TRICARE Quality Monitoring Contract (TQMC)   3

In accordance with Federal Acquisition Regulation (FAR) 5.2, Synopses of Proposed Contract Actions, this synopsis provides notice to potential offerors that the DHA Managed Care Contracting Division is preparing to issue the TRICARE Quality Monitoring Contract (TQMC) solicitation.

Date: 2 June 2022

Year: 2022

Contracting Office ZIP Code: 80011-9066

Product or Service Code: R408

NAICS: 541611

Contracting Office Address: 16401 E. Centretech Parkway, Aurora, Colorado

Subject: TRICARE Quality Monitoring Contract

Proposed Solicitation Number: HT940222R0002

Contact Point: Kristin Moore

Place of Contract Performance: TBD based on Contractor location (nationwide)

Set-aside Status: None (Full and open competition)

Description:

The Defense Health Agency (DHA) is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force Medical Services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime. The DHA supports the delivery of integrated, affordable, and high quality health services to approximately 9.6 million Military Health System (MHS) beneficiaries and is responsible for driving greater integration of clinical and business processes across the MHS. The DHA oversees the military Medical Treatment Facilities (MTFs), TRICARE health plan, and medical resources. DHA works in collaboration with the Service Surgeons General to support the readiness mission.

The MHS is a complex integrated healthcare system that consists of healthcare delivery, medical education, public health, private sector partnerships and innovative medical research and development. The MHS has two major care delivery systems. The direct care system is in the process of implementing a congressionally mandated transition. DHA will oversee the provision of care through military MTFs while the Services focus on readiness and care provided in the operational healthcare units. The private sector care system provides care through private sector contractors including the Managed Care Support Contracts (MCSCs); the Designated Providers (DPs) under the Uniformed Services Family Health Plan (USFHP); the TRICARE Medicare Eligible Program (TMEP); TRICARE Dental Program (TDP); TRICARE Retiree Dental Program (TRDP) and the TRICARE Pharmacy Program (TPharm).

All private sector-care contracts stated above are applicable to this effort.

This effort meets the regulatory requirements of TRICARE's Quality and Utilization

Peer Review Organization Program, 32 Code of Federal Regulations (CFR), Section 199.15; Department of Defense (DoD) Instruction 6025.13, Medical Quality Assurance and Clinical Quality Management in the Military Health System and DHA Procedural Manual (PM) 6025.13 Clinical Quality Management in the Military Health System (MHS).

The purpose of this requirement is to assist DHA Health Care Administration Directorates for Medical Affairs and Health Care Operations in assessing and improving the safety and quality of care delivered under the TRICARE benefit across the direct and private sector care systems. This effort will assist DHA in decreasing unwarranted variation in the quality of medical care, implementing proven clinical and healthcare business practices, and creating an environment for learning and continuous improvement across the MHS. This effort will also support DHA with the management of clinical quality measurement to validate the quality of care.

TRICARE quality monitoring is accomplished through a variety of tasks supporting the direct care and private sector care systems. The tasks include external, third party data collection, analysis and reporting of clinical quality measures, and comparison with national healthcare benchmarks; reviewing, evaluating, and reporting on published clinical care studies, evolving practices, and other data to identify superior quality healthcare services and recommend means to transfer successes; and conducting comprehensive, timely medical peer reviews to ensure medically-appropriate healthcare is provided per 32 CFR 199.

DHA intends to issue the solicitation under full and open competition in a best-value tradeoff source selection for a single award indefinite-delivery/indefinite-quantity (IDIQ) contract in accordance with FAR Part 15 as supplemented. The anticipated period of performance will be 5 years and 5 months.