Disenrollment Survey -Sources Sought Notice.docx

National Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey

THIS IS NOT A FORMAL REQUEST FOR PROPOSAL (RFP) AND DOES NOT COMMIT THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) TO AWARD A CONTRACT NOW OR IN THE FUTURE

This is a SOURCES SOUGHT NOTICE issued for the purpose of planning and market research. The purpose of this notice is to determine the availability of small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) on the GSA Multiple Award Schedule (MAS) SIN 541611 (Management and Financial Consulting, Acquisition and Grants Management Support, and Business Program and Project Management Services) that have the capability to support CMS in activities associated with the Prescription Drug Plan (PDP) and Medicare Advantage (MA) Disenrollment Reasons Survey.

No reimbursement will be made for any costs associated with providing information in response to this Notice. Respondents will not be notified of the results of the capability assessment. All information submitted in response to this announcement must arrive on or before the closing date.

A. General Background

Voluntary disenrollment rates from managed care plans are often viewed as a good “summary” indicator of member satisfaction and plan quality. The Balanced Budget Act of 1997 required that the CMS publicly report two years of disenrollment rates on all Medicare + Choice (M+C) organizations. To ensure that disenrollment rates would be meaningful to beneficiaries in health plan choice, to support quality monitoring activities, and to assist in quality improvement initiatives, CMS funded the development and implementation of an annual national survey to identify the reasons that beneficiaries voluntarily leave health plans. From 2000 through 2005, CMS administered the Medicare Consumer Assessment of Health Plans (CAHPS) Disenrollment Reasons Survey for managed care organization and publicly reported information from this survey.

As the Medicare program had changed significantly since the CAHPS Disenrollment Reasons Survey was administered in 2005 (largely attributable to the 2006 implementation of Medicare’s Prescription Drug, or Part D, benefit), in 2009 CMS funded an effort to develop a revised disenrollment survey to focus on beneficiary reasons for leaving their PDP or MA plan. These surveys were further refined and implemented nationwide under CMS contracts in 2012, 2014, 2017, and 2020 that continued to expand analyses and results shared with plans.

Data collected from the Disenrollment Reasons Survey will be used to produce individual plan reports and for public reporting. Especially as current MA and PDP plans exit the market and new health and drug plans enter the market, it is critical to assess why beneficiaries disenroll from health and drug plans to support quality improvement efforts of individual plans, and provide data to assist consumer choice.

B. Required Knowledge and Experience

At a minimum, the following knowledge and experience are required:

· Knowledge of how CMS uses the Prescription Drug Plan (PDP) and Medicare Advantage (MA) Disenrollment Reasons Survey (Disenrollment Reasons Survey)

· Knowledge of the operations and management of Medicare Advantage Organizations, Prescription Drug Plans, Cost Plans, and Special Needs Plans (SNP), Employer Group Health Plans (EGHP), and Medicare-Medicaid Plans (MMP)

· Knowledge of MA and PDP enrollment and disenrollment guidance, CMS enrollment systems and operational guidance

· Knowledge of monthly voluntary disenrollment data and systems; enrollment data and systems; and Health Plan Management System (HPMS)

· Prior experience with overall planning processes for national implementation of surveys

· Prior experience with various survey administration procedures

· Prior experience with the design and implementation of complex sampling design

· Prior experience determining and applying case-mix adjustment

· Ability to make recommendations for survey administration protocol guided by current research in the discipline, past fielding of Disenrollment Reasons Survey, and ongoing Disenrollment Reasons Survey administration

· Ability to conduct interviews with Medicare beneficiaries, plan representatives or other Disenrollment Reasons Survey audiences

· Ability to store, retrieve, transmit, and analyze data files associated with the Disenrollment Reasons Survey

· Prior experience in analyzing data and producing plan reports of results

· Prior experience that demonstrates the ability to perform the above data production requirements using the most cost efficient methods available

· Prior experience working collaboratively with other large organizations such as CMS or other governmental organizations in large scale multiple data file preparation efforts using multiple data sources

· Track record of keeping to a schedule managing multiple tasks

· Ability to respond to inquiries from plans and others about survey development, implementation, and fielding

· Experience in effective project management

· Experience preparing OMB submission packages

· Thorough understanding of HIPAA requirements and PHI rules and regulations

· Ability to produce ad hoc reports in response to CMS inquiries and deadlines

· Prior experience performing multiple analyses under tight timeframes

· Prior experience using large data sets and merging data from multiple sources

B. Capability Statement Requirements

CMS requests that the respondent specifically address the requirements listed below. Respondents should provide enough information for CMS to make an informed determination of their capability to perform the work as identified below. Please remember that the potential offeror or prime contractor must be able to perform at least 50% of the labor associated with this effort. Please provide a list of contract numbers that your organization has had (if applicable) and your role on the contract (prime contractor or subcontractor). If you were a subcontractor on a particular contract, please clarify the work that you did on that contract.

Please describe your capabilities and detailed experience performing similar activities as those described below. Your responses should demonstrate your understanding of the following:

1. Ability to implement and field a nationwide survey

2. Capacity to develop and distribute survey reports to plans

3. Knowledge and understanding of MBDSS, CAHPS, IDR data, and Health Plan Management System (HPMS)

4. Knowledge and skills with robust statistical analyses

5. Knowledge and skills with relevant, complex sampling design techniques

6. Understand the operations and management of Medicare Advantage Organizations (MAOs) and Part D contracts

7. Knowledge of CMS health and drug plan enrollment/disenrollment policy, operational guidance and systems

8. Interface with a variety of data systems in a secure environment

9. Store, retrieve, and analyze data files

10. Experience conducting qualitative research to improve survey design and results reporting

C. Instructions for Submitting Responses to CMS

The following specific information is requested: (a) company descriptive literature; (b) specific related corporate experience; (c) experience with the type of capability expectations mentioned above; (d) references, to include points of contact, email addresses, and phone numbers; and (e) Business information outlined below.

a. Sources Sought Notice number, title, and date of issuance

b. SAM UEI

c. Company Name

d. Company Address

e. Company Point of Contact, Phone, and Email address

f. Validation of small business status under NAICS Code 541611 - Administrative Management and General Management Consulting Services (size standard of $24.5 million)

g. Current GSA Schedules appropriate to this Sources Sought Notice

Please limit your documentation to the following Page Size, Font Type and Size, Spacing and Page Numbering. Responses shall be submitted using a Microsoft Word document with page size 8.5 by 11 inches. Font type shall be Times New Roman, size 10-12 using standard tabs and indent software features with no less than single spacing between lines. Responses are limited to ten (10) pages for the entire capability statement. The Cover Page is not included in the total page count and shall include the Business information listed above.

All transmitted information marked proprietary shall be treated as such. Therefore, businesses should identify any proprietary information in their responses. Proprietary materials will neither be distributed, nor discussed with, any other organization. Information submitted in response to this will be used at the discretion of the Government. Further, the information submitted will remain confidential insofar as permitted by law, including the Freedom of Information and Privacy Acts.

Respondents should be aware that this Sources Sought Notice is for market research purposes only and any responses thereto, or lack thereof, will not constitute a commitment by CMS to treat any potential offeror more or less favorably in the anticipated forthcoming solicitation and/or ultimate award. Please be advised that CMS will not respond directly to organizations submitting information in response to this Sources Sought Notice.

Teaming Arrangements

Contractors responding to this Notice as a team or that rely on subcontractors to perform any portion of the work must include the above-requested information and certifications for each entity on the proposed team or each proposed subcontractor. Responses must clearly indicate the nature of the teaming arrangement.

The contractor and any subcontractors must not have any relationships or arrangements through business operations or its employees that could be considered as lessening the company’s objectivity concerning any aspect of the proposed tasks. If such relationships or arrangements exist, contractors or subcontractors shall be required, during the procurement process, to identify potential conflicts of interest and discuss how the conflicts will be addressed and mitigated.

All capability statements can be submitted via e-mail to carlos.delgadosanchez@cms.hhs.gov and mark.smolenski@cms.hhs.gov. Responses must be submitted no later than 11:00 AM ET Tuesday, November 26, 2024.