RFP 2015-19 Quality Rating System – Analysis and Implementation for Plan Year 2017 and 2018; Provider Cost and Quality Performance for Provider Directory

This contract tasks the awardee with designing, analyzing, and implementing a Quality Rating System (QRS) for Covered California’s Qualified Health Plans for Plan Years 2017‑2018, and with creating a provider‑directory component that displays cost and quality performance data. The work includes feasibility studies of regional QRS scores, analysis of HEDIS/CAHPS data, preparation of CMS proposals, development of business requirements for the Covered California website, and ongoing reporting and travel support. The contract is a fixed‑price maximum‑price arrangement ($200 K) with time‑and‑materials invoicing for approved deliverables and may be extended for one additional year. • Develop and implement QRS scoring methodology for statewide and regional plan ratings. • Design a consumer‑facing provider‑directory quality‑information service and related website integration. • Conduct data analysis (HEDIS, CAHPS) and prepare CMS sampling proposals, plus regular reporting and project management.