CMS Q

uality Programs

Request for Information

Industry EventO

CTOBER 5, 2017

DENN

IS WA

GN

ER, MPA

DIREC

TOR, Q

UALITY IM

PROVEM

ENT & IN

NO

VATIO

N G

ROUP

CEN

TERS FOR M

EDICA

RE & MEDIC

AID SERVIC

ES U.S. DEPA

RTMEN

T OF HEA

LTH & HUMA

N SERVIC

ES

2A

genda

Welcom

e :15Fram

ing Our W

ork :15Q

I Programs :15

Contracting O

verview :15

Break :20Q

uestion Response :25N

ext Steps & Close :15

3Introd

uction of Today’s Speakers

Jeneen IwugoDeputy Director,

QIIG

Dr. Paul McGannChief Medical

Officer for Quality

Improvement, QIIG

Kim TatumContracting Officer, Division of Quality

Contracts,OAGM

Phyllis LewisDirector, Division of Quality Contracts,

OAGM

Traci ArchibaldDivision Director of ESRD, Population and Community

Health, QIIG

Greg GesterlingContractor

Compliance Officer, Policy, Quality, Data &

Systems, OAGM

4Poll –

Who’s In the A

udience

XTell us w

hat sta

keholder group

you represent?

XQ

IN-Q

IO

XH

IIN

XESRD

Netw

orks

XTC

PI

XO

ther

XTell us how

ma

ny peop

le are in the room

pa

rticipa

ting with you.

X1 (you)

X2

X3

X4

X5 or m

ore

5W

e get more of w

hat we focus on…

XFocus on p

roblem

s –m

ore problems

XFocus on success –

more success

XFocus on w

hat works -m

ore of wha

t works

XFocus on good

stories –m

ore good stories

XFocus on good

results –m

ore good results

We can choose w

hat we focus on!

6M

indset…

Net Forw

ard Energy

7Q

uestions To Run On –

CM

S Plans to

Answ

er These Questions in this Session

XW

hy is CM

S conducting a

n RFI and Ind

ustry Day?

XW

hat are em

erging HH

S/CM

S/CC

SQ/Q

IIG goa

ls?X

Wha

t is a NQ

IIC?

XW

hat is C

MS looking for from

our NQ

IIC offerors?

XW

hat are the benefits of this a

pproach to contractors

and

to the government?

XW

hy is the structure of NQ

IIC im

portant to C

MS?

8Q

uestions for Industry D

ay Participants

XC

ontract type/vehiclea

. Is your organization interested

in pursuing work

under the new

NQ

IIC ID

IQ contract structure?

b. Which w

ork type or work types you are interested

in perform

ing?X

What w

ould incentivize your organization to submit a

proposal?X

What are the three highest priorities/desired outcom

es for future quality im

provement efforts that your

organization is ideally configured to generate?a. A

t what scale are you prepared

to work?

9Q

uestions for Industry D

ay Participants

XW

hat do you recomm

end and what innovative approaches have you

employed to address w

orkforce burden reduction?X

What innovative considerations/recom

mendations do you have

regarding structure, scale and scope of individual Quality

Improvem

ent Task Orders?

a. Wha

t innovative ideas d

o you have or has your organization

begun to test that could generate significant results?

XW

hat measures and m

easures systems do you m

ost recomm

end for us to track the im

provement from

our quality work?

XFor Q

IN-Q

IO Task O

rders that require geographic coverage: What

factors are important to you w

hen proposing to cover a geographic area of the country? W

hat suggestions do you have in structuring task orders to allow

for greatest flexibility and cost efficiencies?

10C

MS A

dm

inistrator Seema V

erma

“We w

ant

accounta

bility –

for outcom

es, not process.”

11O

ur End G

oal

Further Cha

nges in CM

S App

roaches to QI W

orkUsher in a N

ew Era

of FlexibilityX

Put Patients FirstX

Greater collabora

tion, transparency and a

ccountability X

Be far more flexible on the “how

” and tighter on the

“what” outcom

esX

Fewer, m

ore important m

easuresX

Focus on outcomes/results aligned

with C

MS &

HHS

overarching goals

XLess reporting, few

er deliverables, and

more im

provement

work

Framing O

ur Work

DR. PA

UL MC

GA

NN

, CHIEF M

EDIC

AL O

FFICER FO

R QUA

LITY IM

PROV

EMEN

T

JENEEN

IWUG

O, D

EPUTY DIREC

TOR, Q

IIG

TRAC

I ARC

HIBA

LD, D

IVISIO

N D

IRECTO

R FOR ESRD

, POPULA

TION

A

ND

CO

MM

UNITY H

EALTH

, QIIG

13Principles on w

hich our Programs

Operate

XA

ims create system

s, systems genera

te results

XW

e try to do m

ore of what w

orksX

We try to m

ake best-in-class

performa

nce, comm

on performa

nceX

Tight about the “w

hat”—O

utcome;

flexible on the “how”

XA

lwa

ys focus on Results

14H

ow is C

MS p

ositioned to a

chieve the H

HS/C

MS/C

CSQ

/QIIG

goa

ls?

15W

hat is a

NQ

IIC?

XServe as…X

Qua

lity improvem

ent expertsX

Cha

nge agents for healthcare

transforma

tion by achieving bold

aim

sX

Use data

-driven m

ethodologies

suitable for spread

16W

hat is C

MS looking

for from our

offerors?

XServicing m

ultiple area

s

XM

eeting the unique needs of the

population a

nd hea

lthcare provid

ers

17C

urrent QIN

-QIO

Regional M

ap from

11thSO

W

18C

urrent ESRD N

etworks

19C

urrent Landscape is C

omprised

of “Sets” of Sepa

rate Contracts

XC

MS anticipa

tes incorporating potential future quality im

provement w

ork into an Umbrella ID

IQ C

ontractX

CM

S anticipates that task orders und

er the new

Umbrella C

ontract w

ill be approached

in manner

similar to current Q

I work; exam

ples:X

QIO

Task Ord

ers: Industry-d

etermined

service areas, m

ultiple QIN

s, national support contracts to support the w

ork of QIN

s

XESRD

Netw

ork Task Ord

ers: Pre-determ

ined geographic

regions, multiple netw

orks, national support contracts to support the w

ork of ESRD N

etworks

20W

hat a

re the benefits of the

prop

osed ID

IQ Um

brella

ap

proa

ch to q

uality im

provem

ent work?

XPositions governm

ent and contractors to respond

quickly to cha

nging needs and

situationsX

Continues “inclusive” app

roach to tapping sp

ecial a

uthorities, expertise, and relationships of Q

IOs,

hospital a

ssociations, national provider associations a

nd others

XO

pens up multiple, abund

ant opportunities for organizations w

ith specialized

QI expertise to ha

ve ra

pid access to evolving Fed

eral QI need

sX

Flexibility to use different types of m

ore tailored

contracting options (firm

fixed price, cost + fixed

fee, others) w

ithin a single QI um

brella contract

21W

hy is the structure of NQ

IIC

imp

ortant to C

MS?

XProvid

es flexibilityX

Contract w

ill involve a broa

d range of

healthca

re quality im

provement

services involving data-d

riven initiatives to optim

ize health outcom

es for persons a

nd fa

milies w

hile supporting clinicians, provid

ers, patients, fam

ilies a

nd com

munities in im

proving health

and

healthca

re of the population they

serve.

22O

ur Approach to C

linical Quality

Improvem

ent Work

XUse Results-D

riven ap

proach to support successful and

m

eaningful Q

I initiatives

XFocus contra

cting on outcomes and

results, while

providing m

aximum

flexibility to offerors in “how” the

results are achievedX

Directly team

and w

ork with beneficiaries through

active Person/Patient a

nd Fa

mily Engagem

ent (PFE)X

Use data

to drive innova

tion and

changeX

Share data transpa

rently across qua

lity improvem

ent organizations a

nd provid

er organiza

tions

Quality

Improvem

ent Progra

ms

TRAC

I ARC

HIBA

LD, D

IVISIO

N D

IRECTO

R, ESRD, PO

PULATIO

N A

ND

C

OM

MUN

ITY HEALTH

, QIIG

24

Jul/Aug 2017Sept 2017-Feb 2018

Mar–Dec

2018

QIN

-QIO

ESRD

Hospital

Improvem

ent

•N

ew priorities

•Em

erging needs•

TBD

OTH

ER

Quality Im

provement

New

Under N

QIIC

is a Single Quality

Improvem

ent Umbrella C

ontract

Plus a More Integrated A

pproach to Cross-cutting Support C

ontracts: Evaluation, Patient and Fam

ily Engagement, C

ontent Development, m

ore

NQ

IIC

25Substantially D

ifferent Approa

ch via Q

uality Improvem

ent Umbrella

Contract

XA

ligned w

ith new C

MS &

HHS Goals &

PrioritiesX

Maxim

izing patient experience, engagement, choice

and

outcomes –

Put Patients First in genera

ting results that m

atter

XSupp

ort local/state leadership and

engagement

XFocus on outcom

es & results w

hile substantially increa

sing flexibility on “how

” outcomes are achieved

XEsta

blish ability to ad

d new and

evolving work efficiently

26Q

uality Innovation Netw

orks –Q

uality Improvem

ent Organizations

XStatutory requirem

entsX

Must ha

ve a governing bod

y that includes at lea

st one individual w

ho is a representa

tive of health care provid

ers and at least one individ

ual who is

representative of consum

ers.X

Must not be a health care facility, health care facility affiliate and

must not

subcontract with a

health ca

re facility to perform

any case review

activities except the qua

lity of care.

XM

ust not be a payor organiza

tion except as provided

in §475.105(a)(3).X

Must d

emonstra

te the ability to perform the functions of a Q

IO including

XFocused on results

XProvid

e quality improvem

ent support to wid

e variety of healthca

re organization typ

es: nursing hom

es, clinical practices, hospice, home health, hospitals

XSupp

ort providers in com

plying with qua

lity reporting requirements

XIntegra

tive work to connect the d

ots am

ong healthcare provid

er organizations on w

ork like com

munity coalitions to im

prove patient ca

re transitions and more

27End

Stage Renal Disease (ESRD

) N

etworks

XSta

tutory Mand

ate: Social Security A

ct §1881(c)created

the ESRD

Netw

orks to utilize quality improvem

ent to ensure quality

of care and

access to care for ESRD

patients

XESRD

Netw

orks focus on patient-centered care, rapid

cycle im

provement a

nd outcom

es

XESRD

Netw

orks transparently share data across netw

orks

XESRD

Netw

orks conduct perform

ance-based quality

improvem

ent activities

XIncreasingly focus on sm

aller set of key outcomes, and

greater reach to help all 6,000 d

ialysis facilities

28Hospital Im

provement &

Innovation Netw

ork

XPursue and

achieve quantitative AIM

s in results-based task

orders

XFocus on key priorities of the A

dm

inistration

XSustain national scope &

action of effective improvem

ent w

ork (e.g., with 80%

or more of all US hospitals)

XLead

in continuous improvem

ent and culture change

XUtilize sm

all set of key outcom

e measures and

transparent sharing of d

ata for rapid evolution and

improvem

ent

XBe prepared

with a flexible quality im

provement ID

IQ

contracting mechanism

that can respond to em

erging needs

29O

ur End G

oal

Further Cha

nges in CM

S Approaches to Q

I Work

Usher in a N

ew Era of Flexibility

XPut Pa

tients First

XG

reater collaboration, transparency and accountability

XBe far m

ore flexible on the “how” and

tighter on the “what”

outcomes

XFew

er, more im

portant measures

XFocus on outcom

es/results aligned w

ith CM

S & HHS overarching

goals

XLess reporting, few

er deliverables, and

more im

provement w

ork

30Potential A

reas Ripe for Action

Possible improvem

ent areas that have been generated

as a result of C

MS goals and

priorities include the

following:

XW

orkforce Burden Reduction

XIm

prove Behavioral Health, including O

pioid A

buseX

Improve Public Health, includ

ing Obesity Red

uctionX

Increase Patient SafetyX

Increase Q

uality of C

are TransitionsX

Long Term C

are

--Special Attention to Rural A

merica --

Contracting

Overview

PHYLLIS LEW

IS, CM

S DIREC

TOR, D

IVISIO

N O

F QUA

LITY CO

NTRA

CTS,

OA

GM

KIM TA

TUM, C

MS C

ON

TRAC

TING

OFFIC

ER, OA

GM

GREG

GESTERLIN

G, C

MS C

ON

TRAC

TOR C

OM

PLIAN

CE O

FFICER

32C

ontracting Overview

XRem

inder: this event is an op

en exchange w

ith industry and

no answ

ers given will be consid

ered

official or binding on the part of

the government

33W

hat is the NQ

IIC ID

IQ contract

structure?

XM

ultiple-awa

rd ID

IQ contracting

X“Um

brella” contra

cts to be established

with

multiple vend

ors

XFull a

nd open com

petition

XFa

ir Opportunity

XC

ost will be eva

luated

34N

QIIC

contractors under the ID

IQ

X“M

ini” competition for ID

IQ contra

ct hold

ersX

NQ

IIC ID

IQ w

ill encompass a

broad

er outrea

ch of work.

XO

fferors are not required

to propose on a

ll program

s. X

Period of Perform

ance und

er task ord

er aw

ard

s.

35Task O

rder C

ontract Types

FAR 16.5 a

uthorizes the use of any

appropriate cost or pricing arrangem

ent:X

Fixed-price C

ontracts

XC

ost-Reimbursem

ent Contracts

XIncentive C

ontracts X

Time-and

-ma

terials and Labor-hour

Contracts

XO

ption periods

36A

cquisition Schedule (1 of 2)

IDIQ

Aw

ard Sched

uleX

04/2018 –Release RFP in Fed

bizOpps

X04/2018 –

Preproposal Conference

X06/2018 –

Proposals D

ueX

08/17/18 –N

egotiationsX

12/2018 –A

wa

rd IDIQ

Contract

37A

cquisition Schedule (2 of 2)

Task Ord

er 0001 Aw

ard Sched

ule:X

12/2018 –Release RFP to ID

IQ

contractors

X1/2019 –

Preproposal C

onferenceX

2/2019 –Proposa

ls ReceivedX

4/2019 –N

egotiations X

7/2017 –A

wa

rd Ta

sk Ord

ers

38Q

IN 12

thSOW

Task Ord

er

XO

ne task order per aw

ard

eeX

No d

efining regionsX

Ensure fungibility where possible

across tasks and ta

sk order

XM

inimum

two states proposed

39C

onflict of Interest

XG

eneral conflicts

XSta

tutory Requirements

BREAK –

20 minutes

Question Response

CM

S LEAD

ERSHIP REPRESENTA

TIVES

42Q

uestions for Industry D

ay Participants

XC

ontract type/vehiclea

. Is your organization interested

in pursuing work

under the new

NQ

IIC ID

IQ contract structure?

b. Which w

ork type or work types you are interested

in perform

ing?X

What w

ould incentivize your organization to submit a

proposal?X

What are the three highest priorities/desired outcom

es for future quality im

provement efforts that your

organization is ideally configured to generate?a. A

t what scale are you prepared

to work?

43Q

uestions for Industry D

ay Participants

XW

hat do you recomm

end and what innovative approaches have

you employed to address w

orkforce burden reduction?X

What innovative considerations/recom

mendations do you have

regarding structure, scale and scope of individual Quality

Improvem

ent Task Orders?

a. Wha

t innovative ideas d

o you have or has your organization

begun to test that could generate significant results?

XW

hat measures and m

easures systems do you m

ost recomm

end for us to track the im

provement from

our quality work?

XFor Q

IN-Q

IO Task O

rders that require geographic coverage: What

factors are important to you w

hen proposing to cover a geographic area of the country? W

hat suggestions do you have in structuring task orders to allow

for greatest flexibility and cost efficiencies?

Next Steps

45N

ext Steps

XSubm

it feedba

ck on RFI questions by O

ctober 19 no later tha

n 4 pm ea

stern to N

QIIC

@cm

s.hhs.govX

Any new

informa

tion about these solicitations w

ill be ava

ilable on

FBO.gov

46

Thank you!N

QIIC

@C

MS.HHS.G

OV