HHS Awards $1.68B for Medicare Advantage Performance Measurement to National Committee for Quality Assurance

Contract Overview

Contract Amount: $16,827,113 ($16.8M)

Contractor: National Committee for Quality Assurance

Awarding Agency: Department of Health and Human Services

Start Date: 2021-09-29

End Date: 2026-09-28

Contract Duration: 1,825 days

Daily Burn Rate: $9.2K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 1

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: PERFORMANCE MEASUREMENT FOR THE MEDICARE ADVANTAGE PROGRAM

Place of Performance

Location: WASHINGTON, DISTRICT OF COLUMBIA County, DISTRICT OF COLUMBIA, 20005

State: District of Columbia Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $16.8 million to NATIONAL COMMITTEE FOR QUALITY ASSURANCE for work described as: PERFORMANCE MEASUREMENT FOR THE MEDICARE ADVANTAGE PROGRAM Key points: 1. Significant contract value highlights the importance of Medicare Advantage program oversight. 2. The National Committee for Quality Assurance (NCQA) is a key player in healthcare quality. 3. Potential risk lies in the long contract duration and reliance on a single entity for performance measurement. 4. This spending falls within administrative and management consulting services for healthcare.

Value Assessment

Rating: good

The contract value of $1.68 billion over five years is substantial. Benchmarking against similar large-scale performance measurement contracts is difficult due to the specialized nature of NCQA's role, but the pricing appears reasonable given the scope.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a competitive bidding process. This method is expected to yield fair pricing and ensure the best value for the government.

Taxpayer Impact: Taxpayers benefit from a competitive process that aims to secure quality performance measurement services at a reasonable cost, ensuring the integrity of the Medicare Advantage program.

Public Impact

Ensures quality standards for millions of Medicare beneficiaries enrolled in private plans. Supports the Centers for Medicare and Medicaid Services (CMS) in monitoring healthcare provider performance. Contributes to the overall efficiency and effectiveness of the healthcare system. Provides a basis for public reporting and consumer choice in Medicare Advantage plans.

Waste & Efficiency Indicators

Waste Risk Score: 92 / 10

Warning Flags

  • Long-term contract duration (5 years)
  • Sole entity for critical performance measurement

Positive Signals

  • Full and open competition
  • Established, reputable contractor
  • Firm Fixed Price contract type

Sector Analysis

This contract falls under administrative management and general management consulting services, specifically focused on healthcare quality. Spending benchmarks for such specialized services are often difficult to establish due to unique requirements and contractor expertise.

Small Business Impact

The data does not indicate any specific provisions or set-asides for small businesses in this contract. The nature of the work likely requires specialized expertise typically found in larger, established organizations.

Oversight & Accountability

The contract is managed by the Centers for Medicare and Medicaid Services (CMS), a key agency within HHS. Oversight would focus on ensuring NCQA meets performance metrics and delivers accurate, timely quality assessments.

Related Government Programs

  • Administrative Management and General Management Consulting Services
  • Department of Health and Human Services Contracting
  • Centers for Medicare and Medicaid Services Programs

Risk Flags

  • Contract duration
  • Potential for vendor lock-in
  • Reliance on a single source for critical function
  • Evolving healthcare landscape requires adaptable metrics

Tags

administrative-management-and-general-ma, department-of-health-and-human-services, dc, delivery-order, 10m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $16.8 million to NATIONAL COMMITTEE FOR QUALITY ASSURANCE. PERFORMANCE MEASUREMENT FOR THE MEDICARE ADVANTAGE PROGRAM

Who is the contractor on this award?

The obligated recipient is NATIONAL COMMITTEE FOR QUALITY ASSURANCE.

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 $16.8 million.

What is the period of performance?

Start: 2021-09-29. End: 2026-09-28.

What is the primary objective of this contract?

The primary objective is to establish and maintain performance measurement systems for the Medicare Advantage program. This involves developing, implementing, and overseeing quality metrics that assess the performance of Medicare Advantage organizations, ensuring beneficiaries receive high-quality care and that program funds are used effectively.

What are the main risks associated with this contract?

Key risks include over-reliance on a single entity (NCQA) for critical performance measurement, potential for stagnation in innovation if competition is limited in future renewals, and the challenge of ensuring the metrics remain relevant and effective as the healthcare landscape evolves. The long duration also poses a risk if performance issues arise.

How does this contract contribute to the effectiveness of the Medicare Advantage program?

This contract is crucial for the effectiveness of the Medicare Advantage program by providing objective, standardized measures of quality. These measurements allow CMS to monitor plan performance, identify areas for improvement, hold plans accountable, and provide beneficiaries with reliable information to make informed choices about their healthcare coverage.

Industry Classification

NAICS: Professional, Scientific, and Technical ServicesManagement, Scientific, and Technical Consulting ServicesAdministrative Management and General Management Consulting Services

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: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 1100 13TH ST NW FL 3, WASHINGTON, DC, 20005

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

Financial Breakdown

Contract Ceiling: $16,827,113

Exercised Options: $16,827,113

Current Obligation: $16,827,113

Actual Outlays: $14,855,918

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: GS10F0012Y

IDV Type: FSS

Timeline

Start Date: 2021-09-29

Current End Date: 2026-09-28

Potential End Date: 2026-09-28 00:00:00

Last Modified: 2025-09-04

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