Medicare Quality Improvement Contract Awarded to Ohio KePro for $77M to Enhance Beneficiary Healthcare Services
Contract Overview
Contract Amount: $77,162,948 ($77.2M)
Contractor: Ohio Kepro, LLC
Awarding Agency: Department of Health and Human Services
Start Date: 2014-05-08
End Date: 2019-09-07
Contract Duration: 1,948 days
Daily Burn Rate: $39.6K/day
Competition Type: FULL AND OPEN COMPETITION
Number of Offers Received: 2
Pricing Type: COST PLUS FIXED FEE
Sector: Healthcare
Official Description: IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, QUALITY OF CARE REVIEWS, BENEFICIARY COMPLAINT REVIEWS, DISCHARGE AND TERMINATION OF SERVICE APPEALS IN VARIOUS PROVIDER SETTINGS, MEDICAL NECESSITY REVIEWS, AND EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) REVIEWS.AREA 4PERIOD OF PERFORMANCE: MAY 6, 2014 - MAY 5, 2019
Place of Performance
Location: SEVEN HILLS, CUYAHOGA County, OHIO, 44131
State: Ohio Government Spending
Plain-Language Summary
Department of Health and Human Services obligated $77.2 million to OHIO KEPRO, LLC for work described as: IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, … Key points: 1. Contract aims to improve healthcare for Medicare beneficiaries through quality reviews and complaint handling. 2. Ohio KePro, LLC secured the contract, indicating a specific provider's role in quality assurance. 3. The contract duration is approximately 5 years, covering a significant period of service delivery. 4. Focus on statutory review functions suggests a compliance-driven and regulatory aspect to the services.
Value Assessment
Rating: fair
The contract value of $77.16M over approximately 5 years for 'Other Management Consulting Services' appears reasonable given the scope of quality improvement and review functions for Medicare beneficiaries. Benchmarking against similar large-scale healthcare quality assurance contracts would provide a more precise assessment.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The contract was awarded under full and open competition, suggesting a robust price discovery process. This method allows multiple qualified vendors to bid, theoretically driving down costs and ensuring the best value for the government.
Taxpayer Impact: The competitive award process aims to ensure taxpayer funds are used efficiently for essential healthcare quality improvement services.
Public Impact
Improved healthcare quality for millions of Medicare beneficiaries. Enhanced review processes for beneficiary complaints and appeals. Ensured compliance with healthcare regulations through statutory review functions. Potential for cost savings through efficient healthcare delivery and reduced errors.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Contract duration is long, requiring ongoing performance monitoring.
- Cost-plus fixed fee structure can incentivize cost overruns if not managed tightly.
Positive Signals
- Full and open competition ensures market-driven pricing.
- Clear statutory functions provide defined service expectations.
- Focus on quality improvement aligns with government healthcare goals.
Sector Analysis
This contract falls under 'Other Management Consulting Services' but is deeply embedded in the Healthcare sector, specifically focusing on quality improvement for Medicare beneficiaries. Spending in this area is critical for ensuring the effectiveness and efficiency of government healthcare programs.
Small Business Impact
The data does not indicate specific provisions or set-asides for small businesses in this contract. Further investigation would be needed to determine the extent of small business participation.
Oversight & Accountability
The contract's performance is overseen by the Centers for Medicare and Medicaid Services (CMS), a key agency within HHS. Regular reviews and reporting are expected to ensure accountability and adherence to contract terms.
Related Government Programs
- Other Management Consulting Services
- Department of Health and Human Services Contracting
- Centers for Medicare and Medicaid Services Programs
Risk Flags
- Potential for cost creep in CPFF contracts.
- Ensuring consistent quality across diverse provider settings.
- Measuring the direct impact of reviews on beneficiary health outcomes.
- Contractor performance stability over the contract period.
Tags
other-management-consulting-services, department-of-health-and-human-services, oh, definitive-contract, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Health and Human Services awarded $77.2 million to OHIO KEPRO, LLC. IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, QUALITY OF CARE REVIEWS, BENEFICIARY COMPLAINT REVIEWS, DISCHARGE AND TERMINATION OF SERVICE APPEALS IN VARIOUS PROVIDER SETTINGS, MEDICAL NECESSITY REVIEWS, AND EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA)
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 $77.2 million.
What is the period of performance?
Start: 2014-05-08. End: 2019-09-07.
What is the expected impact of these quality improvement efforts on overall Medicare spending?
The primary goal is to improve healthcare quality, which can lead to reduced hospital readmissions, fewer medical errors, and more efficient care delivery. These efficiencies are expected to contribute to long-term cost savings within the Medicare program, although the immediate impact on overall spending may be offset by the contract's cost. Quantifying the exact savings requires detailed analysis of performance metrics and healthcare utilization trends.
How are potential risks of inadequate quality reviews or beneficiary dissatisfaction mitigated?
Mitigation strategies likely involve stringent performance metrics, regular audits by CMS, and clear protocols for handling beneficiary complaints and appeals. The contract's structure, including the 'full and open competition' and the specific statutory functions, aims to ensure a high standard of service. Performance data and beneficiary feedback are crucial for ongoing oversight and corrective actions.
What mechanisms are in place to ensure the 'cost plus fixed fee' structure does not lead to excessive costs?
The 'cost plus fixed fee' (CPFF) structure requires robust oversight to prevent cost overruns. CMS likely employs detailed auditing of incurred costs and closely monitors the contractor's adherence to the fixed fee. Performance incentives or penalties tied to quality outcomes and budget adherence can also be incorporated to ensure cost-effectiveness and value for taxpayer money.
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: FULL AND OPEN COMPETITION
Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE
Solicitation ID: HHSM5002014RFPBFCCQIO
Offers Received: 2
Pricing Type: COST PLUS FIXED FEE (U)
Evaluated Preference: NONE
Contractor Details
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: $77,162,948
Exercised Options: $77,162,948
Current Obligation: $77,162,948
Actual Outlays: $750,948
Contract Characteristics
Multi-Year Contract: Yes
Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED
Cost or Pricing Data: YES
Timeline
Start Date: 2014-05-08
Current End Date: 2019-09-07
Potential End Date: 2019-09-07 00:00:00
Last Modified: 2024-10-22
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