Single Source Procurement: Health Homes Analytics Platform (HHAP) & Delivery Systems Reform Incentive Payment Initiative (DSRIP)

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

Health Homes is a Medicaid state plan service recently added by the Affordable Care Act to develop a higher level of care coordination for Medicaid members with chronic medical and behavioral health conditions who due to lack of care management have historically utilized a significantly higher level of expensive Medicaid services than the Medicaid population as a whole.

A Health Home is a care management service model whereby all of an individual's caregivers communicate with one another so that all of a patient's needs are addressed in a comprehensive manner. This is done primarily through a "care manager" who oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to stay healthy, out of the emergency room and out of the hospital. Health records are shared among providers so that services are not duplicated or neglected. Health Home services are provided through a network of organizations – providers, health plans and community-based organizations. When all the services are considered collectively they become a virtual "Health Home."

The DSRIP Program is a five year initiative that is intended to transform the healthcare delivery system in New York and reduce costly avoidable hospital admissions by 25% over five years. Both critical programs were part of Governor Cuomo's Medicaid Redesign Team work. As technology planning started for DSRIP, DOH identified certain synergies that existed between it and the HHAP effort. During the process many common core building blocks were identified that could effectively support both programs.

These core required infrastructure components included:

  • Utilization of the HIPAA-compliant robust data infrastructure of the Medicaid Data Warehouse;
  • Access by the DSRIP providers to the Medicaid data; and
  • Utilization of the present Medicaid analytics product, Salient, enhanced with timely access to 3M developed and owned Clinical Risk Grouping (CRG) Software and HCI3 Evidence-Informed Care Rate (ECR) Software.

The Medicaid Analytics Performance Portal (MAPP) is a performance management system that will provide tools and program performance management technologies to Performing Provider Systems (PPS) in their effort to develop and implement transformative projects through the Delivery System Reform Incentive Payment (DSRIP) Program. Additionally, MAPP will support care management efforts for the State's Health Home (HH) program. Savings projected from the tools and systems associated with the MAPP are expected to exceed $2 Billion dollars over a five year period.

DOH's procurement analysis concluded that amendment of the present CMA contract is the proper, most advantageous and best means of securing the desired services as this approach reuses and leverages existing assets, present and unique NYS Medicaid Experience, and proven and successful technologies. The approach is also appropriate and necessary as the critical system capabilities noted herein are an extension of work already completed under the CMA contract, including, most notably, the expansion of Health Homes and MAPP deliverables. This approach will expedite the time to market for the completion of these important programs, helping the State to quickly realize the potential value and billions of dollars in savings that will accrue once complete.

Procurement / Program Name Health Homes and DSRIP Initiatives
Contractor Name(s) CMA Consulting Services, Inc.
Contract Period 2/01/2015 – 1/31/2017
Contract Number(s) C024937