MEPS-MPC.solicitation.pdf

Request for Proposal v. FAC 2021-01 Oct 2020 AHRQ-21-10002 MEPS – Medical Provider Component Page 1 of 108

Request for Proposal No. AHRQ-21-10002

PART I - THE SCHEDULE

SECTION A - SOLICITATION FORM

Date Issued: December 10, 2020 Date Questions Due: December 17, 2020 10:00am EST Please Note: All questions and inquires will be processed on a non-attribution basis.

Date Notice of Intent Due: January 8, 2021 Date APS Registration Due: January 12, 2021 Date Proposals Due: January 19, 2021, 11:00 AM, EST

You are invited to submit a proposal to the Agency for Healthcare Research and Quality (AHRQ) for Request for Proposal (RFP) No. AHRQ-21-10002 entitled “Medical Expenditure Panel Survey

– Medical Provider Component (MEPS-MPC)”. Your proposal must be developed and submitted in accordance with the requirements and instructions of this RFP.

Solicitation Information: Please review the table of contents and refer to the appropriate section of this RFP for requirements, proposal instructions and evaluation information. The Government intends to award this contract without negotiations, so it is imperative that all questions are addressed during the solicitation phase, and that all proposals submitted include the required information and accept the terms and conditions as stated. Failure to comply with proposal instructions or submit required information may result in the removal of a proposal from consideration for award. Please review Section L carefully.

Proposal Intent: If you intend to submit a proposal in response to this solicitation, please inform the Contracting Officer of your intent by sending an email to Tara Bertolini, Contract Specialist at tara.bertolini@ahrq.hhs.gov no later than January 8, 2021. Subject line shall read: Proposal Intent RFP No. AHRQ-21-10002.

Questions: All Questions regarding this solicitation shall be received in this office no later than the date shown above. All questions shall be submitted electronically by e-mail to Tara Bertolini, Contract Specialist, at the following email address: tara.bertolini@ahrq.hhs.gov. Subject line shall read: Proposal Questions RFP No. AHRQ-21-10002. Answers to questions and all solicitation amendments will be posted to the Contract Opportunities web page: https://beta.sam.gov/. It is your responsibility to monitor the web site. Questions should be submitted in a work table in the following format:

RFP (or Attachment) Page Number

Relevant Section Number or Title

Question

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Additional Information:

1. A cost plus fixed fee contract is contemplated for a base period of three (3) months, plus four (4), twenty (20) month overlapping option periods.

2. The Government anticipates awarding one contract from this solicitation on or about August 11, 2021.

3. Proposals submitted in response to this solicitation must state that they are valid for a period of at least 120 days (reference FAR clause 52.215-1 in Section L of this document.)

4. The NAICS code for this requirement is 518210 with a size standard of 35M.

5. The proposal shall be signed by an authorized official to bind your organization. Signatures can be electronic if necessary.

Proposal Submission:

To submit a proposal, offerors are required to use the AHRQ Proposal Module (APM). Mailed proposal and E-mailed proposals will not be accepted.

In order to access the AHRQ Proposal System offerors must be registered in the system before the proposal due date. To ensure your organization is registered in the system, offerors are required to send the following information to Tara Bertolini at tara.bertolini@ahrq.hhs.gov no later than 12:00 PM January 12, 2021:

Official Company name:

DUNS Number:

Point of Contact name, email, phone number

Failure to respond timely and provide the requested information could result in an inability to submit a proposal.

Before the proposal due date, instructions on how to upload proposals to the AHRQ Proposal Module will be emailed to your organization’s point of contact.

NOTE: For the Business Proposal submission, the offeror must submit two versions. This includes a Word or PDF version AND an Excel document version.

System for Award Management: In accordance with Federal Acquisition Regulation, all contractors must be registered in the System for Award Management (SAM) database in order to conduct business with the government [See Section I - FAR clause 52.204-7 System for Award Management].Access the System for Award Management (SAM) at https://www.sam.gov/SAM/.

Reminder: The Procurement Integrity Act prohibits the unauthorized disclosure of, inquiry about, or acceptance of procurement information. Communications with any other individual outside the AHRQ contracting office may result in rejection of an offeror’s proposal. All requests for any information concerning this RFP should be referred to Tara Bertolini, (301) 427-1705 or e-mail:

MEPS – Medical Provider Component Page 3 of 108 tara.bertolini@ahrq.hhs.gov. Please note e-mail requests should state subject as RFP AHRQ- 21-10002.

Table of Contents

PART I - THE SCHEDULE

SECTION A - SOLICITATION FORM

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

SECTION C - DESCRIPTION/SPECIFICATION/WORK STATEMENT

SECTION D - PACKAGING AND MARKING

SECTION E - INSPECTION AND ACCEPTANCE

SECTION F - DELIVERIES OR PERFORMANCE

SECTION G - CONTRACT ADMINISTRATION DATA

SECTION H - SPECIAL CONTRACT REQUIREMENTS

PART II – CONTRACT CLAUSES

SECTION I - CONTRACT CLAUSES

PART III- LIST OF DOCUMENTS, EXHIBITS AND ATTACHMENTS

SECTION J – SOLICITATION LIST OF ATTACHMENTS

PART IV– REPRESENTATIONS AND INSTRUCTIONS

SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS

SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

SECTION M- EVALUATION FACTORS FOR AWARD

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SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SUPPLIES OR SERVICES

“Medical Expenditure Panel Survey – Medical Provider Component – (MEPS-MPC)”. See Section C for a complete description.

B.2 ESTIMATED COST AND FIXED FEE

a. The Estimated Cost (exclusive of fees) for performance of the work under the base period of this contract, including direct and indirect costs is $ To Be Determined (TBD).

b. The Fixed Fee for the base period of this contract is $TBD. The fixed fee shall be paid in installments based on the percentage of completion of work, as determined by the Contracting Officer. Payment shall be subject to the withholding provisions of the Clause ALLOWABLE COST AND PAYMENT and FIXED FEE incorporated herein.

c. The total contract value, represented by the sum of the estimated cost plus the fixed fee for the base period is $TBD.

Period of Performance Services Estimated

Cost Fixed Fee Total Base Period Non-severable $ $ $

B.3 OPTION COSTS

If the Government exercises its option(s) pursuant to the option article in Section H of this contract, the Government’s total contract amount represented by the sum of the estimated cost, fixed fee, will be revised as follows:

Period of Performance Services Estimated Cost Fixed Fee Total Option Period 1 Non-severable $ $ $ Option Period 2 Non-severable $ $ $ Option Period 3 Non-severable $ $ $ Option Period 4 Non-severable $ $ $

The base period and each option are separate and distinct from one another for accumulation of costs and billing purposes.

OPTION TASKS

SOW Task Services Estimated Cost Fixed Fee Total

Option Task A Non-severable Option Task B Non-severable Option Task C Non-severable Option Task D Non-severable

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Option Task E Non-severable Option Task F Non-severable Option Task G Non-severable Option Task H Non-severable

All option tasks (if exercised) shall be accomplished in their entirety within the given contract period.

B.4 PROVISIONS APPLICABLE TO DIRECT COSTS

a. Items Unallowable Unless Otherwise Provided

Unless authorized in writing by the Contracting Officer, the costs of the following items or activities shall be unallowable as direct costs:

(1) Acquisition, by purchase or lease, of any interest in real property;

(2) Rearrangement or alteration of facilities;

(3) Purchase or lease of any item of general purpose-office furniture or office equipment regardless of dollar value;

(4) Travel to attend general scientific meetings;

(5) Foreign Travel;

(6) Any costs incurred prior to the contract's effective date;

(7) Rental of meeting rooms;

(8) Any subcontract agreement (including consultants) not otherwise expressly provided for in the contract;

(9) Information Technology hardware or software; and

(10) Food and Beverages.

Note: Food and Beverages are unallowable costs. Contracting Officer Authorization for Food and Beverages will be only made as specifically authorized by statute, which is extremely rare. The contractor shall not provide food or beverages of any type. The contractor shall not accept food or beverages, even if included in, or provided ‘free’ as part of a meeting/conference ‘package’.

b. Travel Costs

This contract is subject to the provisions of Public Law (P.L.) 99-234 which amends the

Office of Federal Procurement Policy Act to provide that contractor costs for travel, MEPS – Medical Provider Component Page 6 of 108 including lodging, other subsistence, and incidental expenses, shall be allowable only to the extent that they do not exceed the amount allowed for Federal employees. The Contractor, therefore, shall invoice and be reimbursed for all travel costs in accordance with Federal Acquisition Regulations (FAR) 31.205-46.

The following applies to Educational Institutions: The Contractor shall invoice and be reimbursed for all travel costs in accordance with OMB Circular A-21 - "Cost Principles for Educational Institutions."

No funding or expenditures will be authorized under this contract for travel or meeting expenses of any person that is not an employee of the contractor or approved subcontractor in accordance with the terms of the contract. See 31 USC § 1345 for appropriations restrictions.

B.5 CONTRACTING OFFICER AUTHORIZATION

Other provisions of this contract notwithstanding, approval of the following items within the limits set forth is hereby granted without further authorization from the Contracting Officer.

To Be Determined

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SECTION C - DESCRIPTION/SPECIFICATION/WORK STATEMENT

Independently and not as an agent of the Government, the Contractor shall be required to furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government, as needed to perform the Statement of Work as follows:

Statement of Work

Unless otherwise noted under a specific task, this Statement of Work applies to the base period and all options (if exercised).

Medical Expenditure Panel Survey (MEPS) - Medical Provider Component (MPC)

1.0 Background Information and Contract Objectives

The Medical Expenditure Panel Survey (MEPS) has been conducted by the Agency for Healthcare Research and Quality (AHRQ) annually since 1996. MEPS is a family of surveys intended to provide nationally-representative estimates of health care expenditure, utilization, payment sources, health status, and health insurance coverage among the noninstitutionalized, nonmilitary population of the U.S. MEPS consists of three core components: the household component (MEPS-HC or HC), the medical provider component (MEPS-MPC or MPC), and the insurance/employer component (MEPS-IC or IC). 1 Together these surveys collect data on specific health services, including the frequency of use, costs, and sources of payment for services, and on the cost and scope of health insurance covering U.S. workers. As such MEPS is the only national data source measuring how Americans use and pay for medical care, health insurance, and out-of-pocket spending. In addition, MEPS data are widely used by policymakers and the research community on a wide range of topics related to the U.S. healthcare system, including access to care, children’s health, chronic conditions, health insurance, health disparities, women’s health, prescription drugs, individuals with disabilities, and the aging population.

The MEPS-HC collects data from a sample of families and individuals in selected communities across the U.S., drawn from a nationally representative subsample of households that participated in the prior year’s National Health Interview Survey (conducted by the National Center for Health Statistics). During the household interviews, MEPS collects for each person in the household detailed information on the following: demographic characteristics, health conditions, health status, use of medical services, medical service charges and sources of payments for those services, access to care, satisfaction with care, health insurance coverage, income, and employment. The MEPS-HC panel design, which features several rounds of interviewing covering two full calendar years, makes it possible to measure changes in respondents’ health status, income, employment, eligibility for public and private health insurance coverage, use of services, and payment for care.

1 The MEPS-HC and MEPS-IC are separate requirements not part of this (or included/covered under) solicitation.

That said, many activities and deliverables associated with the MEPS-MPC project (contract) are directly linked to HC activities, thus requiring careful coordination with AHRQ and the HC contractor. See Task 1 Project Management for further information around MPC and HC coordination.

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A challenge the HC faces is getting complete reporting from the respondents’ on the use of medical services and the associated medical service charges and sources of payments for those charges. To help address that challenge, the MEPS incorporates the MPC with the explicit purpose of collecting data to supplement and/or replace information provided by the HC respondents. To do this the MPC collects data from all hospitals, emergency rooms, home care agencies, outpatient departments, long term health care facilities, and pharmacies reported by HC respondents as well as all physicians who provide services for patients in hospitals but bill separately from the hospital (Separately Billing Doctors or SBDs). Office based medical providers where the provider is either a doctor of medicine (MD) or Osteopathy (DO) or practices under the direct supervision of an MD or DO are included in the MPC as well. For this contract, long term health care facilities include nursing homes, assisted living facilities, rehabilitation facilities, as well as any health care facility providing medical care to those reporting such care in the HC. Jails, prisons, and medical facilities or pharmacies outside the United States are considered out of scope for the MPC.

The primary objective of the MPC is to collect data from medical providers (hospitals, office based doctors (OBDs), home health agencies, pharmacies, long term health care facilities, SBDs) on dates of visits/services, use of medical care services, diagnosis and procedure codes for medical visits/encounters, and the charges, payments and source of payments for the medical services provided to those participating in the HC panel survey. The MPC data serve as an imputation source for HC item nonresponse to reduce the level of bias in survey estimates of medical expenditures. They also serve as the sole source of SBD expenditure information, as well as serving the primary source of expenditure information for Medicaid recipients, hospital care and prescription medicines.

The MPC sample can be seen as consisting of two parts that reflect different sources of selection: (1) the non-SBD MPC sample, and (2) the SBD MPC sample. The non-SBD part of the MPC sample is annually selected from the medical providers identified in the HC as having provided care to the respondent during a specific calendar year (HMOs are included, as well as office-based medical providers where the provider is either a doctor of medicine (MD) or Osteopathy (DO) or practices under the direct supervision of an MD or DO). That said, only providers for whom the respondent completed a signed Authorization Form authorizing contact are candidates for the MPC. The MPC SBD portion of the sample consists of physicians or other medical services providers, reported by hospitals or institutions as providing services during a hospital-based or institution-based event. Thus, the SBD sample is created during the MPC non-SBD data collection.

Home care providers which include all home care agencies, hospitals, social service agencies, and other places identified as providing home care to the sample person are included in the MPC. However, self-employed and unpaid persons providing home care services are not considered in scope for the MPC.

From the above description there is significant integration of work activities between the MEPS HC and MPC projects that requires careful coordination in order to maintain desired MEPS production schedules, including annual releases dates to the MEPS public-use files. The Contractor shall work in close coordination with the MPC COR to ensure deliverable schedules align with the HC production schedules and overall MEPS public-use file release dates.

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2.0 Scope

2.1 Services to be Performed

A core objective for this contract is to continue the MEPS-MPC operation of collecting medical provider data in support of generating annual MEPS household cost and expenditure estimates.

This contract will support medical provider data collection and abstraction efforts designed for use in generating annual MEPS estimates for the 2021 through 2024 survey years. The contractor shall perform the following types of services under this contract:

Survey/project management task activities Project management Maintaining MEPS-MPC continuity Cooperation with AHRQ to obtain necessary clearances and approvals Preparation of annual MEPS-MPC technical documentation and bi-annual management plan updates Project reporting, including monthly progress and financial reports Cooperation with AHRQ and the HC contractor for ensuring timely, accurate, and complete data file transfers so the HC contractor can complete editing/imputation work (for all files but prescribed medicines) and public use file development for all MEPS event files on schedule

Preparing AHRQ/contractor management meetings, including meeting minutes and action items

Project closeout/transfer of operations

Medical Record & Billing Data Collection and Abstraction task activities Receiving and receipting from HC contractor signed household respondent authorization forms that support the MPC sample and allows for contacting respondent identified medical providers for the purpose of data collection

Preparation, implementation, and documentation of both the non-SBD and SBD sample, including de-duplication as necessary

Maintaining MPC National Provider Inventory (NPI directory, including SBDs and pharmacies

Developing medical provider respondent materials (e.g., advanced letters) and associated data collection forms

Recruiting, training, and managing a fully staffed team of Data Collection Specialists (DCS) and Abstractors (ABS)

Collecting and abstracting data from medical and billing offices of various medical provider types (e.g., Hospital, OBD, Home Health, Institution, and Pharmacy)

Data Management and Processing, and Data File Production and Documentation task activities Providing data security consistent for a system designated with a FIPS-199 Moderate classification Forms control and receipt Data entry Identify duplicate events and remove from data file Recruiting and conducting training program for coders, verifiers and supervisors that supports coding of ICD-10-CM, verbatim medical conditions, CPT-4, verbatim medical procedures and supplies, prescribed medicines, and providers including SBD

Data matching for all MPC provider types except prescribed medicines Producing matched files for use in the production of edited/imputed analytic files Producing input files for direct feed into the expenditure editing and imputation programs

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Benchmarking to outside data sources and previous years MEPS estimates several times throughout data collection

Run edit checks throughout the field period and correct data as needed Developing MPC internal files (include matched and unmatched data) including a prescribed medicines file Quality control including interim checks on data quality throughout the field period

2.2 Resources

The contractor shall furnish all the necessary qualified personnel, materials, supplies, equipment, services and facilities necessary to perform the work described below unless otherwise stated. This includes assumptions for supporting remote staffing arrangements resulting from state, local, and company policies to manage the ongoing COVID-19 health pandemic.

2.2.1 Storage

The contractor shall investigate available technology and use the most efficient methods to securely store all necessary project materials, documents, and sensitive data, including Protected Health Information (PHI) and Personally Identifiable Information (PII), for a period of time determined by the Government.

The contractor shall establish and maintain a FTP site so that confidential data and documents can be transmitted from the contractor to AHRQ, and to the HC contractor as approved by

AHRQ.

3.0 Tasks and Activities to be Performed

Base Period The base period or initial contract start-up period is critical time period for the MEPS-MPC project for ensuring that continuity is maintained between ongoing operations on the current contract and the operations supporting this acquisition/contract. Additionally, the base period creates an opportunity for transparency by allowing the contractor and AHRQ to inform MPC medical provider respondents about any forthcoming changes. Thus, base period success is necessary to help ensure a timely start to the 2021 MPC cycle and by default supportive of the overall inelastic HC-MPC coordination efforts. To achieve this, the base period shall include necessary activities to set up and begin testing all project-related systems in order to be approved for operations before the beginning of data collection associated with the 2021 MPC cycle.

In support of these base period activities, the Contractor shall prepare a Survey Operations Implementation Report (DELIVERABLE BP-1) that will contain detailed specifications on the implementation plan, including documenting any deviations or enhancements from current MPC processes as proposed. In doing so the report shall also identify initial specific project risks and risk mitigation strategies to help ensure project objectives are met and that all deliverables will be sufficiently checked for quality control prior to submission. The report shall include an organizational chart showing clear lines of authority and task/function responsibility. As well the report shall include a detailed project schedule that clearly identifies major milestones in data collection, data processing (including statistical matching activities), data file deliveries, and other project deliverables as defined in the delivery schedule. Finally, the report shall address staffing, data collection field timing, and quality management and other management topics (e.g.

data security, document management, and risks/constraints/adjustments). The Contractor shall

MEPS – Medical Provider Component Page 11 of 108 submit to the COR a draft of the report within 45 days of the contract (base period) effective date, with the final report due by no later than the end of the base period.

The Contractor shall provide for the secure and confidential storage of all hardcopy materials and computer files, as specified by the COR. In addition, the Contractor shall provide for the secure and confidential transmission of data between the central office, data collection staff and abstractors, as well as for the secure storage of information residing on the MPC staff computers or laptops, if necessary. In the base period the contractor shall also set up and maintain a secure encrypted data transmission or FTP site so that confidential data and documents can be transmitted from the contractor to AHRQ and to the HC contractor when approved by AHRQ. In addition, during the base period the contractor shall submit an initial draft data security plan (System Security Plan) within 30 days of the contract (base period) effective date and a final plan with implementation schedule, including desired date to secure the Authority to Operate (ATO), within 90 days of the contract (base period) effective date

(DELIVERABLE BP-2).

Supporting MPC materials: https://meps.ahrq.gov/mepsweb/survey_comp/mpc.jsp

Option Periods 1 through 4 The tasks below apply equally to Option Periods 1 through 4. Further, the Option Periods support production of the following MEPS calendar year estimates.

Option Period 1 (2021 MPC cycle for 2021 MEPS estimates) Option Period 2 (2022 MPC cycle for 2022 MEPS estimates) Option Period 3 (2023 MPC cycle for 2023 MEPS estimates) Option Period 4 (2024 MPC cycle for 2024 MEPS estimates)

Task 1 Project Management, Reporting, and Formal Meetings Project management is defined as internal Contractor management activities not specific to any given task defined in the SOW, as well as all forms of interaction and communication between the Contractor and AHRQ that is not specific to any task defined in the SOW. Any internal Contractor communication or communication between the Contractor and AHRQ specific to a task defined in the SOW shall be considered part of that task and charged to the contract appropriately.

1.1 General Project Management and Meetings

Integration of MEPS-HC and MEPS-MPC Contractor Tasks To support an annual MPC data collection cycle AHRQ shall provide the contractor the non- SBD MPC sample in three waves. With that there must be timely and accurate data and documentation deliverables between the MPC and HC contractors (which will go through AHRQ). These deliverables will include MEPS HC data and matching variables and documentation necessary to link the HC and MPC files, as well matched HC and MPC files and documentation for use in the production of edited/imputed analytic files.2 Data delivered to the HC contractor for input into the expenditure editing and imputation process will be in the appropriate format and will contain the appropriate variables and variable specifications to be input directly into the editing and imputation data processing programs. All raw MPC files which will include matched and unmatched data and detailed documentation will be delivered to AHRQ. There will also need to be several discussions between the two contractors (with AHRQ

2 Available for review is an example MEPS MPC/HC coordination schedule.

MEPS – Medical Provider Component Page 12 of 108 oversight) that ensures all changes made in one component of the MEPS processes that has an effect on the other component’s processes are known well in advance and are well documented. There must also be ongoing discussions, as needed, between the contractors on any issues and/or questions regarding file deliveries.

Meetings with the Contractor The Contractor shall meet with the COR within five (5) business days of the Contract Effective Date (CED) to discuss and resolve general issues, as well as specific priorities based on AHRQ’s current data needs. Conference calls between AHRQ COR and project principals and the Contractor’s Project Director and principals shall be held once per week, as needed, for the purpose of discussing the status of each phase of the project. Meeting minutes and corresponding action items resulting from this meeting shall be prepared by the Contractor and submitted to the COR within three business days after completion of the meeting. In addition to weekly conference calls, formal management meetings between AHRQ COR and project principals and the Contractor’s Project Director and principals shall be held at least twice per year (roughly every 6 months). These management meetings shall each be approximately one-half of a business day, with additional time set aside for any special project topics independent of the management meeting in accordance with the COR. All special topic meetings shall be held on an as-needed basis and only include the AHRQ COR and project principals and Contractor Project Director and principals directly involved with the specific topic being discussed. The contractor shall document minutes and associated action items at each management and special topics meeting and provide to AHRQ.

The contractor shall prepare and distribute to AHRQ all meeting agendas (and supporting meeting materials) and resulting meeting minutes (DELIVERABLES 1 and 2). The meeting minutes shall include the contract number, project director, a list of attendees, a description of the issues discussed, action items, assignments, and associated due dates.

All deliverables to AHRQ should be sent as separate PDF files and a naming convention for all files agreed upon by AHRQ and the contractor will be used.

Project closeout/transfer of operations The contractor shall turn over all files, computer programs, tabulations, documentation, and other items within ninety (90) days of request made by the COR in such form (electronic and paper) that the project may be continued by a successor.

1.2 MEPS-MPC Overall Project Documentation

Bi-Annual Project Management Plan The contractor shall prepare and submit a Project Management Plan that documents the plans for managing all project tasks (subtasks) to help ensure project objectives are met and that all deliverables have been sufficiently checked for quality control prior to timely submission. In particular this includes plans for meeting data collection completion targets by specific medical provider type, completion of statistical matching activities between MPC and HC medical events, and associated data file production (DELIVERABLE 3). This plan shall include an organizational chart showing clear lines of authority and task function/responsibility. As well the plan shall include a detailed project schedule that clearly identifies major milestones in data collection, data processing (including statistical matching activities), data file deliveries, and other project deliverables as defined in the delivery schedule. The project plan shall also address staffing, data collection field timing, and quality management and other management topics (e.g. data security, document management, and risks/constraints/adjustments). The plan

MEPS – Medical Provider Component Page 13 of 108 shall also include an appendix that documents (as written memoranda or reports) any survey methodological options considered (and decisions reached)

The plan shall be updated on a bi-annual basis, with each update including a crosswalk between proposed and actual completion dates, including a table documenting specific contract deliverables submitted. Other updates as applicable to the Project Plan shall also be made (e.g., survey methodological decisions) in consultation with the COR.

MEPS-MPC Annual Methodology Report The Contractor shall produce and submit an annual MEPS-MPC Methodology Report (DELIVERABLE 4). The purpose of the MEPS-MPC Methodology report is to document the entire methodology used and summarize the completed experience associated with an annual MPC data collection cycle. This includes documenting changes made from previous MPC data collection cycles, sample preparation, implementation, and maintenance activities, data collection specialist and abstraction staff recruitment and training, and data collection and abstraction results. The Contractor shall include as part of the report a separate appendix including all copies of decision memos, if any, associated with an annual MPC data collection cycle. Final delivery of annual MEPS-MPC Methodology Report made publicly available on the AHRQ MEPS website shall be delivered in 508 compliant PDF format.

The MPC Annual Methodology Report:

https://www.meps.ahrq.gov/data_files/publications/annual_contractor_report/mpc_ann_cntrct_m ethrpt.pdf

1.3 Monthly Progress and Financial Reporting

AHRQ will closely monitor the project management, operations, and costs for this contract. The contractor shall help facilitate this by maintaining strong communication and reporting mechanisms, including the types of formal reporting identified below. The contractor shall anticipate and plan for periodic in-person observation of data collection, abstraction, and data processing activities by AHRQ staff at the CORs discretion.

Monthly Progress Reports (MPR) and Cost-to-Complete (CTC) Reports By no later than the fifteenth (15th) business day of the second month of contract performance and no later than the fifteenth (15th) business day of every month of contract performance thereafter, the Contractor shall submit to the AHRQ Contracts Office, the COR and other designated Center for Financing, Access and Cost Trends (CFACT) staff, both a monthly progress report (MPR) and a cost-to-complete (CTC) report in electronic format, via e-mail as attachments or secure final transfer protocol (ftp) or extranet site with e-mail notification that reports are available for download (DELIVERABLE 5). Similarly, the contractor shall submit a monthly CTC report no later than the fifteenth (15th) business day of the month (DELIVERABLE 6).

At a minimum, the MPR shall include:

Summary of all activities performed for each task during the month and plans for the upcoming month;

A listing of problems encountered and proposed or enacted solutions, and a list of

“significant” problem encountered A listing of all requests for information and assistance that were completed and a listing of outstanding requests for information

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A brief summary of progress made toward meeting the overall deliverable schedule and project schedule

A description of any significant changes in the Contractor's operational personnel, including subcontractors

A summary of all additions, modifications, and configuration changes to project software and database designs, specifications, testing, quality assurance efforts, maintenance and operational solutions and associated work efforts accomplished during the month

Provide a listing of any new work products, computer databases or programs, or any other inventions that may be subject to intellectual property protection and how the contractor intends to manage intellectual property rights based off the MEPS-MPC contract work

A brief discussion of the expenditure of funds, including a statement that indicates the percentage of the funds that have been expended per each exercised option period and other optional tasks

A statement as to whether the contract will be completed in accordance with the time frame specified in the delivery schedule and within the budgeted (and obligated) amount

At a minimum, the CTC shall:

Formatted in excel spreadsheet that includes monthly booked costs, forecasted costs, and budget variance across the life of the contract and broken down by option period and project tasks (and subtasks). Consideration of the report should factor in the difference between booked costs and actual costs as reflected in submitted invoices that may account for salary rate ceilings and other unallowable costs.

A summary tab that captures the cumulative costs and expected drawdown of obligated funds for the option period, including placeholders for any trailing costs and potential provisional (and final) indirect rate adjustments.

A tab with additional metrics, such as Budget at Completion (BAC) – total planned cost of the total project or specified deliverable/ milestone at completion; Budgeted Cost of Work Scheduled (BCWS) – cumulative expected planned cost for activities planned to be completed by the end of the reporting month; Actual Cost of Work Performed (ACWP) – cumulative amount actually spent on activities performed as of the end of the reporting month; Budgeted Cost of Work Performed (BCWP) – cumulative planned costs of the activities actually performed as of the end of the reporting month; and Cost and Schedule Variance – in the form of a %, and Cost Performance Index (CPI) and Schedule Performance Index (SPI) measures.

The specific format of the CTC report shall be discussed with the COR after award of the contract.

Task 2 Sample Preparation and Implementation The MPC sample annually consists of two components: 1) the non-SBD, and 2) the SBD. The non-SBD shall be drawn from medical providers reported by HC respondents and for which the HC respondents provided signed Authorization Forms allowing the MPC contractor to contact their medical providers (including Pharmacy) for purposes of collecting medical and billing data.

To be eligible for the MPC, signed and valid Authorization Forms are required for each HC respondent. Annually AHRQ will provide the MPC contractor with the non-SBD sample (including any OBD subsampling) as collected from the HC. This is typically provided in three waves beginning in early January with about 75% of the total non-SBD sample, then again in early April with an additional 15 percent of the total non-SBD sample, and finally by mid-July with the remaining ten percent of the total non-SBD sample.

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2.1 Non-SBD sample preparation and implementation

The contractor shall prepare a plan that documents steps taken to prepare, implement, maintain, and field the non-SBD sample including provider-type assignment, documentation of splits, merges, and out-of-scopes (e.g., outside of the U.S., prisons, jails), and management of multiple sample waves (DELIVERABLE 7). Included in this is the plan to de-duplicate the sample. Although the provider - the office, clinic, physician, hospital, pharmacy, home care provider, long term health care facility - is the “case” for the purpose of data collection operations, each MPC case may represent one or more household respondents mentioning the same provider.

To prepare for the fielding of the MPC, the Contractor shall consolidate all duplications in the medical provider lists generated by household respondents. Using the most efficient means, the contractor shall review the provider sample generated by the household survey and assign unique provider identification numbers to each provider or group of providers that represent a single MPC respondent. These unique identifiers shall be constructed in a way that allows the MPC provider to be linked to the person-events recorded in the household survey that generated the provider. This de-duplication shall occur within and across households, primary sampling units (PSUs) (e.g., counties) and rounds. (The panel design of the survey, which features five core rounds of interviewing, covers two full calendar years. Each year, providers for the MPC sample are identified based on three rounds of HC data collection (HC data collection is covered under a separate procurement). The resulting unique list of medical providers shall constitute the field sample for the MPC. The schedule for data collection requires that de-duplication be conducted in an ongoing manner. The final MPC file deliveries will contain a consolidated and de-duplicated ID variable that can be used to identify all MPC and HC records for each person/provider pair. This variable is critical to evaluation work at AHRQ and determining measurement error.

Processes will be developed to remove duplicate events prior to data collection.

2.2 Managing the National Provider Identifier (NPI) Directory The contractor shall develop and implement a process that results in the provider directory remaining current in order to maintain functionality for data collection purposes. Currently, when found for a provider, the National Provider Identifier (NPI) is assigned. However, all providers in the MPC do not have an NPI assigned. All separately billing doctors (SBDs) and pharmacies must be included in this directory as well as other provider types eligible for the MPC data collection. Annually, the contractor shall maintain contact information at the provider level as well as for the respondent within the provider organization who provided the data. This will include not only name, title and division, but telephone, fax, and email address information for the individual and the provider. The contractor shall review existing provider directory methodology and may propose alternative methodologies which would support analytic goals and improve data quality.

2.3 SBD Sample Preparation and Implementation

The MPC sample also includes the Separately Billing Doctor (or SBD) component. The SBDs are those physicians or specialty groups providing care to the respondent during a hospital event and who received payment not included in the accounting of charges and payment for the main hospital bill or summary of payments. These newly identified patient provider pairs become part of the MPC sample either as new cases or as additional pairs to existing cases in an ongoing manner throughout the fielding of the hospital cases. Thus, SBDs are not reported by the HC respondent, but rather are identified from the MPC provider or the MPC provider’s

MEPS – Medical Provider Component Page 16 of 108 medical records associated with the HC reported hospital event (outpatient, inpatient, emergency room). In support of this effort the contractor shall prepare a consolidated SBD sample development, preparation, and data collection plan (DELIVERABLE 8). This consolidated plan should address the following dimensions: sample development and preparation, instruments/materials, staffing/training, data collection specialist and abstraction procedures, management plan, quality control procedures, field cost and progress reports, and response rate monitoring efforts.

Alternative strategies on how to identify and collect SBD information shall be discussed with the

COR.

Task 3 Field Preparation (Data Collection Instruments and Materials)

3.1 OMB Clearance Supporting Materials

As necessary the contractor shall coordinate with AHRQ in preparing supporting materials required for any and all OMB clearance actions during the course of the contract. This shall include preparing burden estimates, written descriptions of the MPC operations and statistical matching activities, the design and description of any methodological pilots or experiments, and hard copy reproductions of survey questionnaires and respondent materials (DELIVERABLE 9).

3.2 Data Collection Instruments and Material Preparation

The contractor shall develop in final form all data collection instruments (e.g., contact guides and event forms), respondent materials, and other documents intrinsic to conducting the MPC data collection based on those that have been prepared and used in previous MPC data collection cycles. With that, the contractor shall be responsible for maintaining, revising, and adapting all data collection instruments and respondent materials. On occasion, the COR may request modifications to the data collection instruments and respondent materials. Nonetheless, all proposed revisions adaptations (including new formats or alternatives) shall be submitted to the COR for approval. Final deliveries of instrument documentation including data collection instruments and contact guides made publicly available on the AHRQ MEPS website shall be delivered in 508 compliant PDF format (DELIVERABLES 10 and 11).

Task 4 Field Staff Recruitment and Training

4.1 Data Collection Specialist and Abstraction Staff (Supervisory and Non-Supervisory) Staffing, Recruitment and Retention The contractor shall develop and implement a plan to recruit sufficient numbers of data collection specialist (DCS) and abstraction staff (ABS), both supervisory and non-supervisory, necessary to support successful completion of all data collection and abstraction activities.

These selection and hiring criteria must center qualities indicative of quality data collection and abstraction work performance, including previous work experience, work samples, and educational background (DELIVERABLE 12). The plan shall also address or account for cyclical retention and related work flow issues in concert with meeting desired pair completion targets and associated response rates.

4.2 Data Collection Specialist and Abstraction Staff (Supervisory and Non-Supervisory) Training

Plan The contractor shall develop and submit to the COR an overall DCS and ABS training plan that provides a comprehensive overview on the approach to training for an entire MPC data collection cycle (DELIVERABLE 13). This includes trainer staffing, in-person training (and remote training contingencies due to ongoing COVID-19 concerns), staff support for new DCS and ABS staff transitioning into production, draft training schedule accounting for the various

MEPS – Medical Provider Component Page 17 of 108 types of training to be conducted throughout an entire data collection cycle (and numbers of staff targeted to be trained during each session), the types of training materials to be used, and overall quality control procedures to be used.

The contractor shall also develop and submit to the COR a DCS training program that includes the procedures and materials designed to effectively train staff in collecting data by medical provider type and with a goal of achieving required response rates and data quality (DELIVERABLE 14). This includes ensuring the training program provides all DCS staff performing the same function have access to the same training in content and methods. These trainings shall be scheduled in a way to support both the timely start to a data collection cycle and ensure adequate staffing levels by medical provider type are in place across an entire data collection cycle. The initial training session for all new data collection specialists shall be face to face. Training manuals and materials may be adapted from those used in the current MEPS contract. Trainers are required to have expertise and experience on the tasks in which they train.

Following training, DCS staff must, at a minimum, be able to: a) identify and reach appropriate respondents in physician offices and other medical facilities; b) explain the nature and purpose of the MPC and answer questions commonly asked by medical and billing staff in deciding whether or not to cooperate with data collection; c) arrange with medical and billing staff any of a variety of methods for obtaining the required data; d) collect the data, if appropriate, and know how to utilize data probing procedures ; e) be able to elicit the appropriate expenditure data either over the phone or through the abstraction of financial records; f) know how to handle difficult respondents and potential refusals; g) know when and how to correctly use manuals, references and guides; h) know how to completely, accurately and in a timely manner process all administrative forms.

In addition to the capabilities described above, supervisory personnel shall need be able to perform the following functions: a) observe DCS staff, recording instances of appropriate and inappropriate behavior and conveying these observations to the DCS in a constructive fashion;

b) counsel DCS on appropriate handling of unusual situations; c) monitor DCS production, and other performance measures at appropriate levels; d) conduct DCS training sessions so that all DCS shall receive, in substance and quality, the same training; e) convert difficult refusals; f) identify errors of DCS staff they supervise and convey to them the results of this review in a constructive manner; g) ensure the DCSs are collecting the appropriate data and can distinguish between charges, payments, and billing adjustments.

The contractor shall develop and implement detailed data collection instructions, rules and verification procedures with adjudication procedures specified. The contractor shall develop and maintain procedural manuals.

The contractor shall develop and submit to the COR a data abstraction staff training program that includes the procedures and materials to effectively train all ABS staff in the techniques to accurately abstract desired MPC data from medical and billing records received as part of the overall MPC data collection process (DELIVERABLE 14). This includes ensuring the training program provides all ABS staff performing the same function will have access to the same training content and methods. These trainings shall be scheduled in a way to support both the timely start to ABS activities in a data collection cycle and ensure adequate ABS staffing levels are in place across an entire data collection cycle. The initial training session for all new data abstractors shall be face to face. Training manuals and materials may be adapted from those

MEPS – Medical Provider Component Page 18 of 108 used in the current MEPS contract, if deemed appropriate. Trainers are required to have expertise and experience on the tasks in which they train.

Following training, ABS staff must, at a minimum, be able to: a) accurately abstract data items of interest to MEPS from medical and billing records at an acceptable error rate as determined by the Government, b) identify and reach appropriate respondents in hospitals and physician offices and other medical facilities; c) explain the nature and purpose of the MEPS MPC and answer questions commonly asked by medical and billing staff in terms of follow up phone calls and in deciding whether or not to participate; d) if necessary, be able to arrange with medical and billing staff any of a variety of methods for obtaining the data sought; e) collect the data, if appropriate and know procedures for probing for data;…