AHRQ-11-10014 Response to Questions.doc.docx

Question 1 Section #: General Section title: General Page #: General Question: Please describe the transition process and duration.

Answer: AHRQ will provide all available documentation for the transition process. The duration period for transition is not specified. Contractor should expect to commence work as stated in the expected timeline given.

Question 2 Section #: C Section title: Statement of Work Page #: 8-14 Question: Will all reports, research results and analysis be delivered directly to AHRQ for further dissemination? While there is mention of web sites, list serves, etc. in Section H of the RFP, we see no indication that there is a plan for either creation of or hosting of these tools in the scope of work. Please confirm our understanding.

Answer: Yes, all deliverables will be submitted directly to AHRQ for further dissemination.

Question 3 Section #: C, Task 1.1 Section title: Determination of Injury/Harm Rates for Specified Conditions Page #: 8 Question: How often and in what format will the abstracted medical record data be received? Is this an existing process or does this need to be jointly created? Is the data in the same format for each of the events listed?

Answer: The data will be received by the contractor as an Access 97 file, after data is abstracted using the Medquest tool. All data is in the same format. There is an existing process. Data has been delivered monthly by the CDAC. Data for one CY starts to be received by the contractor from the CDAC in October of the following year.

Question 4 Section #: C, Task 1.1 Section title: Determination of Injury/Harm Rates for Specified Conditions Page #: 8 Question: Task 1.1 refers to previously-developed protocols to determine the injury rate for each of the 21 specified events or conditions. Please describe what information and format will be provided for the previously-developed protocols (e.g., SAS code, analytic algorithms, etc).

Answer: All available information will be provided to use for previously developed protocols to generate rates of adverse events. A data dictionary and clinical help document that is used by abstractors is provided as Attachment # 1. Measure definitions and descriptions (Attachment #2) and a sample measure flow chart and demographic data (Attachment #3) are also attached. The phrasing of the names of the measure is not exactly the same as provided in the RFP in every case, but the 21 measures are the same measures. As described in the response to Question 3, the data will be provided as an Access 97 file.

Question 5 Section #: C, Task 1.6 Section title: CMS Hospital-Acquired Conditions (HAC) Rate Page #: 10 Question: Please confirm the number of years of historical data the contractor will use in the report on HACs and how that data will be received from AHRQ or the prior contractor.

Answer: CMS HAC data is publicly available at the Hospital Compare web site. Please refer to the following link: http://www.cms.gov/HospitalQualityInits/06_HACPost.asp Question 6 Section #: C, Task 1.10 Section title:

Page #: 11 Question: There is no mention of the number of newly-identified measures in Task 1.10. Please confirm if the number of measures is the same as in Task 1.3 (three measures per year).

Answer: Yes, three measures per year.

Question 7 Section #: C, Task 1.1 Page# 8 Question: “The contractor shall receive identified abstracted medical record data from the CMS Clinical Data Abstraction Center (CDAC) for further data analysis to detect adverse events as identified from medical records.” We understand a random sample of national data is used. Could AHRQ provide detailed sample selection method (frequency and sample size)? This will assist in estimating level of effort for the analysis tasks Answer: The sample is drawn according to Inpatient Prospective Payment System (IPPS). Information is on-line at: https://www.cms.gov/AcuteInpatientPPS/FR2012/list.asp#TopOfPage. In summary, records are collected from 800 hospitals per year, with 12 records per hospital per quarter received in 2009 -2011, and 18 per quarter planned for 2012 (as described in the 2012 Final Rule). For the IPPS overall, hospitals are selected from all states with smaller states somewhat oversampled. For MPSMS use of the IPPS in 2011, a total of 34,000 records was identified as the intended sample, out of a potential 38,400 maximum available. Each quarter all available Pneumonia and Surgical Care Improvement Project records were identified by the CDAC for abstraction, with the remainder coming from an equal number of Acute Myocardial Infarction and Heart Failure Patients, for a total of 8,500 records per quarter. The system to be used for the 2012 sample will be similar: based on these four principal diagnosis groups and the new patient group that is being added to the IPPS sample to allow a “global” patient population. The total number of records that will be abstracted for MPSMS has not been determined but is likely to range from 34,000 to 44,000 patients.

Question 8 Section #: C, Task 1.2 Page # 9 Question:

“The contractor shall submit data tables and measure specifications to the NHQR/NHDR team.” The current NHQR/NHDR report lists brief measure specifications for selected adverse events from MPSMS, can AHRQ provide more detailed measure specifications for all adverse events from MPSMS, which include actual diagnosis or procedure codes for population or condition?

Answer: Measure specifications do not include procedure codes as these are not administrative data. Data dictionary and flow chart is provided. Also, see the response and attachments to Question 4.

Question 9 Can AHRQ provide the detailed measure algorithms for all current MPSMS adverse events? It would be similar to the inpatient measure algorithms released on QualityNet from the Specifications Manual for National Hospital Inpatient Quality Measures.

Answer: Yes. Also, see the response and attachments to Question 4.

Question 10 Can AHRQ provide the data dictionary, and data collection paper tool and instructions from the Medquest Production Data Collection tool for the existing MPSMS measures?

Answer: Also, see the response and attachments to Question 4.

Question 11 How will AHRQ make the CDAC data available to the contractor? What is the format of the data?

Answer: Data will come directly from the CDAC and be formatted as an Access 97 document, as described in Question #4.

Question 12 On page 69 of 80, items #2 and #5 are exactly the same “Provide evidence that the offeror has extensive experience and knowledge in administrative support and coordination for complex data analyses projects.” Is this correct?

Answer: Items #2 and #5 were duplicated in error. Please consider only #5.

Question 13 On page 69 of 80, items #3 and #7 are almost the same. Is this correct?

Answer: Items #3 and #7 are not the same. Please address them appropriately in the proposal as requested.

Question 14 Section #: L.3.(c)(2)(v) Page # 60 Question:

We understand the proposal must be accompanied by evidence of the authorized agent's authority. Please provide examples of acceptable evidence of the agent's authority.

Answer: The offeror should indicate in their proposal who their authorized agent is. This individual must have authority to sign contractual documents on behalf of the organization.

Question 15 Section #: L.7.b.

Question:

Is a separate binder for each section desired?

Answer: Yes, Technical Proposal, Business Proposal, Small Disadvantaged Business Participation Plan and Past Performance Information shall be in 4 parts as stated on page 65 c.

Question 16 Section #: L.8.a.(6) Page # 68 Question:

Please define "NIH format" for resumes or provide a link to an example of such.

Answer: See link below:

http://grants.nih.gov/grants/funding/phs398/phs398.html See Biographical Sketch.

Question 17 Section #: Part I, Section A Page#1 Question:

May offerors include samples of relevant documents as evidence of their capabilities, e.g., a report? If so, can such items be included in an appendix over and above the 50-page limit?

Answer: Rather than including extensive appendices, please provide summary information within the 50-page limit. Links to peer-reviewed and other publications that are available that are available on-line may also be provided.

Question 18 Section #: Part I, Section A Page # 1 and L.4. Page 64 Question:

Page 1 says that "A cost plus fixed fee contract is contemplated …" while page 64 says " The Government contemplates award of a cost reimbursement contract resulting from this solicitation." Please clarify.

Answer: A cost plus fixed fee type contract is contemplated.

Question 19 Section #: L.8.a.1A.

Page #69 Question:

Regarding requirement #4: Is the draft work plan included within the 50-page limit?

Answer: Yes, the draft work plan should be included within the 50 page limit.

Question 20 Section #: C, Statement of Work, Task 1, section 1.1 Question:

Will the contractor receive the currently used protocol programming code for injury rates for the 21 specified events or conditions? If so, in what language is this code written? Alternatively, is the protocol written into a homegrown system and if so, will this system be provided to the contractor?

Answer: Yes contractor will receive the currently used protocols. Programming language is SAS.

Question 21 Section #: C, Statement of Work, Task 1, section 1.2 Question:

The contractor is asked to adjust data as necessary to compare data from prior sets to current calculations. Are you referring to risk adjusting data; changes to protocols; changes based on new programming (as opposed to providing the actual codes as queried above); or some other change? Please provide an example of a potential adjustment you foresee.

Answer: Adjustment will be similar in scope to that necessary to make the 2009-2011 and 2012 data comparable and useful for trending, despite the fact that the sample will be different, as described in the response to Question 7.

Question 22 Section #: C, Statement of Work, Task 1, section 1.4 Question:

The contractor shall develop standard reports for sub-events. How frequently will these reports be generated (e.g., annual, bi-annual, etc)? For whom are these reports provided? For example, are these public reports which are posted to a website? Will the contractor be providing the website? Are these hardcopy reports to the contractor? Are these electronic reports, in the common format, which will then be uploaded to the AHRQ site?

Answer: For planning purposes, the estimated number of reports is 3 and the frequency of sub-event reports will be quarterly. These reports will be provided to AHRQ (for internal use or for widespread dissemination) for the AHRQ and public. These may be posted on the AHRQ website. The contractor will not be providing the website. Hard copies and electronic copies will be expected to be submitted.

Question 23 Section #: C, Statement of Work, Task 1, section 1.5 Question:

The contractor will develop a composite formula for calculating rates and will do so for current and prior years, as requested. What is the maximum number of prior years for which rates may be requested?

Answer: The primary prior years for analysis are likely to be 2009, 2010, and 2011. Data may also be provided to allow analysis of prior years such as 2005 and 2006.

Question 24 Section#: C, Statement of Work, Task 1, section 1.7 Question:

The contractor shall provide data and assistance to the evaluation contractor for the HHS HAI Program Evaluation as needed and required. Could you estimate the effort required for this support? For example, do you anticipate annual data requests or more frequent? Is the contractor meant to be an ongoing analytic support for the HAI contract?

Answer: For planning purposes, contractor should estimate that data and assistance for the HHS HAI Program Evaluation will be required annually. The contractor is not meant to be an ongoing analytic support for the HAI contract.

RFP-AHRQ-11-10014

Continuation of the Medicare Patient Safety Monitoring System Page 6 of 6 Proposed Questions