AHRQ-25-10006 MEPS-MPC Amendment 1.pdf

AHRQ-25-10006 MEPS-MPC

Amendment 1

Amendment #1 – RFP AHRQ-25-10006 MEPS-MPC

Attachment #1, 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. L.7 Technical Proposal Instructions

Appendix 5: AHRQ Data Management and Sharing Policy (DMS Policy) added to table of Page Limit Summary

2. Attachment E – Subcontracting Template Updated Subcontracting Goals with HHS

FY2025 goals

Attachment

E

Request for Proposal v. FAC 2024-04 Feb 2024 AHRQ-25-10006 MEPS – MPC Amendment 1 Page 1 of 104

Request for Proposal No. AHRQ-25-10006

PART I - THE SCHEDULE

SECTION A - SOLICITATION FORM

Date Issued: March 25, 2025

Date Questions Due: April 01, 2025

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

Date Amended: April 3, 2025

Date Notice of Intent Due: April 11, 2025, 12:00 PM, EST

Date AHRQ Proposal Module Registration: April 11, 2025, 12:00 PM, EST

Date Proposals Due: April 24, 2025, 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-25-10006 entitled “Medical Expenditure Panel Survey

(MEPS) – Medical Provider Component (MPC)”. Your proposal must be developed and submitted in accordance with the requirements and instructions of this RFP.

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 April 11, 2025. Subject line shall read: Proposal Intent

RFP No. AHRQ-25-10006.

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-25-10006. 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.

Additional Information:

a. A cost-plus fixed fee/cost plus award fee contract is contemplated for a base period of four

(4) months, with four (4) twenty (20) month options.

b. The Government anticipates awarding one contract from this solicitation on or about

August 15, 2025.

c. 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.)

d. The NAICS code for this requirement is 518210 with a size standard of $40.0M.

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.

mailto:tara.bertolini@ahrq.hhs.gov

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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 April 11, 2025:

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 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-25-

10006.

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

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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

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SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SUPPLIES OR SERVICES

“Medical Expenditure Panel Survey (MEPS) – Medical Provider Component (MPC)”. See

Section C for a complete description.

B.2 ESTIMATED COST AND FIXED FEE – Base Period Only

a. The Estimated Cost (exclusive of fees) for performance of the work under the base period of this contract, including direct and indirect costs is $ To Be Determined (TBD).

b. The Fixed Fee for the base period of this contract is $TBD. The fixed fee shall be paid in installments based on the percentage of completion of work, as determined by the Contracting Officer. Payment shall be subject to the withholding provisions of the Clause ALLOWABLE COST AND PAYMENT and FIXED FEE incorporated herein.

c. The total contract value, represented by the sum of the estimated cost plus the fixed fee for the base period is $TBD.

Period of Performance Services Estimated Cost Fixed Fee Total

Base Period Non-severable $ $ $

B.3 OPTION COSTS

If the Government exercises its option(s) pursuant to the option article in Section H of this contract, the Government’s total contract amount represented by the sum of the estimated cost, fixed fee, and award fee pool will be revised as follows:

Period of Performance Services Estimated Cost Fixed Fee Award Fee Pool Total

Option Period 1 Non-severable $ $ $ $ Option Period 2 Non-severable $ $ $ $ Option Period 3 Non-severable $ $ $ $

Option Period 4 Non-severable $ $ $ $

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

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OPTION TASKS

SOW Task Services Estimated Cost Base Fee Award Fee Pool Total Option Task A - Add responding Office Based Doctors (OBD) to the ODB Sample

Non-severable

SOW Task Services Estimated Cost Fixed Fee Total

Option Task B – External Sources for Imputation Non-severable Option Task C – Improve Methods to Ingest Billing Data Non-severable Option Task D – Investigate Alternatives to Collecting SBD Data Non-severable Option Task E – Improve data collection for Pharmacy Event Types Non-severable

All option tasks shall be accomplished in their entirety within the given contract year.

B.4 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:

(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 (including consultants) not otherwise expressly provided for in the contract;

(9) Information Technology hardware or software; and

(10) Food and Beverages.

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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.

B.5 CONTRACTING OFFICER AUTHORIZATION

Approval of the following items within the limits set forth is hereby granted.

To Be Determined

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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:

Background Information and Contract Objectives

The Medical Expenditure Panel Survey (MEPS) has been conducted by the Agency for Healthcare Research and Quality (AHRQ) annually since 1996. MEPS is a family of surveys intended to provide nationally-representative estimates of health care expenditure, utilization, payment sources, health status, and health insurance coverage among the noninstitutionalized, nonmilitary population of the U.S. MEPS consists of three core components: the household component (MEPS-HC or HC), the medical provider component (MEPS-MPC or MPC), and the insurance/employer component (MEPS-IC or IC). 1 Together these surveys collect data on specific health services, including the frequency of use, costs, and sources of payment for services, and on the cost and scope of health insurance covering U.S. workers. As such MEPS is the only national data source measuring how the U.S. population use and pay for medical care, health insurance, and out-of-pocket spending. In addition, MEPS data are widely used by policymakers and the research community on a wide range of topics related to the U.S.

healthcare system, including access to care, children’s health, chronic conditions, health insurance, health disparities, women’s health, prescription drugs, individuals with disabilities, and the aging population.

The MEPS-HC collects data from a sample of families and individuals in selected communities across the U.S., drawn from a nationally representative subsample of households that participated in the prior year’s National Health Interview Survey (conducted by the National Center for Health Statistics). During the household interviews, MEPS collects for each person in the household detailed information on the following: demographic characteristics, health conditions, health status, use of medical services, medical service charges and sources of payments for those services, access to care, satisfaction with care, health insurance coverage, income, and employment. The MEPS-HC panel design, which features several rounds of interviewing covering two full calendar years, makes it possible to measure changes in respondents’ health status, income, employment, eligibility for public and private health insurance coverage, use of services, and payment for care.

A challenge the HC faces is getting complete reporting from the respondents on the use of medical services and the associated medical service charges and sources of payments for those charges. To help address that challenge, the MEPS incorporates the MPC with the explicit purpose of collecting data to supplement and/or replace information provided by the HC respondents. To do this the MPC collects data from all hospitals, emergency rooms, home care

1 The MEPS-HC and MEPS-IC are separate requirements not part of this (or included/covered under) solicitation.

That said, many activities and deliverables associated with the MEPS-MPC project (contract) are directly linked to

HC activities, thus requiring careful coordination with AHRQ and the HC contractor. See Task 1 Project

Management for further information around MPC and HC coordination.

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The primary objective of the MPC is to collect data from medical providers (hospitals, office-based doctors (OBDs), home health agencies, pharmacies, long term health care facilities, SBDs) on dates of visits/services, use of medical care services, diagnosis and procedure codes for medical visits/encounters, and the charges, payments and source of payments for the medical services provided to those participating in the HC panel survey. The MPC data serve as an imputation source for HC item nonresponse to reduce the level of bias in survey estimates of medical expenditures. They also serve as the sole source of SBD expenditure information, as well as serving the primary source of expenditure information for Medicaid recipients, hospital care and prescription medicines.

The MPC sample can be seen as consisting of two parts that reflect different sources of selection: (1) the non-SBD MPC sample, and (2) the SBD MPC sample. The non-SBD part of the MPC sample is annually selected from the medical providers identified in the HC as having provided care to the respondent during a specific calendar year (HMOs are included, as well as office-based medical providers where the provider is either a Doctor of Medicine (MD) or Osteopathy (DO) or practices under the direct supervision of an MD or DO). That said, only providers for whom the respondent completed a signed Authorization Form authorizing contact are candidates for the MPC. The MPC SBD portion of the sample consists of physicians or other medical services providers, reported by hospitals or institutions as providing services during a hospital-based or institution-based event. Thus, the SBD sample is created during the MPC non-SBD data collection.

Home care providers, which include all home care agencies, hospitals, social service agencies, and other places identified as providing home care to the sample person, are included in the MPC. However, self-employed and unpaid persons providing home care services are not considered in scope for the MPC.

The integration of work activities between the MEPS HC and MPC projects requires careful coordination to maintain desired MEPS production schedules, including the annual release dates to the MEPS public-use files. The Contractor shall work in close coordination with the MPC COR to ensure deliverable schedules align with the HC production schedules and overall MEPS public-use file release dates.

Scope

The Purpose of this contract is to continue the MEPS-MPC operation of collecting medical provider data in support of generating annual MEPS household cost and expenditure estimates.

This contract will support medical provider data collection and abstraction efforts designed for use in generating annual MEPS estimates for the 2025 through 2029 survey years.

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Medical Provider Data Collection and Abstraction

• Authorization Forms: Receive, receipt, and manage signed household authorization forms.

• Sample Management: Implement, prepare, and document both non-SBD and SBD portions of the MPC sample.

• Material Development: Develop and produce medical provider respondent materials.

• Data Collection Operations: Conduct nationwide, large-scale data collection efforts from diverse medical and billing offices across multiple provider types.

• Data Abstraction – Billing Records: Abstraction of billing records to gather payment information from each medical event.

• Separately-Billing Doctors (SBDs): Identify potential SBDs for each hospital event.

Data Management and Processing, and Data File Production and Documentation

• Data security. Provide data security for a system designated with a FIPS-199 moderate classification.

• Forms control and receipt. Manage and control the intake of various data collection forms with the ability to handle both electronic and hard copy submissions.

• Data coding. Perform data coding to convert various text fields into standardized numeric codes, including sources of payment (SOP), medical conditions, medical supplies, and prescribed drugs.

• Data editing, processing, and quality control. Edit data to identify and remove duplicate events, roll up events, resolve zero dollar and negative payments, and resolve cases where payments equal or exceed charges and verify outliers.

Project Management, Reporting, and Meetings

• General Project Management: Including creation and maintenance of coordination points between the of MEPS HC and MPC contractor tasks.

• Recruitment and Training: Recruit, train, and manage staff for the successful completion of the MPC project.

• MEPS-MPC Continuity: Ensure continuity of MEPS-MPC operations by managing overlapping contracts and coordinating closely with AHRQ and the MEPS-HC contractor to meet production schedules.

• Liaison and Collaboration: Liaison and cooperation with MEPS principals, including AHRQ Contracting Officer’s Representative (COR) and key staff as well as the contractor’s Project Director and key staff working on the project.

• Documentation and Reporting: Preparation of MEPS-MPC documentation, such as project plans, reports, and meeting minutes

• Meeting Coordination: Meeting arrangements between AHRQ’s COR, key AHRQ personnel, and MPC contractor personnel.

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• Regulatory Compliance: Cooperation with AHRQ to secure necessary clearances and approvals and ensure compliance with federal data security and confidentiality guidelines.

• Project closeout/transfer of operations within 90 days of request.

Tasks and Activities to be Performed

The contractor shall furnish all the necessary qualified personnel, materials, supplies, equipment, services and facilities necessary to perform the work described below unless otherwise stated.

Place of performance: Continental United States Only U.S. citizens, by birth or naturalized, shall be permitted to perform services on this contract.

Base Period

The base period or initial contract start-up period is a critical time period for the MEPS-MPC project for ensuring that continuity is maintained between ongoing operations on the current contract and the operations supporting this acquisition/contract. Additionally, the base period creates an opportunity for transparency by allowing the contractor and AHRQ to inform MPC medical provider respondents about any forthcoming changes. Thus, base period success is necessary to help ensure a timely start to the 2025 MPC cycle and by default supportive of the overall inelastic HC-MPC coordination efforts. To achieve this, the base period shall include necessary activities to set up and begin testing all project-related systems in order to be approved for operations before the beginning of data collection associated with the 2025 MPC cycle. This includes the following tasks:

Kick-off meeting. The Contractor shall arrange a meeting and meet with the COR and other AHRQ staff 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. The contractor shall prepare and distribute to AHRQ the Kick-off Meeting Agenda (DELIVERABLE BP-1) and resulting Kick-off Meeting Minutes (DELIVERABLE BP-2) for the Kick-off meeting.

Survey Operations Implementation Report. The Contractor shall prepare and submit a Survey Operations Implementation Report (DELIVERABLE BP-3) that will contain detailed specifications on the implementation plan. The report shall include:

• A plan for data collection, building of systems for data collection and receipt, outlining recruitment and training of staff.

• Identify specific project risks and risk mitigation strategies to help ensure project objectives are met and that all deliverables will be sufficiently checked for quality control prior to submission.

• Include an organizational chart showing clear lines of authority and task/function responsibility.

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• Include a detailed project schedule that clearly identifies major milestones in data collection, data processing (including statistical matching activities), data file deliveries, and other project deliverables as defined in the delivery schedule.

• Address staffing, data collection field timing, and quality management and other management topics (e.g., data security, document management, and risks/constraints/adjustments).

• Plan for ensuring confidential storage and transmission of hardcopy materials and computer files.

• Plan for ensuring compliance with all data security protocols, for a system that is classified as FIPS-199 moderate. Please refer to the AHRQ Information Security and Privacy Attachment (Attachment #25) for more detailed requirements.

Base Period Deliverables

• BP-1: Kick-off Meeting Agenda – DRAFT/FINAL

• BP-2: Kick-off Meeting Minutes

• BP-3: Survey Operations Implementation Report - DRAFT/FINAL

Option Periods 1 through 4

Tasks 1-7 below apply equally to Option Periods 1 through 4.

The Option Periods support production of the following MEPS calendar year estimates.

Option Period 1 (2025 MPC cycle for 2025 MEPS estimates)

Option Period 2 (2026 MPC cycle for 2026 MEPS estimates)

Option Period 3 (2027 MPC cycle for 2027 MEPS estimates)

Option Period 4 (2028 MPC cycle for 2028 MEPS estimates)

Task 1 Sample Preparation and Implementation

The MPC sample annually consists of two components: 1) the non-SBD, and 2) the SBD. The non-SBD shall be drawn from medical providers reported by HC respondents and for which the HC respondents provided signed Authorization Forms allowing the MPC contractor to contact their medical providers (including Pharmacy) for purposes of collecting medical and billing data.

To be eligible for the MPC, signed and valid Authorization Forms are required for each HC respondent. Annually AHRQ will provide the MPC contractor with the non-SBD sample (including any OBD or Hospital subsampling) as collected from the HC. This is typically provided in three waves beginning in early January with about 75% of the total non-SBD sample, then again in early April with an additional 15 percent of the total non-SBD sample, and finally by mid-July with the remaining ten percent of the total non-SBD sample.

1.1 Non-SBD Sample Preparation and Implementation

The contractor shall prepare and submit a Non-SBD Sample Plan (DELIVERABLE 1) which will include:

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• Steps taken to prepare, implement, maintain, and field the non-SBD sample including provider-type assignment.

• Documentation of splits, merges, and out-of-scopes (e.g., outside of the U.S., prisons, jails)

• Management of multiple sample waves

• The plan to de-duplicate the sample to ensure that providers are not contacted more than needed. While the provider – the office, clinic, physician, hospital, pharmacy, home care provider, long term health care facility – is the “case” for the purpose of data collection operations, each MPC case may represent one or more household respondents mentioning the same provider. De-duplicating the sample prior to contacting the providers is essential to reducing burden and avoid contacting the same provider more than necessary to collect the needed data.

To prepare for the fielding of the MPC, the Contractor shall consolidate all duplications in the medical provider lists generated by household respondents. Using the most efficient means, the contractor shall review the provider sample generated by the household survey and assign unique provider identification numbers to each provider or group of providers that represent a single MPC respondent. These unique identifiers shall be constructed in a way that allows the MPC provider to be linked to the person-events recorded in the household survey that generated the provider. This de-duplication shall occur within and across households, primary sampling units (PSUs) (e.g., counties) and rounds. The panel design of the survey, which features five core rounds of interviewing, covers two full calendar years. Each year, providers for the MPC sample are identified based on three rounds of HC data collection (HC data collection is covered under a separate procurement). The resulting unique list of medical providers shall constitute the field sample for the MPC. The schedule for data collection requires that de-duplication be conducted in an ongoing manner. The final MPC file deliveries will contain a consolidated and de-duplicated ID variable that can be used to identify all MPC and HC records for each person/provider pair. This variable is critical to evaluation work at AHRQ and determining measurement error.

1.2 Managing the Provider Directory

The contractor shall develop and implement a process that results in the provider directory remaining current in order to maintain functionality for data collection purposes. Currently, when found for a provider, the National Provider Identifier (NPI) is assigned. However, all providers in the MPC do not have an NPI assigned. All separately billing doctors (SBDs) and pharmacies must be included in this directory as well as other provider types eligible for the MPC data collection. At the end of non-SBD data collection, the contractor shall prepare and deliver the

Provider Disposition Files (DELIVERABLE 2), which will include:

• Contact information at the provider level as well as for the respondent within the provider organization who provided the data (including name, title, division, telephone, fax, and email address)

• A review of the existing provider directory methodology.

• Propose alternative methodologies which would support analytic goals and improve data quality.

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• A crosswalk to the originally identified providers from the household.

• Disposition code for each person-provider pair in order to facilitate improvements in cleaning up the provider directory for future data collection.

1.3 SBD Sample Preparation and Implementation

The MPC sample also includes the Separately Billing Doctor (or SBD) component. The SBDs are those physicians or specialty groups providing care to the respondent during a hospital event and who received payment not included in the accounting of charges and payment for the main hospital bill or summary of payments. These newly identified patient provider pairs become part of the MPC sample either as new cases or as additional pairs to existing cases in an ongoing manner throughout the fielding of the hospital cases. Thus, SBDs are not reported by the HC respondent, but rather are identified from the MPC provider or the MPC provider’s medical records associated with the HC reported hospital event (outpatient, inpatient, emergency room). In support of this effort the contractor shall prepare and submit an SBD Sample Plan (DELIVERABLE 3) that shall describe the means for identifying the SBD expenses associated with each hospital event addressing the following dimensions:

• Sample development

• Sample preparation

• Instruments/materials

• Staffing/training

• Data collection specialist and abstraction procedures

• Management plan

• Quality control procedures

• Field cost reports

• Progress reports

• Response rate monitoring efforts.

Task 1 Deliverables

1. Non-SBD Sample Plan - DRAFT/FINAL

2. Provider Disposition Files

3. SBD Sample Plan – DRAFT/FINAL

Task 2 Field Preparation

2.1 OMB Clearance Supporting Materials

As necessary the contractor shall coordinate with AHRQ in preparing and submitting OMB Clearance Supporting Materials (DELIVERABLE 4) required clearance actions during the contract. These OMB Clearance Supporting Materials shall include:

• Burden estimates

• Written descriptions of the MPC operations

• Statistical matching activities

• Design and description of any methodological pilots or experiments

• Hard copy reproductions of survey questionnaires

• Hard copy reproductions of respondent materials.

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2.2 Data Collection Instruments and Material Preparation

The contractor shall develop in final form and submit all Data Collection Materials

(DELIVERABLE 5) such as:

• Data collection instruments (e.g., contact guides and event forms)

• Respondent materials

• Other documents intrinsic to conducting the MPC data collection based on those that have been prepared and used in previous MPC data collection cycle.

• PDF of the final versions of the data collection instruments.

The contractor shall be responsible for maintaining, revising, and adapting all data collection instruments and respondent materials. On occasion, the COR may request modifications to the data collection instruments and respondent materials. Nonetheless, all proposed revisions and adaptations (including new formats) shall be submitted to the COR for approval. The Contractor shall contact the Contractor responsible for updating the MEPS website; these materials will be posted on the MEPS website for public access.

Task 2 Deliverables

4. OMB Clearance Supporting Materials - DRAFT/FINAL

5. Data Collection Materials - DRAFT/FINAL

Task 3 Staffing and Training

3.1 Staffing and Training Plan

The contractor shall develop, deliver, and implement a Staffing and Training Plan (DELIVERABLE 6). This document will include:

• A plan for staffing, recruitment, and retention of sufficient numbers of data collection specialist (DCS) and abstraction staff (ABS), both supervisory and non-supervisory, necessary to support successful completion of all data collection and abstraction activities. The selection and hiring criteria must center qualities indicative of quality data collection and abstraction work performance, including previous work experience, work samples, and educational background.

• Address or account for cyclical retention and related workflow issues in concert with meeting desired pair completion targets and associated response rates.

• Include an overall DCS and ABS training plan that provides a comprehensive overview on the approach to training for an entire MPC data collection cycle.

• Include the training plan relevant to staff support for new DCS and ABS staff transitioning into production.

• Draft training schedule accounting for the various types of training to be conducted throughout an entire data collection cycle (and numbers of staff targeted to be trained during each session).

• Types of training materials.

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• Overall quality control procedures.

• Plan for incorporating and monitoring remote work effectively and efficiently, while ensuring data privacy is maintained.

3.2 DCS and ABS Training

The contractor shall develop programs and materials for training DCS and ABS staff and shall submit to the COR all associated DCS and ABS Training Materials (DELIVERABLE 7).

• The DCS training materials shall include the procedures and materials designed to effectively train staff in collecting data by medical provider type and with a goal of achieving required response rates and data quality.

• The ABS training materials shall include the procedures and materials to effectively train all ABS staff in the techniques to accurately abstract desired MPC data from medical and billing records received as part of the overall MPC data collection process.

The training programs for DCS and ABS staff shall be organized so that staff performing the same function shall have access to the same training in content and methods. These trainings shall be scheduled in a way to support both the timely start to a data collection cycle and abstraction activities and ensure adequate staffing levels by medical provider type are in place across an entire data collection cycle.

Prior experience has indicated that initial training is more successful when conducted face-to-face. Training manuals and materials may be adapted from those used in the current MEPS contract and should be reviewed carefully by the contractor to ensure that they represent the most up-to-date data collection strategies. Trainers are required to have expertise and experience on the tasks in which they train.

Following training, DCS and ABS staff must, at a minimum, be able to:

a) Identify and reach appropriate respondents in physician offices and other medical facilities.

b) Explain the nature and purpose of the MPC and answer questions commonly asked by medical and billing staff in deciding whether or not to cooperate with data collection.

c) Arrange with medical and billing staff various approved methods for obtaining the required data.

d) Collect the data, if appropriate, and know how to utilize data probing procedures.

e) Be able to elicit the appropriate expenditure data either over the phone or through the abstraction of financial records.

f) Know how to handle difficult respondents and potential refusals.

g) Know when and how to correctly use manuals, references, and guides.

h) Know how to completely, accurately and in a timely manner process all administrative forms.

i) (ABS staff) Accurately abstract data items of interest to MEPS from medical and billing records at an acceptable error rate as determined by the Government.

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In addition to the capabilities described above, supervisory personnel shall need to be able to perform the following functions:

a) Observe staff, identifying any errors and potential areas for improvement.

b) Counsel DCS and ABS staff on appropriate handling of unusual situations.

c) Monitor production, accuracy, time and expense and keep these and other performance measures at appropriate levels.

d) Convey feedback to staff in a constructive manner.

In concert with AHRQ, a decision log will be maintained and followed as issues arise and decisions are made in how to handle different data collection situations. The decision log will be made available to all data abstractors and all data abstractors will know how to use the decision log. This will ensure consistent data collection procedures. On a regular basis as determined by the contractor in consultation with AHRQ, the decision log will be incorporated into the procedural manual.

Task 3 Deliverables

6. Staffing and Training Plan - DRAFT/FINAL

7. DCS and ABS Training Materials - DRAFT/FINAL

Task 4 Data collection and Abstraction

The MEPS-MPC is designed to collect data on events for which household respondents are less likely to be fully aware of the financial transactions regarding the medical care received, to enrich the sample of events available as donors for imputation, and to provide a basis for methodological analysis of household reported payments for different types of events.

Non-SBD sample. The non-SBD portion of the MPC sample consists of providers specifically identified in the HC as having provided medical care to MEPS respondents. For the purpose of data collection operations, the non-SBD portion of the MPC sample can be split into the following groups:

(1) Hospitals. All hospitals, including psychiatric hospitals, reported as the site of care for inpatient stays, outpatient department visits and emergency room encounters shall be included in the MPC sample. HMOs are included in this effort.

(2) Office Based Doctors (OBD). A sample of office-based physicians providing care to targeted HC sampled persons shall be included in the MPC. HMOs are included in this data collection effort.

(3) Home care providers. All agency home care providers providing care to MEPS HC sampled persons shall be included in the MPC sample.

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(4) Pharmacies. All pharmacies (Corporate and non-Corporate) that have dispensed prescribed medicines to sampled persons shall be included in the MPC sample. HMOs are included in this effort. Note that in certain cases the MPC is unable to collect the needed data from the pharmacies. For those cases, the MPC contractor shall identify the pairs without pharmacy data, prepare, and deliver this Pharmacy Patient Profile List (DELIVERABLE 8) to the HC contractor. The HC contractor then will ask household to request data directly from HC family members. After collecting this data from household respondents, the HC contractor delivers these to the MPC contractor to process, QC, and include in the pharmacy files delivered to AHRQ.

(5) Long term health care facilities - all long-term health care facilities (nursing home, assisted living facilities, rehabilitation facilities, etc.) providing care to MEPS HC sampled persons living in the community for part of the year shall be included in the MPC sample.

Note that for the non-SBD sample, person-provider pairs associated with Veterans

Administration (VA) providers are held back from the MPC sample releases. Instead, the data for these pairs are extracted from agency databases by the Health Economics Resource Center

(HERC). The contractor shall generate HERC-VA Pair Files (DELIVERABLE 9) (in Excel or csv format) containing pairs with Veteran Administration (VA) providers for each wave and transmit those files to AHRQ. Those files will subsequently be used by the Health Economics Research

Center (HERC) to extract the MPC data for the pairs from the VA files. VA providers that are either state administered or CHAMPVA are excluded from the files.

SBD sample. In addition, the MPC sample includes the SBD portion.

(1) Hospital physicians or physician specialty groups (i.e., separately billing doctors or

SBD).

(2) Physicians or physician specialty groups identified by hospitals as providing care to sampled persons during a hospital event (inpatient stay, outpatient visit, emergency room visit) who render bills apart from the hospital facility shall be included in the MPC sample.

All hospitals, home care agencies, pharmacies (Corporate and non-Corporate) and long-term health care health facilities (including nursing homes, assisted living facilities, etc.) are “in scope” for the MPC. Other providers and sites of care are in-scope for MPC (OBD) if the provider is a Doctor of Medicine or osteopathy, or if the provider works under the direction and/or supervision of a MD or DO. For example, physician assistants and nurse practitioners working in clinics are medical providers considered in scope for the MPC. Chiropractors and dentists are out of scope (unless practicing in a hospital). Medical care received in prisons and jails and medical care received outside the United States is considered out of scope for the

MPC.

Based on historical sample size experiences, AHRQ anticipates the eligible sample for each MPC cycle to be no larger than what is specified in Table 1. The MPC sample to provide data for 2025 estimates is composed of two parts -- providers associated with 2025 events for persons enrolled in MEPS beginning in 2024 and providers associated with 2025 events for persons enrolled in MEPS beginning in 2025. For 2025 events encountered by persons/ households in the 2024 HC panel and the 2025 HC panel, the Government will provide sample frame materials and appropriate materials, including permission forms, to the contractor. The estimated eligible sample sizes have taken into account historical permission forms signing rates as well as proportions of providers determined to be out of scope. The expected number

Amendment 1 Page 18 of 104 of completed pairs takes into account the anticipated response rates for each provider type, which are based on recent historical data.

Table 1: Estimated MPC sample sizes - pair level

Event type Eligible sample1 Target Response Rate Completed Pairs2

1 Hospitals 8,100 65.0% 5,265

2 Institutions 110 85.0% 94

3 Home care providers 860 75.0% 645

4 Office-Based Doctors 15,500 65.0% 10,075

5 Pharmacies 15,400 80.0% 12,320

6 SBDs3 13,300 50.0% 6,650

7 HMOs 550 60.0% 330

1 Eligible sample: Eligible sample (after subsampling) for which permission to contact is available minus out of scope. Hospital and OBD estimates are reduced by about 10% from historical sample sizes.

2 Completed pairs: Expected completed pairs (final n x response rate)

3 SBD nodes are created for each separately billed doctor associated with each event identified in the hospital data collection.

While Table 1 provides estimated sample sizes and response rates based on historical data, response rate minimums will be required for certain provider types that are critical to expenditure estimates. These requirements will apply specifically to Hospitals, Office-Based Doctors, and Pharmacies, as detailed in Table 2.

Table 2: Response rate requirements

Provider type Response rates

Hospital Completion Rate

Below Minimum Response Rate: Under 60%

Minimum Response Rate: Over 60% up to 65%

Target Response Rate: Over 65% up to 80%

Desired Response Rate: Over 80%

Office-based Doctors Completion Rate

Below Minimum Response Rate: Under 60%

Minimum Response Rate: Over 60% up to 65%

Target Response Rate: Over 65% up to 70%

Desired Response Rate: Over 70%

Pharmacy Completion Rate

Below Minimum Response Rate: Under 75%

Minimum Response Rate: Over 75% up to 80%

Target Response Rate: Over 80% up to 85%

Desired Response Rate: Over 85%

If at any time the MEPS-HC response rates fall below the established target response rates, the contractor shall propose remedial actions for review and approval by the COR.

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Data Collection Plan. With the purpose of MEPS to annually generate nationally representative estimates of healthcare expenses and the role the MPC fulfills in the effort, the contractor shall prepare and submit a Data Collection Plan (DELIVERABLE 10) that documents the overall approach to data collection, including:

• Any process improvements or efficiencies that maintain or enhance data quality and achieve desired completion targets and response rate goals.

• General data collection and abstraction procedures (such as the use of multi-mode procedures)

• Data collection and abstraction management/supervision and quality control,

• Efforts/strategies toward meeting completion targets and response rate goals.

• Data collection schedule (for both non-SBD and SBD data collection) that covers:

o Data collection for non-SBD event types beginning by early February following the data collection year of interest (e.g., February 2026 for the 2025 MPC cycle).

o SBD data collection beginning by August following the data collection year of interest (e.g., August 2026 for the 2025 MPC cycle) and ending no later than mid-January in the following calendar year (e.g., January 2027 for the 2025 MPC cycle) o Annual specifications of both high priority and low priority events for data collection purposes. These specifications will be made based on various characteristics of the person and event type.

o Plan for accelerating the data collection schedule f there becomes a need from

AHRQ to adjust/change any of the data file delivery dates.

o Plan for allowing flexible assignment of staff to support data collection from multiple provider types depending on the time of year, the flow of incoming records/data, the skill level of the current data collection staff and the status of the current field period.

• Data Quality Control Plan covering quality control of both DCS and ABS data collection, including:

o Identification of Anomalous Data Patterns (“Edit Shop”). The contractor shall develop and implement a process for identifying and resolving anomalous patient-provider pairs and/or events that failed predefined quality checks. This process may include expert review, use of original records when available, and provider call-backs as needed to resolve discrepancies. The plan should include criteria for review frequency and conditions under which an event or pair requires review. Feedback mechanisms to staff should also be included in the plan.

o Initial and Ongoing Quality Verification. The contractor shall ensure that the accuracy of data collected by data collection specialists and abstractors is maintained. The plan should include a proposal for identifying and defining error rates for key data elements (e.g., charge and payment data), and a justification for the proposed definition. Currently, the work for each DCS/ABS staff is checked at 100 percent during the first two weeks of data collection, where

Amendment 1 Page 20 of 104 checking is conducted via complete review of the original data. As each data collection specialist/abstractor achieves the target error rate or better, verification is reduced to a ten percent batch sample.

o Feedback. An approach to providing regular feedback to data collection staff, defining methods for adjudicating failed verifications, and ensuring timely resolution of any discrepancies. Throughout the life of the project, the agreed-upon-error rates and methods for re-review and adjudication can be modified in consultation with and approval by AHRQ to meet the project goals.

In consultation with the COR, AHRQ will help identify for the contractor certain patient-provider pairs as “high priority” for special attention during data collection.

For each MPC data collection cycle, the contractor shall screen all providers to ascertain their eligibility, their association with the MEPS household respondent, and to obtain information to facilitate the conduct of the core MPC interview. Presently data collection methods may include phone, fax, mail, self-administration, secure email, FTP and electronic transmission. The data collection method may vary by provider and should be chosen to obtain the most complete and accurate data while simultaneously minimizing medical provider reporting burden.

Data Collection Progress Reports. Throughout the data collection field operations, the contractor shall prepare and submit to the COR Data Collection Progress Reports (biweekly) (DELIVERABLE 11), which will include:

• Field monitoring reports

• Cost reports

• Quality control reports on a bi-weekly basis

• Reports on error rates

• Reports on performance for each data collection specialist/abstractor

• Overall project metrics

The format of these field monitoring progress and cost reports will be agreed upon with the COR. This schedule may vary at certain times during data collection and requests for this must either be generated from the COR or by approval of the COR. Supervision through supervised data collection and abstraction, reviews of individual data collection and abstraction and other means of observation and verifications shall be maintained to assure the quality of the data. The contractor shall maintain toll-free telephone communications for respondents (and data collection specialists and abstractors, if necessary) with the central office so that all questions can be answered efficiently, and problems anticipated will be dealt with proactively.

End of Data Collection Reports. At the conclusion of each of the non-SBD and SBD data collections, the contractor shall prepare and submit a brief End of Non-SBD Data Collection Memo (DELIVERABLE 12) and End of SBD Data Collection Memo (DELIVERABLE 13) notifying AHRQ that the respective data collections have ended (including the dates or length of the data collection) and documenting the data collection outcomes including provider eligibility rate, disavowal rates, completion rates, refusal rates, and unlocatable rates, by provider type.

In addition, following the end of both non-SBD and SBD data collection, the contractor shall prepare and submit a consolidated End of Data Collection Evaluation Report

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(DELIVERABLE 14) documenting the data collection experience against what was planned for the cycle, including challenges encountered and potential solutions introduced and what should be considered for improving the next cycle of data collection.

Task 4 Deliverables

8. Pharmacy Patient Profile List

9. HERC-VA Pair Files

10. Data Collection Plan - DRAFT/FINAL

11. Data Collection Progress Reports (bi-weekly)

12. End of Non-SBD Data Collection Memo

13. End of SBD Data Collection Memo

14. End of Data Collection Evaluation Report - DRAFT/FINAL

Task 5 Data management and processing

The contractor shall prepare and submit a Data…