The Centers for Medicare and Medicaid Services (CMS) plans to contract with an organization to help CMS modernize the business processes, information technology, data, and planning and analytical capabilities used to manage Medicare, Medicaid, and health reform at the federal level. Today, CMS faces extraordinary policy and management challenges and must face them with inadequate, disconnected, largely antiquated tools. CMS’ plan to hire a contractor is an excellent move forward.

In federal parlance, such a contractor is a Federally Funded Research and Development Center (FFRDC). FFRDC’s are typically a university or non-profit think tank but may also be an “industrial firm.” It may be a separate operating unit of a parent organization.

An RFP is expected in summer of 2011, but CMS has identified a broad, ambitious scope of work. CMS envisions a broad range of tasks, including strategic and tactical planning, conceptual planning, design and engineering, procurement assistance, organizational planning, research and development, continuous process improvement, and security planning. The contractor will also provide analysis, expert advice, and guidance on program and project management.

Other agencies in the Department of Health and Human Services (HHS) – such as the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH) – could also use the services and likely will.  The broad preliminary scope of scope suggests an intention by HHS to modernize and integrate systems across HHS agencies.

Based on CMS notices in the Federal Register, the scope of work to help CMS modernize and beef up its internal capabilities is expected to include:

  1. Strategic and tactical planning including assisting with planning for future CMS program policy, innovation, development, and support for Medicare and Medicaid.
  2. Conceptual planning including operations, analysis, requirements, procedures, and analytic support.
  3. Design and engineering services including technical architecture direction.
  4. Procurement assistance, review and recommendations for current contract processes, including contract reform, technical guidance, price and cost estimating, support and source selection evaluation support.
  5. Organizational planning including functional and gap analysis.
  6. Research and development, assessment of new technologies and advice on medical and technical innovation and health information.
  7. Continuous process improvement, recommendations, and implementation of best practices.
  8. Security including Security Assessments and Security Test and Evaluations (ST&E).
  9. Identify, define, and resolve problems as an integral part of CMS’ management team.
  10. Independent analysis about CMS vulnerabilities and the effectiveness of Medicare, Medicaid, and health reform systems and future healthcare initiatives.
  11. Providing intra-departmental and inter-agency cross-cutting, risk-informed analysis of alternative resource approaches.
  12. Developing and deploying analytical tools and techniques to evaluate system alternatives (e.g., policy-operations-technology tradeoffs), and life-cycle costs that have broad application across CMS.
  13. Developing measurable performance metrics, models, and simulations for determining progress in securing CMS and other HHS data or other authorized data sources, including non-HHS data sources often used by CMS such as U.S. Census, Department of Labor, Veterans Health Administration, and Department of Defense (TRICARE).
  14. Providing independent and objective operational test and evaluation analysis support.
  15. Developing recommendations for guidance on the best practices for standards, particularly to improve the inter-operability of HHS components.
  16. Assessing technologies and evaluating technology test-beds for accurate simulation of operational conditions and delivery system innovation models.
  17. Supporting critical thinking about the HHS enterprise, business intelligence and analytic tools that can be applied consistently across HHS and CMS programs.
  18. Supporting systems integration, data management, and data exchange that contribute to a larger HHS intra and inter-agency enterprise as well as collaboration with State, local, and tribal governments; the business
    sector; academia; and the public.
  19. Providing recommendations for standards for top-level CMS and other HHS systems requirements and performance metrics best practices for an integrated HHS approach to systems solutions and structured and unstructured data architecture.
  20. Understanding key HHS organizations and their specific role and major acquisition requirements.  Support CMS other HHS agencies in the requirements development phase of the acquisition lifecycle