80 FR 54287 - Notification of Single Source Cooperative Agreement Awards

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare and Medicaid Services

Federal Register Volume 80, Issue 174 (September 9, 2015)

The Center for Medicare and Medicaid Innovation (CMMI)/ Seamless Care Models Group will issue a single-source, cooperative agreement award to three (3) grantees to test a data aggregation model that combines data from insurance companies and Medicare in support of an innovative payment and service delivery initiative.

[Federal Register Volume 80, Number 174 (Wednesday, September 9, 2015)]
[Notices]
[Pages 54287-54288]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-22687]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare and Medicaid Services


Notification of Single Source Cooperative Agreement Awards

AGENCY: Centers for Medicare and Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: The Center for Medicare and Medicaid Innovation (CMMI)/
Seamless Care Models Group will issue a single-source, cooperative 
agreement award to three (3) grantees to test a data aggregation model 
that combines data from insurance companies and Medicare in support of 
an innovative payment and service delivery initiative.

FOR FURTHER INFORMATION CONTACT: Janel Jin, U.S. Department of Health 
and Human Services, Centers for Medicare & Medicaid Services, 7500 
Security Blvd., Baltimore, MD 21244, Phone: (410) 786-1438.

SUPPLEMENTARY INFORMATION: Intended Recipients: Rise Health, The Health 
Collaborative, and My Health.
    Purpose of Award: The Centers for Medicare & Medicaid Services 
(CMS) is authorized to test innovative payment

[[Page 54288]]

and service delivery models to reduce program expenditures under 
Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) 
while preserving or enhancing the quality of care furnished to 
individuals under such programs. In October 2012, CMS launched the 
Comprehensive Primary Care (CPC) initiative as a multi-payer 
demonstration to test a model that fosters collaboration between public 
and private health insurance companies (``payers'') to strengthen 
primary care. The program includes 479 participating primary care 
practices and 38 participating payers across 7 regional areas within 
the United States. The CMS Innovation Center executed a Memorandum of 
Understanding (MOU) with each participating payer within the 7 regional 
areas covered by the program. One of the stated goals in the MOU is 
improving the flow of cost and utilization data to CPC primary care 
practices. The test model will aggregate multi-payer data for each 
primary care practice rather than practices receiving the data 
individually from each payer.
    This single-source cooperative agreement award will allow the 
inclusion of Medicare data into the CPC multi-payer data model. The 
awardees will combine Medicare Fee-for-Service (FFS) data with 
utilization data from participating payers resulting in the creation of 
uniform and actionable reports to support physicians care coordination 
and quality improvement efforts.
    Amount of the Award: There will be three (3) single-source, 
cooperative agreements awarded in the initial amount of $200,000-
$450,000 per award for the first budget period. An award for a non-
competing continuation at $200,000-$450,000 may be awarded for a period 
of 12 months.
    Justification for Single Source Award: Commercial payers within the 
7 regions have agreed to work together to improve data-sharing to the 
CPC practices. Each of the awardees currently maintain contracts with 
all of the CPC payers for data-sharing and have worked with the payers 
and practices to develop business requirements for the CPC multi-payer 
claims database system. If CMS were to award another source, the vendor 
would not be aggregating Medicare claims data with claims data from the 
regional payers, as each of the payers have selected the three entities 
of this award to perform this function. Doing so would undermine the 
CPC practices' ability to improve care and lower costs through care 
coordination and quality improvement and is counter to CMS's MOU with 
the payers. In conclusion, the only entities capable of providing the 
data aggregation services described are the three entities identified 
for the single-source awards.
    Project Period: The anticipated period of performance for each 
cooperative agreement is 12 months from date of award with one 
continuation period of up to 12 months.
    Provisions of the Notice: Title: Testing a Model of Data 
Aggregation under the Comprehensive Primary Care (CPC) Initiative.
    CFDA Number: 93.646.
    Estimated Award Date: September 12, 2015.
    CMS has solicited proposal from Rise Health, The Health 
Collaborative, and My Health to include Medicare data into the multi-
payer data model of the CPC initiative.
    CMS requested the following to be submitted with each application:

1. Cover Letter
2. Project Abstract Summary
3. Project Narrative to address how the applicant will implement the 
cooperative agreement program in support of the goals of the 
Comprehensive Primary Care Initiative.
4. Budget Narrative
5. SF-424: Official Application for Federal Assistance
6. SF-424A: Budget Information Non-Construction
7. SF-424B: Assurances-Non-Construction Programs
8. SF-LLL: Disclosure of Lobbying Activities
9. Project Site Location Form(s) [as applicable]

    Applications will be reviewed using the following evaluation 
criteria:
    1. Proposed Approach--describe the development and implementation 
strategy for collecting and aggregating Medicare data with payer data 
from across the specified regions, including an anticipated timeline 
and activities associated with building the infrastructure needed to 
implement the project.
    2. Organizational Capacity and Management Plan--demonstrates 
sufficient infrastructure and capacity to plan and implement the 
cooperative agreement activities and associated funding.
    3. Evaluation and Reporting--overview of plans for quarterly 
reporting to CMS on the progress of the data aggregation activities 
funded under this cooperative agreement.
    4. Budget and Budget Narrative--provide a detailed cost breakdown 
with explanations and justifications for the proposed cooperative 
agreement activities.

    Authority: The CMS award is authorized under section 1115A of 
the Social Security Act, as added by Section 3021 of the Patient 
Protection and Affordable Care Act (P.L. 111-148) which permits the 
obligation of funding for CMS to design, implement, and evaluate 
innovative payment and service delivery models.

    Dated: September 1, 2015.
Daniel F. Kane,
Director, Office of Acquisition and Grants Management, Centers for 
Medicare & Medicaid Services.
[FR Doc. 2015-22687 Filed 9-8-15; 8:45 am]
 BILLING CODE 4120-01-P