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State Medicare Medicaid Date Integration

Solicitation Number: HHSM-500-2013-140831-SS
Agency: Department of Health and Human Services
Office: Centers for Medicare & Medicaid Services
Location: Office of Acquisition and Grants Management
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HHSM-500-2013-140831-SS
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Cancellation
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Added: Dec 03, 2013 12:59 pm
Sources Sought Notice

STATE MEDICARE MEDICAID DATA INTEGRTION: SOURCES SOUGHT
Purpose of Notice


This is a SOURCES SOUGHT NOTICE issued for the purpose of planning and market research. This is NOT a solicitation for proposals, proposal abstracts, or quotations and does not obligate the Centers for Medicare & Medicaid Service (CMS) to award a contract.


The purpose of this notice is to obtain information regarding the availability and capability of qualified small businesses only (including 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) that can provide an IT development and data services solution in support of the CMS requirements for the State Medicare Medicaid Data Integration.


Prior to engaging in procurement activity to acquire vendors for the improvement of the efficiency of State Medicare and Medicaid Integration to improve the health care coordination for both Medicare and Medicaid recipients, the Center for Medicare & Medicaid Services (CMS) is issuing this sources sought notice. The potential small businesses will need to demonstrate the ability to provide the services defined in this notice under Requirements.


Background


An estimated ten million individuals are enrolled in both the Medicare and Medicaid programs, accounting for total annual spending of more than $300 billion. These Medicare-Medicaid enrollees comprise 19% of Medicare enrollees but 27% of Medicare spending; in the Medicaid program, Medicare-Medicaid enrollees make up 15% of enrollees and 39% of spending. With the vast majority of Medicare-Medicaid enrollees receiving fragmented care, the service delivery system for Medicare-Medicaid enrollees is ripe for innovation. Integrated administrative, service delivery and payment models have the potential to achieve positive outcomes by streamlining access and care delivery for Medicare-Medicaid enrollees currently navigating a fragmented system.


The Patient Protection and Affordable Care Act, P.L. 111-148, (ACA) created a number of opportunities to improve care for Medicare-Medicaid enrollees and established the Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office or "MMCO") to advance quality, reduce costs, and improve the experience of Medicare-Medicaid enrollees. The ACA also created the Center for Medicare and Medicaid Innovation (the Innovation Center) within CMS to design, test, and evaluate innovative payment and service delivery models that reduce program expenditures while preserving or improving health outcomes and quality of care.


MMCO is responsible for providing education and tools for developing programs that align Medicare and Medicaid benefits and supporting state efforts to coordinate and align care.


Currently, existing Medicare-Medicaid enrollee data collection and reporting systems are fragmented and thus difficult for States to use in these efforts. States experience a number of challenges in using CMS data that create inefficiencies.


Working with qualified vendors, CMS hopes to decrease those inefficiencies by:


• Developing protocols and common guidelines which will assist States with the integration of multiple datasets, database consolidation, data extraction for data used in addressing goals for care coordination given limited resources.


• Creating a common taxonomy to assist States with the consistent interpretation of data fields across different databases.


• Identifying Platforms for use in State data integration efforts


• Assisting States to develop/find solutions for gaps associated with missing or inconsistent data (e.g. problems enrollment status on Medicare data resulting in flawed classification as dual-eligible (Full vs. Partial)), and many to one, one to many, and many to many relationships with crosswalk files that are used in the integration process.


• Development of a crosswalk between differing enrollment periods and services to establish a minimum level of accuracy related to service use and expenditure patterns.


• Assisting States with programming and complex algorithms that may be required to read and use the data for integration. Develop algorithms to match name, DOB, and other relevant demographic data.


• Developing protocols for cleaning and linking data sets.


REQUIREMENTS
The contractor should have the necessary infrastructure support to effectively interface with all stakeholders. This includes CMS program staff and State Medicaid Agencies.


The work that will be addressed under the future contract will require the vendor to have advanced knowledge of:


• Data integration and of the variables, file construction, and data layouts of Medicare, Medicaid and private sector data sets. This shall include claims data, quality data and, in the case of managed care, encounter data. Specifically, the contractor should have familiarity with the following data sets:
 Traditional Fee-for-Service Medicare
 National Claims History Files that includes all Administrative claims data under the Medicare fee-for-service program
 Institutional data (e.g., Part A -- Hospitals)
 Professional data (e.g., Part B -- Physicians)
 Prescription drug event (PDE) data
 Encounter data
 Online Survey, Certification and Reporting (OSCAR)
 Minimum Data Set (MDS)
 Outcome and Assessment Information Set (OASIS)
 Quality Data(e.g., HEDIS)
 Consumer Assessment of Healthcare Providers and Systems (CAHPS)


• Data integration platforms and experience with critical data integration techniques including but not limited to:
 Key steps in data integration
 Integrating large health care data sets using a wide variety of formats
 Integrating large health care data sets that reside in different locations or are maintained by different organizations
 Integrating large health care data sets such that a wide range of users can access and use data (accounting for a variety of roles of the data users and timeframe)
 Use and knowledge of a variety of data integration platforms such that the offeror can provide a comparative evaluation of optimal criteria for such platforms


• Medicare and Medicaid programs and in the interactions between those programs as they pertain to the provision of care for Medicare-Medicaid enrollees.


• Programming and analysis of large health care data sets including expertise in working with CMS data. The contractor's staff should be knowledgeable in conducting complex health services research using CMS data. The nature of these tasks will require multi-disciplinary skills including but not limited to; epidemiology, health economics, public health, statistics or biostatistics, health care, health services research and research design methodology.
The contractor should be prepared to work with MMCO's State Data Guidance contractor. This contractor provides information on the data available to States for care coordination and assistance requesting and using that data.


Anticipated Period of Performance


The government expects that the final contract for this body of work will be for a base period of 12 months and three (3) twelve month option periods to be exercised at the discretion of the government.



Capability Statements
In response to this Sources Sought Notice, CMS is seeking capability statements. Capability statements are NOT proposals and do not address price/cost. The contractor community is merely asked to provide information which may demonstrate that they have expertise and capacity to meet the requirements of this work as a prime contractor, with subcontractors as they deem necessary.


For the purposes of responding to this notice, contractors should address the following experience and advanced knowledge:


1) Data integration and of the variables, file construction, and data layouts of Medicare, Medicaid and private sector data sets. This shall include claims data, quality data and, in the case of managed care, encounter data;
2) Data integration platforms and experience with critical data integration techniques including but not limited to:
a) Key steps in data integration
b) Integrating large health care data sets using a wide variety of formats
c) Integrating large health care data sets that reside in different locations or are maintained by different organizations
d) Integrating large health care data sets such that a wide range of users can access and use data (accounting for a variety of roles of the data users and timeframes)
e) Use and knowledge of a variety of data integration platforms such that the offeror can provide a comparative evaluation of optimal criteria for such platforms
3) Medicare and Medicaid programs and in the interactions between those programs as they pertain to the provision of care for Medicare-Medicaid enrollees.
4) Programming and analysis of large health care data sets including expertise in working with CMS data. The contractor's staff should be knowledgeable in conducting complex health services research using CMS data. The nature of these tasks will require multi-disciplinary skills including but not limited to; epidemiology, health economics, public health, statistics or biostatistics, health care, health services research and research design methodology.


Responses Requested


Responses are required no later than January 6, 2014 in the following format to the following electronic address:


Donald Bozimski, Contract Specialist
donald.bozimski@cms.hhs.gov


Please cc
Evelyn Dixon, Contracting Officer
evelyn.dixon1@cms.hhs.gov:


Microsoft Word (or PDF) document with page size 8.5 by 11 inches. Font shall be Times New Roman Size 12 with no less than single spacing between lines. The maximum number of pages for submission is 10 pages.


Please be advised that email transmitted files over 5 megabytes are not delivered during standard working hours, are only released from the CMS server after 5:00 PM EST, and may affect the timeliness of your response.


Additional Information
CMS also requests the following additional information:


Business Information:
• DUNS
• Company Name
• Company Address
• Current GSA Schedules appropriate to this effort.
• Do you have a Government approved accounting system? If so, please identify the agency that approved the system.
• Type of company (e.g., small business, 8(a), woman owned, veteran, etc.) as validated via the Central Contractor Registration (CCR). All potential offerors must register on the CCR located at http://www.ccr.gov/index.asp
• Company Point of Contact, Phone and Email address
Teaming Arrangements:


All teaming arrangements should also include the above-cited information and certifications for each entity on the proposed team.


Confidentiality:


No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).


Disclaimer and Important Notes:


This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted.

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Package #1

Posted Date:
December 3, 2013
Description: State Medicare Medicaid Data Integration Sources Sought
:
7500 Security Blvd.
C2-21-15
Baltimore, Maryland 21244-1850
:
Donald E. Bozimski
Phone: 4107861355
:
Evelyn Ryans Dixon,
Contracting Officer
Phone: 410-786-1561
Fax: 410-786-9088