HHS awards $6.7M contract to Mathematica Inc. for dual-eligible care integration technical assistance

Contract Overview

Contract Amount: $6,716,372 ($6.7M)

Contractor: Mathematica Inc.

Awarding Agency: Department of Health and Human Services

Start Date: 2024-07-12

End Date: 2026-07-11

Contract Duration: 729 days

Daily Burn Rate: $9.2K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 1

Pricing Type: COST PLUS FIXED FEE

Sector: Healthcare

Official Description: TECHNICAL ASSISTANCE TO SUPPORT STATE EFFORTS TO INTEGRATE CARE FOR DUAL ELIGIBLE INDIVIDUALS

Place of Performance

Location: WINDSOR MILL, BALTIMORE County, MARYLAND, 21244

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $6.7 million to MATHEMATICA INC. for work described as: TECHNICAL ASSISTANCE TO SUPPORT STATE EFFORTS TO INTEGRATE CARE FOR DUAL ELIGIBLE INDIVIDUALS Key points: 1. Contract focuses on critical integration of care for dual-eligible individuals, a complex and high-cost population. 2. Mathematica Inc. has a strong track record in health policy research and analysis. 3. The contract's cost-plus-fixed-fee structure requires careful monitoring of expenditures to ensure value. 4. Full and open competition suggests a robust market for these specialized services. 5. Performance period of two years allows for meaningful progress in technical assistance delivery. 6. The contract aligns with broader federal goals to improve healthcare coordination and reduce costs.

Value Assessment

Rating: good

The contract value of $6.7 million over two years for specialized technical assistance appears reasonable given the complexity of integrating care for dual-eligible individuals. Benchmarking against similar contracts for health policy research and technical assistance suggests this is within a typical range. The cost-plus-fixed-fee (CPFF) pricing structure, while common for research and development, necessitates diligent oversight to ensure costs remain controlled and that the fixed fee adequately compensates the contractor for their expertise without excessive profit.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded under full and open competition, indicating that multiple qualified vendors had the opportunity to bid. The specific number of bidders is not provided, but the designation suggests a competitive process that likely drove pricing and ensured a selection of a highly capable contractor. This approach is generally favored for ensuring fair market value and access to the best available solutions.

Taxpayer Impact: Full and open competition is beneficial for taxpayers as it fosters a competitive environment, which typically leads to more favorable pricing and a wider selection of qualified contractors, ultimately maximizing the value of federal investments.

Public Impact

State health agencies and Medicaid/Medicare programs will benefit from enhanced technical assistance to improve care coordination for dual-eligible individuals. Services delivered will focus on strategic planning, program design, and implementation support for state-level integration efforts. The geographic impact is national, as state efforts supported by this contract can serve as models for other states. Workforce implications include potential for increased demand for health policy analysts and program managers at the state level.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for cost overruns inherent in Cost Plus Fixed Fee contracts if not closely monitored.
Ensuring the technical assistance directly translates into measurable improvements in care coordination for dual-eligibles.
Dependence on contractor expertise may limit internal government capacity building in this specific area.

Positive Signals

Mathematica Inc. is a reputable research firm with extensive experience in health policy.
Full and open competition suggests a robust market and potential for competitive pricing.
The contract addresses a critical need for improving healthcare for a vulnerable population.

Sector Analysis

This contract falls within the Research and Development sector, specifically focusing on social sciences and humanities related to healthcare policy. The market for health policy research and technical assistance is substantial, with numerous firms competing for federal and state contracts. This award to Mathematica Inc. positions them as a key player in supporting federal initiatives aimed at improving healthcare delivery systems, particularly for complex populations like dual-eligibles, aligning with broader trends towards value-based care and integrated service models.

Small Business Impact

The contract details do not indicate any specific small business set-asides or subcontracting requirements. Given the specialized nature of health policy research and technical assistance, it is possible that larger, established research firms like Mathematica Inc. are best positioned to compete. Further analysis would be needed to determine if opportunities exist for small businesses to participate as subcontractors or if future contracts in this area could be structured to encourage greater small business involvement.

Oversight & Accountability

Oversight for this contract will likely be managed by the Centers for Medicare and Medicaid Services (CMS) within HHS. The Cost Plus Fixed Fee structure necessitates rigorous financial oversight to track expenditures against the approved budget and ensure the fixed fee is justified. Performance monitoring will be crucial to assess the quality and impact of the technical assistance provided. Transparency will be maintained through regular reporting requirements from the contractor and potential reviews by HHS oversight bodies or the Inspector General.

Related Government Programs

State Health Official Technical Assistance
Medicaid Integration Programs
Medicare-Medicaid Coordination Office Initiatives
Health Policy Research Grants
Dual Eligible Beneficiary Programs

Risk Flags

Cost Control in CPFF Contracts
Measuring Impact of Technical Assistance
State-Level Implementation Challenges

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $6.7 million to MATHEMATICA INC.. TECHNICAL ASSISTANCE TO SUPPORT STATE EFFORTS TO INTEGRATE CARE FOR DUAL ELIGIBLE INDIVIDUALS

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 $6.7 million.

What is the period of performance?

Start: 2024-07-12. End: 2026-07-11.

What is Mathematica Inc.'s track record with federal contracts, particularly in health policy and technical assistance?

Mathematica Inc. is a well-established research firm with a significant history of performing work for federal agencies, including the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and others. Their expertise spans health policy, healthcare delivery systems, program evaluation, and technical assistance. They have been involved in numerous projects related to Medicare, Medicaid, and the integration of services for vulnerable populations, including dual-eligible individuals. Their track record generally indicates a capacity to manage complex research and provide valuable technical support, often receiving positive performance reviews on completed contracts. Specific details on past performance metrics and any past issues would require a deeper dive into contract databases and performance reports.

How does the $6.7 million contract value compare to similar technical assistance contracts for dual-eligible integration?

The $6.7 million contract value over two years for technical assistance supporting state efforts to integrate care for dual-eligible individuals appears to be within a reasonable range for specialized federal contracts of this nature. Contracts for health policy research, program development, and technical assistance to state agencies can vary significantly based on scope, duration, and the specific expertise required. Given the complexity of coordinating Medicare and Medicaid benefits for dual-eligibles, and the need for expert analysis and guidance, this funding level suggests a comprehensive effort. Comparable contracts often range from a few million to tens of millions of dollars, depending on the scale and duration of the technical assistance provided. Without specific benchmarks for identical services, this amount seems proportionate to the task.

What are the primary risks associated with this Cost Plus Fixed Fee (CPFF) contract structure?

The primary risks associated with a Cost Plus Fixed Fee (CPFF) contract structure, like the one awarded to Mathematica Inc., revolve around cost control and ensuring optimal value for the government. CPFF contracts reimburse the contractor for allowable costs incurred, plus a predetermined fixed fee representing profit. The risk for the government is that the contractor may have less incentive to control costs compared to fixed-price contracts, as their profit is fixed regardless of the final cost. This can lead to potential cost overruns if not managed diligently. For the contractor, the risk lies in underestimating the costs required to perform the work, which could erode their fixed fee. Effective oversight, detailed cost tracking, and clear performance metrics are essential to mitigate these risks and ensure the government receives good value.

How effective is technical assistance likely to be in driving actual integration of care for dual-eligible individuals?

The effectiveness of technical assistance in driving actual integration of care for dual-eligible individuals hinges on several factors beyond the quality of the assistance itself. While Mathematica Inc.'s expertise can provide states with best practices, strategic guidance, and implementation support, the ultimate success depends on the states' capacity, political will, and resources to adopt and implement the recommended changes. Technical assistance can facilitate better program design, improve data sharing, and enhance coordination mechanisms, but it cannot mandate policy changes or guarantee successful execution at the state level. The contract's success will be measured not just by the delivery of advice, but by the tangible improvements in care coordination, reduced administrative burden, and better health outcomes for dual-eligible beneficiaries resulting from the states' adoption of the provided guidance.

What are the historical spending patterns for technical assistance related to dual-eligible populations?

Historical spending patterns for technical assistance related to dual-eligible populations have generally shown a consistent federal commitment to improving the coordination of Medicare and Medicaid services for this group. Agencies like CMS have historically funded various initiatives, including grants and contracts, to support states in developing and implementing integration strategies. Spending has often fluctuated based on legislative priorities, such as the Affordable Care Act's provisions encouraging integration, and the availability of demonstration project funding. While specific aggregate spending figures for 'dual-eligible technical assistance' can be difficult to isolate, overall federal investment in programs aimed at improving care for this population, including research, evaluation, and technical support, has been in the hundreds of millions of dollars over the past decade. This contract represents a continuation of that investment.

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: 1

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 600 ALEXANDER PARK, PRINCETON, NJ, 08540

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

Financial Breakdown

Contract Ceiling: $15,758,974

Exercised Options: $6,716,372

Current Obligation: $6,716,372

Actual Outlays: $4,900,789

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: 75FCMC19D0091

IDV Type: IDC

Timeline