AHRQ 24-10004.amendment 1.pdf

Amendment #1 - AHRQ-24-10004 MEPS-HC

Amended RFP Modification Summary

Changes are listed below and are highlighted in the attached amended RFP.

Item

No.

Part or Section Description Page No.

1.

B.5 Core Task MEPS Survey (CLIN0001)

Cost Plus Award Fee

Period of Performance Dates have been added to the table to address Q1.

2.

Section C. Task 2 Instrumentation/Task 2.1

Instrument Development and Task 2.2 Main

Interview and SAQ Instrument Testing

Section updated to address Q2. Footnote #1 added

3.

Section C. Task 3: Sample Design and

Selection/Task 3.1 Sample design implementation

Details added to footnote #2 to address Q4 20

Section C. Task 5 Data Collection/Task 5.1

Collect Main Interview Household Data Details added to address Q3 24-25

5. Section F.2 Deliverable Schedule

Due dates for the Full Year (FY)

Consolidation Expenditure File (Deliverable

#60) revised to address Q5

6.

Attachment D – Quality Assurance

Surveillance Plan

SAQ Response Rate Percentages;

Response Rate calculation methods updated to address Q9, Q10 and Q11

Attachment D

IDIQ Request for Proposal v. Jan 2024; FAC 2023-06 AHRQ-24-10004 MEPS-HC Amendment 1 Page 1 of 117

Request for Proposal

No. AHRQ-24-10004

PART I - THE SCHEDULE

SECTION A - SOLICITATION FORM

Date Issued: April 5, 2024

Date Questions Due: April 15, 2024

Please Note: All questions and inquires will be processed on a non-attribution basis.

Date Notice of Intent Due: May 2, 2024

Date and Time Proposals Due: May 10, 2024 and 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-24-10004 entitled “Medical Expenditure Panel (MEPS)

Household Component (HC)”. 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 Tara Bertolini, Contract Specialist at tara.bertolini@ahrq.hhs.gov no later than May 2, 2024. Subject line shall read: Proposal Intent

RFP No. AHRQ-24-10004.

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 Tara Bertolini, Contract Specialist, at the following email address: tara.bertolini@ahrq.hhs.gov. Subject line shall read: Proposal Questions RFP No. AHRQ-24-10004. Answers to questions and all solicitation amendments will be posted to the Contract Opportunities web page: https:// sam.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 mailto:tara.bertolini@ahrq.hhs.gov

MEPS-HC Amendment 1 Page 2 of 117

Additional Information:

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

• The Government anticipates awarding 1 contract from this solicitation on or about

September 24, 2024.

• Proposals submitted in response to this solicitation must state that they are valid for a period of at least 120 days (reference FAR clause 52.215-1 in Section L of this document.

• The NAICS code for this requirement is 541910 with a size standard of $22.5M.

Proposal Submission:

To submit a proposal, offerors are required to use the AHRQ Proposal Module. Mailed proposal and E-mailed proposals will not be accepted.

In order to access the AHRQ Proposal Module offerors must be registered in the system before the proposal due date. To ensure your organization is registered in the system, please send the following information to tara.bertolini@ahrq.hhs.gov no later than 12:00 PM May 2, 2024:

Official Company name:

Unique Entity Identifier:

Point of Contact name, email, phone number

Failure to respond timely and provide the requested information could result in an inability to submit a proposal.

Before the proposal due date, instructions on how to upload proposals to the AHRQ Proposal

Module will be emailed to your organization’s point of contact.

NOTE: For the Business Proposal submission, the offeror must submit two versions. This includes a Word or PDF version AND an Excel document version.

The proposal shall be signed by an authorized official to bind your organization. Signatures can be electronic if necessary.

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 https://www.sam.gov/SAM/

MEPS-HC Amendment 1 Page 3 of 117 information concerning this RFP should be referred to Tara Bertolini, (301) 427-1705 or e-mail:

tara.bertolini@ahrq.hhs.gov. Please note e-mail requests should state subject as RFP AHRQ-24-

10004.

MEPS-HC Amendment 1 Page 4 of 117

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

MEPS-HC Amendment 1 Page 5 of 117

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SUPPLIES OR SERVICES

“Medical Expenditure Panel Survey-Household Component (MEPS-HC)”. See Section C for a complete description.

B.2 IDIQ CONTRACT

This is a Single 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 Single 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 contractor shall not exceed $300,000,000. No costs shall be incurred or reimbursed on this contract unless the cost is associated with an approved, signed Task Order.

B.4 CORE TASK – MEPS Survey (CLIN0001) – Cost Plus Fixed Fee

CLIN# Period of Performance Services Est. Cost Fixed Fee Total

CPFF

0001A 24 September 2024 – 30 November 2024

MEPS-HC Survey Severable $ $ $

0001F 01 December 2028 – 30 November 2029

MEPS-HC Survey Severable $ $ $

0001G 01 December 2029 – 30 November 2030

MEPS-HC Survey Severable $ $ $

0001H 01 December 2030 – 12 January 2031

MEPS-HC Survey Severable $ $ $

MEPS-HC Amendment 1 Page 6 of 117

B.5 CORE TASK – MEPS Survey (CLIN0001) – Cost Plus Award Fee

CLIN# Period of Performance Services Est. Cost Base Fee*

Award Fee Pool

Estimated

CPAF

0001B 01 December 2024 – 30 November 2025

MEPS-HC Survey Severable $ $ $ $

001C 01 December 2025 – 30 November 2026

MEPS-HC Survey Severable $ $ $ $

0001D 01 December 2026 – 30 November 2027

MEPS-HC Survey Severable $ $ $ $

0001E 01 December 2027 – 30 November 2028

MEPS-HC Survey Severable $ $ $ $

*Not subject to outcome of Award Fee performance measures. Proposed Base Fee shall be lower than the Fixed Fee proposed under the CPFF effort.

B.6 OPTION TASKS – Survey Add-ons (CLIN0002) Cost Plus Award Fee

The offeror shall provide one price for each CLIN (0002A and 0002B) broken out by each CLINs period of performances. These costs will be utilized each time that CLIN is exercised regardless of the year of performance. The offeror shall not provide separate costs for grayed out areas.

CLIN0002B – For proposal purposes, a cost should be provided for 500 households. The Government will use the cost for 500 households when exercising any options under CLIN 0002B.

This cost will be used as the starting price and can be multiplied in increments of 500 with a not to exceed of 3,000 households.

CLIN # Period of Performance Services Est Cost Base Fee*

Award Fee Pool

Fixed Fee

Estimated

CPAF

Ceiling

0002A1a 12 months

Enhance Log.

Capacity Severable $ $ $ N/A $

0002A1b 12 months

Enhance Log.

Capacity Severable $ N/A N/A $ $

0002A1c 12 months

Enhance Log.

Capacity Severable $ N/A N/A $ $

0002A2a 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

MEPS-HC Amendment 1 Page 7 of 117

Fee*

Award Fee Pool

Fixed Fee

Estimated

CPAF

Ceiling

0002A2b 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A2c 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A3a 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A3b 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A3c 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A4a 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A4b 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002A4c 12 months

Enhance Log.

Capacity Severable See Above

See Above

See Above

See Above See Above

0002B1a 12 months

Addition of households Severable $ $ $ N/A $

0002B1b 12 months

Addition of households Severable $ N/A N/A $ $

0002B1c 06 months

Addition of households Severable $ N/A N/A $ $

MEPS-HC Amendment 1 Page 8 of 117

Fee*

Award Fee Pool

Fixed Fee

Estimated

CPAF

Ceiling

0002B2a 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B2b 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B2c 06 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B3a 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B3b 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B3c 06 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B4a 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B4b 12 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

0002B4c 06 months

Addition of households Severable See Above

See Above

See Above

See Above See Above

*Not subject to outcome of Award Fee performance measures. Proposed Base Fee shall be lower than Fixed Fee.

The base period and each option are separate and distinct from one another for accumulation of costs and billing purposes.

MEPS-HC Amendment 1 Page 9 of 117

B.7 TASK ORDERS – Survey Enhancements (CLIN 0003)

3.0 Non –Severable Items (to be awarded through the issuance of task orders)

CLIN # Period of Performance

Services Est. Cost Fixed Fee Total

0003A 15 months ARO Pharmacy Provider List Non-Severable $ $ $

0003B 15 months ARO

Enhancing the main MEPS Interview Provider Directory Non-Severable $ $ $

0003C 15 months ARO Medical Events Identification Non-Severable $ $ $

0003D1 36 months ARO

SAQ1

Non-Severable $ $ $

0003D2 36 months ARO

SAQ2

Non-Severable $ see above $ see above $ see above

0003D3 36 months ARO

SAQ3

Non-Severable $ see above $ see above $ see above

0003D4 36 months ARO

SAQ4

Non-Severable $ see above $ see above $ see above

0003D5 36 months ARO

SAQ5

Non-Severable $ see above $ see above $ see above

0003D6 36 months ARO

SAQ6

Non-Severable $ see above $ see above $ see above

0003E 21 months ARO

Collection Authorization Forms – Health Insurance Claims Non-Severable $ $ $

0003F 21 months ARO

Critical Path Main MEPS Survey Instrument and Longitudinal Survey Instrument Non-Severable $ $ $

0003G 21 months ARO Residence History Non-Severable $ $ $

0003H 36 months ARO

Technology Evaluation to Support Multi-Mode MEPS HC Data Collection Activities $ $ $

0003I 36 months ARO Alternative Sample Design $ $ $

0003J 9 months ARO MEPS transition to new vendor $ $ $

*After Receipt of Order (ARO)

B.8 PROVISIONS APPLICABLE TO DIRECT COSTS

a. Items Unallowable Unless Otherwise Provided

Unless authorized in writing by the Contracting Officer, the costs of the following items or activities shall be unallowable as direct costs:

MEPS-HC Amendment 1 Page 10 of 117

(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;

(4) Travel to attend general scientific meetings;

(5) Foreign Travel;

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

(7) Rental of meeting rooms;

(8) Any subcontract agreement not otherwise expressly provided for in the contract;

(9) Information Technology hardware or software; and

(10) 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.

MEPS-HC Amendment 1 Page 11 of 117

SECTION C - DESCRIPTION/SPECIFICATION/WORK STATEMENT

Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, to perform the Statement of Work:

Introduction

The Medical Expenditure Panel Survey Household Component (MEPS-HC), Medical Provider Component (MPC), and Insurance Component (IC), which began in 1996, is a set of large-scale surveys of families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.), and employers across the United States. MEPS collects data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as health insurance held by and available to the civilian non-institutionalized population.

Surveys collecting data on medical expenditures began in the 1970s at a time when the structure of health care services, private insurance, Federal health care programs and the characteristics of the U.S. population were undergoing enormous change. The first of these surveys, the National Medical Care Expenditure Survey (NMCES), was conducted in 1977. Like the MEPS-HC survey, NMCES had three main components: a household survey, a survey of physicians utilized by the household members, and a health insurance employer component.

Approximately 14,000 households participated in five core rounds of interviews over a 14-month period.

In 1987, the National Medical Expenditure Survey (NMES) was conducted. Approximately 16,000 households participated in NMES, including 2,000 American Indian and Alaskan Native households. Once again, the household information was supplemented by surveys of medical and health insurance providers utilized by respondents.

In 1996, the current survey (conducted annually from 1996 to present), the MEPS-HC, is designed to provide more timely information about the nation’s changing health care system.

MEPS-HC introduces a new panel or sample of households into the survey every year and is conducted continually rather than once every 10 years. MEPS-HC households are a subsample of households that previously participated in the National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention approximately six months to a year prior to MEPS. The MEPS-HC collects data from a sample of families and individuals in selected communities across the United States.

Like the earlier surveys, the information collected in MEPS-HC from households is supplemented by surveys of medical providers.

During the household interviews, MEPS-HC collects the following detailed information for each person in the household: demographic characteristics, health conditions, health status, use of medical services, charges and sources of payment, access to care, satisfaction with care, health insurance coverage, income, and employment.

MEPS-HC Amendment 1 Page 12 of 117

The panel design of the survey, which features five core rounds of interviewing covering two full calendar years, makes it possible to determine how changes in respondents’ health status, income, employment, eligibility for public and private insurance coverage, use of services, and payment for care are related.

HC data are available on the MEPS Web site in data tables, downloadable data files (person, job, event, condition, and family level), and interactive data tools, as well as in publications using HC data. Data is released on a flow basis consisting of the following files: population characteristics; jobs; point in time; other medical expenses; dental visits; home health visits;

office-based visits; emergency room visits; outpatient visits; inpatient stays; prescribed medicines; private health insurance detail; medical conditions; and expenditures. Release of data takes place starting 10 months after data collection and ends with the release of the expenditures file 17 months after the end of the reference period. Data processing takes place throughout the data collection process to release the data to the public at the soonest possible date.

The MEPS-MPC, a separate requirement under a different contract, sample includes all hospitals, emergency rooms, home health care agencies, outpatient departments, pharmacies, and long-term health care facilities reported by HC respondents as well as all physicians who provide services for patients in hospitals but bill separately from the hospital (these physicians are identified by the hospitals not the HC respondents). Office-based medical providers (including those in Health Maintenance Organizations) where the provider is either a Doctor of Medicine (MD) or Osteopathy (DO) or practices under the direct supervision of an MD or DO are included in the MEPS-MPC as well. The MEPS-MPC sample is derived from providers reported as providing medical care to a household member during the MEPS-HC interview. The MEPS– MPC data is used to validate, supplement and/or replace MEPS-HC source of payment data reported during the HC interview by matching MEPS-HC and MEPS-MPC data.

The scope of activity under this contract includes the conduct of the HC data collection, data processing throughout the reference period, the preparation and sharing of data files needed for subsequently fielding the MEPS-MPC, imputation and estimation tasks, and the production of an extensive array of analytic (including public-use) files. In addition, the contractor shall use and maintain the Computer Assisted Personal Interview (CAPI) application.

Scope

The contractor shall perform the following types of services under this contract:

Project Management, Reporting, and Meetings

• Project meetings

• Project planning

• Project Reporting

• Data Security plan

• MEPS-HC and MEPS-MPC project coordination activities

Survey Instrumentation

• Instrument Development, including updating main interview and self-administered questionnaires (SAQ) in both English and Spanish

MEPS-HC Amendment 1 Page 13 of 117

• Programming (and testing) the CAPI, CAVI, and SAQ instruments in both English and Spanish

• Develop supporting household data collection field materials in both English and Spanish

• OMB Paperwork Reduction Act (PRA) clearance

Sample Design and Selection

• Designing and implementing the MEPS-HC sample design

• NHIS-HC sample file linkages

• MEPS-HC panel sample maintenance

Field Staff Preparation

• Field Interviewer and Supervisor recruitment/hiring

• Field Interviewer and Supervisor training

MEPS-HC Data Collection

• Collect main interview household data

• Collect SAQ data

• Collect Authorization Forms from MEPS-HC respondents for MEPS-MPC sample

• Collect Pharmacy Patient Profiles

Data management and Data Processing

• Data management and data processing plan

• Forms control and receipt

• Between round data processing

• Data coding/recoding

• Data editing and imputation

• Data weighting and variance estimation

• MEPS-HC file preparation for MEPS-MPC statistical matching activities

Data Files and Documentation

• Analytic File Variable Review

• Analytic Data Files Development and Supporting Documentation

Survey Documentation

• Annual MEPS-HC Methodology Report

• Ad-Hoc Methods Reports

Resources

The contractor and its subcontractors shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government as needed to perform the specific requirements below.

MEPS-HC Amendment 1 Page 14 of 117

Storage

The contractor shall store all necessary materials for a period determined by the Government and shall investigate available technology and use the most efficient means to store all the necessary materials and documents and sensitive data.

The contractor shall also set up and maintain a file transmission protocol (FTP) network so that confidential data and documents can be transmitted from the contractor to AHRQ.

Task 1: Project Management, Reporting, and Meetings

Task 1.1 Project Meetings The Contractor shall meet with the COR within five (5) business days of the Contract Effective Date (CED) to discuss and resolve general issues, as well as specific priorities based on AHRQ’s current data needs. Conference calls between AHRQ COR and project principals and the Contractor’s Project Director and principals shall be held once per week, as needed, for the purpose of discussing the status of each phase of the project. Meeting minutes and corresponding action items resulting from this meeting shall be prepared by the Contractor and submitted to the COR within three business days after completion of the meeting. In addition to weekly conference calls, formal steering meetings between AHRQ COR and project principals and the Contractor’s Project Director and principals shall be held at least monthly covering the full scope of ongoing contract task activities. All special topic meetings shall be held on an as-needed basis and only include the AHRQ COR, and project principals and Contractor Project Director and principals directly involved with the specific topic being discussed. The contractor shall document minutes and associated action items at each management and special topics meeting and provide to AHRQ.

The contractor shall prepare and distribute to the COR all Management Meeting Agendas (and supporting meeting materials) and resulting Management Meeting Minutes (DELIVERABLES 1 and 2). The meeting minutes shall include the contract number, project director, a list of attendees, a description of the issues discussed, action items, assignments, and associated due dates.

Task 1.2 Project Planning The contractor shall prepare and submit a Bi-Annual Project Management Plan (DELIVERABLE 3) that documents the plans for managing all project tasks (subtasks) to help ensure the purposes of those tasks are met and that all deliverables have been sufficiently checked for quality control prior to timely submission. This includes plans for meeting data collection completion targets by each of the panel rounds, completion of statistical matching activities between MPC and HC medical events, and associated data file production. This plan shall include an organizational chart showing clear lines of authority and task function/responsibility. As well the plan shall include a detailed project schedule that clearly identifies major milestones in data collection, data processing, data file deliveries, and other project deliverables as defined in the delivery schedule. The project plan shall also address staffing, data collection field timing, and quality management and other management topics (e.g., data security, document management, and risks/constraints/adjustments). The plan shall

MEPS-HC Amendment 1 Page 15 of 117 also include an appendix that documents (as written memoranda or reports) any survey methodological options considered (and decisions reached).

The plan shall be updated on a bi-annual basis with each update including a crosswalk between proposed and actual completion dates, including a table documenting specific contract deliverables submitted. Other updates as applicable to the Project Plan shall also be made (e.g., survey methodological decisions) in consultation with the COR.

The contractor shall prepare and submit a Data Quality Control Plan (DELIVERABLE 4) that enumerates how quality control will be addressed for all major deliverables). The plan shall detail how the contractor shall monitor and control the services provided in terms of timeliness, accuracy, relevance, accessibility, cost-effectiveness, technical requirements, and contract provisions. This plan shall identify which quality standards are relevant to the project and determine how to satisfy them. The contractor shall apply the quality control activities identified in the plan and monitor specific project results to determine whether they comply with relevant quality standards. The contractor shall identify ways to eliminate causes of unsatisfactory performance. At a minimum this plan shall address:

• Overall project quality control including any proposed evaluations addressing efforts to reduce errors including non-sampling error (non-coverage error, non-responsive error, and measurement error), interviewer monitoring, training and retraining of interviewers, interviewer focus groups, change control process.

• Identification of major data quality indicators that require weekly monitoring during data collection (missing data, interview time, unexpected changes in utilization, response rate)

• CAPI/CAVI change process – question development, programming, testing and evaluation

• Version control for documentation, forms, and memos, and design changes

• A check list of items to be verified for all data deliverables (to include items such as was the correct weight used, was the correct linking variable included, is the number of records correct, has benchmarking been completed (if so, what were the results), has the documentation and cover memo been checked for accuracy).

• Adequate and timely documentation to assure repeatability of editing and imputation activities

• The development and maintenance of decision logs for all coding, data entry, editing, and comment review activities

• Benchmarking to external and previous year MEPS estimates for all key data elements, paying particular attention to health insurance coverage, medical expenditures and sources of payments.

• Plan to enumerate coding standards and monitor coding error rates

• Setting hat-line standards and procedures for monitoring hat-line responses for response time and technical accuracy

• Quality of advanced letters – impact changes have on participation, procedures for letter approval, evaluation of mailing procedures – mailing of dummy materials to project staff to evaluate content and timeliness

• Supervisor related QC activities

• Monitoring of interviewer behaviors

The contractor shall put in place a monthly monitoring system pertaining to interviewer behaviors related to data quality (i.e., calendar path use, record use, interview timings, mode of interview) for new hires as well as the experienced interviewers.

MEPS-HC Amendment 1 Page 16 of 117

Metrics shall consist of the following but are not limited to:

• Proportion of interviewers using any records and proportion of interviewers using one or more key records identified by the Government (e.g., calendar, insurance statement, provider statements, appointment card/reminder, electronic records);

• Administration time of the calendar section;

• Administration time of provider probes per family unit;

• Proportion of multi-session interviews among multi-person RUs; and

• Mean number of true contacts per complete.

The contractor shall also develop and implement a field interviewer staff performance plan establishes a process to manage or retrain poor performers identified in the monitoring system.

The contractor shall continue operation of the ongoing Household Component of the MEPS (MEPS-HC) beginning with Round 1 field interviewing for the 2025 Household Panel. The contractor shall also begin work on planning for data processing for the 2025 estimation and analytic files upon contract award. The transition period between the current MEPS HC contract and this contract is critical to the continuous MEPS-HC operation. It is critical that continuity of the data collection instruments, sample design, interviewing techniques, data processing, editing and data file formatting be maintained and that any changes between the old and new contracts be transparent to respondents and data users.

Task 1.3 Project Reporting AHRQ will closely monitor the project management, operations, and costs for this contract. To facilitate this the contractor shall prepare and submit the following types of monthly reports.

Monthly Progress Reports (MPR) and Cost-to-Complete (CTC) Reports By no later than the fifteenth (15th) business day of the second month of contract performance and no later than the fifteenth (15th) business day of every month of contract performance thereafter, the Contractor shall submit to the AHRQ Contracts Office, the COR and other designated Center for Financing, Access and Cost Trends (CFACT) staff, both a Monthly Progress Report (MPR) (DELIVERABLE 5) and a Cost-to-Complete (CTC) report (DELIVERABLE 6) in electronic format, via e-mail as attachments or secure final transfer protocol (ftp) or extranet site with e-mail notification that reports are available for download. Similarly, the contractor shall submit a monthly CTC report no later than the fifteenth (15th) business day of the month.

At a minimum, the MPR shall include:

• Summary of all activities performed for each task during the month and plans for the upcoming month;

• A listing of problems encountered and proposed or enacted solutions, and a list of

“significant” problem encountered

• A listing of all requests for information and assistance that were completed and a listing of outstanding requests for information

• A summary of progress made toward meeting the overall deliverable schedule and project schedule

MEPS-HC Amendment 1 Page 17 of 117

• A description of any significant changes in the Contractor's operational personnel, including subcontractors

• A summary of all additions, modifications, and configuration changes to project software and database designs, specifications, testing, quality assurance efforts, maintenance and operational solutions and associated work efforts accomplished during the month

• Provide a listing of any new work products, computer databases or programs, or any other inventions that may be subject to intellectual property protection and how the contractor intends to manage intellectual property rights based off the MEPS-HC contract work

• A brief discussion of the expenditure of funds, including a statement that indicates the percentage of the funds that have been expended per performance period and option tasks

• A statement as to whether the contract will be completed in accordance with the time frame specified in the delivery schedule and within the budgeted (and obligated) amount

At a minimum, the CTC shall:

• Formatted in excel spreadsheet that includes monthly booked costs, forecasted costs, and budget variance across the life of the contract and broken down by performance period and project tasks (and subtasks). Consideration of the report should factor in the difference between booked costs and actual costs as reflected in submitted invoices that may account for salary rate ceilings and other unallowable costs.

• A summary tab that captures the cumulative costs and expected drawdown of obligated funds for the current period, including placeholders for any trailing costs and potential provisional (and final) indirect rate adjustments.

• The specific format of the CTC report shall be discussed with the COR and CO after award of the contract.

Earned Value Management System (EVM) The Contractor shall submit Earned Value Management (EVM) data in the form of a Contract Performance Report (CPR) (DELIVERABLE 7) no later than the fifteenth (15th) business days of each month. The CPR should be organized for entire project and by individual tasks (including option tasks) and include typical EVM metrics: Budget at Completion (BAC) – total planned cost of the total project or specified deliverable/ milestone at completion; Budgeted Cost of Work Scheduled (BCWS) – cumulative expected planned cost for activities planned to be completed by the end of the reporting month; Actual Cost of Work Performed (ACWP) – cumulative amount actually spent on activities performed as of the end of the reporting month;

Budgeted Cost of Work Performed (BCWP) – cumulative planned costs of the activities actually performed as of the end of the reporting month; and Cost and Schedule Variance – in the form of a %. In addition, the contractor shall provide a corrective action plan when the EVM Cost Performance Index (CPI) and/or Schedule Performance Index (SPI), exceeds more than 10% from the baseline plan. The Government and the Contractor shall negotiate the performance thresholds. The corrective action plan shall address the following items: Brief description of the issue (identify the nature of the issue as cost, schedule, performance or resources and explain why the issue came to be); Impact on project completion; Brief description of the corrective action plan strategy; and Corrective tasks/actions that are required to eliminate or mitigate the issue, including task/action number, point of contact, start and end dates and comments. If the corrective action plan requires re-baselining (the performance baseline), the corrective action plan also shall address the following items: The proposed new baseline; Reason(s) why re-

MEPS-HC Amendment 1 Page 18 of 117 baselining is required; and documentation of the reasonableness of the proposed new baselines and the accuracy of any new cost estimates

Task 1.4 Data Security The Contractor shall provide for the secure and confidential storage of all hardcopy materials and computer files, as specified by the COR. In addition, the Contractor shall provide for the secure and confidential transmission of data between the central office, field interviewers and other data collection staff, as well as for the secure storage of information residing on the MEPS-HC staff computers or laptops, if necessary. In the base period the contractor shall set up and maintain a secure encrypted data transmission or FTP site so that confidential data and documents can be transmitted from the contractor to AHRQ and to the MEPS-MPC contractor when approved by AHRQ. In addition, during the base period the contractor shall submit an initial Draft Data Security Plan within 30 days of the contract (base period) effective date and a Final Data Security Plan (DELIVERABLE 8) with implementation schedule, including desired date to secure the Authority to Operate (ATO), within 90 days of the contract (base period) effective date.

Task 1.5 MEPS-HC / MEPS-MPC Coordination The MEPS-HC and MEPS-MPC activities are intertwined yet occur across different contracts.

This means the MEPS-HC contractor shall ensure timely and accurate hand-offs of various sample files, data files, and documentation to support the MEPS-MPC activities that are directly linked to the overall effort to generate the MEPS-HC analytic files. Examples of these hand-offs include the signed MEPS-HC respondent Authorization Forms and sample identification that directly support the providers and medical events the MEPS-MPC seeks to collect data about.

Other examples include matching variables necessary to link the HC and MPC files, as well as matched HC and MPC files for use in the production of edited/imputed analytic files.

As needed AHRQ will coordinate discussions between the MEPS-HC and MEPS-MPC contractors in the event any changes made in one component’s processes that might affect the other component’s processes are communicated well in advance and well documented.

The contractor shall ensure coordination with the MEPS-MPC contractor to coordinate activities and provide various files in support of respective tasks. A recent MEPS-HC / MEPS-MPC coordination schedule is included in the Government Furnished Information (see attachment #19). The HC-MPC coordination schedule reflects the interlinked activities associated with a MEPS-MPC data collection cycle and overall MEPS-HC analytic file production.

The contractor shall deliver to AHRQ and the MEPS-MPC contractor the Authorization Forms (AFs) (DELIVERABLE 9) that ultimately support the MEPS-MPC sample.

Task 2: Instrumentation Task 2.1 Instrument Development Using information provided by AHRQ, the contractor shall rely on already developed MEPS-HC products for most of the main interview survey instrument, SAQs, and field interviewer materials, but shall modify for new survey rounds and annual survey updates as determined by

AHRQ.

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The main MEPS-HC instrument shall not exceed an average field administration time of 90 minutes across any of the field interviewing rounds by themselves. The MEPS-HC SAQs are intended to be brief and shall not exceed an average completion time of 10-15 minutes

From year to year only minor changes, if any, are expected to be made to the main MEPS-HC questionnaire and SAQs, with changes generally limited to revisions to resolve errors or inconsistencies found from previous administrations of the survey instrument(s).1 Each year in consultation with the Government, the contractor shall review approximately 20% of the main MEPS-HC questionnaire in terms of analytic content coverage and opportunities for data quality improvement. The contractor shall submit to the COR Proposed Main Interview and SAQ Changes (DELIVERABLE 10), with final decision on implementation being made by the Government. If any major changes to the main MEPS-HC questionnaire or SAQs are required, proposed revisions will be provided to the contractor by the COR.

The contractor shall develop, in final form, separate English and Spanish versions of the MEPS questionnaires (both the main interview across rounds 1-5 and SAQs, as applicable). The contractor shall prepare all associated Main Interview Survey Instruments and Field Interviewer Materials (DELIVERABLES 11 and 12) both in English and Spanish, including show cards, provider directories, manuals, respondent materials (e.g., letters, brochures, calendar) and other MEPS-HC documents intrinsic to successfully administering the survey for Rounds 1, 2, 3, 4, and 5 across a calendar year. The interview materials should reflect required Federal Policy regarding confidentiality and informed consent issues.

Task 2.2 Main Interview and SAQ Instrument Testing The contractor shall assess the performance, stability, and compatibility of the MEPS-HC main interview survey instrument as it relates to the current operating system, supporting applications, and updates made to the main-interview questionnaire and/or SAQs. The assessment shall consider data security, browser compatibility, costs of the data collection effort and other operational risks with the goal of conforming to industry best practices and technological developments.

Additionally, in response to the COVID-19 pandemic, the MEPS-HC main interview expanded to other data collection modes besides in-person, as applicable, including Computer Assisted Video Interviewing (CAVI) and telephone (minimal). The contractor shall consider programming the main MEPS-HC interview using different data collection modalities for administration, as well as the SAQs, and in a way that maximizes data collection efficiency.

The main MEPS-HC interview is a household survey originally designed to be conducted in-person using CAPI. Presently the main MEPS-HC interview is programmed for CAPI using Blaise 4.8 software. The contractor shall prepare and submit the CAPI software, installed in the field equipment (e.g., laptops) for AHRQ/CFACT evaluation, Main Interview Instrument Testing (DELIVERABLE 13), in the fall in preparation for the spring interviews (R1,3,5) and in the spring for the fall interviews (R2,4). The COR will inform the Contractor the number of units to submit.

1The MEPS main interview survey questionnaire and SAQs can be found at the following link. The MEPS main interview is organized by questionnaire section. https://meps.ahrq.gov/mepsweb/survey_comp/survey.jsp

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Task 2.3 OMB Clearance The Contractor shall produce and submit to the COR OMB Clearance Package Materials (DELIVERABLE 14). The clearance package must include a supporting statement and a complete set of exhibits (e.g., lead letter, question and answer brochure, and other documents as specified by the COR). Prior to initiating work on the supporting statement, the Contractor shall coordinate with the COR to review current requirements and policies. The Contractor shall prepare the entire OMB package in electronic format that is compatible with OMB’s Information Request, Review and Approval System (ICRAS). Formatting specifics will be provided by the COR.

Task 3: Sample Design and Selection Task 3.1 Sample design implementation The sample for each new panel of the MEPS-HC will be selected by the Government. The COR will provide each annual sample to the contractor no later than December 1 of the year prior to the fielding of the sample (for instance December 1, 2024, for fielding in early 2025).

The contractor shall submit to the COR a Sample Preparation and Implementation Collection Plan (DELIVERABLE 15) for the sample transmitted to the contractor, including specifications for sample preparation, the procedures to maximize survey response, monitoring response rates, nonresponse bias studies, procedures for adjusting sample weights for nonresponse, and variance estimations procedures

The sample for the 2025 panel of the MEPS-HC will be drawn as a subsample of households (dwelling units) that responded to the 2024 National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.2 The national area probability sample of households (including group quarters as well as other noninstitutionalized and institutionalized dwelling units) will represent the population of the United States and the District of Columbia. Specifically, the 2025 panel sample for the MEPS-HC will be a nationally representative subsample from responding households in two of the four 2024 NHIS panels. (The annual NHIS sample of households is partitioned into four nationally representative subdesigns, referred to as “panels” each with approximately the same number of households. Since 1996, two panels of the four panels in the NHIS have been reserved for use by AHRQ for the MEPS-HC.)

The full (all four panels) 2024 NHIS will consist of sample from 319 primary sampling units (PSUs). The annual NHIS sample based on the 2024 design has a targeted sample of approximately 35,000 responding households. The NHIS sample design has the capacity for sample expansions related to state level estimation in addition to national estimates.

The 2024 NHIS reserved for the 2025 MEPS-HC sample selection will consist of about 200

2 The NHIS sample design will be updated in the coming year to reflect 2020 Decennial Census geography, with the updated NHIS design to be fielded beginning in 2025. Attachment #19 includes a reference on the planned NHIS sample design changes for understanding potential implications for the MEPS Household sample. It is AHRQs understanding that PSU recycling must be in a way that each NHIS panel remains balanced and nationally representative. That means, if a PSU in a panel is cycled out than another PSU must be cycled in the same panel. For all cycled PSUs in a penal that is designed for MEPS-HC, AHRQ will have NHIS data available to select the MEPS-

HC sample.

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PSUs and approximately 13,000 responding NHIS households will be eligible and available for subsampling for the MEPS-HC. In addition, MEPS-HC may oversample additional policy relevant subgroups of the population from among the NHIS eligible sample.

The data collection for the MEPS-HC shall include obtaining information for all members within sample households. MEPS-HC analyses are conducted using the person, families, and the household as units of analysis. Through the reenumeration section of the Round 1 MEPS-HC questionnaire, the status of each individual sampled at the time of the NHIS interview is classified as “key or non-key” and “in-scope”. Sampling reenumeration takes place in each subsequent interview Round for persons in all households selected into the core survey. The “keyness” and “in-scope” indicators, together, define the sample to be used for person level national estimates. Some definitions follow.

Dwelling Units. Reporting Units and Other Definitions: The definitions for Dwelling Units and Group Quarters in the MEPS-HC Household Survey are generally consistent with the definitions of households, families, and group quarters employed for the NHIS. A Reporting Unit is a person or group of persons in the sampled dwelling unit that are related by blood, marriage, adoption or other family associations, who are to be interviewed at the same time in MEPS-HC. Examples of discrete reporting units are:

• married daughter and her husband living with her parents in the same dwelling are considered one reporting unit

• husband and wife and their unmarried daughter, age 18, who is living away from home at college, constitute one family, but two reporting units.

• Three unrelated persons living in the same dwelling unit would be three reporting units.

Unmarried college students under 24 years of age who usually live in the sampled household but are currently living away from home and going to school, will be treated as separate Reporting Units for the purpose of MEPS-HC data collection.

Key Persons: Key survey participants are defined as all civilian individuals who reside in households that responded to the nationally representative NHIS subsample reserved for the MEPS-HC, except for college students interviewed at dormitories. Members of the armed forces that are on full time active duty and reside in responding NHIS households which include other family members who are civilian individuals are also to be defined as key persons but will be considered out of scope for person level estimates derived for the survey.

All other individuals who join the NHIS reporting units that define the 2025 MEPS-HC household sample (in Round 1 or later MEPS-HC rounds) and did not have an opportunity for selection

Task 3.2 National Health Interview Survey (NHIS) NHIS-HC sample linkage files The contractor shall maintain and update a previously designed database (MEPS-NHIS Link File) (DELIVERABLE 16) that takes sampling information from the NHIS and other relevant socio-economic information on sampled persons and their families that will be imported into the MEPS-HC database and CAPI system. The capacity to link the MEPS- HC data back to the

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NHIS sample will also be required.3

Task 3.3 MEPS-HC panel sample maintenance While MEPS Household CAPI application helps identify the sample, the contractor shall maintain the sample including documentation of any splits or merges throughout the field period, including…