Quest Analytics sole-source-determination final.pdf

SOLE-SOURCE DETERMINATION MEMO

FOR SUPPLIES AND SERVICES - FINAL

Date: 10/15/26 Sole source number: S-44300-00018219

To: Kirk N. Rhoades, Designated Procurement Officer ODHS Office of Contracts & Procurement

Requestor: Veronica Guerra Agency/division: OHA Medicaid Division, herein after referred to as

“Agency” Program/office: CCO Operations Quality Assurance Contract specialist: Elvis Howard

Agency Sole source rule: Sole source authority:

DHS OAR 125-247-0275 OAR 125-246-0170(2)

DAS Delegation 649-11, as amended

OHA OAR 137-047-0275 ORS 413.033

Estimated total contract value: $1,007,0341.50 (Est. 5yr spend)

Description of goods or services:

Purchase Quest Analytics software to evaluate, manage, and monitor CCO provider networks in one comprehensive platform.

1. Background: This sole source justification applies to the purchase of:

a) Provide a brief description of the contract or contracts to be covered including contemplated future purchases OHA CCO Operations Quality Assurance is seeking to contract with Quest Analytics to acquire access to their Quest Enterprise Services platform.

b) Describe the product or service to be purchased OHA CCO Operations Quality Assurance is seeking to acquire Quest Enterprise Services Advanced Compliance Oversight which includes up to 40 networks reviews per year. The software enables state agencies to perform regulatory oversight, enforce standards, assess network performance, model scenarios, and develop new standards such as alternative time and distance requirements. The software will provide us with the ability to do the following:

• Evaluate network adequacy using ready-made and customizable templates aligned with regulatory requirements

• Customize dashboards and reporting tools to aid swift decision-making based on insightful data

• Streamline exception workflows with built-in approval tracking and transparency tools

• Model provider network scenarios to assess impact and support proactive decision-making

• Integrate membership and census data for more accurate and equitable adequacy analysis

• Generate maps and visualizations to quickly identify geographic coverage and provider distribution

• Perform side-by-side network comparisons to understand commonalities and differences

• Analyze claims-based data to better identify ghost providers, specialty types, and performance indicators

c) Describe the reasons the agency is seeking this procurement method The software is currently utilized by the Centers for Medicare and Medicaid Services and 30 state and federal regulatory agencies including several state Medicaid programs. Extensive use across federal and state regulators provides OHA with the ability to leverage industry standards and emerging network standards to improve Oregon’s network adequacy strategy.

In addition, the CCO Operations Quality Assurance Unit Performance Analytics Team has faced several staffing losses due to work visa expirations. At the beginning of 2026, five of the seven data analyst positions were filled by staff working on a visa. Since that time there have been visa-related challenges for five members of the team.

The skill set required for the Performance Analytics Team staff are highly technical, requiring an understanding of systems, the ability to provide coding in the development of infrastructure to allow for the collection of data from CCOs, and the evaluation of that data consistent with contractual requirements.

Key bodies of work required by federal regulations have been severely impacted by the continued staffing losses. Network adequacy, care coordination and grievance and appeal system monitoring have lost the lead analysts, which have required us to train remaining staff (two OPA 3) to fulfill a portion of the state’s monitoring and oversight responsibilities. The two remaining staff have not been able to absorb all the data analytics responsibilities associated with these three bodies of work and maintain other responsibilities outside of these areas. The inability to adequately perform our monitoring and oversight duties in the areas of network adequacy, care coordination and grievance and appeal systems poses a federal compliance risk for our Medicaid program. The purchase of this software provides us with the ability to reallocate existing staffing resources to other oversight efforts required by federal regulations.

2. Prospective contractor/vendor:

Legal entity name: Quest Analytics, LLC

DBA: N/A

Address: 9225 Indian Creek Pkwy

Suite 200 Overland Park, KS 66210

Contact person: Patti Schnieder Phone: (402) 802-5169 Email: Patti.Schnieder@questanalytics.com

Protests are due by 3:00 PM within seven calendar days after the first date the notice is posted on OregonBuys. Protests must be sent via mail, fax, email, or hand carried to the following address: Protests via telephone will not be accepted.

Oregon Department of Human Services Office of Contracts and Procurement ATTN: Elvis Howard Address: 500 Summer St NE, Salem, OR 97301 Phone: 503-798-2469 Fax: 503-378-4324 mailto:Patti.Schnieder@questanalytics.com

Email: Elvis.r.howard@odhsoha.oregon.gov

Agency reserves the right to purchase additional goods, services to include on-call maintenance, preventative maintenance, repair (unless available on DAS price agreement), or training.

3. Written findings of fact (market research):

The findings below must include factual information supporting the determination that meet the sole source requirement in statute.

Pursuant to ORS 279B.075, Agency must conduct market research that supports the assertion that there is only one source that can provide goods or services.

Market research includes utilization of the internet, trade journals, agency vendor lists, professional organizations, studies, catalogs/industrial periodicals, vendor sources, yellow pages, etc.

For information technology contracts, any ownership or proprietary issues should be fully addressed with written documentation to support facts. [Attach supporting documentation, if applicable]

Agency must select at least one of the findings and prepare the determination as it specifically relates to the goods or service being procured. More than one finding can be addressed. The findings are as follows:

Pursuant to ORS 279B.075 (2)(a): Provide findings supporting the determination that the efficient utilization of existing goods requires the acquisition of compatible goods or services from only one source.

or Pursuant to ORS 279B.075 (2)(b): Provide findings supporting the determination that the goods or services required for the exchange of software or data with other public or private agencies are available from only one source.

or Pursuant to ORS 279B.075 (2)(c): Provide findings supporting the determination that the goods or services are for use in a pilot or an experimental project.

or

Pursuant to ORS 279B.075 (2)(d): Any other findings that support the conclusion that the goods or services are available from only one source. See market research document.

APPROVED:

By:

Signed by DPO electronically via OregonBuys Kirk N. Rhoades or acting DPO