HHS awards $98.9M contract for primary care evaluation, with Mathematica Inc. as the sole awardee

Contract Overview

Contract Amount: $98,894,731 ($98.9M)

Contractor: Mathematica Inc.

Awarding Agency: Department of Health and Human Services

Start Date: 2016-09-23

End Date: 2023-06-30

Contract Duration: 2,471 days

Daily Burn Rate: $40.0K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 1

Pricing Type: COST PLUS FIXED FEE

Sector: R&D

Official Description: IGF::OT::IGF / COMPREHENSIVE PRIMARY CARE PLUS (CPC+) EVALUATION CONTRACT

Place of Performance

Location: WASHINGTON, DISTRICT OF COLUMBIA County, DISTRICT OF COLUMBIA, 20009

State: District of Columbia Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $98.9 million to MATHEMATICA INC. for work described as: IGF::OT::IGF / COMPREHENSIVE PRIMARY CARE PLUS (CPC+) EVALUATION CONTRACT Key points: 1. Contract focuses on evaluating the Comprehensive Primary Care Plus (CPC+) initiative, a significant program aimed at improving primary care. 2. The contract duration is substantial, spanning over 2000 days, indicating a long-term commitment to the evaluation. 3. Awarded under full and open competition, suggesting a broad market search for qualified contractors. 4. The contract type is Cost Plus Fixed Fee, which can incentivize cost control while allowing for flexibility. 5. Mathematica Inc. has a track record in health services research and evaluation, suggesting relevant expertise. 6. The contract's geographic scope is national, impacting primary care practices across the United States. 7. The value of the contract is significant, reflecting the complexity and importance of evaluating a large-scale healthcare initiative.

Value Assessment

Rating: good

The contract value of $98.9 million over approximately 6.8 years for a comprehensive evaluation of a major healthcare initiative appears reasonable. Benchmarking against similar large-scale program evaluations by CMS or other federal agencies would provide further context. The Cost Plus Fixed Fee structure allows for cost reimbursement plus a predetermined profit, which can be appropriate for research and development where the scope may evolve. However, without specific cost breakdowns or performance metrics, a definitive value-for-money assessment is challenging.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, indicating that multiple interested parties had the opportunity to bid. This process is designed to foster a competitive environment, potentially leading to better pricing and innovative solutions. The number of bidders is not specified, but the 'full and open' designation suggests a robust competition was sought.

Taxpayer Impact: A full and open competition generally benefits taxpayers by encouraging a wider range of proposals and potentially driving down costs through market forces, ensuring federal dollars are used efficiently.

Public Impact

Primary care providers participating in the CPC+ initiative will benefit from the evaluation's insights, which can inform future program design and improvements. The evaluation services delivered will assess the effectiveness and impact of the CPC+ model on patient outcomes, healthcare costs, and provider experiences. The geographic impact is national, as the CPC+ initiative and its evaluation cover practices across the United States. The contract supports a workforce of researchers, analysts, and subject matter experts within Mathematica Inc. and potentially subcontractors, contributing to the health services research sector.

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.
The long duration of the contract could lead to scope creep or require significant adaptation to evolving healthcare landscapes.
Ensuring the evaluation methodology is robust and unbiased is critical for the validity of the findings.

Positive Signals

Awarded through full and open competition, suggesting a competitive process that should yield good value.
Mathematica Inc. is a reputable research firm with experience in health policy and program evaluation.
The contract aims to evaluate a significant initiative designed to improve primary care, aligning with federal health priorities.

Sector Analysis

This contract falls within the Research and Development sector, specifically focusing on social sciences and humanities, with a strong emphasis on healthcare policy and program evaluation. The market for health services research and evaluation is substantial, with numerous firms competing for federal contracts. This award to Mathematica Inc. positions them as a key player in evaluating large-scale federal health initiatives, such as those managed by CMS.

Small Business Impact

The provided data indicates that small business participation (ss and sb fields) was not a specific set-aside or requirement for this contract. Therefore, the direct impact on small businesses through set-asides is likely minimal. However, large prime contractors like Mathematica Inc. often engage small businesses as subcontractors for specialized services, which could provide indirect opportunities.

Oversight & Accountability

Oversight for this contract would typically be managed by the Centers for Medicare and Medicaid Services (CMS) through contract officers and technical representatives. The Cost Plus Fixed Fee structure necessitates diligent monitoring of costs and performance to ensure adherence to the contract's objectives and budget. Transparency would be facilitated through regular reporting requirements and potentially public dissemination of evaluation findings, subject to data privacy and confidentiality regulations.

Related Government Programs

Comprehensive Primary Care Plus (CPC+)
Medicare Quality Payment Program
Health Care Innovation Awards
Center for Medicare & Medicaid Innovation (CMMI) Evaluations

Risk Flags

Long contract duration may increase risk of scope creep or obsolescence.
Cost Plus Fixed Fee contracts require diligent oversight to manage costs effectively.
Ensuring robust and unbiased evaluation methodology is critical for meaningful results.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $98.9 million to MATHEMATICA INC.. IGF::OT::IGF / COMPREHENSIVE PRIMARY CARE PLUS (CPC+) EVALUATION CONTRACT

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 $98.9 million.

What is the period of performance?

Start: 2016-09-23. End: 2023-06-30.

What is Mathematica Inc.'s track record with federal health evaluation contracts?

Mathematica Inc. has a long-standing reputation and extensive experience in conducting large-scale evaluations of federal health programs. They have been a significant contractor for agencies like CMS, HHS, and others, evaluating initiatives related to Medicare, Medicaid, health insurance marketplaces, and public health programs. Their portfolio includes work on payment reform models, quality improvement initiatives, and health services research. This history suggests a deep understanding of federal contracting processes, regulatory environments, and the complexities of health policy evaluation, making them a well-qualified entity for this CPC+ evaluation contract.

How does the Cost Plus Fixed Fee (CPFF) contract type compare to other options for this type of evaluation?

The Cost Plus Fixed Fee (CPFF) contract type is often used for research and development or services where the scope of work is not precisely defined at the outset, allowing for flexibility as the project evolves. In this case, evaluating a complex initiative like CPC+ might involve unforeseen challenges or require adjustments to the evaluation methodology. CPFF reimburses the contractor for allowable costs and pays a fixed fee representing profit. Compared to a Firm-Fixed-Price (FFP) contract, CPFF offers more flexibility but potentially less cost certainty for the government. Compared to a Cost-Plus-Incentive-Fee (CPIF) contract, CPFF has a fixed profit rather than one that can be adjusted based on performance targets, which might offer less incentive for exceptional cost control or performance.

What are the key performance indicators (KPIs) or deliverables expected under this contract?

While specific KPIs and deliverables are detailed within the contract's Statement of Work (SOW), typical expectations for a comprehensive program evaluation like this would include interim progress reports, detailed evaluation plans, data collection instruments, analysis of collected data, and a final comprehensive evaluation report. These reports would likely assess the effectiveness of the CPC+ model in achieving its goals, such as improving patient outcomes, reducing healthcare costs, enhancing patient and provider experience, and assessing the scalability and sustainability of the model. Performance would be measured against the successful completion and quality of these deliverables according to the agreed-upon schedule and standards.

What is the historical spending trend for similar large-scale healthcare program evaluations by CMS?

CMS frequently awards large contracts for the evaluation of its innovative payment and delivery system models. Historically, contracts for comprehensive evaluations of multi-year, multi-state initiatives have ranged from tens of millions to over a hundred million dollars. For instance, evaluations of programs like the Medicare Health Care Quality Demonstration Projects or Accountable Care Organizations (ACOs) have often involved significant funding. The $98.9 million awarded for the CPC+ evaluation is consistent with the scale and complexity of such endeavors, reflecting the extensive research, data analysis, and reporting required to assess major healthcare reforms.

What are the potential risks associated with the long duration (2471 days) of this contract?

A contract duration of over six years presents several potential risks. Firstly, the healthcare landscape, including policy priorities and clinical practices, can change significantly over this period, potentially making the initial evaluation framework less relevant or requiring substantial modifications. Secondly, maintaining consistent project management and key personnel continuity over such a long term can be challenging, potentially impacting the quality and consistency of the evaluation. Thirdly, there's a risk of scope creep if the objectives or methodologies are not tightly managed, leading to increased costs beyond the initial estimates. Finally, the government's needs or budget priorities might shift, creating pressure to alter or terminate the contract prematurely.

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: $98,894,731

Exercised Options: $98,894,731

Current Obligation: $98,894,731

Actual Outlays: $19,837,600

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