RFP_AHRQ-20-10005_Amendment_01.pdf

IDIQ Request for Proposal v. August 2019; FAC 2019-05/08-13-2019 AHRQ-20-10005 Accelerating Change and Transformation in Organizations and Networks (ACTION) IV IDIQ

Request for Proposal – Amendment 01 No. AHRQ-20-10005

PART I - THE SCHEDULE

SECTION A - SOLICITATION FORM

Date Issued: Thursday, November 7, 2019, Amendment No. 1 Date Issued: Wednesday, October 16, 2019 Date Questions Due: Wednesday, October 30, 2019, 11:00 AM EST Please Note: All questions and inquires will be processed on a non-attribution basis.

Date Notice of Intent Due: Monday, November 25, 2019, 11:00 AM EST Date and Time Proposals Due: Monday, December 16, 2019, 11:00 AM EST

You are invited to submit a proposal to the Agency for Healthcare Research and Quality (AHRQ) for Request for Proposal (RFP) No. AHRQ-20-10005 entitled “Accelerating Change and Transformation in Organizations and Networks (ACTION) IV IDIQ”. Your proposal must be developed and submitted in accordance with the requirements and instructions of this RFP.

Solicitation Information: Please review the table of contents and refer to the appropriate section of this RFP for requirements, proposal instructions and evaluation information. The Government intends to award this contract without negotiations, so it is imperative that all questions are addressed during the solicitation phase, and that all proposals submitted include the required information and accept the terms and conditions as stated. Failure to comply with proposal instructions or submit required information may result in the removal of a proposal from consideration for award. Please review Section L carefully.

Proposal Intent: If you intend to submit a proposal in response to this solicitation, please inform the Contracting Officer of your intent by sending an email to Michelle Beatty, Contract Specialist/Contracting Officer at Michelle.Beatty@ahrq.hhs.gov no later than Monday, November 25, 2019. Subject line shall read: Proposal Intent RFP No. AHRQ-20-10005.

Questions: All Questions regarding this solicitation shall be received in this office no later than the date shown above. All questions shall be submitted electronically by e-mail to Michelle Beatty, Contract Specialist/Contracting Officer, at the following email address:

Michelle.Beatty@ahrq.hhs.gov. Subject line shall read: Proposal Questions RFP No. AHRQ- 20-10005. Answers to questions and all solicitation amendments will be posted to the Federal

Business Opportunities web page: www.fbo.gov. It is your responsibility to monitor the web site.

Questions should be submitted in a Word table in the following format:

RFP (or Attachment) Page Number

Relevant Section Number or Title

Question

Additional Information:

An Indefinite Delivery, Indefinite Quantity, multiple-award, task order-type contract is contemplated for a period of five years.

The Government anticipates awarding twelve (12) – seventeen (17) contracts from this solicitation on or about May 27, 2020.

Proposals submitted in response to this solicitation must state that they are valid for a period of at least 180 days (reference FAR clause 52.215-1 in Section L of this document.

The NAICS code for this requirement is 541720 with a size standard of $22,000,000.

Proposal Submission: The proposal shall be signed by an authorized official to bind your organization and must be received by the due date specified above. The proposal must be submitted to the following address:

Agency for Healthcare Research and Quality (AHRQ) Division of Contracts Management 5600 Fishers Lane Mail Stop 06N34B Rockville, Maryland 20857 Attn: Michelle Beatty, (301) 427-1781

Please read this section carefully. Some mail and package delivery procedures have changed due to security controls. All mail and packages are screened at a local offsite facility before being delivered to 5600 Fishers Lane.

The U.S. Postal Service’s “Express Mail” does not deliver to our Rockville, Maryland address.

Please do not use this means of delivery for proposal submission.

Proposals delivered by commercial package delivery company (example: Fedex, UPS, DHL, etc.):

Submit and label as instructed above. These companies are familiar with the delivery procedures at 5600 Fishers Lane.

Hand carried or hand carry courier service: The 5600 Fishers Lane building security does not allow packages to be delivered directly to the building. Hand carried or courier delivered proposals should be labeled as instructed above, however they must be delivered directly to the offsite screening facility at 12225 Wilkins Avenue Rockville MD 20852. The operating hours at the Wilkins Avenue facility are 7:00 AM to 3:30 PM Monday through Friday. Please note that anyone who arrives at the Fishers Lane location with a delivery will be directed to the screening facility, however this will cause delay. Packages will be accepted and date/time stamped at the screening facility. Please allow ample time as proposals cannot be date/time stamped until they have gone through security.

System for Award Management: In accordance with Federal Acquisition Regulation, all contractors must be registered in the System for Award Management (SAM) database in order to conduct business with the government [See Section I - FAR clause 52.204-7 System for Award Management]. Access the System for Award Management (SAM) at https://www.sam.gov/SAM/.

Reminder: The Procurement Integrity Act prohibits the unauthorized disclosure of, inquiry about, or acceptance of procurement information. Communications with any other individual outside the AHRQ contracting office may result in rejection of an offeror’s proposal. All requests for any information concerning this RFP should be referred to Michelle Beatty, (301) 427-1781 or e-mail:

Michelle.Beatty@ahrq.hhs.gov. Please note e-mail requests should state subject as RFP AHRQ- 20-10005.

Additional Information for offerors:

Section B.3 includes the minimum and maximum for this IDIQ.

* Note: Under ACTION III, the average total per contractor was $7 million in work over the course of the 5-year IDIQ. The range of individual total award amount was between $265,000 and $20 million.

Table of Contents

PART I ‐ THE SCHEDULE

SECTION A ‐ SOLICITATION FORM

SECTION B ‐ SUPPLIES OR SERVICES AND PRICES/COSTS

SECTION C ‐ DESCRIPTION/SPECIFICATION/WORK STATEMENT

SECTION D ‐ PACKAGING AND MARKING

SECTION E ‐ INSPECTION AND ACCEPTANCE

SECTION F ‐ DELIVERIES OR PERFORMANCE

SECTION G ‐ CONTRACT ADMINISTRATION DATA

SECTION H ‐ SPECIAL CONTRACT REQUIREMENTS

PART II – CONTRACT CLAUSES

SECTION I CONTRACT CLAUSES

PART III‐ LIST OF DOCUMENTS, EXHIBITS AND ATTACHMENTS

SECTION J – SOLICITATION LIST OF ATTACHMENTS

PART IV– REPRESENTATIONS AND INSTRUCTIONS

SECTION K ‐ REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS

SECTION L ‐ INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

SECTION M‐ EVALUATION FACTORS FOR AWARD

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SUPPLIES OR SERVICES

“Accelerating Change and Transformation in Organizations and Networks (ACTION) IV IDIQ”.

See Section C for a complete description.

B.2 IDIQ CONTRACT

This is a Multiple Award, Indefinite Delivery/Indefinite Quantity (IDIQ) contract. Refer to the following Sections for more information:

Section C for Statement of Work requirements, Section F for Period of Performance information, Section G for invoicing requirements, and Section H for ordering procedures for task orders.

B.3 TASK ORDERS AND PRICES

This is a Multiple Award, Indefinite Delivery/Indefinite Quantity IDIQ contract. All services will be acquired on an as-needed basis through issuance of Task Orders. Under this IDIQ contract, the minimum is $5,000, while the total maximum amount of all task orders awarded to any IDIQ contractor shall not exceed $75,000,000. Once a single IDIQ contractor reaches this maximum, the fair opportunity for competition will be considered reached and no new task orders will be awarded to any IDIQ contractor. No costs shall be incurred or reimbursed on this contract unless the cost is associated with an approved, signed Task Order.

All work shall be performed in accordance with the Statement of Work in each task order. No hours shall be billed for labor categories or labor rates not included as part of this contract as detailed below.

Rates for any proposed subcontracts will be requested in the Request for Task Order (RFTO) for each task order. The subcontractor rates proposed per task order request shall not exceed the rates listed per labor class in this section for the prime contractor.

Ordering Period - Year 1 Labor Class Fully Burdened

Hourly Rate Class I – Senior Class II – Associate Class III – Intermediate Class IV – Junior Class V – Other Technical

Ordering Period - Year 2 Labor Class Fully Burdened

Hourly Rate Class I – Senior

Class II – Associate Class III – Intermediate

Ordering Period - Year 3

Hourly Rate Class I – Senior Class II – Associate Class III – Intermediate

Ordering Period - Year 4

Hourly Rate Class I – Senior Class II – Associate Class III – Intermediate

Ordering Period - Year 5

Hourly Rate Class I – Senior Class II – Associate Class III – Intermediate

LABOR CLASS DEFINITIONS

Class I: Senior management personnel, normally holding a terminal degree, with a 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; Electronic Health Record (EHR) Design, Implementation, or Optimization; Development and Implementation of Clinical Decision Supports; User Centered Design/Human Factors; Policy Assessments/Analysis; Program Assessments; Evaluation Design Studies And Data Collection; Data Visualization; 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; Electronic Health Record (EHR) Design, Implementation, or Optimization;

Development and Implementation of Clinical Decision Supports; User Centered Design/Human Factors; Policy Assessments/Analysis; Program Assessments; Evaluation Design Studies And Data Collection; Data Visualization and creation of health communication materials;

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; Electronic Health Record (EHR) Design, Implementation, or Optimization; Development and Implementation of Clinical Decision Supports; User Centered Design/Human Factors; 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 normally holding an associate’s degree or Bachelor’s degrees, such as editors, social media specialists, management specialists, with two years or less experience in technical areas.

B.4 PROVISIONS APPLICABLE TO DIRECT COSTS

a. Items Unallowable Unless Otherwise Provided

Notwithstanding the clauses, ALLOWABLE COST AND PAYMENT, and FIXED FEE, incorporated into this contract, unless authorized in writing by the Contracting Officer, the costs of the following items or activities shall be unallowable as direct costs:

(1) Acquisition, by purchase or lease, of any interest in real property;

(2) Rearrangement or alteration of facilities;

(3) Purchase or lease of any item of general purpose-office furniture or office equipment regardless of dollar value. (General purpose equipment is defined as any items of personal property which are usable for purposes other than research, such as office equipment and furnishings, pocket calculators, etc.);

(4) Accountable Government property;

(5) Travel to attend general scientific meetings;

(6) Foreign Travel;

(7) Any costs incurred prior to the contract's effective date;

(8) Rental of meeting rooms not otherwise expressly paid for by the contract;

(9) Any subcontract agreement (including consultants) other than those already approved in the contract;

(10) Information Technology hardware or software; and

(11) Food and Beverages.

Note: Food and Beverages are unallowable costs. Contracting Officer Authorization for Food and Beverages will be only made as specifically authorized by statute, which is extremely rare. The contractor shall not provide food or beverages of any type. The contractor shall not accept food or beverages, even if included in, or provided ‘free’ as part of a meeting/conference ‘package’.

b. Travel Costs

This contract is subject to the provisions of Public Law (P.L.) 99-234 which amends the

Office of Federal Procurement Policy Act to provide that contractor costs for travel, including lodging, other subsistence, and incidental expenses, shall be allowable only to the extent that they do not exceed the amount allowed for Federal employees. The Contractor, therefore, shall invoice and be reimbursed for all travel costs in accordance with Federal Acquisition Regulations (FAR) 31.205-46.

The following applies to Educational Institutions: The Contractor shall invoice and be reimbursed for all travel costs in accordance with OMB Circular A-21 - "Cost Principles for Educational Institutions."

No funding or expenditures will be authorized under this contract for travel or meeting expenses of any person that is not an employee of the contractor or approved subcontractor in accordance with the terms of the contract. See 31 USC § 1345 for appropriations restrictions.

SECTION C - DESCRIPTION/SPECIFICATION/WORK STATEMENT

Independently and not as an agent of the Government, the Contractor shall be required to furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government, as needed to perform the Statement of Work as follows:

Statement of Work

Introduction 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. In order to improve the quality, safety, and value of health care and care delivery we rely on our three core competencies: health services research, practice improvement, and data and analytics.

AHRQ carries out this mission in several ways, including field-based research, quality improvement, and dissemination of evidence-based practices. A principle vehicle for such projects is the Accelerating Change and Transformation in Organizations and Networks— ACTION—IDIQ. It is AHRQ’s goal to build and expand on the successful model used to support its mission that was developed under three previous iterations of ACTION and its predecessor, the “IDSRN1”, that have spanned the past 18 years. Specifically, this IDIQ for ACTION 4 is intended to efficiently procure the expertise, resources, and capacities necessary to develop, implement, and disseminate innovative interventions and strategies for improving the delivery of patient care nationwide.

More specifically, this IDIQ will provide AHRQ with a pre-competed set of highly qualified contractors representing broad-based, highly-resourced Partnerships. ACTION 4 Partnerships will be expected to flexibly respond to changing agency-level needs, interests, concerns, and priorities by drawing on the complementary capacities of their Member Organizations, as well as reaching out to new partners and capacities as needs arise. Examples of topics of interest at this time include those cited under “Scope,” below.

Background Experience has shown that research or implementation in real-world settings is critical to successfully developing, testing, adapting and spreading interventions that can improve care delivery while meeting the complex challenges faced by healthcare systems. 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 quality improvement and to support the dissemination and implementation of findings to promote broad impact.

1 IDSRN = “Integrated Delivery System Research Network” = predecessor to ACTION 2001-2004

Key elements of the model that will be sustained in ACTION 4 include:

A continued heavy focus on field-based, real-world informed development, testing and implementation of new approaches for improving care safety and quality;

Use of multi-disciplinary teams to conduct research and quality improvement in diverse real world care settings Development of practical tools, guidance and training to support effective implementation and sustainment of new approaches or interventions; and

Use of collaborations of engaged stakeholders from multiple sectors to support broad-based implementation and dissemination.

New elements in ACTION 4 reflect AHRQ’s interest in leveraging our core competencies in order to address four emerging objectives and one new role. These are:

Supporting efforts by Learning Health Systems (LHS) to use knowledge and data to support continuous improvement in clinical care and care delivery. This objective would be focused on:

o Investigating how to effectively build the capacity of health systems to integrate external data (e.g. from other systems, organizations, guideline developers and government agencies) and internal data (e.g., clinical, operational, financial, and patient experience data) in ways that allow learning and discovery about how to improve;

o Supporting health systems in their journeys to becoming learning health systems;

and o Using data to identify and answer question of particular interest to operational (e.g. C-suite) leaders and other decision-makers and stakeholders.

Promoting “whole person, 360° care” across the full spectrum of care and the entire lifespan, including by improving understanding of social determinants of health and strengthening connections between community-based social services and health services providers, especially for those with multiple chronic conditions and/or socioeconomic disadvantage. In support of this objective, AHRQ would for example, be interested in:

o Generating knowledge about how clinical teams can most effectively elicit and use patients’ values and preferences and personal and social circumstances in formulating care plans;

o Developing methods to capture the information and data needed to foster partnerships and linkages between health care and human service systems (community-based organizations and public health);

o Developing, implementing and evaluating improvements in care delivery across the whole spectrum of care and across the entire life span, especially for individuals with multiple chronic conditions, disability, cognitive decline or at socioeconomic disadvantage;

o Developing, implementing and evaluating improvements to individual and population health while reducing disparities; and o Investigating and promoting use of technology to narrow gaps in access to care, particularly for rural or other under-resourced areas.

Advancing data-driven approaches for population health management and delivery of patient-centered care. This objective is central to successes of both Learning Health Systems and the advancement of whole person care. While the ability to readily leverage partners’ access to data and analytic capacities has always been a defining characteristic of ACTION projects, ACTION 4 is expected to be more expansive in the types of data that partners would be expected to access and in the novel ways those data might be collected, analyzed, shared, and utilized.

Supporting the transformation to a value-based health care system that pays for outcomes, rewards efficiency, focuses on prevention of disease before it occurs, and empowers consumers, providers, and purchasers through improved transparency around price and quality, for example by:

o Exploring how value is defined and assessed by consumers, payers and system leaders;

o Developing and validating measures of care quality, cost, and efficiency;

o Assessing the dissemination, implementation, and outcomes of strategies, programs, and methods of enhancing care value including changes in care practices, delivery, overall organization (e.g. ownership of ambulatory practices by hospitals), payment, measurement and reporting;

o Assessing the real world costs of care delivery, including the costs of implementing innovations;

o Developing methods for evaluating cost reductions associated with implementation of innovative approaches for improving care;

o Understanding the influence of social factors on health outcomes when designing value-based arrangements;

o Conducting economic analyses (e.g., on the relationship between cost and price and price and demand, how market changes affect delivery organizations, and the impact of innovations on efficiency and value);

o Understanding provider perspectives on value-based payment structures and risk arrangements, including those for optimizing primary care to better address challenges and barriers;

o Evaluating models of care to better understand risk arrangements and usefulness of value-based payment approaches, such as bundled payments to promote efficient and effective care choices; and o Investigating methods for synthesizing conceptions of both patient-centered care and efficiency in seeking to deliver high value care.

The new role envisioned for ACTION 4 will be to serve as the preliminary phase of the effort to build a National Test Collaborative (NTC). The purpose of the NTC would be to test Health IT tools in the real world before they are disseminated for use. “Test originators” (e.g., federal agencies) would define health IT testing needs and specify the parameters for testing (e.g., test types, clinical setting options, and patient cohorts). Testing would be conducted by “test executors” (e.g., EHR and other health IT developers, healthcare providers, health systems, public health departments, etc.) in their local test and production environments and share the testing results in the iterative fashion of agile development.

Definitions For the purposes of this IDIQ, the following definitions shall apply:

ACTION 4 Partners (i.e. ACTION 4 Member Organizations): An ACTION Prime’s “partners” (or “Member Organizations”) are those health care systems, stakeholder or other organizations or associations or any other entities that have provided a letter of commitment to a Prime Contractor/Organization indicating their willingness to serve as subcontractors on one or more task orders issued under the IDIQ. NOTE: ACTION 4 Partners/Member Organizations may be members of more than one ACTION 4 Partnership.

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.

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 and encouraging adoptions of knowledge, e.g. through academic detailing.

Dissemination and Implementation (Spread): active, planned – and sometimes externally supported – efforts using diverse vehicles and approaches of varying degrees of intensity to change awareness, culture and behavior (e.g., training program, learning collaborative, practice facilitation, coaching, peer to peer learning) to (a) engage and persuade target groups to adopt an intervention and then (b) prepare for and take the necessary steps to facilitate the actual use of the intervention in practice in a care setting. Relatedly, de-implementation involves similar approaches to encourage and support steps needed to identify when a practice is not effective and stop using it.

Evidence-based treatments or interventions: treatments or models of care that have proven successful in improving health outcomes or on-the-ground care delivery.

Health Systems: organizations of health care providers that are contractually affiliated with one another or owned by the same organization. Health systems may include organizations of a single type of provider (e.g., hospitals or nursing homes) or bring together diverse types of providers (acute care hospitals, affiliated multi-specialty practices, ambulatory care centers) or serve low-income/low-resource populations (e.g. safety net, federally qualified health centers).

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

Interventions: sets of behaviors, routines, and ways of working that are introduced by external or internal change agents 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, safety, and health outcomes. Interventions are implemented by planned and coordinated actions, and can include, but are not limited to:

changes in the organization of care, work processes or staffing; changes in payment;

introduction of quality improvement and patient safety tools, guides, or other products;

application of new assessment-measures and methods (including those using electronic health records); public or private reporting of costs or quality data.

Integrated Delivery Systems. A network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and health status of the population served.

Learning Health Systems (also called Learning Health Care Systems and Learning Health Organizations): health systems that align clinical informatics, patient-clinician partnerships/ patient and family engagement, incentives, and culture to promote the routine delivery of evidence-based care and enable continuous and real-time improvement in both the effectiveness and efficiency of care.

Long term Care: skilled nursing facilities (SNFs), inpatient rehabilitation facilities, and long-term acute care hospitals.

Operational Leaders: individuals within health systems responsible for ensuring that organizational processes are effectively carried out on a day-to-day basis, monitoring performance, addressing constraints, and ensuring that employees understand what is to be done and are provided with the authority, knowledge and skills to do it.

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

Post-acute care: rehabilitation or palliative services that beneficiaries receive after, or in some cases instead of, a stay in an acute care hospital. Depending on the intensity of care the patient requires, treatment may include a stay in a facility, ongoing outpatient therapy, or care provided at home.

Social services: services that improve the well-being of individuals, families or communities, including for example transportation, housing, education, training, nutrition, wellness programs, senior support.

Sustainability: making an intervention routine until it reaches obsolescence.

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.

Tools, Training, Guidance: informational, educational and/or training materials or resources, including electronic resources (apps, APIS, CDS) that contain and communicate actionable guidance for end users (e.g., front line practitioners, quality improvement personnel, healthcare administrators within health systems; patients and their families;

payers; policy makers. All tools or other resources intended for public use will have to meet applicable requirements of section 508 of the ADA.

Whole person, 360° care: the coordination and integration of health, behavioral health, and social services for individuals in manner that reflects people’s needs, values and preferences across the entire spectrum of care (from promotion and prevention to diagnostic, rehabilitation and palliative care) and at all levels of care (including primary care, acute and post-acute care, long-term care, self-care, home care, community care) and throughout the lifespan (from prenatal care through end-of-life), within the context of their communities.

Scope ACTION 4 research and quality improvement (QI) projects can be expected to target all health care settings across the full spectrum of care providers (including, but not limited to, hospitals, integrated delivery systems, Primary Care Practices and other ambulatory settings, home care, post-acute long term care settings) as well as 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 topics that may be undertaken under ACTION 4, although individual Request For Task Orders (RFTOs) may focus on particular types of settings, payers, providers, or patients.

ACTION 4 Task Orders may be local, regional or national in scale and will focus exclusively on the US healthcare system.

ACTION 4 Task Orders will focus on practical, applied topics of high interest to AHRQ and the Department of Health and Human Services as well as to those at the front lines of care delivery and to the patients they serve. ACTION 4 Task Orders will be conceived with end users in mind (especially health systems and other care providers) and will be focused on topics that will benefit from being researched, developed, tested, evaluated, implemented and disseminated in field-based/real world settings. Healthcare in the United States occurs within complicated and complex systems of systems. The services and types of tasks/activities likely to be undertaken or executed under task orders awarded under the ACTION 4 IDIQ Contract are expected to propose methodologically rigorous methods for addressing complexity in real world settings.

The different categories of ACTION 4 task orders are described below. Each ACTION 4 task order would be envisioned to encompass at least one of the following broad types of services and many task orders are likely to include individual tasks or activities from more than one of the sets of activities described here.

a. Exploratory Research, Knowledge Synthesis, Analysis: ACTION 4 Exploratory Research task orders may call for: collection, synthesis and 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 stakeholders, subject matter experts or other key informants; needs assessments; creation of and support for learning communities or learning collaboratives;

observation of promising practices in natural settings; simulations; creation and trials of prototypes and/or other design activities. Findings from these types of task orders would be expected to result in recommended future action steps (e.g., further research or for the development of interventions designed to improve care delivery).

b. Development of interventions: Task Orders focused on development of interventions are expected to result in new or modified approaches for delivering, coordinating or integrating care to improve safety, patient-centeredness, accessibility, and/or clinical outcomes and to advance towards the goal of delivering whole-person, 360-degree care or improving population health management and public health. These types of task orders might request, for example, development of new methods or approaches for: reducing threats to patient safety such as healthcare acquired infections and diagnostic error; measuring and benchmarking care quality for the purpose of identifying areas for practice or system level improvement; ensuring rapid uptake of new evidence by health systems or practitioners;

increasing patient and caregiver engagement and shared decision-making; leveraging technology to understand and meet patient needs; assessing and addressing the needs of patients with multiple chronic conditions in primary care settings through improved care coordination with other community providers; eliciting and utilizing a patients’ values preferences, and social circumstances in the development of care plans; strengthening connections between health care and community-based social services to improve whole-person care. The new interventions may be framed or delivered in any of a number of forms and formats, including but not limited to: tools, guides, training, IT applications; revisions to roles, responsibilities or staffing models. The application of design thinking and patient engagement in development of innovations, interventions, and tools, as appropriate, will be strongly encouraged.

c. Feasibility/Pilot Testing: Some Task Orders may call for testing a previously untested or minimally tested intervention or tool on a small scale in a real world setting. Pilot Testing may be used to assess the logic model underlying the intervention; document whether and how well it worked, and why or why not; examine effects of the context/setting in which an intervention was introduced and the approaches used to facilitate uptake; identify barriers to its use and modifications needed to increase the likelihood of successful implementation and desired outcomes; examine the return on investment (ROI)/business case for its use.

Task Orders aimed at Pilot Testing of one or more interventions commonly require 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, stakeholders and operational leaders; appropriate application of diverse qualitative and quantitative methodologies to preliminarily measure impacts and outcomes;

access to clinical information systems such as electronic health records (EHRs) or other health information technologies; and synthesis of findings.

d. Implementation /Implementation Research: Implementation/Implementation Research task orders will involve actual implementation in multiple sites and investigation of ways that context, intervention characteristics, and implementation approach interact to influence uptake of an intervention, treatment or model of care, and its success in achieving desired outcomes for patients. These task orders would be expected to generate valuable knowledge of the feasibility, utility and impacts of a new approach, as well as factors that may be associated with its successful integration into routine use or adaptations/modifications that may be required in response to local conditions. In most cases, the intervention that will be implemented will have already been tested in a limited number (or type) of settings. Examination of costs associated with an intervention, including implementation costs and longer term financial costs of expected savings will also be of interest.

Successful execution of implementation research task orders are likely to require recruitment of appropriate real world implementation sites; engagement of onsite champions, stakeholders and operational leaders; development and provision of training, resources and technical assistance or support to implementers and/or other stakeholders;

support for exchange of knowledge among implementers and stakeholders (e.g., through learning collaboratives surveillance systems, or public health registries)) and appropriate application of diverse and quantitative and qualitative data collection and analytic methodologies. Task Orders of this kind will also typically require syntheses of findings and communication of new knowledge to appropriate decision-makers/other audiences (“knowledge communication/knowledge transfer”) using diverse print and web based vehicles.

e. Dissemination and Implementation (D and I/Spread); D and I task orders would be aimed at broadly increasing (e.g., across states, regions, nationally) adoption and use of evidence-based treatments or interventions, in support of AHRQ’s dissemination mandate under the ACA and its role as a leader in promoting nationwide implementation of interventions to reduce HAIs and improve patient safety. Such projects are likely to include an underlying logic model and a set of structured plans that utilize diverse strategies for changing awareness, culture and behavior of relevant target audiences (e.g., executives, front line staff, health care professionals from health systems, hospitals, and primary care practices).

Such strategies might include use of measurement and performance benchmarking; training programs, facilitation, coaching, peer to peer learning, and academic detailing. The execution of these plans would be expected to require recruitment, training and implementation phases and development and use of print and web based educational and training materials and technical assistance of varying degrees of intensity.

f. Advancing data-driven approaches for population health management and delivery of high quality, evidence-based, 360°, patient-centered care: Task orders with this particular focus would involve study, development, testing or dissemination of innovative methods for health systems’ use of data to better understand and address patient needs. Areas of interest might include: supporting efforts by Learning Health Systems to use internally- generated data to support continuous improvement and personalized care; fostering data and knowledge-driven approaches for population health management; integrating and analyzing diverse sources of to better understand and address social determinants of health;

developing and sharing information needed to support partnerships and linkages among health care human service systems (community-based organizations and public health) to improve whole-person care; identifying methods for collecting patient reported outcomes (PROs) and information on a patient’s social context and seamlessly providing that information to health care teams; promoting use of information systems and data resources through expansion of clinical decision support for health care professionals, patients and families at the point of care.

g. Measurement. Task orders with this focus might include the identification, development, analysis, testing, evaluation or dissemination of research frameworks and templates, quality of care metrics, methodologies, and tools intended to assess and improve care delivery.

These activities can require innovative use of a variety of complex data sources (e.g., billing/claims data, survey, electronic health records, and laboratory data). Dissemination of metrics, methodologies or tools may require provision of technical support (e.g., provision of guidance about administration and scoring or responses to inquiries from users).

h. Analysis, Assessment, Evaluation: Some Task Orders may call for analysis of outcomes, impacts or sustainability of the types of projects described above (development of interventions, dissemination and implementation projects, or other AHRQ initiatives designed to improve patient care). These services may be procured through a stand-alone task order or, more often, by inclusion in task orders described in b-f above. Specific objectives might include assessing whether and how well an intervention achieved its intended objectives; identifying contextual factors that may affect its effectiveness or desired impact; identifying factors that enhance or impede its integration into routine practice; and the studying the effectiveness of specific strategies or approaches for disseminating evidence into practice.

IMPORTANT NOTE: Since the subjects of such assessments or evaluations are likely to be complex delivery interventions, researchers will need to use research designs that explicitly (a) examine how interventions interact with the contexts (themselves complex systems) 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 that supports 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, qualitative comparative analysis, 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.

SECTION D - PACKAGING AND MARKING

All deliverables required under this contract shall be packaged, marked and shipped in accordance with Government specifications. At a minimum, all deliverables shall be marked with the Contract Number, Contractor Name and Item Number. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition. Note as appropriate on the face page of each deliverable, or on the binding, (1) one volume only, or (2) volume 1 of 2, etc.

SECTION E - INSPECTION AND ACCEPTANCE

E.1 INSPECTION AND ACCEPTANCE

a. The Contracting Officer or the duly authorized representative will perform inspection and acceptance of materials and services to be provided.

b. For the purpose of this SECTION the Contracting Officer’s Representative is the authorized technical representative of the Contracting Officer.

c. Inspection and acceptance will be performed at:

Agency for Healthcare Research and Quality 5600 Fishers Lane Rockville, Maryland 20857

E.2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if it were given in full text. Upon request, the Contracting Officer will make their full text available.

FAR Clause No. Title and Date

52.246-4 Inspection of Services-Fixed Price

(August 1996)

52.246-6 Inspection Time-and Material and

Labor Hour (May 2001)

SECTION F - DELIVERIES or PERFORMANCE

F.1 PERIOD OF PERFORMANCE

The ordering period shall begin on May 27, 2020 and run through May 26, 2025.

All task orders must be completed in accordance with FAR 52.216-22 Indefinite Quantity (see full text clause in Section I).

F.2 DELIVERABLE SCHEDULE

Please refer to the deliverable schedule in each task order award. The following applies on the IDIQ level:

Task Format Deliverable Due Date Audience Section 508 Standards

N/A

As specified in each task order

Administrative, progress, and financial reports

As specified in each task order

As specified in each task order

To be determined in the Request for Task Order (RFTO) for each task order.

N/A

As specified in each task order

All other deliverables identified in each task order

As specified in each task order

As specified in each task order

To be determined in the RFTO for each task order.

N/A Electronic via eSRS

Subcontracting Report for Individual

Contracts (SF- 294)

April 30 (annually) October 30 (annually)

Expiration Date of Contract

Federal Staff NA

N/A Electronic via eSRS

Summary Subcontractor

Report (SF-295)

October 30 (annually)

Federal Staff NA

F.3 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following clauses by reference, with the same force and effect as if they were given in full text.

FEDERAL ACQUISITION REGULATION (FAR) (48 CFR CHAPTER 1) CLAUSE:

52.242-15, Stop Work Order (AUG 1989)

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 KEY PERSONNEL, HHSAR 352.237-75 (DEC 2015)

Pursuant to the Key Personnel clause incorporated in Section I of this contract, the following individual(s) is/are considered to be essential to the work being performed hereunder:

NAME TITLE

(To Be Determined)

The clause cited above contains a requirement for review and approval by the Contracting Officer of written requests for a change of Key Personnel reasonably in advance of diverting any of these individuals from this contract. Receipt of written requests at least 30 days prior to a proposed change is considered reasonable.

G.2 CONTRACTING OFFICER’S REPRESENTATIVE (COR) & TASK ORDER OFFICER

(TOO)

The Contracting Officer’s Representative (COR) for this IDIQ is:

NAME TITLE

(To Be Completed at Time of Award)

The Task Order Officer (TOO) is designated in each Task Order. For each Task Order, the TOO is responsible for: monitoring the contractor’s technical progress, including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements; interpreting the statement of work and any other technical performance requirements; performing technical evaluation as required; performing technical inspections and acceptances required by this contract; and, assisting in the resolution of technical problems encountered during performance.

The Government may unilaterally change its Contracting Officer’s Representative or Task Order Officer designation.

G.3 CONTRACTING OFFICER

The Contracting Officer is the only person with authority to act as an agent of the Government under this contract. Only the Contracting Officer has authority to: (1) direct or negotiate any changes in the statement of work; (2) modify or extend the period of performance; (3) change the delivery schedule; (4) authorize reimbursement to the contractor of any costs incurred during the performance of this contract; or (5) otherwise change any terms and conditions of this contract.

G.4 INVOICE REQUIREMENTS AND INSTRUCTIONS

The directions below must be followed to meet the requirements of a "proper" payment request pursuant to FAR 32.9, and must be in accordance with the General Provisions clause 52.232-25 Prompt Payment (JAN 2017).

a. INVOICE CONTENT REQUIREMENTS

(1) The contractor shall use a Standard Form 1034, Public Voucher for Purchases and Services Other Than Personal, as an invoice coversheet when submitting/depositing invoices. An electronic copy of the SF-1034 in PDF format may be found at:

https://www.ahrq.gov/funding/contracts/1034-form.html?tca=jWR- LY2xeuTDCg9DluOnvNb131SIoJqIQd06MOL6coI.

Instructions how to complete the SF-1034 form can be found at:

https://www.ahrq.gov/funding/contracts/invoice-guide.html?tca=WK1a3t- LpRvys5y_5Vwz2QLqUlfsRvowGd8BVQJqcxM

For Firm Fixed Price (FFP) task orders:

(2) The contractor shall furnish the following MINIMUM information as an attachment to the SF-1034 in support of invoiced amounts:

NOTE: Fixed Price Invoices shall be billed in accordance with the payment schedule.

a. Contractor Information – include organization name and address as it appears on the contract (or task order/BPA call as applicable). Include the DUNS and TIN number

b. Contract Information – include the project number, contract number and if applicable, the task order or BPA call number

c. Invoice Information – include the invoice number, which shall be a unique number specific to each individual invoice. Letters and numbers may be used. Please note that the invoice number can only be used one time regardless of the number of contracts or orders held by an organization.

Duplicate invoice numbers are not allowed and will result in invoices being returned unpaid.

d. Task Number/Description/Milestone – (if applicable) identify the task number, milestone and/or description being billed.

e. Current amount billed – by individual cost element and…