HHS awarded $17.1M for Medicare Episode Grouper services, with Brandeis University as the contractor

Contract Overview

Contract Amount: $17,103,781 ($17.1M)

Contractor: Brandeis University

Awarding Agency: Department of Health and Human Services

Start Date: 2010-09-30

End Date: 2016-05-31

Contract Duration: 2,070 days

Daily Burn Rate: $8.3K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 6

Pricing Type: COST PLUS FIXED FEE

Sector: Healthcare

Official Description: TAS::75 0511::TAS EPISODE GROUPER FOR MEDICARE

Place of Performance

Location: WALTHAM, MIDDLESEX County, MASSACHUSETTS, 02454

State: Massachusetts Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $17.1 million to BRANDEIS UNIVERSITY for work described as: TAS::75 0511::TAS EPISODE GROUPER FOR MEDICARE Key points: 1. The contract's value of $17.1 million over its period of performance suggests a significant investment in healthcare data analytics. 2. The use of a 'Cost Plus Fixed Fee' contract type indicates potential for cost overruns if not closely managed. 3. The duration of the contract (2070 days) points to a long-term need for these specialized services. 4. The primary agency involved is the Centers for Medicare and Medicaid Services (CMS), highlighting the focus on healthcare program integrity. 5. The award to Brandeis University, an academic institution, suggests a reliance on research and specialized expertise for this task.

Value Assessment

Rating: fair

Benchmarking the value of this $17.1 million contract is challenging without specific details on the scope of 'TAS EPISODE GROUPER FOR MEDICARE' services. However, the Cost Plus Fixed Fee (CPFF) contract type can sometimes lead to higher costs compared to fixed-price contracts if not managed diligently. The duration of the contract (over 5 years) suggests a substantial project, and the pricing would need to be assessed against the deliverables and the complexity of Medicare data analysis.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under 'FULL AND OPEN COMPETITION,' indicating that multiple bidders had the opportunity to submit proposals. The presence of 6 bidders suggests a reasonably competitive environment for this type of specialized service. A competitive process is generally expected to yield better pricing and value for the government.

Taxpayer Impact: A full and open competition is beneficial for taxpayers as it encourages a wider range of solutions and potentially drives down costs through market forces.

Public Impact

Beneficiaries of this contract include Medicare beneficiaries, as the episode grouper is intended to improve the efficiency and effectiveness of Medicare payments. The services delivered are crucial for the operational integrity and financial management of the Medicare program. The geographic impact is national, affecting Medicare operations across the United States. The contract supports academic research and specialized analytical capabilities within the healthcare sector.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

The Cost Plus Fixed Fee (CPFF) contract type carries inherent risks of cost escalation if not rigorously monitored.
The long contract duration (2070 days) necessitates sustained oversight to ensure continued relevance and performance.
The complexity of Medicare data and episode grouping requires specialized expertise, and performance issues could impact program integrity.

Positive Signals

Awarded through full and open competition, suggesting a robust selection process and potential for competitive pricing.
The contractor, Brandeis University, likely brings significant academic and research expertise to the task.
The contract's focus on improving Medicare operations indicates a commitment to enhancing healthcare delivery and efficiency.

Sector Analysis

This contract falls within the Health Information Technology and Services sector, specifically focusing on data analytics for healthcare program management. The market for such services involves specialized firms and academic institutions capable of handling large, complex healthcare datasets. Comparable spending benchmarks would typically be found in contracts related to healthcare data analysis, payment integrity, and program evaluation within federal health agencies.

Small Business Impact

There is no indication from the provided data that this contract involved small business set-asides or significant subcontracting opportunities for small businesses. The award to a large academic institution suggests the primary focus was on specialized expertise rather than small business participation.

Oversight & Accountability

Oversight for this contract would primarily reside with the Centers for Medicare and Medicaid Services (CMS). As a definitive contract awarded through full and open competition, it is subject to standard federal procurement regulations and oversight mechanisms. Transparency would be expected through contract award databases and potentially through program performance reports, though specific details on accountability measures are not provided.

Related Government Programs

Medicare Payment Advisory Commission (MedPAC)
Centers for Medicare and Medicaid Services (CMS) Data Analytics Initiatives
Healthcare Data Standards and Interoperability Programs
Federal Health IT Spending

Risk Flags

Cost Plus Fixed Fee contract type requires diligent oversight to manage potential cost overruns.
Long contract duration necessitates sustained performance monitoring and adaptation to evolving needs.
Complexity of healthcare data analytics requires specialized expertise and robust quality control.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $17.1 million to BRANDEIS UNIVERSITY. TAS::75 0511::TAS EPISODE GROUPER FOR MEDICARE

Who is the contractor on this award?

The obligated recipient is BRANDEIS UNIVERSITY.

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 $17.1 million.

What is the period of performance?

Start: 2010-09-30. End: 2016-05-31.

What specific functionalities does the 'TAS EPISODE GROUPER FOR MEDICARE' provide, and how do they contribute to Medicare's operational goals?

The 'TAS EPISODE GROUPER FOR MEDICARE' likely refers to a system or methodology used by the Centers for Medicare and Medicaid Services (CMS) to categorize patient healthcare episodes into distinct, clinically meaningful groups. These episode groups are crucial for various Medicare initiatives, including bundled payment models, quality measurement, and program integrity efforts. By grouping services related to a specific condition or procedure into a single 'episode,' CMS can better assess the total cost and quality of care provided. This facilitates the transition from fee-for-service to value-based care by allowing for more accurate cost attribution and performance evaluation. The specific functionalities would involve complex algorithms to assign claims data to appropriate episode definitions, considering factors like diagnosis, procedures, dates of service, and provider types.

How does Brandeis University's expertise align with the requirements of developing and maintaining a Medicare episode grouper?

Brandeis University, through its Heller School for Social Policy and Management and other research centers, possesses significant expertise in health policy, healthcare economics, and data analysis. This academic background is well-suited for developing and refining complex methodologies like episode grouping, which require a deep understanding of healthcare systems, clinical pathways, and statistical modeling. Universities often engage in research that informs policy and program design, making them ideal partners for agencies like CMS seeking evidence-based solutions. Brandeis's involvement suggests a focus on the analytical rigor, research-backed development, and potential for long-term refinement of the episode grouper, ensuring it remains aligned with evolving healthcare practices and CMS objectives.

What are the potential risks associated with a Cost Plus Fixed Fee (CPFF) contract for a service like Medicare episode grouping?

A Cost Plus Fixed Fee (CPFF) contract, while allowing for flexibility in scope, carries inherent risks for the government. The primary risk is that the contractor may have less incentive to control costs compared to a fixed-price contract, as the government reimburses allowable costs plus a predetermined fixed fee. If the contractor's costs exceed initial estimates, the government bears that additional expense. For a complex service like Medicare episode grouping, unforeseen technical challenges or data complexities could lead to cost overruns. Effective oversight by CMS is critical to scrutinize allowable costs, ensure efficiency, and prevent scope creep that could inflate the final price beyond the initial expectations. Without stringent management, CPFF contracts can become more expensive than anticipated.

Given the $17.1 million award and a performance period of over 5 years, how does this spending compare to similar federal investments in healthcare data analytics?

The $17.1 million awarded over approximately 5.7 years (2070 days) translates to an average annual expenditure of roughly $3 million. This figure is moderate within the broader landscape of federal healthcare IT and data analytics spending. Large-scale federal health initiatives, such as the development of national health information exchanges, electronic health record mandates, or major data warehousing projects, often involve hundreds of millions or even billions of dollars. However, for a specialized service like developing and maintaining a specific episode grouper, $3 million annually is a reasonable investment, reflecting the need for expert analysis and ongoing refinement of complex algorithms. It suggests a focused, targeted investment rather than a broad, enterprise-wide system overhaul.

What does the 'MASSACHUSETTS' state code (ST: MA) signify in the context of this federal contract award?

The 'MASSACHUSETTS' state code (ST: MA) indicates the primary location of the contractor, Brandeis University, which is situated in Waltham, Massachusetts. In the context of federal contract awards, this information is often used for statistical tracking, economic impact analysis, and understanding the geographic distribution of federal spending. While the services provided are likely national in scope for Medicare, the award contributes to the economic activity within Massachusetts through employment, resource utilization, and indirect economic effects associated with the university's operations and research activities.

Industry Classification

NAICS: Educational Services › Colleges, Universities, and Professional Schools › Colleges, Universities, and Professional Schools

Product/Service Code: RESEARCH AND DEVELOPMENT › N – Health R&D Services

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Offers Received: 6

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 415 SOUTH ST MAILSTOP 048, WALTHAM, MA, 02453

Business Categories: Category Business, Corporate Entity Tax Exempt, Educational Institution, Higher Education, Nonprofit Organization, Not Designated a Small Business, Higher Education (Private), Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $17,103,781

Exercised Options: $17,103,781

Current Obligation: $17,103,781

Subaward Activity

Number of Subawards: 66

Total Subaward Amount: $80,789,692

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: YES

Timeline