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QIN NCC Amendment Number 1 Industry Questions CMS Responses June 12, 2014
| Question # |
| Section Name |
| Section Number |
| Question Received |
| CMS Response/Comment |
| Would CMS provide a level of estimate in hours for the QIN NCC? |
| The estimated level of effort is not provided for this procurement. |
| Is it possible to obtain a comprehensive list of incumbent contractors and subcontractors for the QIO Program Structure participants? |
| Incumbent NCC contractors are Oklahoma Foundation for Medical Care, Telligen, Virginia Health Quality Center, and Delmarva Foundation for Medical Care, Inc. |
| The RFP is titled Quality Improvement Network National Coordinating Center, but the name used in the body of the RFP is Quality Innovation Network National Coordinating Center. Please clarify which name should be used. |
| The RFP title should read “Quality Innovation Network National Coordinating Center.” |
| Will QIN NCC users be part of the same QNET AD domain like current QIO users, or will there be a separate domain? If it is the same, can a user involved in both contracts use the same ID for both? Can they use one e-mail address? |
| Technically it can be done but the issue is that with a single domain UID/email account there is no separation of contracts. All emails for both contractors would go to a single email address. The program would have to determine if sharing a single email/account for both contracts is acceptable or not. |
| If a contractor is awarded both the QIN NCC and a QIN-QIO contract will the network equipment share the same address space (IP schema)? For example, can network printers setup for the QIN-QIO be used by QIN NCC staff? |
| If they will be located in the same building/office space, yes they can leverage the same resources such as circuits/servers/etc as long as the program supports it. The access to resources may be different between contracts but can be isolated based on user accounts and access rights. |
| Are partner organizations eligible to use GSA rates for the business proposal if they hold a GSA Federal Supply Schedule Contract? |
| No because it is not a GSA contract. |
| 7 |
| Type of Contract |
| B.2 |
| The QIN NCC is required to have an accounting system suitable for federal cost reimbursement contracts. Is this also required of NCC subcontractors or can the NCC execute some fixed price agreements with subcontractors that may not have adequate systems for cost reimbursement contracting? |
| An approved accounting system is only required for cost reimbursement type contracts. The NCC can execute fixed price agreements with subcontractors who do not have approved accounting systems. |
| 8 |
| Transition Services |
| B.8 |
| It would be useful to know which organizations are currently performing the various pieces of this work. See also which begins: At the end of this contract,…) |
This Section refers to the future transition from the 2014 QIN NCC to the 2019 QIN NCC. Not the transition from the current 10th SOW NCCs to the new QIN NCC.
| 9 |
| Contract Limitations |
| B.9 |
| The QIN NCC is not eligible to be awarded a contract as the Independent Evaluation Center (IEC). If an organization is a subcontractor to a prime that is awarded the QIN NCC does that disqualify this subcontractor from bidding as a prime contractor on the IEC RFP? |
| Yes it would disqualify the subcontractor from bidding in the IEC. |
| 10 |
| Contract Limitations |
| B.9 |
| As far as we are aware, the Strategic Innovation Engine (SIE) contract RFP has not yet been released. Could CMS please clarify how actions of the SIE will relate to or be coordinated with activities of the QIN NCC. In particular, will the SIE work through the NCC to interface with the QIN QIOs? |
| The QIN-NCC and the SIE are not designed to provide duplicative services. However, the contracts are structured to by synergistic of one another and there should be every expectation that the QIN-NCC will coordinate and collaborate with the SIE and vice versa. As currently designed, the SIE will generally work through the QIN-NCC on core 11th SoW tasks rather than directly with the QIN QIOs. The SIE may work directly with QIN QIOs on special innovation projects and QIO initiated projects. |
| 11 |
| Contract Limitations |
| B.9 |
| According to the RFP, “CMS shall not enter into a contract under this part with any entity (prime or subcontractor)” that is affiliated with a health care facility. In response to questions submitted to potential bidders on the QIN QIO RFP CMS indicated that it was acceptable for subcontractors to be affiliated with health care facilities and that the prohibition on contracting with organizations affiliated with health care facilities only applied to the prime contractor. Could CMS please clarify whether NCC QIN subcontractors are allowed to be affiliated with health care organizations (as defined in the final paragraph on page 10)? |
| The statute states that the prohibition applies to both primes and subcontractors. The only exception is whether they fall below the 20% rule. If they do, then the prohibition does not apply to either the prime or subcontractor. |
| 12 |
| Contract Limitations |
| B.9 |
| Please clarify the distinct responsibilities of the PCC and the NCC and how CMS will ensure that the two entities are not providing duplicative services |
| The QIN NCC will primarily provide technical assistance and support to QIN QIOs and support the achievement of National QIN outcomes and learning activities. The PCC will provide program management support for CMS to collaborate across contracts and communication with internal and external stakeholders. There may in fact be some services that are similar in nature and CMS expects that the PCC and NCC, working with CMS, will work to coordinate and collaborate to ensure a comprehensive program that services QIOs, patients, families and all stakeholders. |
| 13 |
| Contract Limitations |
| B.9 |
| Must the successful QIN NCC contractor also hold a QIN-QIO contract? |
| No, that is not a requirement. |
| 14 |
| Contract Limitations |
| B.9 |
| May a subcontractor or consultant on a successful QIN NCC bid still be eligible as a prime for the Program Collaboration Center? |
| No per the limitation chart. |
| 15 |
| Contract Limitations |
| B.9 |
| Is it necessary to be a QIO-like entity to be eligible for award of the QIN-NCC contract? |
| Yes, the awardee must be a QIO-like entity. |
| 16 |
| Reduce Health and Healthcare Disparities |
| C.2.d |
| For budgeting purposes, how much training should the NCC plan on providing per year, please indicate in person (and location) vs. teleconference etc.? Is it 3 trainings per year or contract? |
| Three trainings per year which may be in person in the Baltimore/Washington Area or via webinar. |
| 17 |
| Reduce Health and Healthcare Disparities |
| C.2.e.10 |
| How often will the NCC report on the results of the patient activation surveys; how many NCC reports per year are required? |
| Quarterly; 4 reports per year. |
| 18 |
| Reduce Health and Healthcare Disparities |
| C.2.k |
| Will this health disparities conference be a one-time national conference or will this conference take place in regions or states of QIOs? |
| It will be a national conference held annually (via webinar). |
| 19 |
| Reduce Health and Health Care Disparities |
| C.2.1 |
| Every Diabetic Counts (EDC) is referred many times in prior paragraphs, but here it is referred to as "the EDC special innovation project." Is there a special innovation project that is different/separate from the EDC referred to earlier? |
| No, it is referring to the same work. The terms “special innovation project” has been removed. |
| 20 |
| QIO Program Structure |
| C.2.2 |
| Is the QIN NCC responsible for working with the QIN-QIOs on the task specific work and the Program Collaboration Center responsible for overarching themes and trainings on topics like QIN-QIO branding and LANs? |
| The QIN NCC is responsible for providing technical assistance to support LAN effectiveness and content for National LANs. |
| C.3.1 & C.3.2 |
| It is understood that some of the QIN NCC tasks will support multiple QIN-QIO tasks. To be clear though, are tasks C.3.1 and C.3.2 most closely related to the QIN-QIO Task B.4, Improving Prevention Coordination through Meaningful Use of HIT In Collaborating with RECs? |
| No. |
| 22 |
| Hardware/Software |
| C.3.2.1 |
| If an equipment refresh is mandated during the course of the contract will CMS be funding the refresh of the base equipment (file server, DB server, routers/switches, laptops) that is initially provided? |
| Yes. |
| 23 |
| Hardware/Software |
| C.3.2.1 |
| Should the prime and all subcontractors propose hardware/software costs in their bids, or should the prime and all subcontractors just provide a list of the equipment needed to fulfill the SOW? |
| The bidder should propose costs for all equipment for only the prime contractor. |
| 24 |
| Hardware/Software |
| C.3.2.1 |
| Will there be a contractor to run the WebEx event center for the QIN-QIO program as a whole or should we include webinar expenses in our proposed budget? If another contractor will support webinar access, what is the timeframe for the period of performance for that contract? |
| Webinars for related QIO related conferences will supported by CMS. Non-CMS related WebEx will be the responsibility of the contractor. |
| 25 |
| Information Systems Security Requirements |
| C.3.3 |
| If a contractor is awarded both a QIN-QIO contract and the QIN NCC can the same personnel serve as SPOC and IT representatives for both contracts? |
| Yes. |
| 26 |
| Information Systems Security Requirements |
| C.3.3 |
| Do the subcontractors need their own SPOC or can the prime SPOC serve that role? |
| There will be 1 SPOC with alternates assigned to each contract. The assigned SPOCs oversee their subcontract sites as well. |
| 27 |
| Certification by SPOC for Compliance with CMS Security Requirements |
| C.3.3.1 |
| If a contractor is awarded both the QIN NCC and a QIN-QIO contract will there be two separate FISMA audits conducted for each one or will they be combined? |
| These are separate contracts therefore will have separate deliverables .If the contractor is subject to a CMS FISMA audit, it will depend on the “scope” of the audit. Depending on the reason for the audit, this could be a particular site or it may be any area within the scope of the contract. If two contracts are under the same organization, this could mean that the organization is using the same strategies to satisfy both FISMA requirements. If a finding occurs via an audit, self-assessment or incident, then both contracts may be responsible of holding the ‘findings’ associated to the control. |
In addition, if there is a sub-contract affected in the same manner then there would be only 1 finding to maintain.
| 28 |
| Certification by SPOC for Compliance with CMS Security Requirements |
| C.3.3.1 |
| To what extent does FISMA apply to subcontractors if they do not have a data center (only QualityNet laptops connecting via VPN)? Will they be audited? |
| FISMA audits can come from any realm where CMS data is being transferred and/or stored. A FISMA audit does not necessary mean all controls will audited but instead ONLY the controls that would apply for that site or sub-site (subcontractors). |
| 29 |
| Certification by SPOC for Compliance with CMS Security Requirements |
| C.3.3.1 |
| How will FISMA audits be funded? Will they continue to be conducted annually? |
| FISMA audits are funded by CMS and will be conducted per CMS request on an as needed basis. |
| 30 |
| Clinical Data Abstraction Center Subcontractor |
| C.4.4 |
| Can CMS please clarify what the QIN NCC’s role will be with regard to the CDACs? |
The QIN NCC may interact with CDAC if needed and desired to complete the work.
| 31 |
| Coordination with Stakeholders Outside the QIO Program |
| C.4.5 |
| The RFP states that, “at a minimum, the QIN NCC must participate annually in collaborative activities that are sponsored by the applicable CMS Regional Office and focus on CMS-identified priority initiatives. For budgeting purposes, please clarify the degree of participation expected and if travel to the various CMS Regional Offices would be anticipated for NCC staff. If yes, could CMS provide an estimation as to the number of trips per year? |
| There may be up to four meetings per year, one each in the DQI regional offices and anticipate at least 2-3 NCC staff in attendance at each meeting. |
| 32 |
| Communications: Use of Web Technology/Web Content and Communications |
| C.4.6 |
| Is it correct to assume that if a new website is proposed, CMS will either provide the software tools (e.g. Java/ .net/ PHP) and the relevant development hardware and hosting environment; or it will reimburse the contractor for the fees incurred? Please confirm. |
| Hosting a website has now been removed from the SOW for this RFP. |
| 33 |
| Communications: Use of Web Technology/Web Content and Communications |
| C.4.6 |
| It states. (…create a new website or maintain existing websites.) Which is the preference for CMS? |
| Hosting a website has now been removed from the SOW for this RFP. |
| 34 |
| Knowledge Management System Collaboration Tool |
| C.4.8 |
| There are issues with Healthcare Communities (HCC) site responsiveness, navigation, and organization of the portal. Will those be addressed for the 11SOW? (Our experience is that QIOs tend to not use HCC because of these issues.) |
| CMS’ goal is to have the HCC website HealthcareCommunities.org, responsive to users (customers) needs. |
| 35 |
| Knowledge Management System Collaboration Tool |
| C.4.8 |
| The RFP states “QIN NCCs are required to utilize the Healthcare Communities Portal (Collaboration Tool) to foster education, outreach, communication, and collaboration.”; however in Task A.4.2 (web presence), the RFP states the “QIN NCC’s communications plan shall include a website. The QIN NCC shall create a new website or maintain an existing website(s) on which communications pursuant to the quality improvement QIO's Medicare contract activities appear”. To ensure a cohesive and consistent overall web presence, please clarify if the NCC can create an external website presence to also act as a knowledge management system collaboration tool. |
| Hosting a website has now been removed from the SOW for this RFP. |
| 36 |
| Contractor Performance Evaluation |
| C.5 |
| Could you please elaborate on CMS priorities? Such as when would the winning contractor be notified of shifts in priorities and what would be the negotiation process for timeline to complete. There may be unintended consequences and impacts to timelines caused by changing priorities |
| CMS priorities are clearly set and stated in the CMS quality strategy and the three aims. CMS does not anticipate any other significant change in direction. As with any quality improvement initiative, the activities to support those aims may change over time based on the data, PDSA cycles, and input from providers and beneficiaries. An NCC must be flexible and adaptable to rapid cycle change. CMS with work with the NCC to avoid unintended consequences. |
| 37 |
| National Nursing Home Quality Care Collaboratives |
| C.5.2.d |
| “Provide 2 hour trainings x6 per collaborative annually”. For budgeting purposes how many trainings should the NCC plan on providing per year; is it a total of 6 trainings per year; how many collaboratives are there per year? |
| The requirement is for six trainings per collaborative (for 2 collaboratives over 5 years), with a minimum of one per year. |
| 38 |
| General Methods/Approaches to Reach Desired Outcomes |
| C.6.1 |
| The QIN NCC is instructed to collaborate with the Strategic Innovation Engine (SIE). In answers to questions for the QIN-QIO procurement, CMS stated that the SIE was no longer applicable and it did not appear on the 11th SOW schematic (chart with colored boxes). Please clarify whether there will be an SIE and if so, when it will be operational. |
| Yes, there will be an SIE contractor. All CMS Contractors are expected to coordinate and collaborate with and among one another. The QIN-NCC will need to coordinate with the SIE and vice versa. |
| 39 |
| Utilizing Data as a Core Component of Quality Improvement Efforts |
| C.6.1.2 |
| Please clarify the expectations CMS has for the NCC contractor to do with 3rd party payer data? |
| Ad hoc analyses may be requested by the QIN NCC GTL that would incorporate 3rd party data provided by CMS. |
| 40 |
| Utilizing Data as a Core Component of Quality Improvement Efforts |
| C.6.1.2 |
| Under C.6.1.2.d, the QIN NCC is expected to implement processes to collect data. Is there an expectation on the type of data collection vehicles that should be developed (e.g., Web-based)? |
| The QIN-NCC shall create deliverable templates for the QIN QIOs to submit in order to support data collection at the direction of CMS COR/GTL. The QIN NCC may also develop data collection tools to be used by QIN QIOs to perform their work. |
| 41 |
| Results-Oriented Learning and Action Networks (LANs) |
| C.6.1.5 |
| “The QIN-QIO will actively recruit beneficiaries to participate in LANs. The QIN-QIO will use the following in targeting beneficiaries for recruitment: (1) a cultural competency approach and (2) collection of data to identify trends and disparities and/or gaps in quality of care provided or in the prevalence of specific disease(s). Data collected and used for this purpose must be stratified by race, ethnicity, and language proficiency in order to better identify trends and disparities.” What will be the source of the stratified data? Will the QIN NCC develop and disseminate the data collection tools? |
| The QIN NCC will provide data analyses to support QIN QIO recruitment of beneficiaries to participate in LAN activities. |
| 42 |
| Results-Oriented Technical Assistance |
| C.6.1.6 |
| QIN Technical Assistance—to what extent will the QIN NCC be responsible for and accountable for the activities performed by the individual QINs? |
| The QIN NCC will provide technical assistance and support to QIN QIOs per the SOW as directed by CMS COR/GTL. While QIN QIOs will have the opportunity to provide feedback on the value of assistance provided by the NCC, QIN QIOs are responsible for their own performance |
| 43 |
| Use Data to Facilitate Technical Assistance |
| C.6.1.6.2 |
| Under this section, the QIN NCC is expected to use Medicaid data to facilitate technical assistance. What Medicaid data will be made available to the QIN NCC? |
| CMS will provide Medicaid if it is available. The exact data will be determined working collaboratively with CMS Office of Minority Health. The NCC is also expected to provide ideas on useful data. |
| 44 |
| Use Data to Facilitate Technical Assistance |
| C.6.1.6.2 |
| Under this section, the QIN NCC is expected collect and monitor local provider community data trends and site reports for potential adverse effects and/or outcome effectiveness or interventions. Can you please elaborate on CMS’ expectations for this activity? |
| The QIN NCC shall use data submitted in QIN QIO deliverables to perform this activity. The QIN NCC shall identify top performers for the purpose of spread and monitor trends based on intervention outcomes across communities. |
| 45 |
| Comprehensive Work Plan |
| C.6.2 Task A.2 |
| Please confirm that a draft Comprehensive Work Plan must be submitted as part of the RFP response. If so, please confirm that it may be submitted as an appendix that is not subject to the technical proposal page limits. |
| Yes, an appendix is fine; however, the final version of the work plan is not due until after award. |
| 46 |
| Comprehensive Work Plan |
| C.6.2 Task A.2 |
| Please clarify whether the detailed project plan is a component of the Comprehensive Work Plan, or a separate, task-level plan. Do offerors need to provide a project plan outline as part of the RFP response, along with the work plan outline? If so, may this be an appendix? |
| Yes, as an appendix. |
| 47 |
| Comprehensive Integrated Communications Plan |
| C.6.2 Task A.4 |
| Is the Comprehensive Integrated Communications Plan a deliverable? A requirement for quarterly updates is in the SOW, but not in Section F, Schedule of Deliverables. |
| This has been removed from the RFP requirements. |
| 48 |
| Comprehensive Integrated Communications Plan |
| C.6.2 Task A.4.1 |
| Please explain how the communications role and responsibilities of the QIN NCC differ from those of the Program Collaboration Center. Are we correct in understanding that the QIN NCC supports QIN-QIOs’ regional communications (including consistency across those efforts) and the PCC supports CMS’ national communications efforts, including QIO Program branding? Are there other differences of which we should be aware? |
| The Comprehensive Integrated Communications Plan has been removed from the SOW. |
| 49 |
| Developing & Supporting Learning and Action Networks |
| C.6.2 Task A.4.5 |
| Are we required to use the HCQIS webinar provider, or is CMS open to other options? |
| CMS is open to other credible options. |
| 50 |
| Developing and Supporting Learning and Action Networks |
| C.6.2 Task A.4.5 |
| Task A.4.5 states that the QIN NCC shall develop and support LANs. Can CMS please clarify if there is a required number of LANs to be developed/supported? |
| The numbers of LANs are included per task throughout this contract. |
| 51 |
| Objectives of the CIQIP |
| C.6.2 Task A.5.1 |
| What is meant by “a permissible range of deviation with minimum effort?” |
| This language has been removed. |
| 52 |
| General Contract Management |
| C.6.2 Task A.6 |
| Will the QIN NCC have a single GTL? Are the QIN-QIO Task Leads referenced in this section CMS personnel, and if so, is the requirement to teleconference with each of them every two weeks? |
| Yes, the QIN NCC will have a single GTL. The QIN-QIO task leads are CMS personnel who will participate in these standing calls every two weeks. |
| 53 |
| General Contract Management |
| C.6.2 Task A.6 |
| The first sentences states the QIN NCC shall provide….quarterly reports…. The second sentence states: “These monthly reports shall include….” Are the reports monthly covering a rolling quarter of data? |
| The word monthly has been removed from this language. |
| 54 |
| Designation of Key Personnel |
| C.6.2 Task A.7.1 |
| #1 under the minimum requirements for an Analytic Director requires healthcare analysis experience in a managed care environment. Is the reference to managed care correct? Please clarify. |
| This bullet has been edited in the SOW to remove managed care. |
| 55 |
| Designation of Key Personnel |
| C.6.2 Task A.7.1 |
| Key Personnel include NCC Project Director, Clinical Director and Analytic Director. Other recommended personnel category also includes a Clinical Director and Analytic Director. Is CMS suggesting two Clinical Directors and two Analytic Directors–two key and two recommended? Please clarify. |
| This language has been edited in the SOW to indicate that those positions are the only key personnel positions not recommended. |
| 56 |
| Designation of Key Personnel |
| C.6.2 Task A.7.1 |
| The RFP indicates that the three key personnel positions are each 1 FTE with 100% commitment. Will CMS consider the potential for the clinical director to be two individuals each with 50% commitment to gain broader clinical expertise for different task areas? |
| No, the requirement is for 100% commitment for the Clinical Director for 1 FTE. |
| 57 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Please clarify what information will need to be included in an IT change request for keeping data measures current? |
| This bullet has been removed from the SOW. |
| 58 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Please confirm that the “high performers” referenced here are improvement project participants (e.g., providers), rather than QIN QIOs. Please clarify whether these analyses should be based on CMS-provided data (e.g., claims) or on self-reported data collected by the QIOs. |
| High Performers can be both QIN QIOs and improvement project participants depending on the type of analyses being performed. A variety of data sources including claims and QIO collected data may be used. |
| 59 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Is the intent to provide QIOs with actionable data for sharing with participants, and is the goal national consistency in analysis? |
| Yes, these analyses should provide actionable data for participants and QIN QIOs. Consistency of analysis is desired, but may not always be indicated. |
| 60 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Is the desired cost savings report a one-time or recurring report? When would CMS like it to be produced? Is it a deliverable, and if so, should it be included in Section F? Are we correct in assuming the scope of the analysis is limited to the QIO Program, and that “individual provider” level implies an average per provider savings rather than a calculation for each Medicare participating provider? |
| This analyses may be included in the ad hoc analyses at the request of the CMS COR/GTL. |
| 61 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| The wording in this section indicates that the QIN NCC will be maintaining what sounds like an existing measure specification guide. Is this correct, and if so, is the September 30, 2014 deadline noted in the Schedule of Deliverables the due date for the first update? |
| No. The QIN NCC is responsible for creating and maintaining the measure specification guide with CMS input. The language has been clarified in the SOW. |
| 62 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Under Task B.1.b., the “QIN NCC shall provide quarterly updates on the status of each QIN QIO Task for each QIN-QIO and by state….” What will be the look-back period for each outcome measure and/or Three-Part Aim? Will the trending be by quarter? |
| Look back periods will be included in the measure specification guide and are specific to each measure. Trending time will also be based on the individual measure. |
| 63 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Under Task B.1.d., the “QIN NCC shall calculate and produce reports of evaluation measures as directed by the CMS GTL/QIO QIN Task Lead for each QIN-QIO and by state…” Is a sample, comparable report from the current 10th SoW NCC contract available that depicts the level of detail CMS is requesting in this task? |
| Reports will include each evaluation measure listed in the QIN QIO Attachment J-1(b) Evaluation Table by state and QIN QIO as directed by the CMS GTL/COR. The QIN QIO Attachment J-1(b) Evaluation Table is added as Attachment J-14. |
| 64 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Are the required reports for each evaluation measure submission for each state required for each Task evaluation measure after every deliverable submission? |
| No, the report will be quarterly or annually at the direction of the CMS COR/GTL. |
| 65 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Under Task B.1.f., the “QIN NCC shall generate IT Change requests as necessary to keep data measures current and accurate for all QIN-QIO Tasks…due to coding changes or new medical practice guidelines.” If changes to medical practice guidelines become apparent to the QIN NCC prior to a measure being refined by the measure developer (and receiving endorsement, etc.), what steps need to be taken other than the submission of an IT Change request? For example, would the original steward of the measure need to be contacted and provide approval of any measure refinements recommended by the QIN NCC? |
| This bullet has been removed from the SOW. |
| 66 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Under Task B.1.h., the “QIN NCC shall provide a report with documentation/calculation of cost savings as it pertains to each component of the Three-Part Aim. The savings must be calculated to the individual provider/state/Medicare Trust Fund or others…” Has the methodology for calculating cost savings already been defined by CMS? If so, is a copy of the methodology available? If not, is it CMS’ expectation that the QIN NCC propose a methodology based on the data sources available to the QIN NCC (as stipulated in RFP Attachment J-4)? |
| This analyses may be included in the ad hoc analyses at the request of the CMS COR/GTL. CMS will provide specifications for existing cost savings measures which may need further development. |
| 67 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| What data source will be used to calculate the savings to the individual provider/state/ Medicare Trust Fund? |
| Claims data. |
| 68 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Under Task B.1.k., the “QIN NCC shall manage a comprehensive measure specification guide for the 11th SOW QIN-QIO measures…” It is understood that the QIN NCCC would be responsible for revising and updating the comprehensive measure specification guide, but would the QIN NCC also be responsible for drafting the initial comprehensive measure specification guide? If not, is a draft currently available? If a draft is not currently available, when does CMS anticipate the initial draft becoming available? |
| No. The QIN NCC is responsible for creating and maintaining the measure specification guide with CMS COR/GTL input. The language has been clarified in the SOW. |
| 69 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Task B.1 (k) states that the QIN NCC shall manage a comprehensive measure specification guide for the 11th SOW QIN-QIO measures and provide a narrative report on September 30, 2014. Can CMS please clarify the required elements for the narrative report? |
| The measure specification guide may include tables and narrative language. The guide shall include all elements associated with each evaluation measure in the QIN QIO Attachment J.1 (b). The QIN QIO Attachment J-1(b) Evaluation Table is added as Attachment J-14. |
| 70 |
| Data Collection and Analysis |
| C.6.2 Task B.1 |
| Task B.1 requires identification of top quartile high performers across geographies and tasks. To what extent will the Government provide baseline and trend data on participants? |
| CMS will provide historical claims data from 2009 to the most recently available time period to the QIN NCC. Other baseline data will vary depending on availability for each data source. |
| 71 |
| Data Collection and Analysis |
| C.6.2 Task B.2 |
| Will CMS impose requirements/limitations on software tools to be used by the NCC for data processing, analysis, and reporting (e.g., require all software used to be in the CMS Technical Reference Model)? Does CMS have a preferred suite of tools for the NCC to use for data processing, analysis, and reporting? |
| Each contractor will/can have their own suite of software tools to use as long as it clears through a CMS Information Security audit. If the contractor would like for CMS to purchase the software then it would have to go through the ERB process for further analysis. |
| 72 |
| Data Collection and Analysis |
| C.6.2 Task B.2 |
| What process will CMS require for reports and analyses generated by the NCC in Task B.1 be submitted to CMS for review and approval before dissemination to QIN-QIOs? |
| The QIN NCC will submit reports into DDST as deliverables and then to the Reports Repository within DDST when directed by the CMS COR/GTL. |
| 73 |
| Data Collection and Analysis |
| C.6.2 Task B.2 |
| Will CMS provide any specific guidance or methodologies for how cost savings are to be calculated for the Three-Part Aim? |
| This analyses may be included in the ad hoc analyses at the request of the CMS COR/GTL. CMS will provide specifications for existing cost savings measures which may need further development. |
| 74 |
| Use of CMS-supported Collaboration Tools |
| C.6.2 Task B.2.1 |
| The next to last sentence in the first paragraph says: The QIN NCC shall perform a community owner in coordination with the GTL for this contract. Should the word “as” follow “perform”? If not, please clarify |
| Yes, the language was revised. |
| 75 |
| Use of CMS-supported Collaboration Tools |
| C.6.2 Task B.2.1 |
| Please clarify the relationship of the Outcomes Sharing Site (OSS) to the HealthcareCommunities.org website. Is the QIN NCC responsible for managing the OSS? |
The language has been revised in the SOW.
| 76 |
| Use of CMS-supported Collaboration Tools |
| C.6.2 Task B.2.1 |
| Historically, CMS has provided WebEx seats for use by the NCCs performing contract work. Will WebEx seats continue to be provided in this SOW for the NCCs? Will there be a cost associated with this at the contractor level? |
| Yes CMS will provide WebEx for 11th SoW work only. If there are calls/conferences for non-QIO work, the contractor is responsible for providing their own services to external entities at a cost. |
| 77 |
| Use of CMS-supported Collaboration Tools |
| C.6.2 Task B.2.1 |
| The RFP states that the QIN NCC shall work with the CMS designated knowledge management system tool(s) at the HealthcareCommunities.org website. Should CSI be included in the budget? |
| No. |
| 78 |
| Development and Dissemination of Tools |
| C.6.2 Task B.2.2 |
| “The QIN NCC shall develop, revise, and modernize at least 20 tools per QIN task per year…”; please clarify if these tools are related to the clinical priority areas referenced in Task C (i.e., cardiac, disparities, care management, HAIs, HACs, medication safety, admissions/readmissions, and behavioral health)? |
| Yes, section C.6.2 Task B.2.2 is referencing the clinical priority areas. |
| 79 |
| Development and Dissemination of Tools |
| C.6.2 Task B.2.2 |
| Please clarify the way in which CMS is defining “task” for the purposes of developing, revising and modernizing tools. Is it at the primary level, e.g., Task C.1 (Cardiac Population Health), Task C.2 (Reduce Health and Healthcare Disparities), which means 160 tools/year (20 per task)? |
| For the purposes of developing, revising and modernizing tools, CMS aligns the usage of the word “task” to indicate the primary level support services to QIN QIOs for all priorities, QII, and tasks designated in the QIN contracts. |
| 80 |
| Development and Dissemination of Tools |
| C.6.2 Task B.2.2 |
| These requirements seem to be specific to the Prevention tasks. Are we correct in assuming CMS wishes for the QIN NCC to provide QIN-QIOs with similar support (e.g., training packages, monthly calls, logistical support) as appropriate to the other QIN-QIO tasks? |
| CMS expects the QIN NCC will provide QIN-QIOs with general technical support to QIO operations and services. For details of this supportive services, review QIN NCC C.6.2 Task B.2.2. |
| 81 |
| Development and Dissemination of Tools |
| C.6.2 Task B.2.2 |
| The QIN NCC shall develop, revise and modernize at least 20 tools per QIN task per year to assist QIN-QIOs and practices. Are the 20 tools to be a mix of clinical, measurement and evaluation, community organizing, communication, or a combination of these tools and others as appropriate as long as there are 20 per task per year? Or should the tools be specific to clinical interventions specific to each task? |
| Under the direction and acceptance of the COR/ GTL when needed, the QIN QIOs could produce a combination of clinical, measurement/interventions, community organizing, and local communication tools that meet the needs of the QIN QIOs. |
| 82 |
| Development and Dissemination of Tools |
| B.2.2.a |
| Has CMS determined what types of tools should be developed and what existing tools will need revising and modernized, or will that be left up to the QIN NCC to determine or collaborate with CMS on? Please define “tools” – does this include each piece of a change package (e.g., guidelines), or would this be considered the entire change package? |
| Section C.6.1 outlines many types of tools that could be developed to support the QIN QIOs. CMS COR/GTL will collaborate and work together with the QIN NCC to determine what types of tools will need to revised to meet the needs of the QIN QIOs. |
In this RFP, the term tool means any type of item that could be implemented and used to improve healthcare outcomes.
| 83 |
| Training and Education |
| C.6.2 Task B.3 |
| Will the QIN NCC design, develop, and seek CMS approval for the deliverable template prior to training on how to use the template, or will the template be offered from CMS? |
| The QIN NCC will design the deliverable templates based on criterion that the CMS GTL/COR provides after award. |
| 84 |
| Training and Education |
| C.6.2 Task B.3 |
| How are the responsibilities going to be delineated and shared among the different contractors: QIN NCC, PCC, SIE, BFCC NCC? Who will have “ownership” for the different training and educational activities in order to avoid duplication, inconsistencies, etc.? |
| Training to support QIN QIO activities will be the responsibility of the QIN NCC. |
| 85 |
| Training and Education |
| C.6.2 Task B.3 |
| “The QIN NCC shall work in collaboration with the PCC and SIE on this task to accomplish the goals of the QIO program.” Please explain the specific roles of the three contractors with respect to training and education. |
| Training to support QIN QIO activities will be the responsibility of the QIN NCC. QIN NCC will be responsible for subject matter expertise and content and may collaborate with other support contractors such as the PCC which will provide logistical support for some events. |
| 86 |
| Centralized Source of Support and Technical Expertise |
| C.6.2 Task B.4 |
| The following item appears to be a partial sentence. Please complete or clarify. |
“g. Continuous monitoring and identification of QIN-QIO learning and action network support needs, and act” Language was revised in the SOW.
| 87 |
| Centralized Source of Support and Technical Expertise |
| C.6.2 Task B.4 |
| The QIN NCC is tasked with mentoring and teaching QIN QIOs the principles of learning and action networks and how they differ from collaborations that QIOs have previously developed. Please explain how this work differs from the work designated to be carried out by the Program Collaboration Center. |
| Mentoring and teaching QIN QIOs the principals of LANs will be the responsibility of the QIN NCC. The PCC will not generally provide technical assistance to support QIN QIO activities for core 11th SOW activities. |
| 88 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Sub-task c) states that the QIN NCC will develop, coordinate and maintain a listserv. Is the NCC required to use a HCQIS listserv? Is the NCC also required to manage separate listservs in HealthcareCommunities.org? |
| The QIN NCC will use and manage listservs in HealthcareCommunities.org. |
| 89 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Sub-task n) states that the QIN NCC will develop and maintain a website-like system for the purpose of sharing tools and practices. Is this website separate and distinct from the website the QIN NCC is required to develop as part of its Integrated Communications Plan in Task A.4.2.? Is it separate and distinct from the designated CMS/QIO website noted in sub-task e)? Is either of these sub-tasks (n, e) intended to be a reference to the National Collaborative Tool? |
| Website development and support and the Integrated Communications Plan have been removed from this SOW. The QIN NCC will provide content as needed for HealthcareCommunities.org. |
| 90 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Sub-task f) states that the QIN NCC will identify characteristics of QIN-QIO high performance, best practices and/or state-specific issues or characteristics that may contribute to achieving success. Will the QIN NCC have access to QIN-QIO deliverables as a method to identify best practices, or will that information be provided in a different manner? If so, please describe. |
| Yes, the QIN NCC will have access to QIN QIO deliverables. |
| 91 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Is the requirement for a weekly call with the GTL to discuss NCC events/operations different from the biweekly call required in RFP Task A.6.a on page 54? |
The calls are the same and will occur weekly.
| 92 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Are the two patients to remain the same (to the extent possible) throughout the life of the LAN, or can the two patients change? Is it permissible to seek identification of patients from established patient relationships within the QIN-QIOs, or should the QIN NCC seek to engage its own patient participation? |
| The QIN NCC may select patients that will be able to contribute towards the intended outcome of each LAN event. CMS will not be prescriptive as to how patients are engaged. |
| 93 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Under Task B.5.g., “Identify the highest performing (top 3%) providers in the country in the areas of each QIN task…” Is the high performer analysis limited to the QIN QIO-related metrics being tracked in each QIN task, or is it CMS’ expectation that the QIN NCC will include ancillary sources of data related to each QIN task (i.e., data available to the QIN NCC but not the QIN QIOs) in deriving its approach to identify the highest performing providers? |
| Top performers may be determined using a variety of data sources available to the QIN NCC. |
| 94 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Task B.5 (g) states the QIN NCC shall conduct a site visit with one highly performing provider/system every quarter. Is there a requirement as to whether these site visits must be in-person, or can they be conducted virtually? |
| The site visits should occur in person as approved by the CMS GTL/COR. |
| 95 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Should the QIN NCC prepare to invite the QIN-QIO to join in the site visit with the one highly performing provider/system every quarter, or plan and conduct the site visit without the QIN-QIO? Should the QIN-QIO be alerted to the identification of the selected provider and date of the visit? |
| Yes, the QIN QIO should be included in all relevant aspects of the site visit. |
| 96 |
| Effective and Efficient Communications |
| C.6.2 Task B.5 |
| Does the QIN NCC have to conduct a site visit with a highly performing provider from each of the QIN QIO task areas (Prevention, Cardiac Health, etc.) every quarter or each quarter conduct a site visit with one high performer regardless of Task Area? In which contract quarter does this start? |
| Site visits will occur once per quarter in total across tasks. Site visits may start quarter 2 or 3 with approval from CMS COR/GTL. |
| 97 |
| Effective and Efficient Communications |
| B.5.a |
| Did you mean “Recruit at least two patients…” rather than “Promote at least two patients…”? |
| Yes the language was revised. |
| 98 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6 |
| How many LAN meetings will there be per year? |
| There will be one National LAN meeting per year (in person or via webinar). |
| 99 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6 |
| Are we correct in understanding that CMS will contract with a meeting support vendor for assistance with facilities, registration, A/V, etc., or should we include those costs? |
| Costs should be incorporated to support National LAN via webinar. |
| 100 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6 |
| Please clarify anticipated length of each National Learning and Action Network Meeting, i.e., total number of days for each meeting. |
| The number of days per meeting will be determined in collaboration with the CMS COR/GTL depending on the intended outcomes of the LAN event. |
| 101 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6 |
| We note that these elements are very specific to the HAI task. Are we correct in understanding that National LAN meetings will encompass all QIN-QIO tasks, including their equivalents for these elements? |
| Yes. |
| 102 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6.c |
| CMS has provided guidance that in budget preparation we should estimate that three people would require assistance with travel. Please clarify if CMS anticipates that these proposed travel arrangements would include any overnight stays. |
| Yes, one overnight depending on the location of the speakers in relationship to the event site. |
| 103 |
| National Learning and Action Network Meetings |
| C.6.2 Task B.6.j |
| CMS indicates that they will provide the criteria to be used by the QIN-NCC and QIN-QIOs to identify high performers working on HAI reduction. Will CMS be providing high performer criteria for other tasks or will the development of high performer criteria in other areas, where stipulated in the RFP, be the responsibility of the QIN-NCC? |
| The QIN NCC will participate in developing high performer criterion for tasks as directed by the CMS COR/GTL. |
| 104 |
| Patient Safety Meetings |
| C.6.2 Task B.6.3 |
| How many of these meetings should we assume that the QIN NCC will attend? Where are these meetings located? How many QIN NCC personnel should attend? |
| Please assume that these meetings will be attended virtually. |
| 105 |
| Patient Safety Meetings |
| C.6.2 Task B.6.3 |
| For budgeting purposes how many trainings should the NCC plan on providing per year, please indicate in person (and location) vs. teleconference etc.? |
| Assume two trainings per year via teleconference. |
| 106 |
| Monitoring and Evaluation Assistance |
| C.6.2 Task B.7 |
| Please clarify if it will be the role of the NCC to do data collection around the continuous evaluation questions on a quarterly basis. |
| The QIN NCC will have access to relevant data sources to perform this analysis quarterly. |
| 107 |
| Monitoring and Evaluation Assistance |
| C.6.2 Task B.7 |
| Will the NCC be able to use QualityNet for information exchange with QIN-QIOs and/or providers, as the CMS Information System? |
| Yes. The QIN NCC will also submit reports for QIN QIOs to a reports repository area of DDST. |
| 108 |
| Monitoring and Evaluation Assistance |
| C.6.2 Task B.7 |
| Task B.7 (c) states that QIN-QIOs with inadequate progress that are not on a trajectory to meet contract goals shall receive a high level of support from the QIN NCC, including weekly calls. Does CMS have an estimate as to the number of QIN-QIOs that would require this elevated level of assistance? |
| No. |
| 109 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Regarding this requirement: “The QIN NCC shall provide support to at least 95% of the QIN-QIOs on a continuing basis (unless a different frequency is indicated) by providing services that include…..” How will this be measured? What does “continuing basis” mean? |
| Technical assistance provided by the QIN NCC will occur on an ongoing basis as needed by QIN QIOs. |
| 110 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Obtain completed Patient Activation surveys (pre and post DSME) from QIN-QIOs, calculate, analyze and report on collected results of Diabetes Knowledge/ Need Assessment Survey to CMS based on the Patient Activation Scoring Scale; |
Question: Is this done monthly, quarterly?
Monthly, aggregate, analyze data and provide data results from the EDC special innovation projects which includes HbA1c, Lipids, blood pressure, Weight and eye exam clinical measures for Medicare beneficiaries who complete the DSME trainings;
Question: To clarify, CMS is requesting monthly aggregation and analysis of the clinical data?
Quarterly.
Language has been revised in the SOW
| 111 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Task C.2 (e) #9 states the QIN NCC will provide quarterly ad hoc reports to CMS. Does this count toward the 25 ad hoc reports for data analysis referenced in Task B.1 (j)? |
| Yes. |
| 112 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Under Task C.2.e.10., “Obtain completed Patient Activation surveys (pre and post DMSE) from QIN-QIOs, calculate, analyst and report on collected results…” Will the Patient Activation Measure (PAM) scoring algorithm be provided by CMS? |
| Yes. |
| 113 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Under Task C.2.e.10., “Obtain completed Patient Activation surveys (pre and post DMSE) from QIN-QIOs …” Will the actual completed PAM surveys be provided (requiring data entry/capture by the QIN NCC) or will the survey response data be provided in a standardized format from each QIN-QIO? |
| The individual QIOs enter the survey responses in a spreadsheet (CMS will provide the spreadsheet to the QIN NCC). CMS will provide a SAS code to score (5 point Likert scale) and analyze the survey data. The NCC shall validate a small (2% - 5%) random sample of the actual original surveys from each QIO and the responses the QIOs send in the spreadsheet via DDST. |
| 114 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| When is the QIN NCC to start the data collection of the Patient Activation Surveys from QIN-QIOs? How often is the report to be produced? |
| Quarterly. |
| 115 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2 |
| Task C.2 (k) requires the QIN NCC to develop and host an annual health disparities conference. Is this conference required to be in-person, or can it be held virtually? |
| It will be a national conference held annually (via webinar). |
| 116 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2.d |
| Is it expected that any of these trainings and presentations (other than conference calls) will be virtual, or should we build in travel? |
| Many of these events will be virtually. |
| 117 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2.e |
| Some sub-bullets reference different time periods than monthly (e.g., quarterly). Can you confirm/clarify the expectations on delivery for all elements under this sub-task? |
| Quarterly |
| 118 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2.e.10 |
| Will Patient Activation surveys be submitted as hard copy or electronic, or either? What is the expected sample size? Are we expected to store hard copies, and if so, for what time period? |
| A random sample (2% - 5%) surveys will be scanned and submitted electronically via DDST by QIN QIOs and accessed by the QIN NCC for validation. |
| 119 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2.f |
| Sub-section “f” states that the QIN-NCC will conduct a minimum of seven national webinars annually on the following subjects… Yet, many of the subjects listed in the RFP include reference to a “series” of webinars (e.g., Improve Cultural Competency of Providers, Increase Adherence to Clinical Guidelines, etc.). For budgeting purposes can CMS define their expectations in regard to the actual number of webinars that are required in this section of the RFP, i.e., seven vs. references in the 6 topical areas to a “series.” |
| Seven webinars annually. |
| 120 |
| Reduce Health and Healthcare Disparities |
| C.6.2. Task C.2.j |
| The site appears to be primarily programmed in straight HTML and ASP, managed by Dreamweaver templates. Is that correct? Are there any other root programming technologies that we need to know about? |
| CMS will facilitate posting. |
| 121 |
| Reduce Health and Healthcare Disparities |
| C.6.2. Task C.2.j |
| Is there a built in content management system (CMS) for decentralized information additions and updates? If so, please identify. |
| The QIN NCC will provide content to a PCC contractor who will support posting and maintaining the website. |
| 122 |
| Reduce Health and Healthcare Disparities |
| C.6.2 Task C.2.k |
| Please clarify if the annual health disparities conference is expected to be a virtual conference or face to face? If face to face, is the location assumed to be in the Baltimore/Washington area with the NCC responsible for all associated conference costs? |
| Virtual conference is expected. |
| 123 |
| Information Technology Enabled Care Management |
| C.6.2 Task C.3 |
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