Justification for a Sole Source Acquisition_AHA_2026_1_Redacted.pdf

e. Name and address of the proposed contractor.

American Hospital Association (Health Forum, LLC) 155 North Wacker Drive, Suite 400 Chicago, IL 60606 Ellen Nixon enixon@aha.org

4. Identification of the statutory authority permitting a sole source.

This sole source acquisition is being conducted using the procedures of FAR Part 12 and FAR Subpart 13.5 in accordance with 41.U.S.C 1901 for a commercial item not exceeding $7.5 million. Acquisitions conducted under simplified acquisition procedures are exempt from the requirements in Part 6. In accordance with FAR 13.106-1(b) and FAR 13.501(a) contracting officers may conduct sole source acquisitions if the need to do so is justified in writing.

This sole source justification is prepared using the format at FAR 6.303-2, modified to reflect the procedures in FAR subpart 13.5 were used.

5. Proposed contractor’s unique qualifications or nature of the acquisition requires use of the authority cited.

The contracting officer has determined that Health Forum, Inc. (the American Hospital Association (AHA)) is the only source that is reasonably available because AHA has a long-standing, data collection effort in place designed to capture information on the adoption and use of electronic health records, as well as users’ attitudes towards them in U.S. hospitals. Since 2008, the National Coordinator for Health IT (ONC) has supported the data collection and acquired the resulting dataset through a single-source cooperative agreement. Because we have used this method of tracking hospital use of health IT for over a decade, the survey measures provide ONC an ability to track trends over a long period of time, which would be lost if we used another data source that didn’t use the same methodology and survey content.

The AHA Annual Survey of Hospitals collects data from more than 6,300 hospitals across the U.S. This dataset is a primary resource for government agencies and has been used by the Centers for Disease Control and Prevention, the U.S. Census Bureau, and Centers for Medicare & Medicaid Services. The IT Supplement is a separate collection effort from the AHA’s general census tracking survey project that has been conducted continuously since 1946. Over this time span, the general census tracking survey has yielded an average response rate of more than 75 percent. Such a high level of response is exceptional for a voluntary survey that includes both member and non-member hospitals. Building on the success of the general survey, the response rates for the IT Supplement have exceeded 60 percent each year since its inception, an exemplary response rate for a national data collection effort. The IT supplement survey can be linked to the AHA Annual Survey of Hospitals to provide detailed information on the characteristics of hospitals beyond the use of health IT.

Additionally, it can be linked to external data sources such as the Healthcare

Cost and Utilization (HCUP) data to conduct studies that assess the impacts of health IT on quality of inpatient care.

As the leading acute care hospital membership organization (approximately 80 percent of non-federal acute care hospitals are members), the AHA is uniquely suited to build on the response rate successes of prior years. Its credibility and reputation as a hospital advocacy and research center are unmatched by any other organization. In addition, the AHA has more than 60 years of experience in survey development, design, and effective data collection through mail-based, and now web-based, efforts. No other organization has the experience or membership to achieve such high survey response rates from a large and diverse national sample of U.S. hospitals.

To measure key components of interoperability, ASTP has made it a priority to measure health care providers’ ability to electronically send, receive, find, and integrate information received from outside sources. Without funding to supplement the cost of data collection, the AHA would not conduct an IT survey of this scope. The AHA’s IT Supplement is the only known source that tracks key performance measures regarding the interoperable exchange of health information by hospitals. Our national progress on interoperability also has a direct impact on the success of federal initiatives such as delivery system reform and achieving “widespread interoperability” as outlined in Health Information Technology for Economic and Clinical Health Act (HITECH), the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and the 21st Century Cures Act.

Tracking and reporting on progress allow us to know where we are starting from, how much progress we have made over time, and whether we have met important milestones. In addition, the AHA’s IT Supplement has the capability to track specific functionalities included or under consideration for future inclusion in federal programs (such as the Promoting Interoperability Program). No other organization conducts surveys of U.S. hospitals with the same breadth and level of specificity about hospital IT use as the AHA.

This survey has served the public good in that it has been the foundation of important public research on EHR adoption, as well as examining the impact EHR use has on the quality and efficiency of care in inpatient settings. Examples of such studies include Barker et al. 2024, Richwine and Meklir 2024, and Nong et al. 2025.

6. Description of efforts made to ensure that offers are solicited from as many potential sources as is practicable, including whether a notice was or will be publicized as required by FAR subpart 5.2 and, if not, which exception under 5.202 applies.

Although there are a number of companies with survey methodology expertise relevant to health care, and these organizations offer strong survey administration capabilities, none of them have a near-census proprietary database of U.S. hospitals, nor have they fielded the AHA annual survey or IT supplement in the past. Using an alternative contractor would require the development of a new sampling frame, reduce comparability and trending estimates with prior national hospital health IT data, increase respondent burden, and may result in lower response rates from hospitals.

7. Determination by the Contracting Officer that the anticipated cost/price to the Government will be fair and reasonable.

Historically the Government has been able to verify the pricing for the survey based on a search of the company website and previous contracts. The contractor implements a 6% escalation annually, which is above the industry standard but still fair and reasonable in regard to the overall dollar amount

8. Description of the market research conducted (see FAR Part 10) and the results, or a statement of the reasons market research was not conducted.

We conducted market research through querying the government-wide database of contracts and other procurement instruments intended for use by multiple agencies (including the GSA eLibrary), contacting knowledgeable individuals in Government regarding market capabilities to meet requirements, reviewing the results of recent market research undertaken to meet similar or identical requirements, and obtaining source lists of similar items from other contracting activities. Based on our market research, there are a number of companies with survey methodology expertise relevant to health care. While these organizations offer strong survey administration capabilities, none of them have a near-census proprietary database of U.S. hospitals, nor have they fielded the AHA annual survey or IT supplement in the past. Using an alternative vendor would require the development of a new sampling frame, reduce comparability and trending estimates with prior national hospital health IT data, increase respondent burden, and may result in lower response rates from hospitals. These companies, therefore, cannot meet the governments’ requirements for continuity, national representativeness of hospitals, and linkage with other existing hospital data sets. The AHA is the only known organization capable of fulfilling the governments’ need for a nationally representative hospital health IT survey within project timelines while minimizing respondent burden.

9. Any other facts supporting the justification.

N/A

10. Listing of sources, if any, that expressed, in writing, an interest in the acquisition.

N/A