SOLICITATION NOTICE
R -- TRICARE Quality Monitoring Contract (TQMC) Draft Solicitation - DRAFT TQMC RFP
- Notice Date
- 3/10/2015
- Notice Type
- Presolicitation
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Other Defense Agencies, Defense Health Agency, Contract Operations Division - Aurora, 16401 E. CenterTech Pkwy., Aurora, Colorado, 80011, United States
- ZIP Code
- 80011
- Solicitation Number
- HT9402-15-R-0005
- Point of Contact
- Cynthia Turk, , Mike Sharpe,
- E-Mail Address
-
cynthia.d.turk.civ@mail.mil, Michael.Sharpe.ctr@dha.mil
(cynthia.d.turk.civ@mail.mil, Michael.Sharpe.ctr@dha.mil)
- Small Business Set-Aside
- N/A
- Description
- Draft Section H Draft Section F M2 Data Dictionary MDR Data Dictionary DP Map Reg Map IHI Global Trigger Tool Draft Section M Section L Exhibit L-10 Section L Exhibit L-9 Section L Exhibit L-8 Section L Exhibit L-7 Section L Exhibit L-6 Section L Exhibit L-5 Section L Exhibit L-4 Section L Exhibit L-3 Section L Exhibit L-2 Section L Exhibit L-1 Draft Section L Draft Section C TQMC Draft RFP Questions The Defense Health Agency (DHA) is contemplating a new indefinite delivery/indefinite quantity (IDIQ) contract with fixed unit prices for the TRICARE Quality Monitoring Contract (TQMC). The TQMC will assist the Clinical Support Division (CSD) in assessing and improving the quality of care delivered under the TRICARE benefit across the direct and purchased care systems and support DHA with the management of clinical quality performance measurements to validate the quality of care. The purpose of this Notice is to provide potential offerors with sections of the DRAFT request for proposal (RFP) for the TQMC. This Notice is a follow on to earlier Requests for Information (RFIs) (DHA-RFI-15-CQSS and DHA-RFI-14-CQMP) and is part of ongoing market research. It is intended solely for information and planning purposes and is NOT a solicitation. Offerors are invited to review the attached DRAFT solicitation documents and submit questions or comments about the DRAFT RFP via email to Ms. Cynthia Turk, Contract Specialist, cynthia.d.turk.civ@mail.mil, not later than March 24,2015. Please include the following in the subject line: DRAFT TQMC HT9402-15-R-0005. DHA seeks industry questions and feedback on the adequacy of the description of the TQMC requirements and DHA's approach in the draft RFP sections attached to this draft solicitation. DHA requests industry input concerning healthcare best practices, industry standards, and incentives to promote the delivery of high clinical quality monitoring services within the applicable statutory and regulatory limitations. DHA requests responders submit any questions or comments about the DRAFT RFP via email to Ms Turk. Interested firms shall not send proposals in response to this Notice, nor shall they contact any other individuals about this Notice or the TQMC requirement. Any information provide to DHA is strictly voluntary and given with no expectation of compensation and is clearly provided at no cost to the Government. DHA requests that responders identify the specific solicitation document and cite specific paragraphs where appropriate, using the Word file attached to this DRAFT solicitation. DHA will treat all questions/comments as source selection information (FAR 2.101 & 3.104). DHA is not issuing a solicitation at this time, and this Notice shall not be construed as DHA's commitment to issue a solicitation nor does it restrict DHA to a particular acquisition approach. DHA estimates a formal solicitation may be issued on the Federal Business Opportunities (fbo.gov) website in the near future. If DHA issues a solicitation, DHA will conduct any source selection in accordance with FAR 15, as supplemented, at Contract Operations Division-Aurora (COD-A), in Aurora, Colorado. Any future information on this acquisition (statement of work, specifications, solicitation, etc.) will be posted on www.fbo.gov. It is the responsibility of the prospective offeror to review this site regularly for updates and/or changes. BACKGROUND: The DHA's mission is to achieve greater integration of the direct and purchased health care delivery systems to accomplish the Military Health System's (MHS) Quadruple Aim: Readiness, Population Health, Experience of Care and Per Capita Cost. DHA is tasked with making military medicine stronger, better and more relevant for the future. The Health Systems Performance Branch, Clinical Support Division, under the Health Operations Directorate, is responsible for overseeing the quality of healthcare provided throughout the MHS. The MHS has a $50 billion budget and serves about 9.5 million beneficiaries. The MHS consists of two major care delivery systems: Direct care is provided in military treatment facilities (MTFs). Currently, there are 430 MTFs: 54 military hospitals and 373 military medical clinics around the world. Purchased care is provided by contractors, including the Designated Providers (DP) under the Uniformed Services Family Health Plan (USFHP), the managed care support contractors (MCSCs), the TRICARE Overseas Program (TOP) contractor, the TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC), and pharmacy contractor. The TQMC will enable DHA to implement proven clinical and business practices more rapidly, and reduce unwarranted variation, creating the conditions for learning and continuous improvement across the MHS. The TQMC contractor will support the DHA in managing clinical quality measures and functions; perform quality management activities to validate the quality of care delivered to TRICARE beneficiaries; and compile and compare DHA quality data with national performance and available benchmarks while supporting MHS compliance with healthcare mandates. The TQMC is anticipated to perform the non-personal advisory and assistance services (A&AS) and non-A&AS tasks listed below in accordance with TRICARE's Quality and Utilization Peer Review Organization Program (Code of Federal Regulations 32 CFR 199.15) and DoD Instruction and Manual 6025.13, Medical Quality Assurance and Clinical Quality Management in the Military Health System, and TRICARE manuals (http://manuals.tricare.osd.mil/): • Perform contract oversight and management of all TQMC requirements as the prime contractor. • Implement effective quality control program equivalent to International Organization for Standardization (ISO) 9001:2008 and other healthcare best practices and standards. • Review clinical performance studies which DHA identifies as having significant importance to the MHS mission and beneficiaries. • Collect, analyze and display MHS clinical quality measures data with nationally comparable benchmarks in support of the MHS Strategic Plan, • Collect, analyze National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) compliance audits. • Collect, submit and present the Joint Commission (JC) ORYX® National Hospital Quality Measures data for comparative analysis with healthcare organizations nationwide and to support the accreditation of Department of Defense (DoD) hospitals, • Conduct independent medical peer reviews for Standard of Care (SOC) cases at 54 Military Treatment Facility (MTF); conduct medical necessity (Reconsideration) reviews (Second Level Appeals); and provide independent and impartial evaluations of the healthcare provided to MHS beneficiaries and other medical peer review services to support DHA's oversight of clinical quality in the MHS as mandated by 32 CFR 199.15, Quality and Utilization Review Peer Review Organization Program; Part 199, Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). • Use the IHI Global Trigger Tool (GTT) to conduct medical record reviews to identify possible adverse events. • Provide clinical/expert witnesses for medical appeal administrative hearings and proceedings; • Assess evolving practices, devices, medicines, treatments and procedures; • Conduct initial certification/re-certifications of TRICARE-authorized freestanding partial hospitalization programs (PHP); residential treatment centers (RTC); substance use disorder rehabilitation facilities (SUDRF). • Conduct quality improvement studies based on information gathered from DHA leadership including the Services, the Managed Care Support Contractors and other contractors; current trends in the healthcare industry with reference to the application to the MHS and findings from previously performed focused studies performed in the MHS or the results of outcome measures from MHS data.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/notices/98ae4fd9e228c03cabbc94d9295d4364)
- Place of Performance
- Address: Worldwide, United States
- Record
- SN03662848-W 20150312/150310235206-98ae4fd9e228c03cabbc94d9295d4364 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
| FSG Index | This Issue's Index | Today's FBO Daily Index Page |