CMS awards $18.7M contract to Ohio KePro for quality improvement, with limited competition

Contract Overview

Contract Amount: $18,748,064 ($18.7M)

Contractor: Ohio Kepro, LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2011-07-31

End Date: 2014-07-31

Contract Duration: 1,096 days

Daily Burn Rate: $17.1K/day

Competition Type: NOT AVAILABLE FOR COMPETITION

Number of Offers Received: 1

Pricing Type: COST PLUS FIXED FEE

Sector: Healthcare

Official Description: QIO 10TH SOW AWARD

Place of Performance

Location: SEVEN HILLS, CUYAHOGA County, OHIO, 44131

State: Ohio Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $18.7 million to OHIO KEPRO, LLC for work described as: QIO 10TH SOW AWARD Key points: 1. Contract awarded to a single bidder, raising questions about price competitiveness. 2. Services align with broader CMS efforts to enhance healthcare quality and efficiency. 3. Contract duration of three years suggests a need for sustained support. 4. The 'Other Management Consulting Services' NAICS code indicates a broad scope of work. 5. Lack of competition may limit opportunities for innovative solutions from other firms.

Value Assessment

Rating: fair

The contract's value of $18.7 million over three years for quality improvement services appears within a reasonable range for specialized consulting. However, without more specific benchmarks for similar quality improvement initiatives or detailed cost breakdowns, a definitive value-for-money assessment is challenging. The cost-plus-fixed-fee structure necessitates careful monitoring to ensure costs remain controlled and the fixed fee is justified by the scope and complexity of the work. Comparing this to other CMS contracts for similar services would provide better insight into its cost-effectiveness.

Cost Per Unit: N/A

Competition Analysis

Competition Level: limited

This contract was awarded under a 'not available for competition' justification, indicating that the agency likely identified a specific contractor deemed uniquely qualified or that circumstances prevented a broader solicitation. The limited competition means that potential cost savings and a wider array of solutions that might arise from a full and open competition were not realized. This approach is typically reserved for situations where only one source can fulfill the requirement, which warrants scrutiny.

Taxpayer Impact: The lack of robust competition means taxpayers may not have received the most competitive pricing. This approach can also limit the government's ability to leverage a broader market of innovative solutions.

Public Impact

Beneficiaries of Medicare and Medicaid services indirectly benefit from improved quality of care. The contract supports the Centers for Medicare and Medicaid Services (CMS) in its mission to oversee healthcare quality. Services are likely delivered nationwide, impacting the broader healthcare system. The contract may involve analysis and recommendations that influence healthcare provider practices.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Limited competition raises concerns about potential overpayment and lack of market-driven pricing.
The broad NAICS code could indicate a scope that is difficult to track and measure performance against.
Cost-plus-fixed-fee contracts require diligent oversight to prevent cost overruns.

Positive Signals

The contractor, Ohio KePro, LLC, has experience in quality improvement, suggesting relevant expertise.
The contract duration indicates a recognized need for ongoing support in this critical area.
Awarding to an established entity can ensure continuity of essential services.

Sector Analysis

This contract falls within the Management Consulting Services sector, specifically focusing on healthcare quality improvement. The broader healthcare consulting market is substantial, with significant government spending directed towards improving the efficiency and effectiveness of public health programs like Medicare and Medicaid. CMS is a major procurer in this space, often seeking expertise to navigate complex regulatory environments and drive better patient outcomes. Benchmarks for similar quality improvement contracts would typically consider the scope of services, the target population, and the duration of the engagement.

Small Business Impact

The contract was not set aside for small businesses, and there is no indication of subcontracting requirements for small businesses in the provided data. This suggests that the primary focus was on securing specialized expertise, and opportunities for small business participation may have been limited in this specific procurement. Further analysis would be needed to determine if small businesses could have contributed to any part of the service delivery.

Oversight & Accountability

Oversight for this contract would primarily reside with the Centers for Medicare and Medicaid Services (CMS). As a cost-plus-fixed-fee contract, CMS would be responsible for monitoring expenditures, ensuring that costs are reasonable and allocable to the contract, and verifying that the fixed fee is earned based on performance. Transparency would depend on CMS's reporting practices and the public availability of contract performance reviews and audits. Inspector General jurisdiction would apply if any fraud, waste, or abuse were suspected.

Related Government Programs

Medicare Quality Improvement Programs
Medicaid Quality Improvement Initiatives
Healthcare Consulting Services
CMS Program Support Contracts

Risk Flags

Limited competition may result in higher costs.
Cost-plus-fixed-fee contracts require diligent oversight.
Broad NAICS code may obscure specific service details.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $18.7 million to OHIO KEPRO, LLC. QIO 10TH SOW AWARD

Who is the contractor on this award?

The obligated recipient is OHIO KEPRO, LLC.

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 $18.7 million.

What is the period of performance?

Start: 2011-07-31. End: 2014-07-31.

What is Ohio KePro, LLC's track record with government contracts, particularly with CMS?

Ohio KePro, LLC has a history of working with government agencies, including CMS, on quality improvement initiatives. Their experience often involves serving as a Quality Improvement Organization (QIO) or performing similar functions related to healthcare quality assessment and enhancement. Reviewing their past performance on similar contracts, including any documented successes or challenges, is crucial for understanding their capability and reliability. Data on past performance ratings, contract modifications, and any disputes or terminations would provide a more comprehensive picture of their track record.

How does the $18.7 million contract value compare to similar quality improvement contracts awarded by CMS?

The $18.7 million contract value for a three-year period for quality improvement services needs to be benchmarked against comparable contracts. CMS awards numerous contracts for quality improvement, program support, and consulting across various initiatives. A direct comparison would involve identifying contracts with similar scopes of work, target populations (e.g., Medicare beneficiaries, specific disease states), and contract types (e.g., cost-plus-fixed-fee). Without access to a detailed database of comparable contract values and performance metrics, it's difficult to definitively state if this award represents excellent, fair, or questionable value. However, the amount suggests a significant undertaking requiring specialized expertise.

What are the primary risks associated with a 'not available for competition' award for management consulting services?

The primary risks associated with a 'not available for competition' award include a lack of price competition, potentially leading to higher costs for taxpayers. It can also limit the government's access to a wider range of innovative solutions and potentially stifle competition in the long run. Furthermore, it raises concerns about whether the agency adequately explored all available sources or if there were specific, justifiable reasons for the sole-source nature of the procurement. Ensuring the justification for limited competition is robust and well-documented is critical to mitigating these risks.

How effective are quality improvement contracts like this in achieving measurable improvements in healthcare outcomes?

The effectiveness of quality improvement contracts hinges on several factors, including the clarity of objectives, the contractor's expertise, the robustness of performance metrics, and the agency's oversight. Contracts that clearly define measurable outcomes (e.g., reduction in hospital readmissions, improved patient safety scores, better chronic disease management) and tie contractor compensation to achieving these outcomes are more likely to be effective. Regular performance reviews, data analysis, and adaptive management strategies are essential. The success of this specific contract would be evaluated based on the achievement of its stated goals and the resulting impact on healthcare quality for Medicare and Medicaid beneficiaries.

What has been the historical spending trend for 'Other Management Consulting Services' by the Centers for Medicare and Medicaid Services?

Historical spending by CMS on 'Other Management Consulting Services' (NAICS 541618) can be substantial, reflecting the agency's need for specialized expertise in areas such as program management, policy analysis, data analytics, and quality improvement. Trends often show an increasing reliance on external consultants to navigate complex healthcare reforms, implement new technologies, and manage large-scale programs. Analyzing spending over several fiscal years would reveal patterns, identify key service areas, and highlight any significant shifts in procurement strategies or areas of focus within CMS.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Other Management Consulting Services

Product/Service Code: MEDICAL SERVICES › DEPENDENT MEDICARE SERVICES

Competition & Pricing

Extent Competed: NOT AVAILABLE FOR COMPETITION

Solicitation Procedures: ONLY ONE SOURCE

Solicitation ID: CMS10THSOW

Offers Received: 1

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Parent Company: Keystone Peer Review Organization, LLC

Address: 5700 LOMBARDO CTR STE 100, CLEVELAND, OH, 44131

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

Financial Breakdown

Contract Ceiling: $18,748,064

Exercised Options: $18,748,064

Current Obligation: $18,748,064

Actual Outlays: $10,000

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Timeline