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Recovery - Comparative Effectiveness Research Data Infrastructure Medicaid Analytic eXtract Production, Enhancement, and Data Quality

This opportunity is a Recovery and Reinvestment Act action
Solicitation Number: RTOP-CMS-2010-003JF
Agency: Department of Health and Human Services
Office: Centers for Medicare & Medicaid Services
Location: Office of Acquisition and Grants Management
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Award Notice
March 31, 2010
Mathematica Policy Research
PO Box 2393

Princeton, New Jersey 08543
United States
Added: Mar 31, 2010 4:08 pm

Recovery Act-Funded Contract Action

Identification of OPDIV/Contracting Activity: OAGM/AGG/DRCG
Project Officer: Susan Radke, ORDI
Title: Production and Enhancement Activity
Contract Type: Cost-Plus-Fixed-Fee
Contractors: Medicare and Medicaid Research and Demonstration (MRAD) Task Order Contractors (LB/SB)

I. Authority

This task order is funded by the American Recovery and Reinvestment Act of 2009, (Recovery Act, P.L. 111-5) which specifies, "To the maximum extent practicable, contracts funded under this Act shall be awarded as fixed-price contracts through the use of competitive procedures."
II. This contract action is competitive.
__X__ Yes
_____ Not Available for Competition. This action is statutorily exempt from competition, e.g., noncompetitive 8(a) set-aside, Tribal agreements (for IHS only), mandatory source.
_____ No As appropriate, please attach a copy of (1) the Justification for Other than Full and Open Competition (JOFOC); (2) the Limited Source Justification (LSJ); (3) documentation of Exception to the Fair Opportunity Process (under FAR 16.505(b)(5)); or (4) for simplified acquisitions, a brief description of the circumstances which justify not competing, signed by the contracting officer.
III. This contract action is fixed price.
_____ Yes
___X_ No
This task order is to produce person level data files on Medicaid eligibility, service utilization and payment information to support Comparative Effectiveness Research (CER) that is funded by the American Recovery and Reinvestment Act of 2009 (ARRA). As a component of the ARRA, CMS has been approved by the Department of Health and Human Services to produce and enhance the Medicaid Analytic eXtract file (MAX).
The MAX Production, Enhancement and Data Quality is offered as a competitive contract with a one-year base period and two one-year option periods.. The base includes tasks relating to the production of MAX along with the development of an accelerated version of MAX to produce more timely data for research use. Options include a range of activities including: Verification of SSNs, production of a master file of Medicaid/CHIP enrollment, linkage to Federal surveys, the development of provider characteristics, technical assistance to States for Medicaid encounter data, and technical assistance to States for CHIP encounter data.
This contract will allow the continuation of transforming Medicaid Statistical Information System (MSIS) data into (MAX) data which merges Medicaid demographic and claims information as well as converts fiscal year quarters into a calendar year. The purpose of MAX is to organize Medicaid data and make it usable for researchers to support research and policy analysis on Medicaid populations.
In addition to producing MAX data, the contractor will also design, develop, and establish an early release version of MAX data named Beta MAX so that researchers may obtain Medicaid data more timely for CER. This contract also provides an option to continue major activities that enhance MAX data for comparative effectiveness research activities.
All tasks in the base contract as well as the optional tasks will build and expand the Medicaid Data infrastructure to provide quality data sets and a variety of data sources needed for CER.
Optional tasks may be awarded at any time during the period of performance.

Key Deliverables (subject to change):
• Base: Design Report and Work plan 90 Days after award
• MAX Production and Beta-MAX 2009 Data 12/2011
• Base: Final Report 9/1/2013
• Options V-X:
o Design reports 60 Days after award
o Specific Products 9/2010-9/2013
• Options Final Reports 9/2013

Specificity/nature of requirement (risk and profit):
The MAX CER initiative will enhance and expand the experience that CMS has in building research data from States on Medicaid eligibility and claims information. This foundation must be continually enhanced in significant ways to make it more adaptive to the needs of researchers examining comparative effectiveness of health care procedures and services. The below described MAX/CER contract requirements illustrate the problem in developing accurate and comprehensive price information. In addition, problems with data accuracy and production efforts affect a determination of the realistic cost of capturing Medicaid data.
1) Production and Enhancement Activity

• The inherent nature of all the work to be performed involves improving the production and the development of enhancements to an evolving system of Medicaid data which, by definition, are prototypical and non-standard, and, therefore not naturally predisposed to being priced with accuracy in advance.

• The work to be performed is to occur at a time in which there is a potential for significant Medicaid program changes to existing CHIP mandates and potential health care reform legislation. These evolving requirements will make it impossible to design a statement of work with the level of certainty that would be conducive to fixed pricing without creating a contract environment that would require constant change orders as the nature of the requirement is solidified.

• Even if the "production" activity were to be considered as potentially possible under fixed price, the necessary enhancements could not be produced without having on uncertain impact on the core production tasks in the contract.

• The open and less certain aspects of the "Production and Enhancement Activity", in addition to the absence of a defined performance base may lead to proposals that reflect higher prices to protect against the risk of unsuccessful performance.
Monitoring and Cost Control
CMS has always utilized a significant degree of cost control over contracts that are not conducive to fixed pricing arrangements. This has been possible because of the vast knowledge and experience within the Office of Research Demonstrations and Information regarding Medicare, Medicaid and CHIP research programs. In addition, OAGM proposes to compete the acquisition utilizing the MRAD (15 long time CMS contractors) Task Order Contracts. This acquisition approach combines the knowledge and experience of CMS' technical program acumen and the vast experience of our contractor community with CMS programs and goals. This partnering relationship permits the most efficient use of CMS funds, promotes efficiencies and costs savings, and quickly facilitates the identification and resolution of problems. Although the above considerations are positive the very nature of research projects has demonstrated that projected results at the start of a project are subject to varying circumstances, most notably the enactment of new legislation and/or regulations that may govern the nature of the final requirement. In addition to the above concerns with determining a sound basis for developing a scope of work that would be conducive to fixed price contracting environment, the following price and technical issues also adversely affect that process:
Although a fixed price contract is desirable in that the contractor assumes the risk for performance, the CMS must consider the potential financial and performance risk to the contractor under these highly visible ARRA programs.
Technical Generic Issues that Adversely Impact State MSIS Reporting
• Lack of timely MSIS submissions
• Multiple failures of submitted MSIS data meeting minimum standards for quality
• Missing service records
• Miscoding of critical data elements
• Changing "unique" MSIS personal identifiers
• Unexpected and inconsistent changes in enrollment records eligibility groups
• Unexpected and inconsistent changes in utilization by type of service, and
• Incomplete reporting of encounter records for person in prepaid managed care plans

IV. If this contract action is not both fixed price and competitive, describe any additional steps taken to pursue a fixed priced competitive award (e.g., prepared more precise requirements documents; established more stringent review thresholds; expanded market research). If no additional steps were taken, please so state.
No additional steps were taken to pursue a fixed price award. 
V. Determination:
Based upon the findings, it is the determination of the government that Cost-Plus-Fixed-Fee contract type enhances the degree of potential successful performance and promotes the potential of competition from the MRAD contractors that could not absorb the risk of a fixed-price contract type.
The HCA (or a GS-1102-15 or higher designee) certifies that a fixed price award is not appropriate (considering contract risk, profit, and specificity/nature of requirement).


7500 Security Blvd.
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Evelyn R Dixon
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Fax: 410-786-9088