NQIIC_IDIQ__Sources_Sought_Notice_Amend_1.pdf

SOURCES SOUGHT NOTICE

Project Title: Network of Quality Improvement and Innovation Contractors (NQIIC)

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

NAICS Code : 541618 (Small Business Size Standard is $15 Million)

Contracting Office Address

Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd. B3-30-03, Baltimore, MD, 21244-1850, UNITED STATES

Description: This is a SOURCES SOUGHT NOTICE to determine the availability of Small Businesses that have the capability to perform Indefinite Delivery Indefinite Quantity (IDIQ) Task Order Contracts for the “Network of Quality Improvement and Innovation Contractors (NQIIC).” This Sources Sought Notice serves as a means of conducting market research to identify parties having an interest in and the resources to support the program entitled “Network of Quality Improvement and Innovation Contractors (NQIIC).” NQIICs are defined as a set of quality improvement contractors that have the capability to achieve large scale improvement results using effective and innovative quality improvement strategies that are data driven, transparent, and empower patients, families and clinicians to make decisions about their healthcare. This program will allow for the full spectrum of quality improvement (QI) work that is in operation under current various QI contracts. This work may include statutorily required work, such as Quality Innovation Network- Quality Improvement Organizations (QIN-QIOs) and End Stage Renal Disease (ESRD) Network work as well as hospital focused large scale quality improvement work, and clinician-focused technical assistance work, and other quality improvement work.

Other Important Considerations : There is no solicitation at this time. This request for capability information does not constitute a request for proposals; submission of any information in response to this market survey is purely voluntary; the government assumes no financial responsibility for any costs incurred. It is anticipated that a Request for Proposals (RFP) will be issued at a later time, follow by a bidders’ conference briefing.

Capability Statement:

Interested small businesses should provide a response that includes the following information in accordance with the eligibility requirements as follows:

Requirement 1: Experience or capability reaching a broad spectrum of healthcare providers, beneficiaries, and local communities, allowing them to serve as change agents to improve healthcare quality through focused activities with measurable healthcare quality outcomes.

Requirement 2: Experience working with regional key stakeholders to implement innovative tools and to assist providers in implementing and measuring quality improvement interventions.

Requirement 3: Experience or capability developing agile teams able to recognize emerging quality improvement needs, teaming with CMS and other stakeholders to respond to those emerging needs, and successfully evolving to meet new quality improvement priorities.

Requirement 4: Have an established infrastructure and network or membership of providers and/or the demonstrated ability to recruit/engage a network of providers to work within a learning community and achieve bold quality improvement outcomes.

The government will evaluate market information to ascertain potential market capacity to provide services similar in scope and scale with those described in this notice and otherwise anticipated.

Submission Instructions:

If your firm is a Small Business, certified HUBZone, 8A, Woman-Owned Small Business or Service Disabled Veteran Owned Business and your organization has the potential capacity to perform these contract services, please provide the following information:

1. Organization information including name, point of contact, address, website address, telephone number, size and type of ownership.

2. Identification and verification of the company's small business status. Based upon the NAICS code specified herein, indicate whether your firm is classified as a large business, small business, small disadvantaged business, 8(a) concern, women-owned small business, HUBZone small business, veteran-owned small business, service-disabled veteran-owned small business and whether the firm is U.S. or foreign owned. Please note that non-profit organizations are classified as large businesses.

3. Tailored capability statements addressing the particulars of this effort, with appropriate documentation supporting claims of organizational and staff capability. Indicate experience performing or completing all of the capability requirements stated above and in accordance with Attachment 1(provide specific examples where experience is similar or equivalent to the CMS requirements, reference where and when the work was completed, and provide the applicable contract number and value). If significant subcontracting or teaming is anticipated in order to deliver technical capability, organizations should address the administrative and management structure of such arrangements. Include information on the lead’s prior experience as a prime contractor, experience with teaming arrangements, and prior teaming experience with the specified partners, if applicable. Work must have been self-performed (or 50% self-performed) to qualify as experience.

4. Please briefly discuss any potential conflicts that may preclude your company from performing any such work under this requirement.

All interested Small Businesses, certified HUBZONE, 8A, Woman-Owned Small Businesses or Service Disabled Veteran Owned Business contractors who consider themselves qualified to perform the above-listed services are invited to submit a response to this Sources Sought Notice by 2:00 PM (local time) on January 15, 2018. All responses under this Sources Sought Notice must be emailed to Kelley.Williams-Vollmer@cms.hhs.gov, Jonathan.Nolan@cms.hhs.gov and copied to Kimberly.Tatum@cms.hhs.gov.

Disclaimer and Important Notes: Based on the responses to this sources sought notice/market research, several IDIQ contract awards may be reserved for small businesses. Telephone inquiries will not be accepted or acknowledged, and no feedback or evaluations will be provided to companies regarding their submissions.

Confidentiality: No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

If you have any questions concerning this opportunity please contact Jonathan Nolan at (410)786-1896 or Kelley Williams-Vollmer at (410)786-8177.

mailto:Kelley.Williams-Vollmer@cms.hhs.gov mailto:Jonathan.Nolan@cms.hhs.gov mailto:Kimberly.Tatum@cms.hhs.gov

Attachment 1: Draft Statement of Work (SOW)

Note: Since some of the quality improvement efforts considered for the NQIIC IDIQ include statutorily required work, sections of the drafted SOW have been omitted from the small business capability requirements.

Overview

CMS is planning an Indefinite Delivery/Indefinite Quantity (IDIQ) multiple award contract to support quality improvement efforts across settings and programs to maximum impact to healthcare and value to taxpayers, entitled the Network of Quality Improvement and Innovation Contractors (NQIIC).

The work under the NQIIC contracts will involve a broad range of healthcare quality improvement services involving data-driven initiatives to optimize health outcomes for persons and families while supporting clinicians, providers, and communities in improving health and healthcare of the population they serve. Most projects will be large-scale in nature (state, regional, or national level) with others on a smaller scale. Note, any type of plans mentioned shall be performed and provided as a deliverable at the task order level.

NQIICs are defined as a set of quality improvement contractors that have the capability to achieve large scale improvement results using effective and innovative quality improvement strategies that are data driven, transparent, and empower patients, families and clinicians to make decisions about their healthcare.

Eligibility Requirements

NQIIC task order requirements will be crafted with the expectation to achieve bold aims through innovation, broad reach, and data-driven methodologies suitable for spread that demonstrate value to Medicare beneficiaries, providers, and the CMS Quality Program qualitatively and/or financially. Individual task orders may include evaluation criteria based on specific statutory requirements for existing quality improvement programs (QIN-QIO and ESRD Networks), as well as other requirements specific to the scope and scale of the desired quality improvement work. CMS is interested in ensuring that desired outcomes within a task order allow for efficient but flexible use of contract dollars. CMS continues to encourage transparency and collaboration across programs and amongst contractors to maximize efficiency, results, and impact.

CMS seeks quality improvement efforts that are results-focused, data driven, transparent in their approach and results, employ comprehensive analysis, address diverse and special populations, and demonstrate meaningful impact that leads to spread and sustainability. The NQIICs will successfully implement and conduct large scale projects related to achieving quality health care and patient safety at the local level in hospitals, communities, outpatient settings, nursing homes and other settings, in a cost-effective manner.

Performance as a NQIIC will be conducted under the terms and conditions of this Base IDIQ Contract and pursuant to Task Orders issued by the Contracting Officer during the contract term.

The broad-ranged overarching tasks will include the following:

a. Direct Technical Assistance

NQIICs will engage in direct technical assistance to all participants as required by the task orders for healthcare quality improvement. Technical assistance is the process by which the NQIICs will work directly with participating providers, practitioners, and other stakeholders. Technical assistance may include, but is not limited to, one-on-one assistance, sharing of established resources, tools, development of performance reports, and use of health information technology. The NQIIC will design, implement, and operate educational campaigns as part of its technical assistance efforts, using workshops, conferences, webinars, and other diverse methods. Beyond the specifically-defined areas for technical assistance in the task orders, NQIICs are expected to maintain a focus on vulnerable populations, rural health, and patient and family engagement activities.

i. Vulnerable Populations and Disparities Focus

a. NQIICs shall assist community members and additional regional participants to identify and effectively target interventions for special and vulnerable populations based on race, gender, socio-economic factors, and individuals with chronic conditions who take multiple medications, are in need of behavioral health, and facing socioeconomic issues as well as dually-enrolled individuals.

ii. Rural health

a. NQIIC shall include participants residing in rural areas in all patient and family engagement activities as well as focusing efforts on serving the special and challenging healthcare needs of rural communities and providers. According to the Center for Rural Affairs, residents of rural counties face access to health care and transportation issues, low literacy issues, and socioeconomic issues such as poverty and unemployment. Compared to their urban counterparts, residents of rural areas face longer distances to reach healthcare delivery sites, more often have chronic conditions such as diabetes, and have higher mortality rates from heart disease. Rural areas are designated by the 2010 US Census Bureau definition.

iii. Person and Family Engagement

NQIICs shall work to engage beneficiaries and their families in improving their health by:

1. Promoting an environment where beneficiaries are the center of the healthcare team.

2. Actively encouraging beneficiaries, family, and caregiver engagement across the care continuum including areas that are medically underserved, rural and/or otherwise inclusive of vulnerable patient populations.

3. Utilizing plans, strategies, and practices that consider the social determinants that may contribute to poor health outcomes.

4. Forging partnerships between beneficiaries and providers in care settings.

5. Promoting tools and measurement strategies that support beneficiaries’ health care goals, values, and preferences through patient advocacy, shared decision making, and health literacy.

6. Supporting the creation of person-centered health and wellness goals that are accessible, appropriate, effective, and sufficient and that align with beneficiary, family, and caregiver values and preferences.

7. Improving the quality and experience of care for beneficiaries, caregivers, and families by developing best practices and techniques for widespread integration and scaling.

8. Promoting improved quality and reduced cost by utilizing a collaborative process that supports health care transformation.

9. Supporting beneficiary engagement and beneficiary self-management including ensuring beneficiary and/or caregiver preferences are assessed and incorporated.

10. Promoting the inclusion of patient representatives on provider and practitioner quality improvement activities and/or committees.

b. Health Information Technology

NQIICs will facilitate the ongoing sharing of successful interventions related to reducing burden in the use and evolution of Health Information Technology (HIT) across the healthcare continuum.

c. Recruitment NQIICs will promote CMS quality improvement initiatives/projects and recruit participants as defined by task orders that may include, but are not limited to the following: hospitals, nursing homes, physician practices, home health agencies, hospices, dialysis facilities, pharmacists, pharmacies, beneficiaries, and communities.

d. Community Coalitions NQIICs will promote community coalition participation to all relevant stakeholders to support healthcare improvement at the larger system level, and to assist communities in achieving specific quantitative and qualitative healthcare goals.

e. Learning and Action Networks (LANs) The NQIIC shall adhere to the following minimum requirements for a LAN:

1. The NQIIC shall facilitate LANs and learning sessions for communities virtually and/or face to face (any specific conference and meeting approval requirements will be provided in TO(s)). The learning sessions may be either held as large and/or small-scale events at regular intervals based on the specific quality improvement initiative.

2. The NQIIC shall actively recruit beneficiaries to participate in LANs and shall ensure LANs provide a voice to regional populations experiencing disparities, rural populations, and vulnerable populations.

3. The NQIIC shall ensure that LAN education, resulting actions, and measurable outcomes are timely, accurate, and relevant to the quality improvement Aims of the SOW and local improvement needs.

4. The NQIIC shall have the flexibility to pilot tests of change to address root causes with actions to spread is feasible.

f. Continuous Improvement, Measurement, Data, and Reporting

i. Problem Statement and Continuous Improvement Strategy NQIICs shall aggressively pursue meeting CMS Aims by identifying challenges/problems in real- time, applying problem solving techniques - such as Root Cause Analysis - and developing and implementing action plans. NQIICs may use any number of desired change improvement methodologies (e.g., Continuous Quality Improvement, Model for Improvement, Six Sigma, Lean, etc.) to support its own work as well as to assist project participants with rapid cycle testing for continuous quality improvement, action and results.

ii. Measurement Strategies

NQIICs will be in alignment with the CMS “Meaningful Measures” initiative.

Meaningful Measures will involve use of measures that are most vital to providing high-quality care and improving patient outcomes. CMS intends and expects NQIICs to utilize fewer, more meaningful measures. The focus is on the outcomes (“what”), versus the processes (“how"). NQIICs will be “results-oriented” with a focus on generating outcomes to support the stated goals and Aims.

NQIICs shall:

1. Establish benchmarks and/or interim performance measures that map to desired goals using short, medium, and long-term outcomes.

2. Align local and/or state measures with nationally recognized consensus measures to reduce duplication and burden on healthcare partners

3. Utilize data to develop or implement (when designated in the task order) measures and/or a measurement strategy for generating, supporting, monitoring, improving and quantifying results of local quality improvement efforts.

4. Develop specific measurable goals/benchmarks within the target population to address identified health disparities.

5. Develop methods to implement and illustrate progress toward benchmark results, intervention implementation, and community engagement.

iii. Data-driven

The foundation of any effective quality improvement effort is accurate and timely data. Therefore, the NQIIC shall collect, aggregate, analyze, display, and openly share data (i.e., to achieve or work toward transparency) with other CMS contractors.

By creating a transparent approach to the work, the NQIIC Contractor will assist the Learning and Action Network (LAN) constituents, as well as other CMS-identified support contractors and parties in using data in other data-related efforts. NQIICs shall be data-driven in all facets of the task orders to ensure the implemented interventions have the greatest possibility of success.

iv. Data Collection

It is imperative to have sound, regular, and secure means to collect data related to the projects in order to monitor and define performance.

a. Use available data sources to achieve the contract goals, including but may not be limited to: CMS claims data, beneficiary complaint data, CMS survey and certification data, third party payer data, provider data, practitioner data, medical record abstracted data, census tract and disparities data, data directly provided by beneficiaries, registry data, and other NQIIC and/or partner data.

b. Implement processes (i.e., data collection vehicles or methods) to securely collect and store data on the measures specified in task orders.

v. Data Analytics

Strong data analytics must be at the foundation of the NQIICs’ organization to identify potential opportunities for improvement, monitor their project’s performance, and understand the impact of improvement activities.

a. Identifying target populations and subpopulations within communities (e.g. dual-eligible beneficiaries, beneficiaries with multiple chronic conditions, stakeholders, and beneficiary and/or their family members and/or patient advocates/representatives) for recruitment in task order quality improvement efforts;

b. Assessing gaps in quality of care delivered and coordination between and among institutional and community care providers and practitioners;

c. Developing specific measure and measurement strategies to track identified health disparities;

d. Using data to track progress and direct impact of quality improvement efforts within the NQIIC service area at the community, state, and/or regional levels in a time-frame that allows for timely assessment of improvement efforts;

e. Using data to improve healthcare and/or sustain quality improvement efforts;

f. Utilizing data in a manner that is easily shared, translatable and creates a compelling case for change; and

g. Monitoring and determining the level of improvement, at the intervention and community level, through time series, and/or through annotated run and control charts that document the interventions and performance over time.

vi. Reporting NQIICs will support transparency in reporting their project results and quality improvement methods with CMS, other quality improvement contractors, and others as appropriate. Sharing data and the corresponding analyses about outcomes and interventions is vital to identifying and replicating interventions that show promise, as well as to identify when the desired results were not achieved. NQIICs shall be able to determine the level of improvement, at both the intervention and community level, through time series, and/or through annotated run and control charts, that document the interventions and performance over time. Transparency in reporting successful interventions, promising practices, lessons learned and/or other relevant information has led to improvements in health, healthcare and/or lower costs of healthcare for Medicare beneficiaries.

vii. Transparency NQIICs will support transparency by sharing results and methods utilized with CMS, quality improvement contractors, and other NQIICs, to rapidly identify opportunities to accelerate improvement in health care. Sharing successes and challenges regularly will spread what is working, opportunities for improvement, and help all, to also learn of approaches that were not successful across the country, in order to maximize the collective use of performance data to accelerate improvement. Contractors will be expected not only to share methods and results with others, but to use key learnings from other contractors to rapidly evolve and improve their own approaches to generating results.

g. Strategic Management Structure

i. Management Plan

NQIICs shall have an established management structure that strongly and seamlessly supports contract operations. A management plan shall be results-oriented and, at a minimum, includes effective lines of communication, budget and cost controls, quality assurance reviews, project schedule management, resource management to include staffing matrices by task/subtask, progress reviews and performance monitoring, risk management, change management, timely delivery, and clearly defined roles, responsibilities, lines of authority, and resources appropriately aligned to services and deliverables.

The management plan shall include a Continuous Internal Quality Improvement Program Plan (CIQIP) which is updated as necessary for additional task orders. The CIQIP purpose is to support and foster an environment of continuous quality improvement within the NQIIC. Such an environment helps to assure success of the NQIICs in their performance of the contract through ongoing assessment of and improvement when necessary in areas that are critical to organizational success, including but, are not limited to:

• Leadership

• Human Resources

• Customer Satisfaction

• Performance Measures

• Process Management

• Task Order Results

ii. Communications

The NQIICs shall make the substantially adapted and new materials developed and approved in writing by CMS for distribution available to other NQIICs.

As part of the communications plan, the NQIICs will have a web presence to house educational and resource materials along with communications related to the NQIIC task order(s). In addition to traditional web presence(s) (like the website), the NQIICs may integrate social media or Web 2.0 functionalities as one of the tactics they deploy in meeting stakeholders’ information and communications needs. The web site and social media efforts will be in compliance with applicable regulations, policies, and requirements.

Collaboration and Coordination

a. Flexibility CMS recognizes that the healthcare landscape is dynamic so flexibility is essential in maximizing one’s positive impact on work efforts/products. NQIICs will support flexibility in operations, including their collaboration and coordination efforts with project participants, other contractors, CMS, and other stakeholders. Thinking and behaving collaboratively creates a foundation for the NQIICs and its stakeholders to build, adjust, and sustain ways of thinking and working that lead to increased resourcefulness and performance.

b. Contractor Teaming NQIICs will maximize impact in quality improvement efforts by utilizing synergies with other contractors and stakeholders that are focused on similar outcomes and/or collaborating with the same participants/customers. NQIICs may consider a defined, written teaming arrangement with other CMS contractors that would detail responsibilities of each team member in how they will work together to meet agency requirements.

c. Actively Working to Maximize Synergy and Prevent Duplication It is important for the NQIICs to achieve synergy with other contractors and initiatives, and to avoid duplication of efforts performed by another state or federal contractor. This is why communicating and teaming with other contractors is so important. NQIICs are expected to routinely assess the potential for synergy and duplication on their work;

actively reach out to other contractors where there is potential for synergy or duplication;

and to develop smart, tailored, localized solutions to generate synergy and prevent duplication. These efforts should be documented by involved parties and shared back to CMS for affirmation or any needed changes.

Key Elements of Evaluation

a. Outcomes-driven:

NQIIC contractors will be healthcare quality experts capable of defining and solving healthcare issues in their local areas. CMS will drive these efforts by establishing and committing to bold, data-driven goals. NQIICs will use their expertise to leverage partnerships and drive healthcare quality change to reach these bold goals and strive for maximum healthcare quality improvement and cost savings. CMS places an investment in NQIIC contractors and recognizes that improvements in healthcare outcomes/metrics and/or cost savings are both important ways of generating returns on investments.

b. Flexibility and teaming:

The NQIIC mode will allow for maximum impact to healthcare quality by leveraging all CMS quality contractors under one umbrella. NQIIC contractors are expected to flexibly team with other quality contractors to meet the bold goals set forth in the task orders. In addition, NQIIC contractors will partner with CMS as the contracting model allows for the addition of new task orders to rapidly and responsively deploy new initiatives to meet emerging healthcare needs. Responsiveness and flexibility in teaming with both CMS and NQIIC partners will be key to meeting evaluation goals within task orders of the NQIIC contract.