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
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 Services › Management, Scientific, and Technical Consulting Services › Administrative 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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