National Cancer Institute, Research Contracts Branch, PSAS, 6120 Executive Blvd, EPS/Room 638, Bethesda, MD 20892-7227

A -- CAPACITY AND RESOURCE COST OF PROVIDING SCREENING SIGMOIDOSCOPY SERVICES IN THE CONTEXT OF AN ORGANIZED SCREENING PROGRAM SOL NCI-RFQ-90233-NV DUE 092399 POC Debbie Moore, Purchasing Agent (301) 402-4509, Todd Cole, Contracting Officer (301) 402-4509 The National Cancer Institute (NCI), Division of Cancer Control and Population Sciences (DCCPS), Applied Research Branch plans on procuring data on capacity and resource costs of providing screening Sigmoidoscopy services in the context of an organized screening program. NCI plans on procuring this data from the Kaiser Foundation Research Institute, Division of Research, 3505 Broadway, Oakland, CA 94611-5714. Colorectal cancer is a major source of morbidity and mortality in the United States. It is estimated that there will be 149,000 new cases of colorectal cancer in 1999 and 56,000 deaths attributable to the disease. Recent evidence suggests that a substantial portion of this morbidity and mortality may be controlled through screening for the early detection of colorectal cancer and pre-cancerous lesions. A number of case-control and other studies have suggested that screening for colon cancer using sigmoidoscopy has the potential to reduce morbidity and mortality from this disease. Despite the promising results, Sigmoidoscopy screening is not yet widely performed in the United States. One major concern is the cost of such screening. If the current population of GI specialists lack the capacity to perform such screening, then primary care physicians might have to be trained to perform sigmoidoscopies. Screening costs might be unacceptable in the setting of low-volume primary care practices. A large expansion in the use of screening sigmoidoscopy has the potential to increase Medicare and insurance costs in the short run. Therefore, it is important to estimate the cost of such an expansion under different models of the delivery of Sigmoidoscopy screening. Currently there is no known empirical data on a well organized screening program and the resource and pecuniary costs associated with such a program. This requirement is for precisely estimating the capacity and cost of delivering Sigmoidoscopy screening to a large population in the context of a managed health care organization with membership greater than 1.5 million and that has a screening program. This will enable accurate tracking of screening, visits, patients, and most importantly costs. For one year, the contractor shall collect screening data and ultimately report the following: 1) average time of screening sigmoidoscopies performed by GI physicians; 2) average time of screenings performed by nurses; 3) number of sigmoidoscopies performed per day in each clinic; 4)average time of screening sigmoidoscopies with positive findings; and 5) costs of providing screening sigmoidoscopies to a population under these several different assumptions. Kaiser Foundation Research Institute (KFRI) is affiliated with Kaiser Permanente Norther California (KPNC), an HMO providing medical and hospital services to 6.6 million members nationwide and 2.8 million members in Northern California. KFRI has access to the KPNC automated utilization databases which contain: 1) oupatient visits to physicians and nonphysicians providers, by department; 2) planned outpatient visit time and planned screening procedures, including sigmoidoscopy screenings broken out; 3) complete sigmoidoscopy results; and 4) fully allocated costs of outpatient visits adjusted for visit length, provider type and certain outpatient procedures. In addition, there is uniformity in the sigmoidoscopy practices within each clinic of KPNC. One or more physicians typically spend an entire day doing only sigmoidoscopy, and rooms for the procedure are designated. This allows in-person observation to be performed to verify database data and to estimate actual time from the planned/scheduled time (there could be cancellations not evident in the database). Based on the aforementioned requirement and information, Kaiser Foundation Research Institute is the only source known to the NCI that can perform the above analyses by virtue of its unique database, membership size, volume of screenings, and the ability to track sigmoidoscopy screenings. This notice of intent is not a request for competitive quotation. However, if any interested party believes it can meet the above requirement, it may submit a statement of capabilities. The capability statement and any other furnished information must be in writing and must contain material in sufficient detail to allow NCI to determine if the party can fully meet the requirements. Capability statements must be received in the contracting office by 2:00 p.m., EST on September 23, 1999. If you have any questions, please contact Debbie Moore, Purchasing Agent on (301)402-4509. A determination by the Government not to compete this proposed requirement based on responses to this notice is solely within the discretion of the Government. Information received shall be considered solely for the purpose of determining whether to conduct a competitive procurement. No collect calls will be accepted. Posted 09/07/99 (W-SN376893). (0250)

Loren Data Corp. http://www.ld.com (SYN# 0007 19990909\A-0007.SOL)