Healthcare Claims Benchmark Data
Awarded Limited / Sole Source Justification Posted
- Solicitation number
- OPM202601
- Set-aside
- No set-aside
Opportunity facts
- Contract number
- 24322626C0004 Federal contract award
- Awardee
- Milliman Solutions LLC
- NAICS code
- 513210 Software Publishers
- Place of performance
- Seattle, Washington, United States
- Points of contact
-
- Matthew Manning opmcontracting@opm.gov (202) 936-2484
Notice details come from SAM.gov. Updated .
About this opportunity
The Office of Personnel Management has awarded a sole-source contract to Milliman Solutions, LLC for healthcare claims benchmark data and proprietary grouper software, with a base year value of $300,000 and estimated total value of $927,270 across the base year plus two option years at 3% annual escalation.
OPM's Office of Health Systems Analytics requires two interdependent products available exclusively from Milliman: the MedInsight Data Products License, a de-identified longitudinal commercial claims dataset covering approximately 80 million lives across 100 contributors with medical, pharmacy, enrollment, and provider data updated monthly from 2017 forward across all 50 states; and Application of Health Cost Guidelines (HCGs), Milliman's proprietary grouper software applied to OPM's approximately 8 million Federal Employees Health Benefits lives to categorize claims using identical methodology underlying the MedInsight benchmark data. These products support fraud, waste, and abuse detection, provider analysis, and program integrity oversight.
The acquisition is justified under FAR 6.302-1, only one responsible source, because the HCG methodology is proprietary to Milliman and no equivalent commercial products produce HCG-compatible output. Alternative groupers from competitors such as 3M APR-DRGs and Optum would require substantial additional validation work. Market research confirmed the products are not available through GSA Multiple Award Schedules or other federal contract vehicles. The contract is Firm Fixed Price. OPM commits to conducting market surveys at the beginning of each option year and publishing a sources sought notice on SAM.gov at least 12 months prior to contract expiration to reassess competition opportunities for any follow-on requirement.
Notice text
OPM's Healthcare and Insurance, Office of Health Systems Analytics (HSA) requires access to external healthcare claims benchmark data and the proprietary software grouper necessary to analyze that data in a methodologically consistent manner.
Awarded contract 24322626C0004 to unknown vendor for unknown amount on 2026-09-29.
Files
| File | Type | Posted |
|---|---|---|
| HCG_JA.pdf |
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