MCBS RFI FY2026 - Final.pdf

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Medicare Current Beneficiary Survey (MCBS) Request for Information Reference No.: HHS-CMS-RFI-2026-270043 NAICS Code: 541720 – Research and Development in the Social Sciences and Humanities

A. General InformaƟon

THIS IS A REQUEST FOR INFORMATION (RFI). This is NOT a solicitaƟon for proposals, proposal abstracts, or quotaƟons and in no way obligates the Government to award a task order.

The purpose of this RFI is to obtain knowledge and informaƟon for project planning purposes and for exploring alternaƟve soluƟons and determining industry standards for the administraƟon and operaƟon of the Medicare Current Beneficiary Survey (MCBS) requirement.

B. Project Background

CMS is the largest single payer of health care in the United States, administering health insurance coverage for more than 120 million people across the Medicare, Medicaid, CHIP, and Exchange populaƟons. The agency serves as an effecƟve steward of taxpayer resources and a trustworthy partner in improving healthcare quality, accessibility, and affordability while safeguarding program integrity and prevenƟng fraud, waste, and abuse. Central to this mission is puƫng paƟents first in the delivery of their healthcare needs. CMS conƟnuously strives to advance these objecƟves in response to evolving care delivery approaches, technological advancements, and new statutory requirements.

To support conƟnuous improvement and innovaƟon, CMS relies on comprehensive data generated through administering the Medicare program. Enrollment, claims, and assessment data are essenƟal in informing program evaluaƟon and future program planning. However, while these data are an important resource, certain key acƟviƟes – such as developing fiscal projecƟons, evaluaƟng how Medicare policies affect beneficiaries' health and healthcare experiences, planning innovaƟve payment and service delivery models, and conducƟng strategic program planning – oŌen require data that cannot be obtained from administraƟve sources alone. EssenƟal informaƟon on beneficiary income, supplemental insurance coverage, non-Medicare payments (including out-of-pocket spending), and non-covered services can only be obtained by surveying beneficiaries directly. Likewise, data on beneficiary knowledge of the Medicare program, health history, access to care, and saƟsfacƟon with services must be collected directly from beneficiaries.

The MCBS is a conƟnuous, mulƟ-purpose longitudinal survey, represenƟng the populaƟon of Medicare beneficiaries residing in the United States. Since 1991, the MCBS has met CMS' need for data on beneficiaries' unique perspecƟves and experiences by collecƟng comprehensive informaƟon on beneficiaries' social and medical risk factors and their relaƟonship to healthcare uƟlizaƟon and health outcomes. Linking survey data with Medicare claims and assessment data, the MCBS provides criƟcal insights for policy development, program evaluaƟon, and understanding beneficiary experiences that cannot be obtained from either administraƟve or survey data alone. The MCBS is also the only source that provides complete informaƟon on total healthcare expenditures and sources of payment for

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Medicare beneficiaries, including out-of-pocket costs, supplemental insurance payments, and spending on non-covered services.

The MCBS is designed to represent the full diversity of the Medicare populaƟon. The survey collects data directly from beneficiaries across all segments of Medicare, including those:

• enrolled in Fee-for-Service and Medicare Advantage

• aged 65 and over, as well as those aged 64 and below with certain disabling condiƟons

• who use healthcare services and those who do not

• living in community and facility seƫngs

This comprehensive approach ensures that MCBS data reflect the experiences of all Medicare beneficiaries, not just those who are most visible in claims data or who interact frequently with the healthcare system.

Data from the MCBS are used extensively across the Federal government and research community to inform evidence-based policymaking and regulatory analysis. MCBS data are used to inform CMS and Congressional Budget Office projecƟons of Medicare spending and to support Medicare Payment Advisory Commission’s analyses of Medicare payment policy and spending trends. Beyond federal applicaƟons, the survey provides data to hundreds of external researchers annually. Findings from MCBS analyses are regularly published in peer-reviewed journals.

The breadth and depth of MCBS data support a wide range of criƟcal needs across CMS, informing development of policies on emerging priority topics, design of new InnovaƟon Center models, and validaƟon of algorithms developed using administraƟve data. Data from the MCBS have been instrumental in informing advancements to the Medicare program, including the creaƟon of benefits such as Medicare's Part D prescripƟon drug benefit. The survey's longitudinal design and consistent data collecƟon methodology enable stakeholders to respond to emerging policy quesƟons, conduct rigorous program evaluaƟon, and track changes in beneficiary experiences and outcomes as the Medicare program evolves.

The MCBS conƟnuously evolves to meet CMS's changing data needs and policy prioriƟes while maintaining core content areas that enable longitudinal analysis and trend monitoring. As the healthcare landscape shiŌs and new policy quesƟons emerge, the survey adapts by thoughƞully reƟring outdated content and introducing new measures that reflect current prioriƟes. This commitment to relevance is evident in recent and ongoing enhancements to the survey.

In 2026, the MCBS received Office of Management and Budget (OMB) approval to redesign its sampling approach, which, once fully implemented, will enable the survey to produce robust state-level esƟmates and capture geography-specific healthcare experiences. AddiƟonally, CMS requires the MCBS to have the flexibility to rapidly respond to emerging policy quesƟons and urgent informaƟon needs. The survey must be capable of quickly fielding targeted quesƟons to current respondents, providing Ɵmely insights on criƟcal topics such as public health emergencies, implementaƟon of new programs or benefits, or other Ɵme-sensiƟve policy issues.

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The survey also conƟnuously refines its methodology, incorporaƟng advances in data collecƟon techniques and idenƟfying new approaches for delivering Ɵmely, policy-relevant data to stakeholders.

CMS is commiƩed to leveraging emerging technologies and innovaƟve approaches to ensure the security of beneficiaries' protected informaƟon; enhance data quality and analyƟcal capabiliƟes; improve operaƟonal efficiency and reduce respondent burden; and make MCBS data more discoverable and accessible to diverse users. These enhancements reflect CMS' commitment to ensuring that MCBS remains a dynamic, data collecƟon instrument capable of responding to the evolving needs of a policy-driven agency.

C. Survey Methodology and OperaƟons

The MCBS currently employs a complex multistage probability sample design. At the first stage of selection, the sample consists of 104 primary sampling units (PSU) defined to be metropolitan areas and clusters of nonmetropolitan counties. At the second stage, a sample of 703 secondary sampling units consisting of Census tracts or groups of tracts (SSUs) is selected within the sampled PSUs. At the third and final stage of selection, stratified samples of beneficiaries within the selected Census tracts are sampled annually at rates that depend on age group and Hispanic or non-Hispanic ethnicity. The geographically-clustered nature of the current design was developed to support in-person-only interviewing by ensuring that sampled beneficiaries are clustered into relatively small areas. Under this design, the sampled beneficiaries within each state are not representative of their state as a whole, and 14 states contain no PSUs (and thus no beneficiaries selected for data collection), resulting in a design which supports only national-level estimation. It is not possible to produce representative estimates for states or other sub-national regions.

The 2026 redesign, to be launched starting with the Fall 2026 data collection, will employ a national frame, which covers all 50 states and the District of Columbia. The sample will be stratified by state1 to provide approximately equal numbers of beneficiary interviews within each state. The redesigned approach will no longer rely on PSUs or SSUs, and all beneficiaries in the United States will be eligible for sampling and recruitment. In place of the PSUs and SSUs, the national frame will be partitioned by state, and within each state, beneficiaries will be selected at rates designed to preserve adequate representation of the under-65 disabled population, beneficiaries 65-79 years of age, and beneficiaries 80 years of age and older. There will no longer be additional stratification based on ethnicity.

While both the current design and the 2026 redesign yield nationally representative samples, the new design will include sampled beneficiaries and completed interviews in each of the 50 states and the District of Columbia. Once fully implemented, the 2026 redesign will allow for state-level and sub-national region-level estimation, while continuing to support national-level estimation for the many domains of interest.

1 A total of 51 strata that include the 50 states and the District of Columbia.

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Phased ImplementaƟon Plan

ImplementaƟon of the sample redesign will occur incrementally over four years due to the MCBS rotaƟng panel structure:

• Fall 2026: The first new panel will be selected and fielded under the redesigned, state-straƟfied sample. At this Ɵme, exisƟng panels will conƟnue to be fielded under the historic geographically clustered design.

• Fall 2027: A second panel will be selected and fielded under the redesigned sample. At that point, two panels will operate under the new design and two panels will conƟnue under the legacy design.

• Fall 2028: A third panel will be fielded under the new design, and one will remain under the legacy design.

• Fall 2029: Full implementaƟon will be achieved when all four rotaƟng panels are operaƟng under the redesigned sample.

The phased redesign will require a forward-looking approach that sustains data quality, conƟnuity, and transparency during the period in which legacy and redesigned panels operate concurrently, while ensuring rigorous staƟsƟcal integraƟon, operaƟonal modernizaƟon, and clear communicaƟon to stakeholders as new analyƟc capabiliƟes are introduced.

D. Data MigraƟon and Cloud HosƟng

The CMS Office of InformaƟon Technology (OIT) cloud system has developed a strategic vision for CMS to become the leading agency in leveraging modern cloud technology. Cloud CompuƟng has afforded CMS the ability to scale up criƟcal applicaƟons to meet the agency’s program specific goals, while maintaining CMS technical architectural and security standards. CMS desires soluƟons that implement best pracƟces, employ a Financial OperaƟons (FinOps) culture (promote cost opƟmizaƟon), and deliver business value quickly and conƟnuously using naƟve cloud services, when possible, which provide an abstracƟon layer over physical and virtual hardware, network and security devices or tools.

CMS is conƟnually conducƟng Security Impact Assessments (SIA) on new perƟnent services idenƟfied and desired by the stakeholder community. This is especially true with the expansion and increasing adopƟon of ArƟficial Intelligence (AI) capabiliƟes at CMS including machine learning, generaƟve AI, and products derived from AI tools available on the market. CMS conƟnuously reviews industry-provided AI capabiliƟes against CMS security requirements to ensure compliance with CMS and Federal security requirements and the development of standards and guidelines for how AI products and capabiliƟes should be configured to reduce risk and exposure of sensiƟve CMS data.

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E. QuesƟons for Industry

CMS is seeking informaƟon from industry regarding the MCBS. Accordingly, please consider the enƟrety of informaƟon provided above when responding to each of the following quesƟons:

1. The MCBS currently relies on Unicom Intelligence and BLAISE 4.8 for administering a complex data collecƟon, with features such as preloaded data, longitudinal logic, and looping. Is there an industry-preferred survey applicaƟon (i.e., cloud supported, cloud based, or cloud naƟve) that you would recommend for supporƟng these requirements while operaƟng within the CMS cloud environment? If a change from the exisƟng applicaƟon is recommended, what level of effort and key consideraƟons would be associated with migraƟng the survey applicaƟon?

2. In addiƟon to the survey instrument itself, MCBS requires business operaƟons capabiliƟes to support efficient case management, including tracking and assignment of cases, transiƟons between community and facility cases, and management of case disposiƟons. Many contractors support these funcƟons using internally developed systems or commercial off-the-shelf (COTS) tools. What experience and best pracƟces can you describe regarding the use of business intelligence, workflow, or case-management tools to support these funcƟons, including the level of effort and consideraƟons associated with configuring or implemenƟng such soluƟons in the CMS cloud environment? Please include if this experience is from successful work at CMS or other government agencies and if you used COTS or contractor-developed applicaƟon.

3. Do you have a best pracƟce for capturing data from paper ExplanaƟon of Benefits (EOBs) and other health care receipts as well as informaƟon from paƟent portals in an online, in person, or telephone survey?

4. CMS operates in a dynamic policy environment that can require rapid data collecƟon on emerging or previously unmeasured concepts. In advance of fielding quesƟons through a rapid “pulse” mechanism, what experience and best pracƟces can you describe for quickly developing, tesƟng, and refining new survey quesƟons, parƟcularly where tradiƟonal cogniƟve tesƟng Ɵmelines are not feasible?

5. At the Ɵme of award, MCBS will be implemenƟng a new sample design, simultaneously fielding cases under both the redesigned sample and the legacy sample (which is being phased out).

What best pracƟces, methodologies, or approaches would you recommend for managing this transiƟon period, including strategies for concurrent administraƟon of both sample designs?

6. MCBS faces increasing requirements for data transparency and reporƟng across the complete data lifecycle —from collecƟon through processing, revision, and disseminaƟon —including comprehensive documentaƟon of changes over Ɵme. What best pracƟces do you recommend for developing, maintaining, and sharing metadata in a CMS Cloud-hosted environment? Please address approaches that ensure metadata are structured to support modern analyƟcal and reporƟng tools, including CMS Cloud-naƟve applicaƟons.

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7. Does industry recommend one contracƟng scope mechanism for MCBS to use (Statement of Work (SOW) or Statement of ObjecƟves (SOO) with a Performance Work Statement (PWS))?

Please provide an explanaƟon for your recommendaƟon. The MCBS has relied on a SOW in all of its past contracts. This next contract will include innovaƟve enhancements that could reimagine current deliverables.

8. ArƟficial intelligence capabiliƟes are evolving rapidly, and CMS anƟcipates that future uses of AI in survey operaƟons and data processing may emerge over the life of the contract. What industry best pracƟces would you recommend for responsibly using AI in survey research and data operaƟons today, and how should CMS plan for potenƟal future AI applicaƟons that are not yet defined?

9. The migraƟon of the MCBS system to the CMS Cloud will be completed without a stop in data collecƟon. Keeping in mind the complex system dependencies and handling of sensiƟve personal data requiring protecƟon (PII and PHI), does industry recommend best pracƟces for tracking progress as well as remedies for schedule or budget slippage during the migraƟon?

10. CMS will be migraƟng MCBS, currently hosted in an on-premise environment that's managed and owned by a CMS contractor, to a government-owned (CMS Cloud), contractor-operated environment starƟng with the next contract. What innovaƟve process efficiencies can CMS expect to realize as a consequence of leveraging cloud-naƟve tools during this migraƟon and modernizaƟon? And how much Ɵme would it take to complete this process?

We appreciate your Ɵme and effort in responding to this request for informaƟon.

F. InstrucƟons for Submiƫng RFI Responses to CMS

Email responses are due no later than 12:00 PM EST on April 1, 2026 to Jessica Foster (Contract Specialist) at Jessica.Foster@cms.hhs.gov and Jennifer Davis (ContracƟng Officer) at Jennifer.Davis@cms.hhs.gov in the following format:

• MicrosoŌ Word document with page size 8.5 by 11 inches, with a minimum of 1" margins.

• Times New Roman or Aptos Font Size 12

• Submissions shall not exceed 10 pages. The Cover Page is not included in the total page count.

G. ProtecƟon of Privileged or ConfidenƟal Commercial or Financial InformaƟon

The Freedom of InformaƟon Act (FOIA), 5 U.S.C. § 552, provides individuals with a right to access certain records in the possession of the Federal government, subject to certain exempƟons. ExempƟon 4 of the FOIA permits informaƟon to be withheld that is in the nature of "trade secrets and commercial or financial informaƟon obtained from a person and privileged or confidenƟal." The term "person" refers to a wide range of enƟƟes, including corporaƟons, banks, state governments, agencies of foreign

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InformaƟon that does not qualify withholding under the ExempƟon will be disclosed.

CMS may invoke ExecuƟve Order 12600 in accordance with FOIA RegulaƟon 45 C.F.R. § 5.42. InformaƟon provided by enƟƟes to CMS in response to this RFI may be subject to FOIA disclosure requirements unless protected under ExempƟon 4 of the FOIA itself. Should enƟƟes wish to protect any trade secret or confidenƟal informaƟon under ExempƟon 4, they should mark their submission accordingly ciƟng applicable redacƟons and non-disclosure raƟonale. Pre-disclosure redacƟons and non-disclosure raƟonale shall be sent via e-mail to the requesƟng contracƟng officer with a copy to the CMS FOIA Office at 12600@cms.hhs.gov.

If an enƟty’s submission is not marked and CMS receives a FOIA request related to this RFI, the CMS ContracƟng Officer will noƟfy the enƟty. The enƟty will have 10 working days to object to the release of any part of their informaƟon submiƩed to CMS ciƟng relevant case law. Final determinaƟon on the applicability of ExempƟon 4 of the FOIA are made on a case-by-case basis by CMS.

The statutory language of the FOIA is codified at 5 U.S.C. § 552(b). AddiƟonal informaƟon and resources, including the 9 FOIA ExempƟons and HHS FOIA RegulaƟon, and examples, can be found on the HHS FOIA Website.

H. Other InformaƟon:

1. Proprietary InformaƟon and Disclaimers: All transmiƩed informaƟon marked proprietary shall be treated as such. Therefore, respondents should idenƟfy any proprietary informaƟon in its RFI response. InformaƟon submiƩed in response to this RFI will be used at the discreƟon of the Government. Proprietary materials will neither be distributed, nor discussed with any other organizaƟon or business. Further, the informaƟon submiƩed will remain confidenƟal insofar as permiƩed by law, including the Freedom of InformaƟon and Privacy Acts. CMS reserves the right to uƟlize any non-proprietary technical informaƟon in the anƟcipated SOW or solicitaƟon.

2. Respondents should be aware that this RFI is for market research purposes only and any responses submiƩed do not consƟtute a commitment by CMS to treat any respondent more or less favorably in any anƟcipated forthcoming solicitaƟon and/or ulƟmate award.

3. Responses to the RFI are not offers and cannot be accepted by CMS to form a binding contract.

CMS does not intend to award a contract on the basis of this RFI, or to otherwise pay for the informaƟon solicited. No reimbursement for costs will be made associated with providing informaƟon in response to this RFI or follow-up informaƟon request.

4. Responses to the RFI will not be returned and will not be accepted aŌer the due date. All communicaƟons shall be by email.

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5. Respondents will not be noƟfied of the results of the review of the responses. InformaƟon received will be considered solely to make informed decisions regarding a potenƟal procurement.

On behalf of the Centers for Medicare & Medicaid Services, thank you for your interest in this Request for InformaƟon.