AHRQ Quality Indicators Analysis and Support

Introduction: This is a Small Business Sources Sought notice (SBSS). This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this notice is to obtain information regarding: (1) the availability and capability of qualified small business sources; (2) whether they are small business; HUBZone small businesses; service-disabled, veteran-owned small businesses; 8(a) small businesses; veteran-owned small businesses; woman-owned small businesses; or small disadvantaged businesses; and (3) their size classification relative to the North American Industry Classification System (NAICS) code for the proposed acquisition. Your responses to the information requested will assist the Government in determining the appropriate acquisition method, including whether a set-aside is possible. An organization that is not considered a small business under the applicable NAICS code should not submit a response to this notice. Project Description and Requirements: The AHRQ Quality Indicators (QIs) are a suite of quality measures that are scientifically rigorous and clinically meaningful for use in quality improvement at the hospital and geographical area levels. The purpose of the QI Program is to produce quality measures, provide documentation of the measure specifications, as well as analytic or research products for the development, maintenance or refinement of quality measures resulting in the analytic code required to produce publicly available software for use by frontline clinicians in their quality improvement efforts. The nature and the uses of the AHRQ QIs have evolved considerably since inception. The original Quality Indicators were primarily used for quality improvement efforts and were based upon a "common denominator" hospital discharge data set, (i.e., using administrative data elements collected by hospital data systems through the Uniform Bill). The original set of measures focused on hospital outcomes and utilization and access to primary care, highlighting potential quality concerns, identifying areas that need further study and investigation and tracking changes over time. The AHRQ QIs take advantage of data enhancements, improvements in coding practices and advanced statistical methodologies, where possible. New data elements for which the evidence suggests inclusion in the measure specifications improves the accuracy and the reliability of the measures (e.g. Present on Admission (POA)). This level of rigor has moved the QI metrics from rudimentary measures to important quality improvement tools utilized by front line providers for improving hospital care, for screening of primary care access or outpatient services in a community, and for hospital comparison, among other uses. This complex set of metrics have been grouped into modules including the Prevention Quality Indicators (PQIs), Inpatient Quality Indicators (IQIs), Patient Safety Indicators (PSIs), and Pediatric Quality Indicators (PDIs). The AHRQ QIs are reported at one of two levels: the hospital level (IQIs, PSIs, and some PDIs) and the area level (PQIs, EDIs and some PDIs). Hospital level indicators provide measures of quality of hospital care and potentially preventable patient safety and adverse events. Area level Indicators capture all cases of the potentially preventable hospitalizations that occur in a given area (e.g., metropolitan service area or county). Area level indicators can be used with hospital inpatient discharge data to identify quality of care for “ambulatory care sensitive conditions.” Recently, area-level AHRQ QIs have been expanded to include potentially preventable patient safety and adverse events from Emergency Department (ED) visits. Area-level indicators capture all causes of potentially preventable hospitalizations and ED visits that occur in a given area (e.g., metropolitan service area or country). The focus of this task order is for both hospital and area-level indicators . More information is available at: www.qualityindicators.ahrq.gov. The QIs use multiple data sources, including those available through the Healthcare Cost and Utilization Project (HCUP), such as measures from the State Inpatient Database (SID) and the State Emergency Department Database (SEDD). The HCUP databases facilitate quality improvement, research, and policymaking on a broad range of health service issues including quality of health services, medical practice patterns, access to healthcare projects, hospital cost and utilization, and treatment outcomes at the national, state, and local market levels. Additional data sources including the Centers for Disease Control & Prevention Behavioral Risk Factor Surveillance System (BRFSS) and US Census are also required to generate the AHRQ QIs. AHRQ anticipates augmenting measurement capabilities with the use of other similar datasets in the future. Currently the AHRQ QIs require approximately 120,000 files, consuming an estimated 6 terabytes of data storage, exclusive of the database/data source sizes from which these files are generated. The AHRQ QIs are used by a multitude of provider types including state-based agencies, hospitals, policy makers and payers like the Centers for Medicare and Medicaid Services (CMS), as well as others interested in improving healthcare quality. AHRQ QIs enable research on a broad range of health service issues, including comparison of health care quality at individual hospitals to the national average, overall population health patterns across the United States, and identification of health care quality issues. AHRQ QIs must be scientifically sound, clinically meaningful and actionable to effectively meet the needs of users. AHRQ QIs are used to help hospitals identify potential problem areas that may need further study; provide the opportunity to assess quality of care inside and outside the hospital; include mortality indicators for conditions or procedures for which mortality can vary from hospital to hospital; include utilization indicators for procedures for which utilization varies across hospitals; and include volume indicators for procedures for which outcomes may be related to the volume of those procedures performed. AHRQ QIs can be used to help hospitals identify potential adverse events that might need further study; provide the opportunity to assess the incidence of adverse events and hospital complications; and include indicators for complications occurring in hospital that may represent patient safety events. Similarly, the AHRQ QIs are used by entities overseeing the healthcare quality of geographical areas. The field of quality measurement continues to evolve, and AHRQ continuously evaluates the need for refinement of the existing quality measures, the development of new measures, possibilities for data stratification and reporting (e.g., identification of disparities), as well as giving providers the ability to analyze their own data through the release of free software for the benefit of patients. The objectives of this project are for the Contractor to provide the following types of support for both hospital and area level AHRQ QIs: Evaluate changes to the International Classification of Disease, 10th Revision –Clinical Modification/ Procedure Coding System (ICD-10-CM/PCS) technical specifications as they relate to AHRQ QIs and identify refinements to measures and risk adjustment methodology as needed, using the latest scientific methods Research, develop, test, and maintain AHRQ QIs, including implementation of measures currently under development Provide accurate and scientifically robust documentation for AHRQ QIs Provide reports to document and support the methodology used to create and/or risk adjust the AHRQ QIs and other exploratory topics Develop Research Code (e.g., SAS) that Supports the Updates and Refinements to the AHRQ QIs Evaluate Scientific Acceptability of the AHRQ QIs Provide support and the necessary documentation for specifications and software testing towards the development of AHRQ QI Software for public use on an annual basis Provide technical support for all AHRQ QIs The Contractor shall demonstrate that they have the personnel, knowledge and experience to successfully complete required analytic & development tasks. The Contractor shall be required to coordinate the work of the AHRQ QI team and all QI Contractors. The Contractor shall be required to collaborate and communicate frequently with the AHRQ Task Order Officer (TOO) and any supporting contractors of the QI Program (e.g. other AHRQ contractors), including, but not limited to the QI Software Maintenance Contractor. The contractor shall be required to acquire needed data for the project on behalf of AHRQ and so potential respondents must be familiar with and able to manipulate large data sets like HCUP, U.S. Census Bureau, and Centers for Disease Control and Prevention (CDC) data. The Contractor shall demonstrate experience and knowledge with measure specifications focused on quality improvement for the purpose of identifying areas of quality concern and target areas for more intensive study. The Contractor shall also be aware of ICD-10-CM/PCS coding and updates in order to make refinements to measures and risk adjustment methods. The Contractor should also have expertise in sophisticated methodologies required for measure development, refinement, and maintenance. Contractors shall be required to compile a complete list of suggested changes to AHRQ hospital and area quality indicators from the coding updates, environmental scan, technical support feedback, national review committee feedback and stakeholder input; provide rationale for the proposed change (why the change is being suggested; document support for proposed changes from the scientific literature and expert advice; indicate the expected change in the magnitude and direction of the rate of the indicator; and estimate the level of effort, budget, and steps necessary to implement changes to the indicator. The Contractor shall be required to create a research SAS v. 2024 software by updating SAS v. 2023 with coding updates. As part of the refinement, calculation of numerators, denominators, observed, expected, risk adjusted and smoothed rates for each hospital and area-level indicators, using a consistent data year for numerators and denominators will need to be done. Estimates, as well as standard errors of the estimates are expected. The Contractor shall update risk-adjustment and risk-stratified models and smoothed rate calculations with each release of the hospital- and area-level AHRQ QIs. The Contractor shall also be required to provide analytic and clinical support to AHRQ QI users including providing explanations and methods for using hospital- and area-level AHRQ QIs, software tools, and documentation, and the identification/referral of relevant written hospital and area-level AHRQ QI reports 3) resolving technical issues identified by users. Anticipated Period of Performance: Base Period of 12 Months, plus 2 Option Periods (12 months each) Other important considerations: The Contractor shall have prior experience and demonstrated success in the areas of healthcare quality measure maintenance and development. Respondents shall have demonstrated the capabilities to make refinements to hospital- and area-level measures for quality improvements guided by validity and reliability statistical testing as well as clinical assessments of content validity. Information Sought: The tailored response to this Small Business Sources Sought notice should describe the requested information below. Respondents must provide, as part of their response, information concerning: a) Staff expertise, including their availability, experience, and formal and other training; b) Current in-house capability and capacity to perform the work at the scale/magnitude of the QI project; c) Corporate experience and management capability; d) Prior completed projects of similar size and nature that involve maintaining and managing multiple, multi-faceted activities concurrently at the highest level of professional and scientific quality; e) Examples of prior completed Government contracts, references, and other related information; and f) Any applicable Governmentwide Acquisition Contracting (GWAC) vehicle information (example: GSA Schedule and SIN). Respondents must demonstrate their understanding of the scientific properties of measurement at the hospital and area levels and the challenges of using inpatient data to identify quality of care within and outside the hospital setting using billing data. Key aspects of such an understanding include: a) ascertaining the scientific acceptability of existing quality measures at the hospital and area levels, such as assessment of validity and reliability through empirical analysis, and b) strengths and weakness of using administrative data for measurement at the hospital and area levels. Respondents must demonstrate their capacity in the areas of project management, data acquisition, and their ability to conduct evaluations to ensure scientific acceptability of quality improvements tasks, and their ability to make improvements to AHRQ QIs by conducting measure refinement using statistical, clinical, and other technical work Respondents must demonstrate their ability to create refined specifications, conduct risk adjustments, develop research code that support updates and refinement of AHRQ QIs. Respondents must describe their capacity and experience as it relates to the analytical and project management requirements described above. Information Submission Instructions: Interested qualified small business organizations should submit a tailored capability statement for this requirement. The cover page must include the following: UEI number Organization name Organization address Size and type of business (e.g., 8(a), HUBZone, etc.) pursuant to NAICS code 546111. Technical point(s) of contact, including names, titles, addresses, telephone, and e-mail addresses. All Capability Statements sent in response to this SMALL BUSINESS SOURCES SOUGHT notice must be submitted electronically (via e-mail) to Lisa Slavin Contract Specialist, [email protected] in MS Word, or Adobe Portable Document Format (PDF), no later than 11:00 AM EST on January 26, 2023. Responses should not exceed 10 single-sided pages (including the cover page, all attachments, resumes, charts, etc.) presented in single-space and using a 12-point font size minimum, that clearly details the ability to perform the aspects of the notice described above. Disclaimer and Important Notes: This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation will be published in Federal Business Opportunities. However, responses to this notice will not be considered adequate responses to a solicitation. Confidentiality: No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).