SOLICITATION NOTICE
A -- Outcome Performance Measure Development for Persons with Multiple Chronic Conditions (MCC)
- Notice Date
- 11/20/2014
- Notice Type
- Presolicitation
- NAICS
- 541990
— All Other Professional, Scientific, and Technical Services
- Contracting Office
- Department of Health and Human Services, National Institutes of Health, National Institute on Mental Health, Contracts Management Branch, 6001 Executive Blvd, Rm 8154, MSC 9661, Bethesda, Maryland, 20892-9661
- ZIP Code
- 20892-9661
- Solicitation Number
- HHS-NIH-NIDA(AG)-RFP-14-005
- Archive Date
- 12/20/2014
- Point of Contact
- Jon J. Gottschalk, Phone: 3014439456, Yvette Brown, Phone: 301 443-2696
- E-Mail Address
-
jon.gottschalk@nih.gov, Yvette.Brown@nih.gov
(jon.gottschalk@nih.gov, Yvette.Brown@nih.gov)
- Small Business Set-Aside
- N/A
- Description
- The National Institute on Aging (NIA), National Institutes of Health (NIH), Department of Health and Human Services (DHHS) intends to compete a requirement for Outcome Performance Measure Development for Persons with Multiple Chronic Conditions (MCC). This procurement is being competed under Full and Open Competition under FAR Part 15. It is anticipated that a single cost reimbursable option type contract will be awarded for a one year base period of performance with a one year optional period beginning on or about July 22, 2015. PURPOSE AND OBJECTIVES: The objective of this project is to develop routine measurements of health outcomes for older adults living in the community with multiple chronic conditions, through validated patient-reported outcome measures of health, functional status and quality of life and to conduct research suitable for inclusion in materials to be submitted for quality measure endorsement by the National Quality Forum (NQF). The targeted care settings are ambulatory or delivery system level. This project consists of two phases, each of which shall produce a report suitable for inclusion in a submission to the NQF for endorsement of a performance measure on health related quality of life for persons living with MCC. In this project, MCC should be defined consistent with DHHS (two or more conditions that last a year or more and require ongoing medical attention and/or limit activities of daily living), including at least 10 chronic conditions prevalent in the older population. The project reports shall address NQF's Measurement Evaluation Criteria for the proposed performance measure. The report shall address the criteria that are current as of the initiation of work, include the importance, scientific acceptability, feasibility, and usability of the study (at present they are dated November 2012 and are available online at http://www.qualityforum.org/docs/measure_evaluation_criteria.aspx). Phase 1 (Base) addresses Veterans Rand 12 (VR-12) while Phase 2 (Option) addresses Patient Reported Outcome Measurement Information System (PROMIS)-29. A strongly justified alternate proposal for a different measure for Phase 1 may be considered acceptable. PROJECT REQUIRMENTS: A.Phase 1 (Base) Phase 1 involves the analysis of existing data on health-related quality of life on persons with MCC during the first 12 month period. The Offeror shall propose a Patient Reported Outcome (PRO)-based performance measure, with a preference for the VR-12-item Health Survey, Short-Form 36 (SF-36) or Short-Form 12 (SF-12), and perform the following: I.Construct the PRO performance measure by using average change or percentage improved over time (functional stability or functional gain). Specify how the PRO will be used to determine the numerator, the method for including persons with MCC in the denominator, and any exclusion. Present a strong justification for the choice and indicate why it is superior to potential alternative measures. II.Refine the performance measure and conduct analyses in a sample of MCC patients from available data against the NQF criteria, for reliability, validity, and threats to validity. The analysis of threats to validity shall measure exclusions; missing data or poor response rate; case mix differences and risk adjustment; discrimination of performance. III.Develop and refine risk adjustment of the performance measure using available data and modeling. Evaluate and compare random-effects and fixed-effects approaches. Examine model stability. Evaluate potential risk-adjustment considering potential patient factors: socio-demographic, dual status, comorbidity, disability, and other clinical factors. Consider current NQF guidance on use of socioeconomic status as an adjustment factor. IV.Using the existing data and simulations, assess the potential for the performance measure to demonstrate differences between ambulatory practices; similarly assess the potential to demonstrate differences between health care systems. Consider variations in sample size and proxy response rates. Propose suggestions for future collection of PRO-Performance Measure data. V.Prepare documents describing the work to be conducted in Phase 2 that can be submitted to obtain human subjects review/clearance and for NIH clinical exemption from OMB clearance (included in Base Period). Source of Data for Phase 1: For this phase, the Offeror shall specify and justify their proposed source of secondary data which is suitable for conducting the required analyses, and assure its availability. The Offeror shall provide sample size, disease ascertainment, outcome measures and a power calculation for the main analyses. Potential sources of available data for this phase include but are not limited to: 1)The Medicare Health Outcomes Survey (http://www.hosonline.org/Content/Default.aspx) from the Centers for Medicare and Medicaid Services 2)Health ABC (http://www.grc.nia.nih.gov/branches/ledb/healthabc/index.htm) available from the National Institute on Aging; 3)Linkage of the Surveillance, Epidemiology and End Results (SEER) with the Medicare Health Outcomes Survey (MHOS) known as SEER-MHOS and available from the National Cancer Institute; 4)Medical Expenditure Panel Survey (MEPS) which is co-sponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS). Currently, as part of the MHOS, Medicare Advantage (managed care) plans collect information on limited health outcome measures in older adults, including: I.Proportion of patients with improved or maintained physical health over two years based on patient self-report to the VR-12-item Health Survey. II.Proportion of patients with improved or maintained mental health over two years based on patient self-report to the VR-12-item Health Survey. These measures are reported to the public in aggregate and used by Centers for Medicare and Medicaid Services (CMS) to provide Medicare Advantage Organizations with quality bonus payments based on their performance compared to a benchmark. Currently these measures are reported for all adults (mostly above age 65 years) enrolled in Medicare Advantage health plans, a self-selected group of Medicare beneficiaries. Because the report covers a general older adult population, it is not known if disparities exist, and to what degree, in the quality of care provided specifically for older adults with MCC as measured by these outcomes. It is also unclear if there is variation in the magnitude of the disparity across health providers. B.Phase 2 (Option) Phase 2 involves the collection and analysis of data using the PROMIS-29 profile and other instruments from a sample of persons age 65 and over with MCC. Many short forms developed by the PROMIS group for self-administration to patients have been tested for reliability, face validity (through focus groups, expert panels, cognitive interviewing), construct validity (convergent and discriminate validity) and differential item functioning testing. The PROMIS tools, in particular the PROMIS-29 Profile measure, have not been extensively tested in an adult population age 65 and over. Testing of the PROMIS measures was done via the internet with a primarily healthy adult population. The sample size of older adults, particularly the very old (over age 80 years), was limited. Additional research and analysis is necessary to test the validity of the PROMIS tools in an older adult population with multiple chronic conditions and advance toward a potential quality measure for outpatient care. REPORTS/DELIVERABLES: The Offeror shall be required to deliver/perform the following: 1) Monthly calls with the Contracting Officer's Representative (COR); 2) Semi-Annual Progress Reports; 3) Draft and Final Reports and the end of each phase; 4) Draft data sets and manuscripts; 5) Overall Final Project Report. OTHER IMPORTANT INFORMATION: The North American Industry Classification System (NAICS) Code is 541990 with a size standard of $15.0 million. All responsible sources may submit a proposal which will be considered by the agency. This notice does not commit the Government to award a contract. No collect calls will be accepted. No facsimile transmissions will be accepted. Primary Point of Contact: Jon Gottschalk, Contract Specialist, jon.gottschalk@nih.gov Phone: 301-443-9456 Secondary Point of Contact: Yvette Brown, Contracting Officer
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