HHS awards $45M for Primary Care First model evaluation to Mathematica Inc

Contract Overview

Contract Amount: $44,979,058 ($45.0M)

Contractor: Mathematica Inc.

Awarding Agency: Department of Health and Human Services

Start Date: 2019-09-16

End Date: 2026-12-31

Contract Duration: 2,663 days

Daily Burn Rate: $16.9K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 1

Pricing Type: COST PLUS FIXED FEE

Sector: Healthcare

Official Description: EVALUATION OF THE PRIMARY CARE FIRST MODEL

Place of Performance

Location: WINDSOR MILL, BALTIMORE County, MARYLAND, 21244

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $45.0 million to MATHEMATICA INC. for work described as: EVALUATION OF THE PRIMARY CARE FIRST MODEL Key points: 1. Contract focuses on evaluating a novel healthcare delivery model aimed at improving primary care. 2. The contract duration of over 7 years suggests a long-term commitment to assessing model impact. 3. Awarded under full and open competition, indicating a broad search for qualified contractors. 4. The cost-plus-fixed-fee contract type allows for flexibility in research scope while managing costs. 5. The specific NAICS code points to research and development in social sciences, aligning with program evaluation needs. 6. The contract is a delivery order, suggesting it's part of a larger indefinite-delivery/indefinite-quantity (IDIQ) vehicle or a multi-award contract.

Value Assessment

Rating: good

The contract value of $44.98 million over approximately 7.5 years averages to about $6 million per year. Benchmarking this against similar large-scale healthcare model evaluations is challenging without more specific contract details. However, the cost-plus-fixed-fee structure suggests that costs are reimbursed, plus a fixed fee for profit, which can be efficient for research projects with evolving requirements. The fixed fee component provides a degree of cost control for the government.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting that multiple vendors were likely solicited and evaluated. This approach typically fosters a competitive environment, encouraging bidders to offer their best pricing and technical solutions. The specific number of bidders is not provided, but the open competition indicates a robust process was followed to select the most capable contractor.

Taxpayer Impact: Full and open competition generally benefits taxpayers by promoting a competitive marketplace, which can lead to more cost-effective solutions and better value for the government's investment.

Public Impact

Beneficiaries include Medicare beneficiaries who may experience improved primary care services through the evaluated model. The services delivered involve rigorous research, data analysis, and evaluation of the Primary Care First model's effectiveness. The geographic impact is likely nationwide, as the Primary Care First model is a federal initiative. Workforce implications may include employment for researchers, data analysts, and project managers at Mathematica Inc. and potentially subcontractors.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Long contract duration could lead to scope creep if not managed tightly.
Cost-plus-fixed-fee contracts require careful oversight to ensure costs remain reasonable and the fixed fee is justified.
The success of the evaluation is highly dependent on the quality of data provided by participating healthcare providers.

Positive Signals

Award to a single, experienced contractor like Mathematica Inc. suggests a focus on expertise for a complex evaluation.
The long duration allows for comprehensive assessment of the model's impact over time.
Full and open competition indicates a commitment to finding the best value and capability.

Sector Analysis

This contract falls within the Research and Development sector, specifically focusing on social sciences and humanities as applied to healthcare policy and delivery. The market for healthcare program evaluation is significant, with government agencies frequently contracting for such services to assess the efficacy and efficiency of new healthcare initiatives. Comparable spending benchmarks would typically involve other large-scale program evaluations conducted by HHS or other federal health agencies.

Small Business Impact

The provided data does not indicate any specific small business set-aside or subcontracting requirements for this contract. Mathematica Inc. is a large research organization, and it is possible they may engage small businesses for specialized support, but this is not explicitly stated. Further analysis of subcontracting plans would be needed to assess the impact on the small business ecosystem.

Oversight & Accountability

Oversight for this contract would primarily reside with the Centers for Medicare and Medicaid Services (CMS), a division of HHS. As a cost-plus-fixed-fee contract, CMS will likely monitor expenditures closely to ensure they align with the research objectives and budget. Transparency would be facilitated through regular reporting requirements from Mathematica Inc. and potentially through public release of evaluation findings. Inspector General jurisdiction would apply to any potential fraud, waste, or abuse.

Related Government Programs

Medicare Modernization Act
Center for Medicare & Medicaid Innovation (CMMI) initiatives
Healthcare payment and delivery system reform programs
Health Services Research and Development

Risk Flags

Long-term contract duration requires ongoing monitoring.
Cost-plus-fixed-fee contracts necessitate robust cost oversight.
Dependence on external data sources introduces potential quality risks.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $45.0 million to MATHEMATICA INC.. EVALUATION OF THE PRIMARY CARE FIRST MODEL

Who is the contractor on this award?

The obligated recipient is MATHEMATICA INC..

Which agency awarded this contract?

Awarding agency: Department of Health and Human Services (Centers for Medicare and Medicaid Services).

What is the total obligated amount?

The obligated amount is $45.0 million.

What is the period of performance?

Start: 2019-09-16. End: 2026-12-31.

What is the track record of Mathematica Inc. in conducting large-scale healthcare program evaluations for the federal government?

Mathematica Inc. has a well-established track record as a research organization conducting numerous evaluations of federal health programs. They have significant experience working with agencies like CMS, NIH, and AHRQ on studies related to Medicare, Medicaid, and various health reforms. Their portfolio includes evaluations of payment models, quality improvement initiatives, and health services research. This extensive experience suggests they possess the necessary expertise, infrastructure, and understanding of federal contracting requirements to successfully execute the Primary Care First model evaluation. Their history indicates a capacity to manage complex data, engage diverse stakeholders, and produce rigorous analytical reports for policymakers.

How does the annual cost of this contract compare to other large federal healthcare program evaluations?

The annual cost of this contract, averaging approximately $6 million per year ($44.98M / ~7.5 years), is substantial but falls within the typical range for large-scale, multi-year federal healthcare program evaluations. Major initiatives by CMS or other health agencies often involve tens of millions of dollars over several years to account for extensive data collection, analysis, stakeholder engagement, and reporting. For instance, evaluations of large demonstration projects or national policy impacts can easily reach or exceed this annual expenditure. Without specific comparable contracts, a precise benchmark is difficult, but the funding level appears commensurate with the scope of evaluating a national primary care model.

What are the primary risks associated with the success of the Primary Care First model evaluation?

Key risks include challenges in data acquisition and quality from participating healthcare providers, potential shifts in healthcare policy or priorities during the long evaluation period, and the inherent complexity of isolating the impact of the Primary Care First model from other confounding factors influencing healthcare outcomes. There's also a risk related to contractor performance, ensuring Mathematica Inc. maintains rigorous methodologies and timely deliverables. Furthermore, the model itself might face implementation challenges at the provider level, which could affect the data available for evaluation. Finally, ensuring sustained stakeholder engagement and buy-in throughout the multi-year evaluation is crucial.

What is the expected effectiveness of the Primary Care First model based on preliminary research or similar initiatives?

While this contract is for the *evaluation* of the Primary Care First model, preliminary research and the design of the model itself suggest an aim to improve patient outcomes, enhance patient and caregiver experience, and reduce the growth of healthcare costs. Models like Primary Care First often focus on shifting reimbursement from fee-for-service to value-based payments, incentivizing providers to focus on preventive care, chronic disease management, and care coordination. Similar initiatives have shown mixed results, with some demonstrating improvements in quality metrics and patient satisfaction, while cost savings can be more elusive or take longer to materialize. The evaluation will be critical in determining the actual effectiveness and scalability of this specific model.

How has federal spending on healthcare program evaluation evolved over the past decade?

Federal spending on healthcare program evaluation has generally increased over the past decade, driven by legislative mandates and a growing emphasis on evidence-based policymaking and accountability. The Affordable Care Act, for example, spurred numerous new initiatives and delivery system reforms, many of which required rigorous evaluation. Agencies like CMS and AHRQ consistently fund research and evaluation to assess the impact of new payment models, quality improvement programs, and public health interventions. While specific figures fluctuate annually based on budget appropriations and program priorities, there is a sustained commitment to understanding the effectiveness and efficiency of federal healthcare spending, making contracts like this a consistent feature.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Scientific Research and Development Services › Research and Development in the Social Sciences and Humanities

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY

Offers Received: 1

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 1100 1ST ST NE FL 12, WASHINGTON, DC, 20024

Business Categories: Category Business, Not Designated a Small Business, Special Designations, Subchapter S Corporation, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $44,979,058

Exercised Options: $44,979,058

Current Obligation: $44,979,058

Actual Outlays: $32,946,259

Subaward Activity

Number of Subawards: 4

Total Subaward Amount: $572,530

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: HHSM500201400034I

IDV Type: IDC

Timeline