HHS Awards $19.4M for Medicare Alternative Payment System Testing

Contract Overview

Contract Amount: $19,439,496 ($19.4M)

Contractor: Research Triangle Institute

Awarding Agency: Department of Health and Human Services

Start Date: 2023-01-26

End Date: 2027-01-25

Contract Duration: 1,460 days

Daily Burn Rate: $13.3K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 2

Pricing Type: COST PLUS FIXED FEE

Sector: R&D

Official Description: THE PURPOSE OF THIS TASK ORDER IS TO OBTAIN THE SERVICES OF A QUALIFIED VENDOR TO IMPLEMENT AND MONITOR THE TESTING OF AN ALTERNATIVE PAYMENT SYSTEM FOR MEDICARE FEE FOR SERVICES (FFS) BENEFICIARIES. THE CONTRACTOR SHALL PROVIDE IMPLEMENTATION AND MO

Place of Performance

Location: WINDSOR MILL, BALTIMORE County, MARYLAND, 21244

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $19.4 million to RESEARCH TRIANGLE INSTITUTE for work described as: THE PURPOSE OF THIS TASK ORDER IS TO OBTAIN THE SERVICES OF A QUALIFIED VENDOR TO IMPLEMENT AND MONITOR THE TESTING OF AN ALTERNATIVE PAYMENT SYSTEM FOR MEDICARE FEE FOR SERVICES (FFS) BENEFICIARIES. THE CONTRACTOR SHALL PROVIDE IMPLEMENTATION AND MO Key points: 1. Contract focuses on implementing and monitoring testing of an alternative payment system for Medicare FFS beneficiaries. 2. The awardee, Research Triangle Institute, is a known entity in research and development. 3. The contract type is Cost Plus Fixed Fee, which can lead to cost overruns if not managed carefully. 4. This initiative falls under the Research and Development in Social Sciences and Humanities sector.

Value Assessment

Rating: fair

The Cost Plus Fixed Fee contract type allows for flexibility but carries a risk of costs exceeding initial estimates. Benchmarking against similar R&D contracts for system implementation and testing is needed for a precise value assessment.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a competitive bidding process. However, the specific pricing discovery mechanisms used during negotiation are not detailed, impacting the assessment of price reasonableness.

Taxpayer Impact: Taxpayer funds are being used to explore potential improvements in Medicare payment systems, which could lead to long-term efficiencies if successful.

Public Impact

Potential for improved Medicare payment efficiency and beneficiary experience. Testing an alternative system could influence future healthcare payment policies. Research findings may inform broader healthcare system reforms. Impacts beneficiaries by testing new ways to receive payments. Government investment in healthcare innovation.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Cost Plus Fixed Fee contract type
Limited detail on price discovery
Potential for scope creep in R&D

Positive Signals

Full and open competition
Focus on improving Medicare FFS
Experienced awardee in R&D

Sector Analysis

This contract falls within the Research and Development in Social Sciences and Humanities sector, specifically focusing on healthcare payment systems. Spending benchmarks for similar R&D initiatives in healthcare technology implementation and testing would provide further context.

Small Business Impact

The data does not indicate any specific provisions or set-asides for small businesses in this task order. Further investigation would be needed to determine if small businesses were involved as subcontractors.

Oversight & Accountability

The Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing this task order. Standard government oversight procedures for R&D contracts, including milestone reviews and performance monitoring, are expected to be in place.

Related Government Programs

Research and Development in the Social Sciences and Humanities
Department of Health and Human Services Contracting
Centers for Medicare and Medicaid Services Programs

Risk Flags

Cost Plus Fixed Fee contract type may lead to higher costs than anticipated.
Potential for scope creep in research and development activities.
Effectiveness hinges on robust testing and accurate data analysis.
Limited information on specific performance metrics and success criteria.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $19.4 million to RESEARCH TRIANGLE INSTITUTE. THE PURPOSE OF THIS TASK ORDER IS TO OBTAIN THE SERVICES OF A QUALIFIED VENDOR TO IMPLEMENT AND MONITOR THE TESTING OF AN ALTERNATIVE PAYMENT SYSTEM FOR MEDICARE FEE FOR SERVICES (FFS) BENEFICIARIES. THE CONTRACTOR SHALL PROVIDE IMPLEMENTATION AND MO

Who is the contractor on this award?

The obligated recipient is RESEARCH TRIANGLE INSTITUTE.

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 $19.4 million.

What is the period of performance?

Start: 2023-01-26. End: 2027-01-25.

What is the expected return on investment for testing this alternative payment system?

The return on investment is not explicitly defined in the provided data. Success will likely be measured by the effectiveness of the alternative payment system in improving efficiency, reducing administrative burden, and potentially lowering costs for Medicare Fee for Service beneficiaries. Quantifying this ROI will depend on the outcomes of the testing phase and subsequent analysis.

What are the primary risks associated with implementing and monitoring this alternative payment system?

Key risks include potential technical challenges in implementing the new system, difficulties in accurately monitoring its performance, and the possibility that the alternative system may not yield the expected improvements or could introduce unintended negative consequences for beneficiaries or providers. Inadequate data collection or analysis during the testing phase could also compromise the validity of the findings.

How will the effectiveness of the alternative payment system be measured?

Effectiveness will be measured through the implementation and monitoring of testing. This likely involves defining key performance indicators (KPIs) related to system efficiency, cost-effectiveness, beneficiary satisfaction, and administrative burden reduction. The contractor will be responsible for providing data and analysis to CMS to evaluate whether the alternative system meets its intended objectives.

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: RESEARCH AND DEVELOPMENT › N – Health R&D Services

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY

Offers Received: 2

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 3040 E CORNWALLIS RD, RESEARCH TRIANGLE PARK, NC, 27709

Business Categories: Category Business, Corporate Entity Tax Exempt, Nonprofit Organization, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $29,244,644

Exercised Options: $19,439,496

Current Obligation: $19,439,496

Actual Outlays: $10,681,740

Subaward Activity

Number of Subawards: 9

Total Subaward Amount: $7,851,874

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: 75FCMC19D0095

IDV Type: IDC

Timeline