OS for policy research and analysis related to international disability, aging issues, mental health issues, substance use disorder issues, and long-term care. Policy areas that DALTCP staff work on include: disability measurement and analysis of trends; housing, health, income supports, education, training and employment needs of people with disabilities; financing, delivery, and quality of services and supports for individuals with mental illnesses, substance use disorders, or intellectual disabilities, population aging and aging-related services; long-term care and personal assistance services, including informal caregiving; post-acute care; palliative care; long-term rehabilitation services; home and community-based services and supports, linkages between the acute, post-acute and long-term care systems; long-term care quality; employment supports for individuals with disabilities including mental health-related disability; private long-term care insurance, saving, and financing issues. Activities in these areas routinely require policy planning, policy and budget analysis, regulatory review, formulation of legislative proposals, data development and analysis, and policy research and evaluation.

Substantive Areas of Interest to the Office of Disability, Aging, and Long-Term Care Policy

The following broad areas are representative of work to be undertaken under this ID/IQ task order contract; however, these substantive areas are neither exhaustive nor mutually exclusive, and work may logically fit into two or more categories:

Disability Measurement: Work in this area will focus on developing, modifying, and/or utilizing conceptual models of disability for broad populations (children, the working-age population, and the elderly) and subgroups of specific interest to policymakers (e.g., persons with developmental disabilities (DD), persons with severe physical disabilities, persons with serious mental illness or memory impairments, etc.); developing new measures of disability or refining existing ones based on current or proposed conceptual frameworks; developing and testing concise measures of disability; and conducting methodological reviews of existing disability-related surveys. Work may also focus on developing statistical techniques for producing estimates for specific groups with small numbers of persons.

Disability- and Aging-Related Services Policy Development and Analysis: Policy development and analysis activities will determine the implications of trends in disability among children, working age adults, and the older population; analyze the implications of population aging for health, human services and economic security policy; and analyze policy options and legislation related to disability and aging issues. Data likely to be of use in conducting these analyses include the:

• Survey of Income and Program Participation (SIPP),

• Current Population Survey (CPS),

• American Community Survey (ACS),

• National Health Interview Survey (NHIS),

• Medical Expenditure Panel Survey (MEPS),

• Health and Retirement Study (HRS),

• National Long-Term Care Survey (NLTCS),

• National Health and Aging Trends Study (NHATS),

• National Survey of Caregiving (NSOC),

• National Survey of Residential Care Facilities (NSRCF),

• National Home and Hospice Care Survey (NHHCS),

• National Nursing Home Survey (NNHS),

• National Study of Long-Term Care Providers (NSLTCP),

• Medicare Current Beneficiary Survey (MCBS),

• Medicare and Medicaid administrative data,

• State-level administrative and policy data, and

• Census data.

Also of interest are studies of the implications of chronic illness and disability for the design and administration of health and long-term care systems; trends in residential care models for the frail elderly and younger persons with disabilities; access to, and costs of, care for persons with specific disabilities and illnesses (e.g., MR/DD, Alzheimer's disease); the economic impact of extended disability on individuals, families, and society; modeling the components and costs of disability and trends in aging;

determining the effects of changing family patterns and intergenerational support on the well-being of persons with disabilities and the elderly; and analyses of proposed changes in federal programs.

Long-Term Care Policy Development and Analysis: Work in this area will focus on the need to understand the characteristics of the long-term care population and the implications of trends in long-term care use, including changes in health and disability, changing consumer preferences, alternative ways of providing services, and options for financing services. Analyses will examine issues related to both community and institutional long-term care services, including the impact of legislative, regulatory, and policy changes on the provision of services. Work will focus on analyzing the coverage and use of long-term care and rehabilitation services under Medicare, Medicaid, and other federal and state-sponsored programs. Work will also focus on the role of private insurance in the provision and financing of long-term care, including its impact on public and out-of-pocket/other private-pay spending. Other general issues of interest under this area include access to long-term care services; transitions between long-term care settings; improving the capacity and effectiveness of the long-term care workforce; and quality of care and related outcomes, including user satisfaction.

Data from a variety of sources are likely to be of use in conducting analyses of the long-term care system.

Examples include the:

• Survey of Income and Program Participation (SIPP),

• National Health Interview Survey (NHIS),

• Medical Expenditure Panel Survey (MEPS),

• Health and Retirement Study (HRS),

• National Long-Term Care Survey (NLTCS),

• National Health and Aging Trends Study (NHATS),

• National Survey of Caregiving (NSOC),

• National Home and Hospice Care Survey (NHHCS),

• National Nursing Homes Survey (NNHS),

• National Nursing Assistant Survey (NNAS),

• National Home Health Aide Survey (NHHAS),

• National Survey of Residential Care Facilities (NSRCF),

• National Study of Long-Term Care Providers (NSLTCP),

• Medicare Current Beneficiary Survey (MCBS),

• Medicare and Medicaid administrative data,

• state-level administrative and policy data, and

Medicare Post-Acute Care Policy Development and Analysis: Work in this area will focus on examining trends and issues related to Medicare post-acute (i.e., home health, skilled nursing facility, rehabilitation hospital/unit, long-term care hospital, hospice, and durable medical equipment) and palliative care services. Of particular interest is the impact of changing eligibility, coverage, and payment policies on access to and quality of services. Tasks may include: analyzing the impact of existing regulations and interpretive guidelines; analyzing secondary data such as claims, patient assessment and other data;

conducting site visits and case studies; designing and conducting data collection efforts; synthesizing policy-relevant materials; and developing and analyzing alternative eligibility, coverage, payment and quality-monitoring policies.

Mental Health and Substance Use Disorder Policy Development and Analysis: Work in this area will focus on examining trends and issues related to the financing, delivery, and quality of services and supports for individuals with mental illnesses or substance use disorders. Topics of interest include changes in access to and quality of mental health and substance use disorder services resulting from changes in eligibility, coverage, and payment policies in private insurance, Medicaid, and Medicare.

Additional areas of interest include federal, state, and local programs and initiatives that address the needs of individuals with significant mental health or substance use disorders, including those administered by CMS, SAMHSA, and HRSA. Tasks may include analyzing the impact of existing or proposed regulations and interpretive guidelines; analyzing secondary data such as claims, patient assessment, administrative data from state mental health and substance abuse systems, and other data; conducting site visits and case studies; designing and conducting data collection efforts; synthesizing policy-relevant materials; and developing and analyzing alternative eligibility, coverage, payment and quality monitoring policies.

Data from a variety of sources are likely to be of use in conducting analyses of the mental health and substance use disorder policy issues. Examples include the:

• American Community Survey (ACS),

• National Survey on Drug Use and Health (NSDUH),

• Behavioral Health Services Information at SAMHSA,

• National Health Interview Survey (NHIS),

• Medical Expenditure Panel Survey (MEPS),

• Medicare Current Beneficiary Survey (MCBS),

• Medicare and Medicaid administrative data,

• Social Security administrative data,

• Private insurance coverage and spending data,

• State-level administrative and policy data, and

Disability, Aging, Mental Health, Substance Use Disorder, and Long-Term Care Data Infrastructure:

Tasks under this topic area will include developing and improving the data infrastructure needed to provide information about trends in disability, aging, mental health, substance use disorders, and long-term care services, as well as the impact of policy changes, particularly those affecting the health care system, the human services system, and the economic security and well-being of persons with chronic illness, including mental health or substance use disorders, and disability, and the older population in general. Work may include constructing consistent and computable definitions and measures of concepts across surveys and Medicare and Medicaid administrative data sets; developing new national surveys or components of existing surveys to better address disability, aging, mental health, substance use disorder, and long-term care issues; developing methods of linking national and sub-national survey data;

proposing alternative approaches to linking community and institutional data sets; and appending administrative records (e.g., Medicare claims, Medicaid enrollment data, Social Security administrative data) and other proprietary information (e.g., private long-term care insurance claims, private health insurance data, state-level nursing home information) to survey or demonstration/evaluation data.

Approaches for producing regional and state-level estimates may also be explored under this area.

Disability, Aging, and Long-Term Care Modeling and Forecasting: Work in this area will focus on using appropriate modeling techniques to estimate the current and future demand for, and supply of, disability, aging, health care, and long-term care services (including community-based support services) for different populations with disabilities (e.g., children with disabilities, working-age adults with disabilities, the elderly, and other subgroups such as those with developmental disabilities, individuals with mental illness and/or substance use disorders, and those with cognitive impairment). This work will involve estimating the net influence of major trends—changes in health and disability, changes in consumer preferences, mortality declines, changes in coverage under the Affordable Care Act, etc.—some of which may be interrelated. In determining the impact of these trends, analyses of secondary data (e.g., national surveys and administrative data) may be required, as well as the collection of new data, to add to the capabilities of existing models and to improve estimates.

SERVICES TO BE PROVIDED

Within the Disability, Aging, and Long-Term Care Policy and Data Analysis technical area, the Contractor shall provide expertise in policy development and analysis; demonstration and evaluation design; program assessment and evaluation; and data infrastructure development and modeling. In conjunction with these services, the Contractor shall provide organizational and logistical support for conferences, meetings, and other events to assist in the development and dissemination of the deliverables produced under this ID/IQ. Logistical support may entail making travel arrangements, securing hotel accommodations and meeting space, editing and report formatting, and providing technical expertise in support of conferences (e.g., agenda setting, recruitment of expert presenters, and preparation of conference papers and materials). An individual delivery order may require expertise in only one area of expertise or a combination of areas.

Policy Development and Analysis: The Contractor shall undertake the development and analysis of disability, aging, mental health, substance use disorder, and long-term care policy options currently under consideration and/or likely to be considered in the future. Information produced by these efforts is expected to contribute to internal debate on budgetary, legislative, and program modification decisions;

provide background analysis and support for major administration initiatives; support short- and long-range strategic planning; and, occasionally, produce the information base for Congressionally-mandated reports. Policy development and analysis work will focus on current disability, aging, mental health, substance use disorder, and long-term care policy options, as well as on emerging issues and future planning efforts. Because timeliness of information is critical to these activities, the Contractor shall respond quickly to requests and work under tight deadlines. Policy development and analysis activities will often be iterative, as less fruitful study areas and data sources are eliminated from subsequent analysis. The Contractor shall develop and refine new approaches to policy analysis as needed. This may entail researching and piloting new methods to improve the timeliness, reliability, and policy relevance of analysis; developing new methods of data collection such as electronic and web-based approaches;

supporting work with various agencies to coordinate policy planning; and improving the quality, relevance, and utility of policy analysis.

Policy development and analysis activities will produce a wide range of deliverables, some for HHS internal use and others for broader dissemination. These include: issue and discussion papers summarizing the state of knowledge on a given topic; memoranda and spreadsheets that succinctly summarize the findings from a specific policy analysis (e.g., estimated changes in coverage, cost, and impact of specific policy options); memoranda and reports identifying significant gaps in current knowledge or program effectiveness; options papers identifying the strengths and weaknesses of proposed policy initiatives or changes in disability, aging, mental health, substance use disorder, and long-term care programs; and formal briefings for senior policy officials. Because these products are generally intended for a wide audience within HHS, including technical analysts and senior policymakers, written material and briefings need to be presented clearly and concisely.

Demonstration and Evaluation Design: The Contractor shall design demonstrations and evaluations of disability, aging, mental health, substance use disorder, and long-term care programs and policy options.

The goal of demonstrations and evaluations is to understand how modifications to existing disability, aging, mental health, substance use disorder, and long-term care programs or entirely new approaches impact service delivery, outcomes, and costs. Demonstration and evaluation design will frequently be iterative, requiring the Contractor to produce a general design with options before developing a more fully elaborated approach. As a result, the Contractor shall undertake background or preliminary work as well as formal demonstration and evaluation design. Background information will be used by program managers and policymakers to determine the feasibility and basic parameters of a design prior to full-scale development. Examples of this type of preliminary work include literature reviews, the development of issue/concept papers, primary data collection of limited scope, microsimulations, and secondary data analysis and tasks related to the preparation of data for analysis. Formal demonstration and evaluation design projects will develop specific components or the entire approach for determining the implications of changes to disability, aging, mental health, substance use disorder, and long-term care programs and/or policy. When needed, the Contractor shall convene Technical Expert Panels and/or Federal Advisory Panels to get feedback on proposed approaches. The final design must be sufficiently detailed to comprehensively describe the intervention being tested and how the effects of the intervention will be assessed. The scope of demonstration and evaluation designs may be local, regional, or national.

Formal demonstration and evaluation design will typically include the following:

• Identification of the policy question(s) to be addressed and the hypotheses to be tested, including a clear elaboration of the treatment/intervention and comparison groups;

• Development of a technical approach to rigorously examine the impact of policy or program changes, including necessary sample sizes to detect statistically significant differences;

• Identification of the data (e.g., administrative records, surveys and assessments, case studies, focus groups, etc.) necessary to determine the impact of the treatment/intervention, with a critical review of the availability, cost to obtain, content and quality of data sources;

• Development of data collection instruments and methods of data collection, including survey design, data collection protocols and procedures; and

• An analysis plan that specifies statistical treatment of the data.

The Contractor shall address general problems and issues associated with HHS demonstrations and evaluations, and propose solutions such as: developing new methodological approaches; researching and piloting new methods of data collection; and developing new approaches that improve the quality and utility of program data collection.

Program Assessment and Evaluation: The Contractor shall conduct program assessments and evaluations of disability, aging, mental health, substance use disorder, and long-term care programs and policies.

Program assessments and evaluations will be used to determine the effectiveness of current programs (e.g., operation, outcomes, costs, etc.) and proposed changes and/or new approaches. Program assessments typically involve analysis of existing data or limited data collection from either individuals or through site visits. Site visits would obtain information on program performance, corroborate or correct information from other sources, and determine the feasibility of proposed measures and comparisons.

Program assessments may entail descriptive field work on how a policy is being implemented;

identification of best and promising practices in program sites; analysis of preliminary data on efficiency and effectiveness (impact); and presentation of options for program change or subsequent evaluation.

Data collection on a more extensive basis may be required on occasion and all applicable clearances shall be obtained prior to proceeding.

Full-scale demonstrations and evaluations almost invariably require extensive data collection and analysis to determine program/policy impacts. The Contractor shall prepare required OMB clearance packages for submission, test survey instruments for validity and reliability, prepare the specifications and content of computer assisted interviewing software (e.g., CAPI or CATI), conduct cognitive and field testing of survey instruments and data collection protocols, train interviewers, analyze results, compile documentation and prepare data for public release, and develop a final report summarizing findings.

Data Infrastructure Development and Modeling: The Contractor shall provide expertise to develop and improve the Department’s data infrastructure and modeling capabilities to determine trends in the use of disability, aging, mental health, substance use disorder, and long-term care programs and services, as well as to determine the impact of policy changes, particularly those affecting the well-being of children and working-age adults with chronic illness, including mental health and substance use disorders, and disabilities, in addition to the older population in general. The Contractor shall identify, develop, and prepare analytic files to support development of demographic and micro-simulation models and policy analysis using national and local surveys as well as HHS administrative data. Work may include constructing analytic files, editing and manipulating data elements, and linking multiple data files to undertake cross-sectional and longitudinal analyses to determine how people are affected by broad changes in disability, aging, mental health, substance use disorder, and long-term care policy. Estimating the net influence of major trends (e.g., changes in health and disability, changes in consumer preferences, mortality declines, etc.), some which may be interrelated, will be a critical activity. In determining the impact of these trends, analyses of secondary data (e.g., national surveys and administrative data) may be required, as well as the collection of new data, to add to the capabilities of existing models and to improve estimates.

Model development and policy analysis may involve merging survey data with administrative data (e.g., Medicare and Medicaid claims, enrollment records, Social Security payment and disability records, OASIS and MDS data, etc.) or the use of administrative data exclusively. Tasks may require staff knowledgeable about analytical techniques for data collected through surveys with complex designs.

Work may also require the Contractor to work in a secure location such as data centers at the U.S. Bureau of the Census, National Center for Health Statistics, and the Agency for Healthcare Research and Quality.

C.3.2 TECHNICAL AREA 2: HEALTH INFORMATION TECHNOLOGY, ELECTRONIC

HEALTH RECORDS, AND HEALTH INFORMATION EXCHANGE

Work under this technical area will support the Office of the Assistant Secretary for Planning and Evaluation (ASPE), the Agency for Healthcare Research and Quality (AHRQ), and the Office of the National Coordinator for Health Information Technology (ONC) policy development, research and planning; health services research, demonstration, implementation and evaluation of programs and technical options; and information dissemination activities related to health IT, EHRs, and HIE. ASPE, AHRQ, and ONC are responsible for planning, developing, coordinating, managing, implementing, and/or evaluating, many of the HHS policies and programs, including policies and programs to accelerate the use, interoperable exchange and re-use of health information to support the independence, productivity, health and security of the American people including vulnerable populations such as persons with various physical and mental health conditions, including children, working age adults, and older persons. Electronic health information exchange, including interoperable health information exchange, is increasing in response to provisions in HITECH and the Affordable Care Act. Activities are being undertaken to extend, evaluate, and further support widespread implementation of interoperable health information use and exchange across the care continuum, including through the use of electronic health records (EHRs) and other health IT applications, to enable improvements in care coordination, quality of care, and efficiencies in service delivery, payment, and eligibility determination. These activities are being undertaken and encouraged at the federal, state, local, provider, and/or consumer levels.

Generally, ASPE, AHRQ, and ONC will engage in a range of policy, program, and health services research, planning, implementation, evaluation, and information dissemination activities to support and accelerate the widespread adoption and use of health IT, EHRs, and health information exchange (including interoperable HIE) to improve health care quality. These activities span a range of HHS, other federal, state, and private sector programs; providers across the care continuum, and public and private sector payers. These activities may focus on the delivery of care in traditional fee-for-service and/or service delivery and/or payment environments undergoing transformation. The work undertaken by

ASPE, AHRQ, and ONC in this technical area is described below in the following broad areas. However, these substantive areas are neither exhaustive nor mutually exclusive, and work may logically fit into two or more categories.

Substantive Areas of Interest to ASPE, AHRQ, and ONC

Refinement and Expansion of Nationwide Health Information Technology (IT) Infrastructure

Work in this area may involve:

• Developing and implementing a data policy and governance framework that supports the use, exchange and re-use of health information for multiple activities for consumers, providers across the care continuum, health services researchers, public and private payers;

• Identifying and developing solutions to address barriers to the implementation and use of health IT standards, implementation guides, and testing tools;

• Identifying and addressing barriers to interoperable health information exchange;

• Identifying issues and interventions related to health IT safety and usability; and

• Providing support for executing Standards and Interoperability (S&I) initiatives including: use case development, data flow and architecture design/diagram development, standards support and harmonization activities, collaboration with standards development organizations, architecture and tools, and standards validation and testing.

Accelerating Interoperable Health Information Exchange

• Accelerating and supporting the capture, use, re-use, management, and secure and private exchange of interoperable health information at the consumer, provider, organization, state, and federal levels. Some activities of interest include the use of health IT, such as (but not limited to) EHRs, for the:

o Exchange of interoperable information to support coordination of care across the care continuum including at times of transitions in care and instances of shared care;

o Re-use and exchange of information by health information exchange organizations, Accountable Care Organizations, integrated delivery systems, and other organizations;

o Use and re-use of health information to support efficient, high quality and safe care including through use of electronic clinical decision support applications;

o Development and implementation of technical assistance materials to support health information exchange and reuse, applications to support clinical information reconciliation;

o Use of health IT to support efficient and real time quality measurement and data analytics; and o Patient and family engagement through the use of technology (such as when the patient is remotely located from other members of the interdisciplinary care team or uses technology to capture health information);

Analyses of the Health IT Infrastructure, Health IT and Health Information Exchange and their Ability to Improve Health Care Quality

• Analyses of health IT/EHR adoption and use rates;

• Analyses of the factors that drive health IT/EHR adoption and use for providers across the care continuum; and impact, including costs and benefits, of using health IT, including certified EHRs, and engaging in interoperable health information exchange (from multiple perspectives including:

providers, states, and the Federal Government);

• Analyses of the impact of implementing electronic health IT applications on work flow and the work force from the clinical, administrative, and payer perspectives;

• Analyses of the use and impact of health IT applications to enable and support consumer and caregiver engagement in health care; and

• Analyses of the use and impact of health IT applications to improve health care quality.

Disseminating Information and Evidence

• Preparing a variety of clearly written, timely documents for internal and external audiences regarding the work conducted related to the nationwide health IT infrastructure, accelerating interoperable health information exchange, analyses of these activities and ability of health IT to improve quality;

• Synthesizing information needed to support various program management activities related to health IT/HIE (e.g., producing annual reports of health IT research projects, meeting summaries);

and

• Designing, implementing, and maintaining Web sites; and the creating content for Web sites.

SERVICES TO BE PROVIDED

Within this Health Information Technology, Electronic Health Records, and Health Information Exchange technical area, the Contractor shall provide expertise in the following domains:

1. Policy Research, Health Services Research, and Planning, Development, and Analysis

2. Pilot Program Demonstration, Implementation, and Evaluation

3. Program Implementation, Management, and Evaluation

4. Information Dissemination Activities

The work described in each of these domains is neither exhaustive nor mutually exclusive, and work may logically fit into two or more domains.

In conjunction with these services, the Contractor shall provide organizational and logistical support for conferences, meetings, and other events to assist in the development and dissemination of the deliverables produced under this technical area. Logistical support may entail making travel arrangements, securing hotel accommodations and meeting space, editing and report formatting, and providing technical expertise in support of conferences (e.g., agenda setting, recruitment of expert presenters, and preparation of conference papers and materials). An individual delivery order may require expertise in only one area of expertise or a combination of areas.

Policy Research, Health Services Research, and Planning, Development, and Analysis: The Contractor shall undertake development and analysis of a variety of policy, program, health services research and infrastructure options related to the nationwide health IT infrastructure, supporting health IT adoption (including EHRs) and accelerating health information exchange currently under consideration and/or likely to be considered in the future. These activities may address gaps and/or barriers to support the use of health IT, health information exchange and re-use in and across federal, state, and local programs, public and private payers, and health care providers across the continuum (including institutional and community-based long-term and post-acute care services and supports and behavioral health services) and/or consumers. Activities related to policy research, health services research, planning, development, and analysis may involve:

• Completing environmental scans and/or literature reviews on topics of interest

• Conducting focus groups on topics of interest

• Designing and completing case study reviews of certain activities related to health IT and health information exchange and re-use

• Designing and conducting surveys to assess various topics related to the use of health IT and participation in HIE activities

• Engaging health IT/HIE experts and other stakeholders (e.g., consumers, providers, states) on a variety of policy research or health services research, planning, development and analysis activities related to health IT/HIE - including evaluating the value of health IT and HIE, and developing tools needed for effective communication, collaboration, information sharing, and knowledge management for payers (e.g., State Medicaid agencies), and health care providers across the care continuum

• Synthesizing and analyzing federal and state laws, regulations, and programs related to health IT, electronic health information, and electronic health information exchange and re-use (including requirements related to privacy and security);

• Supporting and evaluating providers across the care continuum in their use of health IT and participation in health information exchange activities (including for example providing and evaluating the use and effectiveness of technical assistance materials)

• Identifying information needed and opportunities for aligning electronic health data collection activities to measure quality, coordination, and costs of care

• Identifying available health IT standards and gaps in standards needed to support interoperable health information exchange and re-use across providers, specialties, programs, and payers

• Developing strategic plans and activities related to health IT and health information exchange including quality improvement

• Analyzing, synthesizing, and reporting on activities, resources, tools, and gaps related to health IT safety, EHR usability, and EHR certification criteria

Information produced by these efforts is expected to contribute to internal discussion on budgetary, legislative, research and program modification decisions; provide background analysis and support for major administration initiatives; support short- and long-range strategic planning; and, occasionally, produce the information base for Congressionally-mandated reports. Policy and program development activities and analyses will focus on current policy options, program implementation activities, as well as on emerging issues and future planning efforts related to the nationwide health IT infrastructure, health IT, and health information exchange and re-use. Because timeliness of information is critical to these activities, the Contractor shall respond quickly to requests and work under tight deadlines.

Policy/program/research development and analysis activities will often be iterative, as less fruitful study areas and technical solutions are eliminated from subsequent analysis.

The Contractor shall develop and refine new approaches to policy and program analyses as needed. This may entail researching, developing, and/or piloting new methods and technical solutions to support and accelerate health information exchange and re-use across the care continuum, identifying and evaluating new methods for protecting the security and privacy related to the use, exchange and appropriate re-use of health information, developing and disseminating information to care providers, state and federal officials, and other entities related to health IT and health information exchange; and supporting work with various agencies to coordinate policy planning, quality improvement and program management.

Policy research, planning, development and analysis activities will produce a wide range of deliverables, some for HHS internal use and others for broader dissemination. The purpose of these activities is to identify, develop, implement, and evaluate policies and programs related to health information technology and health information exchange to improve the quality, continuity, safety, efficiency, and effectiveness of health care for all Americans. These include: issue and discussion papers summarizing the state of knowledge on a given topic; memorandum and spreadsheets that succinctly summarize the findings from a specific policy analysis (e.g., types of information needed to be exchanged for particular use cases [such as transitions and referrals in care, care planning, and medication ordering] and the availability of health IT standards and EHR certification criteria to support the interoperable exchange of that information);

memorandum and reports identifying significant gaps in current knowledge, policies and programs;

technical solutions (i.e., development of industry accepted health IT standards and implementation guides) to support needed health information exchange; options papers addressing the strengths and weaknesses of proposed policy and/or programmatic initiatives or changes related to the nationwide health IT infrastructure (such as the strengths and limitations of alternative data governance policies and practices) and accelerating health information exchange across the continuum; and formal briefings for senior policy officials. The Contractor must deliver products intended for multiple audiences, including senior policymakers, providers, and technical experts, and may require development of new methods of information dissemination such as web-based approaches. Written material and briefings need to be presented clearly and concisely.

Pilot Demonstration, Program Implementation, and Evaluation: The Contractor shall design pilot demonstrations, program implementations, and evaluations of programs and policy options related to the nationwide health IT infrastructure, use of health IT, and the exchange and re-use of standardized health information to improve the quality and continuity of health care. The goal of pilot demonstrations and evaluations is to understand how modifications to data governance policies and practices, refinements to health IT standards (including those that are identified through the Standards and Interoperability framework initiative and balloted through standards development organizations), use of implementation guides, and specific health IT applications (such as clinical decision support tools): may impact policy, support and accelerate the use of health IT and participation in health information exchange activities, enable the re-use of health information, and impact service delivery, outcomes, and costs.

Pilot demonstrations and program implementations may provide support to providers, provider organizations, and states to use health IT and health information exchange solutions to support health care transformation and/or other quality improvement programs. For example, such activities may include support for development, pilot testing, evaluation, and/or program implementation of activities to:

• Accelerate the use of health IT and interoperable health information exchange;

• Support the use of technical assistance materials for health IT-enabled assessment, service authorization, care planning, and clinical decision support tools; and

• Develop and use electronically specified quality measures

Quantitative and qualitative demonstration/evaluation designs may be required, and will frequently be iterative, requiring the Contractor to produce a general design with options before developing a more fully elaborated approach. As a result, the Contractor shall undertake background or preliminary work as well as formal demonstration/evaluation design. Background information may be used by program managers and policymakers to determine the feasibility and basic parameters of a design prior to full-scale development/implementation. Examples of this type of preliminary work include environmental scans, literature reviews, development of issue/concept papers, primary data collection of limited scope, micro-simulations, and secondary data analysis and tasks related to the preparation of data for analysis. Formal pilot demonstration/evaluation design will develop specific components or the entire approach for determining the implications of changes to policies and programs related to health IT/EHRs and health information exchange. When needed, the Contractor shall convene Technical Expert Panels and/or Federal Advisory Panels to get feedback on proposed approaches. The final pilot design must be sufficiently detailed to comprehensively describe the intervention being tested and how the effects of the intervention will be assessed. The scope of the pilot demonstration and evaluation design may be local, regional, or national. Evaluations may include examinations of the: costs and benefits of health IT implementation; factors associated with successful use of specific health IT implementations (including market characteristics, organizational, work force, and other factors); impact of health information exchange and re-use on consumers, providers, delivery systems, and payers; and the effectiveness of health IT-enabled quality improvement programs.

Quantitative analyses evaluation design may include the following:

• Identification of the policy question(s) to be addressed and the hypotheses to be tested;

• A clear articulation of the health IT/health information exchange intervention to be tested and how the intervention will be assessed, including a clear elaboration of the treatment/intervention and comparison groups;

• Development of a technical approach to rigorously examine the impact of policy, program, and/or technical changes, including if necessary, sample sizes to detect statistically significant differences;

• Identification of the data (e.g., data created, exchanged, and/or incorporated by health IT/EHRs, administrative data, surveys and assessments data, case studies, and…