Revised Attch 1-PWS HT001124R0042 11-12-24.pdf

DHA PWS Template V13 November 16, 2021

Department of Defense Defense Health Agency

Performance Work Statement

Women’s Health Quality Improvement

Medical Affairs Clinical Support Division

Solicitation Number: HT001124R0042 Version: 1

Date: 12 November 2024

PART 1

1.0 GENERAL INFORMATION

1.1 This is a non-personal services contract to provide Women’s Health Quality Improvement Services. Services include but are not limited to providing review, analytics and trending of women’s health and perinatal care with the Military Treatment Facilities (MTFs) and Private Sector Care Facilities (PSCFs) against concurrent civilian maternal, fetal, and neonatal quality benchmarks.

1.2 Description of services/introduction: This requirement is in support of the Defense Health Agency (DHA), Clinical Support Division (CSD) Integrated Clinical Operations Policy Support Branch, to provide critical metrics for the Military Health System (MHS) in support of the quadruple aim for all MTFs with obstetrics and PSCFs. The resultant contract shall provide support through external performance analysis of women’s health /perinatal care done in up to 41 individual MTFs and designated community/civilian facilities delivering care to TRICARE beneficiaries in the United States. Services include comparison of women’s health and perinatal outcomes against established concurrent civilian maternal and neonatal benchmarks.

The contractor shall provide the Department of Defense (DoD) Direct Care MTF Continental United States (CONUS) and Outside Continental United States (OCONUS) member hospitals with quarterly comparative reports and Civilian/community facilities will receive quarterly reports for selected metrics to include all or some of the following: financial, clinical, and quality indicators. Hospital specific data is compared to a subgroup with comparable volume and acuity, to Direct Cares a whole with inclusion of trends and to a national benchmark of the contractor average. Each report profiles Women’s Health, Obstetrical Services, Neonatal Services, Neonatal Special Care Services, Linked Mother/Baby Analyses, Perinatal Quality Indicators and Five- Year Trends.

The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Women’s Health and Perinatal Quality Improvement Services as defined in this Performance Work Statement (PWS) except for those items specified as government furnished property and services. The contractor shall perform to these standards while assisting DHA by evaluating the quality of women and perinatal care provided within the MHS.

1.3 Background: The DHA Deputy Assistant Director for Medical Affairs (DAD-MA) is responsible for oversight of clinical quality for the MHS. The MHS involves all military hospitals and clinics worldwide and care delivered to TRICARE beneficiaries in community and civilian care facilities. The objective of surveillance of the clinical quality is to monitor performance and to demonstrate and improve quality of care within the MHS. The purpose of this contract is to independently analyze the women’s and perinatal care outcomes in up to 41 MTFs and a determined number of designated community and civilian care facilities or PSCFs to highlight improvement opportunities in the MHS and the quality of care delivered to TRICARE.

The Contractor shall also provide analysis and comparison of women’s health and perinatal care provided to MHS beneficiaries treated at designated community and civilian care facilities or PSCFs in the United States to the Contractor’s benchmark average.

1.4 Objectives: Contractor shall provide program management support services and technical expertise in direct support to DHA’s Office of Women Health and Special Medical Programs.

Specific assistance is required in the analysis of women’s health and perinatal outcomes against concurrent civilian maternal, fetal, and neonatal clinical and quality benchmarks. The Government shall not exercise any supervision or control over contract service personnel performing the services herein. Such contract service personnel shall be accountable solely to the Contractor who, in turn is responsible to the Government. The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, and supervision necessary to perform services for DHA as defined in this PWS except for those items specified as government furnished property and services.

1.5 Scope: The Contractor will provide non-personal services for the external review and analysis of Women’s Health and Perinatal outcomes from the MTF’s, Networks and PSCFs against specified concurrent civilian maternal, fetal, and neonatal quality benchmarks. A database(s) that collects, analyzes, and reports data on various perinatal (maternal and neonatal) and women’s health metrics is essential to providing the required benchmarks as well as successfully accomplishing tasks outlined in this Performance Work Statement (PWS).

The services provided will aid DHA in determining best clinical practices and evaluating and improving the quality of care provided to the MHS beneficiaries. Services include but are not limited to program management, statistical analysis, reporting and documentation, healthcare Subject Matter Expertise analysis and support, healthcare database and analytics support. The Contractor will also advise and provide technical support in the areas of safety, quality, and access to knowledge of industry best practices. The Contractor will also provide program management activities that includes, but are not limited to, the following:

• Monthly Progress Report

• Performance Information Reports

• Quarterly reports

• Quarterly Report Comparisons and Summary Levels

• Quarterly Report Groupings and Measures

• Quarterly Report Time Period

• Quarterly Report Executive Summary DHA and Networks

• Quarterly PSCF Reports Quarterly Report Groupings and Measures

• Inpatient and Referral Analysis

• Civilian Delivery Analysis

• Perinatal Woman’s Health Reporting

1.6 Period of Performance (PoP): The Period of Performance includes a 12-month base period, plus four (4) 12-month option periods.

Name Start End Base Period Date of Award Through 12 months of performance Option Period 1 Expiration of Base Period Through 12 months of performance Option Period 2 Expiration of Option Period 1 Through 12 months of performance Option Period 3 Expiration of Option Period 2 Through 12 months of performance Option Period 4 Expiration of Option Period 3 Through 12 months of performance

1.6.1 Transition: Transition-in/transition-out period.

1.6.1.1 Transition-in period: There will be a 30-day transition-in period. Contractor shall have key personnel identified in accordance with PWS 1.12 and onboard day one of the period of performance start date. Contractor full performance must occur no later than the end of this 30-day transition-in period. During the transition-in period, the contractor shall prepare to meet all contract requirements and ensure their personnel are functionally trained and qualified on the full performance start date.

The Contractor shall submit a 30-day Transition-in Plan for review and approval by the Contracting Officer (CO) and Contracting Officer Representative (COR). This transition plan shall include, but is not limited to (CDRL 0002 – See PWS Section 7, Technical Exhibit 1):

• Coordination with Government representatives

• Review, evaluation and transition of current support services

• Transition of historic data to new Contractor system

• Government-approved training and certification process

• Transfer of hardware warranties and software licenses (if applicable)

• Transfer of all necessary business and/or technical documentation

• Transfer of compiled and uncompiled source code, to include all versions, maintenance updates and patches (if applicable)

• Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes

• Distribution of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment, etc.

• Transfer of Government Furnished Equipment (GFE) and Government Furnished

Information (GFI), and GFE inventory management assistance

• Applicable DHA briefing and personnel in-processing procedures

• Coordinate with the Government to account for government keys, ID/access cards, and security codes

1.6.1.2 Transition-out period: The transition-out plan shall facilitate the accomplishment of a seamless transition from the incumbent to an incoming contractor/Government personnel at the expiration of the contract. (CDRL 0003 - See PWS Section 7, Technical Exhibit 1). The Contractor shall provide an Outgoing Transition plan for 30 days of outgoing transition for transitioning work from an active task order to a follow-on contract/order or Government entity.

This transition may be to a Government entity, another Contractor or to the incumbent Contractor under a new contract/order. In accordance with the Government-approved plan, the Contractor shall assist the Government in planning and implementing a complete transition from this Contract and/or orders issued under this Contract to a successful provider. This shall include formal coordination with Government staff and successor staff and management. It shall also include delivery of copies of existing policies and procedures, and delivery of required metrics and statistics. This transition plan shall include, but is not limited to:

• Coordination with Government representatives,

• Review, evaluation, and transition of current support services,

• Transition of historic data to new Contractor system,

• Government-approved training and certification process,

• Transfer of hardware warranties and software licenses (if applicable),

• Transfer of all necessary business and/or technical documentation,

• Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes,

• Transfer of Government Furnished Information (GFI).

• Applicable DHA debriefing and personnel out-processing procedures.

• Turn-in of all government keys, ID/access cards, and security codes.

1.6.1.2.1 The contractor shall comply with transition-out requirements of the DHA for contractors who have been issued a CAC or who generate “records”, as defined by DoD (records manual), including DoD-directed disposition of records, and others displayed on the In/Out (I/O) Processing Portal.

1.7 Administrative specifications

1.7.1 Place of performance: The work shall be performed at the contractor’s facility.

1.7.2 Recognized Federal holidays: The contractor is not required to perform services on holidays.

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Day Christmas Day Independence Day

1.7.3 Hours of operation: The contractor is responsible for conducting business during the core business hours from 0900-1500 hours Eastern, while the duty hours are from 0730-1530, Monday through Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. Core business hours or emergency work hours will be established in the event of an extended local or national emergency (e.g., COVID-19). The contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons.

1.7.4 Emergency Services: On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours.

1.8 Contractor travel: Contractor may be required to travel within the CONUS region to attend ad hoc meetings at DHA HQ Falls Church, VA. Contractor will be notified by the Contracting Officer Representative (COR) NLT 15 working days prior to event. Local travel will not be reimbursed. Local travel is defined as any travel within a 50-mile radius of the National Capital Region. Arrangements for and costs of all travel, transportation, meals, lodging, and incidentals are the responsibility of the Contractor. All travel and transportation shall utilize commercial sources and carriers. The Government will not pay for business class or first-class travel. Contractors shall refer to FAR 31.205-46 Travel Costs, for adherence to allowable and allocable travel costs. No burdens, indirect rates, or G&A may be charged to travel. Only direct travel costs that the COR has pre-approved, and that the COR finds allowable and allocable may be charged to the contract. All travel (other than local travel) requires Government preapproval/authorization and notification to the COR within 15 days of scheduled travel. The Government is providing a Not-to-Exceed (NTE) ceiling amount for travel. Travel outside of the local area must be pre-approved by the COR and contractor travel must have occurred in order to be billed. It is the responsibility of the contractor to manage the travel costs through the duration of the contract as no additional funding will be provided.

1.9 Contractor Requirements: The contractor shall furnish all supplies, equipment (external database), facilities and services required to perform tasks outlined in Section 5 of this PWS.

1.10 Quality

1.10.1 Quality Control (QC): The contractor shall develop and maintain an effective QC program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure nonrecurrence of defective services. The contractor’s QC program is the means by which the work complies with stated requirements. Within 30 days after contract award, a comprehensive written Quality Control Plan (QCP) shall be submitted to the CO and COR , and within 5 working days when changes are made thereafter. After acceptance of the QCP, the contractor will receive the CO’s acceptance in writing of any proposed change to his QC system. (CDRL 0001- See PWS Section 7, Technical Exhibit 1.)

1.10.2 Quality assurance (QA): The government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan provides a systematic method for the Government to evaluate performance and to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.11 Contractor personnel

1.11.1 CAC requirements: Reserved.

1.11.2 Contractor onboarding and training. Reserved

1.11.3 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use.

1.11.4 Key control: Reserved.

1.11.5 Lock combinations: Reserved.

1.12 Key personnel (Contractor): The contractor shall provide a Contract Manager (CM) and alternate. Contract manager will be responsible for the performance of the work performed and overall management of this contract, to include day-to-day activities of the program, correspondence with the COR, travel arrangements, staffing, performance, schedule, and meetings. The CM and alternate shall have knowledge of DoD and DHA contracting requirements in order to maintain compliance with federal and local regulations, policies, and procedures.

Key personnel shall be designated in writing to the CO and COR. The alternate shall act on behalf of the CM when unavailable. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM or alternate shall be available between 8:00 a.m. to 4:30 p.m. Eastern Standard Time, Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

1.12.1 Key Personnel Limitation. Key Personnel proposed pre-award, or replacement Key personnel (authorized in writing by the CO), shall not be replaced for a period of twelve (12) months after award, except for:

• Serious, prolonged illness (that onset after the Contractor's submission of that Key Person's name to the Government);

• death;

• In the case of a Key Person who was a Contractor employee when the Contractor submitted his or her name to the Government, the Key Person leaves the Contractor's employer for reasons other than retirement and does not commence work for a Sub-contractor working on this contract or commence work for the Contractor after a hiatus.

1.12.2 The Contractor agrees that it has a contractual obligation to mitigate the consequences of the loss of Key Personnel and shall promptly secure any necessary replacements within 14 days and in accordance with this PWS section. Failure to replace a Key Person within the established timeframe shall be considered a condition endangering contract performance. A lapse in fulfillment of this position may provide grounds for default termination.

1.12.3 Replacement of Key Personnel shall be designated and approved in writing to the CO and COR. Replacements shall have qualifications equal to or superior to the Key Personnel being replaced. The Contractor shall submit those qualifications to the CO and COR in writing that the replacement is fully qualified to assume duties at least two (2) weeks (or as the COR otherwise agrees in writing) before Key Personnel may be replaced. The CO will approve based on recommendation from the COR.

1.13 Data rights: The Government has unlimited rights to all documents and/or material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership and/or copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the Contractor without written permission from the Contracting Officer. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights. “Government data” means any information, document, media, or machine-readable material, regardless of physical form or characteristics, which is created or obtained in the course of official Government business.

• “Government-related data” means any information, document, media, or machine-readable material, regardless of physical form or characteristics, that is created or obtained by a Contractor through the storage, processing, or communication of Government data. This does not include a Contractor’s business records, e.g., financial records, legal records, or data such as operating procedures, software coding or algorithms that are not uniquely applied to the Government data.

• “Spillage” means an unauthorized transfer of classified data or controlled unclassified information to an information system that is not accredited for the applicable security level of the data or information

1.14 Reporting

1.14.1 Contractor Manpower Reporting (CMR): Contractor Manpower Reporting (CMR):

Please refer to DFAR 252.204-7023 REPORTING REQUIREMENTS FOR CONTRACTED SERVICES (JUL 2021) which is incorporated into the Contract for specific manpower reporting requirement.

1.14.2 Non-Disclosure Agreement (NDA): All contractor personnel who will obtain access to proprietary, classified, or confidential information or any information release of which is protected or governed by law or regulation associated with DHA acquisitions shall be required to complete and sign a DHA contractor NDA (DHA Form 49 prior to beginning work on the subject contract. The contractor shall execute an NDA on behalf of the company and shall ensure that all staff assigned to, including all subcontractors and consultants, or other personnel performing on contract/Task order execute an NDA protecting the procurement sensitive information of the Government and the proprietary information of other contractors. The NDA shall be executed not later than first day of employment and to be renewed upon exercising a contract option period. Assignment of staff who has not executed this statement or failure to adhere to this statement shall constitute default on the part of the contractor. The contractor shall maintain originally signed NDAs of individual employees and provide copy to the COR. Section

7.3 DHA Form 49 Non-Disclosure Agreement (NDA) for further guidance.

1.14.3 Government’s COR: The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the contractor performs the technical requirements of the contract; perform inspections necessary in connection with contract performance; maintain written and oral communications with the contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including Government drawings, designs, specifications; monitor contractor's performance and notifies both the CO and contractor of any deficiencies; coordinate availability of government furnished property; and provide site entry of contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the contractor, states the responsibilities and limitations of the COR, especially regarding changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.15 Contractor Identification

1.15.1 Contractor personnel performing services in a contractor capacity in a Government facility are required to possess and wear an identification badge that displays his or her name and the name of their company. All contractor personnel shall identify themselves as contractor support personnel in all forms of communication with all entities with whom DHA/Deputy Assistant Director for Acquisition (DAD-A)/Head of the Contracting Activity (HCA) has business dealings. The contractor shall: Answer all telephone calls and have a personalized voice message with an introductory statement that includes the fact that the person is contractor support personnel. Ensure all those with whom the person interacts in any face-to-face dealings while supporting the DAD-A understands that the person is contractor support personnel.

Include a title block in all emails that states the fact that the person is contractor support personnel. Ensure all those with whom the person interacts in any face-to-face dealings while supporting DHA/DAD-A/HCA understands that the person is contractor support personnel.

1.15.2 Contractor personnel will be required to attend meetings or otherwise communicate via telephone or email with Government and/or other contract representatives to meet the requirements of this contract. Contractor personnel shall make their contractor status known during introductions.

1.15.3 Contractor personnel, while performing in a contractor capacity, are prohibited from using their retired or reserve component military rank or title in any written or verbal communications associated with the contracts in which they provide services.

1.16 Contractor Access to Health Affairs (HA)/DHA Network(s): RESERVED.

1.17 Personnel Security

1.17.1 The contractor shall comply with DoD 8140.03, Cyberspace Workforce Qualification and Management Program” (latest version); 8500.01, Department of Defense Instruction (DoDI) “Cybersecurity”, (latest version); DoD Manual (DoDM) 6025.18, “Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule Compliance in DoD Health Care Programs” (latest version); DoDI 6025.18 “HIPAA Privacy Rule Compliance in DoD Health Care Programs”, (latest version); and DoDM 5200.02 “Procedures for the DoD Personnel Security Program (PSP),”(latest version). Contractor responsibilities for ensuring personnel security include, but are not limited to, meeting the following requirements:

1.17.1.1 Follow the DHA Personnel Security Office guidelines for submittal of security clearances. Contact the DHA Personnel Security Office for guidance on the appropriate background investigation required for personnel on the contract. The DHA Personnel Security Office can be reached at (703) 681-2286.

1.17.1.2 Initiate, maintain, and document personnel security investigations appropriate to the individual’s responsibilities and required access to Controlled Unclassified Information (CUI).

1.17.1.3 DHA Personnel Security Office does not deny any access to any automated information system (AIS), network, or Controlled Unclassified Information (CUI). If a contractor receives an unfavorable background investigation, the request for access will be sent back to the Facilities Security Officer (FSO) for further action. Any unfavorable adjudication will result in DHA Personnel Security Office not signing off on any access request.

PART 2

2.0 DEFINITIONS, ACRONYMS, AND APPLICABLE

PUBLICATIONS/INSTRUCTIONS

2.1 Definitions:

2.1.1 Category D: Information Technology (IT) and Telecommunications Services (called D- Services)

2.1.2 Category R: Support (Professional/Administrative/Management) Services (called R- Services)

2.1.3 Contracting Officer (CO): A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.1.4 Contracting Officer’s Representative (COR): An individual, including a contracting officer’s technical representative (COTR), designated, and authorized in writing by the CO to perform specific technical or administrative functions. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.5 Nonpersonal services contract: a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

2.1.6 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance. The Government will prepare the QASP and utilize for monthly and annual performance assessments.

2.2 Acronyms:

AIS Automated Information System AQL Acceptable Quality Level CAC Common Access Card CDRL Contract Data Requirement List CIO Chief Information Officer CLIN Contract Line-Item Number CM Contract Manager CMMC Cybersecurity Maturity Model Certification CMR Contractor Manpower Reporting CO Contracting Officer(s) CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative CUI Controlled Unclassified Information

DAD-A Deputy Assistant Director for Acquisition DC3 DoD Cyber Crime Center DFARS Defense Federal Acquisition Regulation Supplement DHA Defense Health Agency DISA Defense Information System Agency DoD Department of Defense DoDD Department of Defense Directive DoDI Department of Defense Instruction DSAs Data Sharing Agreements DSAA Data Sharing Agreement Application DoDM Department of Defense Manual DPCLO DHA Privacy and Civil Liberties Office DUA Data Use Agreement FAR Federal Acquisition Regulation FedRAMP Federal Risk Authorization and Management Program FSO Facilities Security Officer HA Health Affairs HIPAA Health Insurance Portability and Accountability Act HCA Head of the Contracting Activity IA Information Assurance I/O In/Out Processing Portal IS Information System IT Information Technology MHS Military Health System MTFs Military Treatment Facilities NCR National Capitol Region NDA Non-Disclosure Agreement OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs PSCF Private Sector Care Facilities PHI Protected Health Information PII Personally Identifiable Information POC Point of Contact PM Program Manager PoP Period of Performance PRS Performance Requirements Summary PSP Personnel Security Program PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Plan SPRS Supplier Performance Risk System US United States

2.3 Applicable Publications: Additional NIST References and Related DoD Issuances. The references below support the IA requirements outlined in the following paragraphs.

• 48 CFR Parts 204, 212, and 252 as amended by 76 FR 69273 - 69282 /Vol. 78, No. 222

• NIST Special Publication (SP) 800-53, in accordance with DFARS 252.204-7012

"Security and Privacy Controls for Federal Information Systems and Organizations"

• NIST SP 800-53A, in accordance with DFARS 252.204-7012 "Guide for Assessing the

Security Controls in Federal Information Systems and Organizations"

• NIST SP 800-37, in accordance with DFARS 252.204-7012 "Guide for Applying the

Risk Management Framework to Federal Information Systems"

• NIST SP 800-34, in accordance with DFARS 252.204-7012 "Contingency Planning

Guide For Federal Information Systems"

• DoDD 5230.09 "Clearance of DoD Information for Public Release," (latest version)

• DoDI 8510.01 "Risk Management Framework (RMF) for DoD Information Technology

(IT)," (latest version)

• Health Insurance Portability and Accountability Act (HIPAA)

• Security Standards, Final Rule," (latest version)

• DoD 5400.11-R, DOD Privacy Program

• DoD 5200.2-R, DoD Personnel Security Program

• OMB M-06-16, Protection of Sensitive Agency Information

PART 3

3.0 GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

The Requiring Activity Authority has assessed the need for Government Furnished Property, Equipment, and Services and determined:

3.1 Services: The Government:

☐ Will NOT provide Government Furnished Services in support of this contract/task order. As a result, this paragraph is Not Applicable.

☒ WILL provide Government Furnished Services required in support of this contract/task orders. To facilitate data collection, DHA will provide access data from the applicable central and local Standard Inpatient Data Record (SIDR), the Standard Outpatient Data Record (SADR), and the Composite Health Care System (CHCS),the Military Data Repository (MDR), TRICARE Encounter Data-Institutional (TED I) and Clinicomp Essentris® and Cerner Genesis the electronic health record or other records system that maybe added. The DHA data will be provided electronically via secure resources, de-identified and aggregated as de-identified data within the contractor’s benchmark. In the event the Government is unable to provide access data due to Government system issues, the Contractor will be notified within 24 to 48hrs by the COR.

The Contractor will not be held responsible as a result of any Government delays.

3.2 Facilities: The Government:

☒ Will NOT provide Facilities in support of this contract/task order. As a result, this paragraph is Not Applicable.

☐ WILL provide Facilities in support of this contract/task orders. The Government provided Facilities are described below:

3.3 Utilities: The Government:

☒ Will NOT provide Utilities in support of this contract/task order. As a result, this paragraph is Not Applicable.

☐ WILL provide Utilities in support of this contract/task orders. The Government provided Utilities are described below:

3.4 Equipment: The Government:

☒ Will NOT provide Equipment in support of this contract/task order. As a result, this paragraph is Not Applicable.

☐ WILL provide Equipment in support of this contract/task orders. The Government provided Equipment is described below:

3.5 Materials: The Government:

☐ Will NOT provide Materials in support of this contract/task order. As a result, this paragraph is Not Applicable.

☒ IS providing Materials in support of this contract/task orders. The Government-provided Materials are described below: The Government will provide secure files that include the specified set of women’s health and perinatal data for all women’s/perinatal discharge and readmission as designated by the DAD-MA or Office of the Chief Medical Officer.

PART 4

4.0 CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: The contractor shall furnish all supplies, equipment, facilities, and services required to perform work listed under Section 5 of this PWS.

4.2 Secret Facility Clearance: Not applicable.

4.3 Materials: The contractor shall furnish materials and supplies necessary to meet the requirements under this PWS.

4.4 Equipment: The contractor shall furnish an external database necessary to meet the requirements under Part 5 of the PWS.

4.4.1. External data base: Contractors external data base should consist of multi-state women’s Health and neonatal discharge databases available for research and benchmarking analytics.

Supports analysis of the relationship between structure and outcome variables. Data base will be used as a benchmark to identify trends, outliers, areas for further review, missing data in support of DHA goals and measures. Contractor will provide specificity in their data base and capability to build benchmarks, understanding the data provided by DHA will include more than 200,000 discharges annually.

Contractor will identify benchmarks for women’s health, perinatal and neonatal conditions available in their external data bases. Contractor will identify the strength of their data base, identifying the utilizing large datasets for woman’ health, perinatal and neonatal benchmarking to allow for study of rare outcomes (e.g., cord prolapse), frequency or infrequently encountered in a single location, facility, or enterprise as a whole. Databases do not change care, datasets enable the aggregation of information from diverse women in various settings, for enterprise to identify outcomes, targets, and recommended care.

External data infrastructure should be contractors’ digital foundation that enables the sharing and consumption of data. Infrastructure includes several key elements, including:

data ingestion, data storage, data security, data retrieval, data analysis, data quality, data availability, data usability, data integrity, data compliance, data security.

Contractor will provide their internal processes that ensure external and DHA data are accurate when compared to other known data; Complete with no missing fields; Consistency across multiple systems and across time; Timely with process for ingesting fresh data and comparison to older data, looking for trends, or inconsistencies; Uniqueness without duplication of data;

Validity in crosswalks to ensure ingested and reported data are in agreed upon format.

4.5 Facilities: The contractor shall furnish facilities necessary to meet the requirements under this PWS.

PART 5

5.0 SPECIFIC TASKS

5.1 Task Management:

The Contractor shall provide all services efficiently, accurately, on time, and in compliance with the requirements of this PWS. Specifically, it shall provide services in support of DAD MA or the Office of the Chief Medical Officer; specifically, review of Women’s Health data including perinatal (antepartum, intrapartum, and postpartum; maternal and fetal) and neonatal outcomes serving as a quality benchmark. The Contractor’s database(s) shall collect, analyze, and report data on various perinatal (maternal and neonatal) and women’s health metrics to result in adequate benchmarks. The Contractor’s database will allow for equitable comparison of quality across participating institutions, allowing for comparison against regional, national, and/or international benchmarks. DHA will equip the Contractor with discharge data for care delivered through MTFs and Private Sector care through TRICARE coverage.

Any proprietary data and analytics will be used for reports, analytics, and research, benchmarking MHS data to propriety database. Perinatal and women’s health database will include but not be limited to:

• Representing nearly 10% of delivery volume in the US,

• Inclusive of academic and nonacademic centers, rural and urban setting,

• At least 10% of facilities with level II or higher NICUs,

• Multi-state database (at least representatives of 10 states),

• Established performance metrics, developing database elements based on trends, priorities and interests which may include but not limited to national benchmarks.

Proprietary analytics and data shall provide DHA leadership (MTF, Network, Direct/Private Sector Care, and enterprise) reports that identify an assessment of the performance of perinatal and women’s Health service lines through;

• Volume and utilization by level of perinatal care and women’s health setting

• Assessment to assist enterprise to determine areas of concern or risk exposure

• Assessment to assist enterprise, with longitudinal data, system-wide impact of practice patterns and interventions.

• Capacity to demonstrate improvement or change in data related to of perinatal and women’s health through comparative data analysis, program evaluation, health services research and professional continuing education.

• Displays and tracks key performance indicators

The MHS involves all military hospitals and clinics, and civilian facilities treating military beneficiaries worldwide. The objective of this program is to define, demonstrate, monitor, and improve the quality of care within the MHS through the monitoring of performance, processes, and clinical outcomes. In addition, services will provide support through external analysis and benchmarking the outcomes and performance of Women’s Health and perinatal care done in military MTFs and PSCFs treating TRICARE beneficiaries with standard metrics that are nationally recognized, benchmarked, and consistent with research and emerging evidence to improved outcomes for mothers and infants.

Contractor shall incorporate de-identified MHS data into repository/benchmark to provide a more robust database set enhancing the ability of the DoD to validate and/or assess the quality of care provided by DoD treatment facilities and maintain compliance with related DoD quality assurance and patient privacy directives. This shall be done IAW applicable DoD and DHA Information Technology and Security requirements in PWS part 6.

The Contractor shall designate a single manager to oversee this service and supervise staff assigned. The Contractor will ensure timely follow up (within 3 business days) to data inquiries from MTF or DHA. Contract manager is responsible as a single point of contact for reports, data, inquiries expenditures, and any problems/ issues encountered in the performance of this task.

5.1.1 Monthly Progress Report (MPR)

The Contractor shall submit an MPR outlining the expenditures, billings, progress, status, and any problems/ issues encountered in the performance of this task, by the 15th of the month next month. (CDRL 0004 – See PWS Section 7, Technical Exhibit 1)

5.1.2 Contract Period Close-Out Summary: At the end of each Contract year, the Contractor will provide the PM/COR a compilation of deliverables, invoices, monthly progress reports, and all other materials produced under this contract. The materials will be aggregated electronically and sent to the COR. (CDRL 0015- See PWS Section 7, Technical Exhibit 1.)

5.2 Performance Information Reports

5.2.1 The Contractor shall collect and analyze women’s health and perinatal data applying biostatistical and epidemiological processes to determine appropriate sample size, accurate data collection techniques, scientifically sound analytical processes, appropriate sample stratification procedures, association of patient risk factors, any required risk adjustment, and a gap analysis of the quality of the available DoD data. The Contractor shall compare Women’s, maternal, fetal, and neonatal outcome, and process measures against civilian benchmark hospitals. (CDRL 0005

- See PWS Section 7, Technical Exhibit 1)

5.2.2 Quarterly Report

The Contractor shall submit a Quarterly report in accordance with the CDRL Schedule (CDRL 0006- See PWS Section 7, Technical Exhibit CDRL). The Quarterly Report shall be hospital specific and contain both a quantitative and qualitative component. Contractor will determine the data fields needed to provide the following specific data sets, and in addition include graphs and tables as needed for data clarity and trending. Delivery of data sets will be collaborated with DHA PM, COR, and the contractor during the first 30 days of contract award and reviewed annually thereafter. Reports shall include extensive tables and graphs displaying utilization and outcome trends for specific MTF(s) and PSCFs compared to the contractor external benchmark.

Data displayed with be the most recent four (4) quarters of data. Trendlines shall be up to 5 years of data. Data and trending shall be shown/displayed with 2 standard deviations from contractor external benchmark and include confidence intervals. The Government reserves the right to alter, change, add or delete metrics at any time. This normally occurs quarterly. The Government will direct the aggregation of the MTFs, and civilian facilities based on most current DHA structure.

The aggregation of MTFs and civilian facilities may change at any time. The quantitative analysis shall include the following:

• Comparative Facility, Subgroup and Database Overview Data on all inpatient discharges for the four-quarter period for the database subgroup and hospital.

• Perinatal population APR-MDC 14 Pregnancy, Childbirth, and the Puerperium for eighteen months post-delivery. A utilization and charge analysis for MDC 14 cases. Expansion to include various Women’s heath MDC diagnosis as determined by DoD.

• Perinatal Deliveries by APR DRG Subclass A utilization and charge analysis for deliveries assigned to one of four APR-DRG severity subclasses based on complications, co-morbidities, age, or other extenuating circumstance.

• MDC 14 Cases by MS DRG A utilization and charge analysis of all MDC 14 cases by MS

DRG.

• Delivery Analysis Comparative data on vaginal and c-section deliveries; c-section delivery data is also subdivided into primary and repeat c-sections. Utilization and charge analyses are provided.

• Comparative C-Section Rates: Comparative data display of a hospital’s c-section rate with a 95% confidence interval (CI).

• Obstetrical Trend Analysis hospital’s data compared to the Benchmark

• C-Section Deliveries with Trendlines o Primary C-Section Deliveries with Trendlines Rate of primary c-sections as a percent of total cases without a prior uterine scar.( Inpatient Quality Indicator 22 (IQI 22) Vaginal Birth After Cesarean (VBAC) Delivery Rate) o Uncomplicated o Repeat C-Section Deliveries with Trendlines Rate of repeat c-sections as a percent of total cases with a prior uterine scar.

o Overall, both primary and repeat deliveries with Trendlines- Rate of all c-sections as a percentage of total cases o Coded Reasons for C-Sections Coded reasons and percent of total for your primary c-section and repeat c-section cases.

o Distribution of Coded Reasons for Primary and Repeat C-Sections Trend Analysis

• Operative Vaginal Deliveries o Includes each type of instrumented delivery-forceps deliveries, vacuum extractions, and other operative vaginal deliveries. Operative vaginal deliveries are shown as a percent of total vaginal deliveries and each procedure category is displayed as a percent of total operative vaginal deliveries. The database top decile average is also displayed.

o Operative Vaginal Deliveries with 5-year Trendlines

• Delivery Analysis by Day of Week Total deliveries with induction procedure codes divided into vaginal, primary, and repeat c-section deliveries. Includes distribution by day of the week. Table also displays repeat c-section deliveries as a percent of total deliveries and distribution by day of the week.

• Induction Rates with Trendlines

NEONATAL

• Neonatal Overview (all cases age 0-28 days old at admission) Total neonates and total inborn neonates (subdivided into singletons, twins, other multiples and unknown), other neonatal admits (subdivided into neonates transferred in, inborn readmissions, all other), inborns and other neonatal admits transferred out.

• Inborn Twins/multiples Birth Analysis with Trendlines

• Neonates Transferred In from another hospital 0-28 days old at admission by Birthweight Category

• Neonatal Trend Analysis by Birthweight Category

• MDC 15 Neonate Analysis by MS DRG A utilization and charge analysis of all MDC 15 neonates by MS DRG. Cases 0-28 days old at admission not grouping to an MDC 15 MS DRG are also displayed.

• Inborns by APR DRG Subclass A utilization and charge analysis for inborns assigned to one of four APR-DRG severity subclasses based on complications, co-morbidities, age or other extenuating circumstance.

• Neonates Transferred In 0-28 days old at Admission by APR DRG Subclass

• Mortality Analysis by Admission Status All neonates at admission, the number who died and percent of total neonates. Also subdivided into inborn ≥ 500 grams, transferred in and other neonatal admits. Mortality rates at 0-7 days old, 8-27 days old and >= 28 days old.

• Inborn Mortality Rate ≥ 500 Grams

• Transferred In Mortality Rate

• Inborn Neonatal Trend Analysis: Deaths by Birthweight Category

• Inborn Neonatal Mortality Analysis (≥ 500 Grams) with Trendlines

• Mortality Analysis by Birthweight Category & Admission Status

• Neonatal Special Care Trend Analysis

• Special Care Discharges with Trendlines

• Special Care Analysis: Complications Count and rate of selected neonatal complications. The denominator for all rates is the total special care population with the exception of Meconium Aspiration Syndrome (subdivided into inborns in special care with MAS and transfers into special care with MAS) and Retinopathy of Prematurity with eye procedure (all special care discharges with ROP).

• Special Care Analysis: Therapeutic hypothermia and/or HIE diagnosis

• Special Care Analysis: Complication Trends Neonates

• Special Care Analysis with Trendlines: Proportion of BPD to RDS,

• Special Care Analysis with Trendlines: NEC Rate,

• Special Care Analysis with Trendlines: IVH (Grade III or IV) Rate, 500-1499 Topics added or deleted based on discussion and advantage to the GVT no more frequently than annually.

MATERNAL

• Maternal Indicators

• Coded Reasons for Postpartum Readmissions

• Postpartum Readmission Rate with diagnosis category and LOS o Postpartum Readmission Rate with Trendlines

• Postpartum Hemorrhage Rate o Postpartum Hemorrhage Rate with Trendlines (1000cc -1999cc, 2000cc-2999cc, 3000cc or more)

• Rate of Disruption or Infection of Obstetrical Wound o Rate of Disruption or Infection of Obstetrical Wound with Trendlines

• Rate of Vaginal Deliveries Coded with Shoulder Dystocia

• Rate of Inductions Resulting in Cesarean Delivery

• Coded Reasons for Inborn Readmissions

• Inborn Readmission Rate

• Linked Mother/Baby Indicators

• Vaginal Deliveries with Coded Shoulder Dystocia Linked to an Inborn ≥ 2500 Grams with

Birth Trauma

• Coded Maternal Conditions with Neonatal Special Care Admission: to include o Hypertension o Diabetes Mellitus o Obesity o Thyroid Dysfunction

• Scheduled (primary or repeat) Cesarean Deliveries ≥ 37 Weeks with Neonatal Special Care Admission

• Severe Maternal Morbidity o Severe Maternal Morbidity (SMM) Overall Rate o SMM Excluding Transfusion Only Cases o SMM Among Pre-eclampsia Cases Overall Rate o SMM Among Pre-eclampsia Cases, excluding Blood Transfusions o SMM Hemorrhage Cases Overall Rate o SMM Hemorrhage Excluding Transfusion Only Cases

5.2.2.1 Heat Map- elements mutually agreed upon and update annually

Develop Women’s Health metrics as agreed upon with Government for quarterly reporting.

The Contractor, in collaboration with the Government PM/COR, shall develop and report on up to 10 mother-infant indicators to display on a “Heat Map” for both Direct (MTF care) and PSCF.

The Government reserves the right to adjust by addition, subtraction or alteration of indicators and aggregation of MTFs and civilian facilities once a calendar year. In addition, the quarterly reports shall identify specific opportunities for improvement for each MTF/PSCF.

5.2.3 Quarterly Report Comparisons and Summary Levels

1) Comparisons: Each Report shall include four types of comparison:

a) The MTFs will be compared to the subgroup of other MTFs with distinct levels of service such has Basic, Basic teaching, Specialty, OCONUS.

b) The facilities will be compared to an appropriate subgroup of civilian hospitals for external benchmarking.

c) The MTFs will be compared to a civilian hospital external benchmark. Direct and PFC will also be compared to external benchmarks.

d) PSCF to MTF facilities, benchmarking based on Government determined aggregation of facilities.

2) Summary Levels: Specific Service/regional and MHS comprehensive level summaries shall provide trends, areas of levels. Summary level reports shall include –additional comparison groups may include but will be determined by the Government; Branch of Service, Networks, and other Government defined regions.

Semiannual report of summary with 5-year trend lines for a) DHA as an aggregate b) for each Network and c) PSCF- final report is yearend for total 4 quarter of calendar year.

5.2.4 Quarterly Report Groupings and Measures

The Quarterly Comparative Reports (see PWS Section 5.2.2) shall display perinatal cases by different patient subgroups and clinical diagnoses. Comparative measures shall include average length of stay, average charge, case mix adjusted length of stay, case mix adjusted average charge, mortality rates, documented reasons for performing a C-section, analysis of elective deliveries prior to 37 completed weeks gestation,…