HHS awarded Livanta LLC $75.8M for Medicare beneficiary healthcare quality improvement services

Contract Overview

Contract Amount: $75,788,989 ($75.8M)

Contractor: Livanta LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2014-05-08

End Date: 2019-09-07

Contract Duration: 1,948 days

Daily Burn Rate: $38.9K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 2

Pricing Type: COST PLUS FIXED FEE

Sector: Healthcare

Official Description: IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, QUALITY OF CARE REVIEWS, BENEFICIARY COMPLAINT REVIEWS, DISCHARGE AND TERMINATION OF SERVICE APPEALS IN VARIOUS PROVIDER SETTINGS, MEDICAL NECESSITY REVIEWS, AND EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) REVIEWS.AREA 5PERIOD OF PERFORMANCE: MAY 6, 2014 - MAY 5, 2019

Place of Performance

Location: ANNAPOLIS JUNCTION, HOWARD County, MARYLAND, 20701

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $75.8 million to LIVANTA LLC for work described as: IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, … Key points: 1. Contract focuses on improving healthcare services for Medicare beneficiaries through quality of care reviews and complaint resolutions. 2. Performance period spans over five years, indicating a long-term commitment to these essential healthcare oversight functions. 3. The contract was awarded under full and open competition, suggesting a robust selection process. 4. Services include medical necessity reviews and EMTALA compliance, critical for patient safety and access. 5. The contractor, Livanta LLC, is tasked with a broad range of statutory review functions.

Value Assessment

Rating: good

The total award amount of $75.8 million over approximately five years for comprehensive quality improvement services appears reasonable given the scope. Benchmarking against similar QIO contracts is challenging without more specific service breakdowns, but the breadth of statutory functions covered suggests a significant undertaking. The cost-plus-fixed-fee structure allows for flexibility while maintaining cost control, though it requires diligent oversight to ensure efficiency.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded through full and open competition, indicating that multiple qualified bidders had the opportunity to submit proposals. The presence of at least two bidders (as suggested by 'no': 2) implies a competitive environment that likely drove pricing and service offerings. This approach is generally favored for ensuring the government receives the best value.

Taxpayer Impact: Taxpayers benefit from a competitive process that aims to secure high-quality services at a fair price, reducing the risk of overpayment for essential Medicare oversight functions.

Public Impact

Medicare beneficiaries directly benefit from improved healthcare quality and timely resolution of complaints and appeals. Healthcare providers are subject to quality reviews, encouraging adherence to standards and best practices. The services impact healthcare delivery nationwide, ensuring consistent quality for Medicare enrollees. The contract supports a specialized workforce in healthcare quality assessment and review.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for scope creep in a cost-plus-fixed-fee contract requires vigilant monitoring.
Ensuring consistent quality of reviews across all provider settings and geographic areas is a challenge.
Managing the complexity of numerous statutory review functions demands robust contractor management.

Positive Signals

Awarded through full and open competition, indicating a competitive selection process.
The contract addresses critical aspects of healthcare quality and beneficiary rights.
A defined period of performance allows for structured program execution and evaluation.

Sector Analysis

This contract falls within the Management Consulting Services sector (NAICS 541618), specifically focusing on healthcare quality improvement and oversight. The market for such services is driven by government mandates and the need for independent review of healthcare providers serving federal programs like Medicare. Comparable spending benchmarks would involve other QIO contracts and similar government health program oversight contracts, which are substantial given the scale of federal healthcare spending.

Small Business Impact

The data indicates this contract was not set aside for small businesses (ss: false, sb: false). There is no explicit information on subcontracting plans for small businesses. Therefore, the direct impact on the small business ecosystem is likely minimal unless Livanta LLC voluntarily engages small businesses for specialized support.

Oversight & Accountability

Oversight is primarily managed by the Centers for Medicare and Medicaid Services (CMS), the awarding agency. The contract type (Cost Plus Fixed Fee) necessitates close financial and performance monitoring. While specific IG jurisdiction isn't detailed, the HHS IG typically oversees contracts of this nature, ensuring accountability and investigating potential fraud, waste, or abuse.

Related Government Programs

Medicare Quality Improvement Organization (QIO) Program
Beneficiary Complaint and Appeal Reviews
Healthcare Quality Measurement and Reporting
Medical Necessity Reviews
EMTALA Compliance Reviews

Risk Flags

Contract type (Cost Plus Fixed Fee) requires robust oversight to manage costs.
Broad scope of services necessitates clear performance metrics and monitoring.
Ensuring consistent quality of reviews across diverse healthcare settings.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $75.8 million to LIVANTA LLC. IGF::CT::IGFTHE PURPOSE OF THE BENEFICIARY AND FAMILY CENTERED CARE (BFCC) QUALITY IMPROVEMENT ORGANIZATION (QIO) CONTRACT IS TO IMPROVE HEALTHCARE SERVICES FOR MEDICARE BENEFICIARIES THROUGH BFCC PERFORMANCE OF NUMEROUS STATUTORY REVIEW FUNCTIONS, INCLUDING, BUT NOT LIMITED TO, QUALITY OF CARE REVIEWS, BENEFICIARY COMPLAINT REVIEWS, DISCHARGE AND TERMINATION OF SERVICE APPEALS IN VARIOUS PROVIDER SETTINGS, MEDICAL NECESSITY REVIEWS, AND EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA)

Who is the contractor on this award?

The obligated recipient is LIVANTA LLC.

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 $75.8 million.

What is the period of performance?

Start: 2014-05-08. End: 2019-09-07.

What is the historical spending trend for this specific Beneficiary and Family Centered Care (BFCC) QIO contract or similar contracts awarded to Livanta LLC?

The provided data reflects a single award of $75,788,989.38 for the period of May 6, 2014, to May 5, 2019, with an extended completion date of September 7, 2019. This represents the total value for this specific contract. To assess historical trends, one would need to examine prior QIO contracts awarded to Livanta LLC or other contractors performing similar functions, as well as subsequent QIO contracts. Analyzing year-over-year spending, contract modifications, and the number of active contracts over time would reveal spending patterns within the BFCC QIO program and Livanta's participation.

How does the per-unit cost of specific review functions (e.g., quality of care review, complaint review) compare to industry benchmarks or other QIO contracts?

The provided data does not include a breakdown of costs per specific service or review function, making a direct per-unit cost comparison impossible. The contract is a Cost Plus Fixed Fee (CPFF) type, covering a broad scope of statutory review functions. To perform such an analysis, detailed financial reports from the contractor and historical data from CMS on the volume and cost of individual review types would be necessary. Benchmarking would involve comparing these internal costs against publicly available data for similar services provided by other QIOs or private healthcare consulting firms specializing in regulatory compliance and quality assessment.

What is Livanta LLC's track record and past performance in delivering similar healthcare quality improvement services?

Livanta LLC was awarded this significant contract for BFCC QIO services, indicating they were deemed capable of performing these complex functions. A comprehensive assessment of their track record would require reviewing past performance evaluations (e.g., Contractor Performance Assessment Reporting System - CPARS), any prior contract history with CMS or other federal agencies related to quality improvement, and any documented instances of performance issues or successes. The fact that they secured this full and open competition contract suggests a positive or at least acceptable past performance record at the time of award.

What are the key performance indicators (KPIs) used to measure the success of this contract, and how has Livanta LLC performed against them?

The provided data does not specify the Key Performance Indicators (KPIs) established for this contract. Typically, QIO contracts include metrics related to the timeliness and quality of reviews, beneficiary satisfaction with complaint resolution, reduction in adverse events, and adherence to statutory requirements. Measuring Livanta's performance would involve accessing official performance reports, quality assurance reviews conducted by CMS, and potentially data on healthcare outcome improvements in the regions served. Without access to these specific performance metrics and evaluation reports, a definitive assessment of their success against KPIs cannot be made.

Are there any significant contract modifications or cost overruns associated with this contract, and what were the reasons?

The provided summary data does not detail any contract modifications or cost overruns. A thorough analysis would require reviewing the contract's official modification history. Significant modifications could indicate changes in scope, unforeseen challenges, or adjustments to the contract's financial terms. Cost overruns, if they occurred, would need to be justified by the contractor and approved by CMS, often requiring detailed explanations and documentation. The absence of readily available modification data in this summary suggests either a stable contract execution or that such details are not publicly surfaced in this particular data extract.

How does the geographic scope of Livanta LLC's service delivery under this contract compare to previous QIO contractors in Area 5?

The data specifies 'AREA 5' for this contract, indicating a defined geographic region. To compare this to previous QIO contractors, one would need to identify which entities previously held the QIO contract for Area 5 and review the geographic boundaries of their respective contracts. QIO contracts are often regional, and boundaries can shift over time due to contract consolidations, reorganizations, or changes in CMS's contracting strategy. Understanding these shifts is crucial for assessing continuity of service and potential impacts on healthcare providers and beneficiaries within Area 5.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Other Management Consulting Services

Product/Service Code: MEDICAL SERVICES › DEPENDENT MEDICARE SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: HHSM5002014RFPBFCCQIO

Offers Received: 2

Pricing Type: COST PLUS FIXED FEE (U)

Evaluated Preference: NONE

Contractor Details

Address: 9090 JUNCTION DRIVE STE 9, ANNAPOLIS JUNCTION, MD, 20701

Business Categories: Category Business, Limited Liability Corporation, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $75,788,989

Exercised Options: $75,788,989

Current Obligation: $75,788,989

Actual Outlays: $-60,107

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: YES

Timeline