TRICARE Quality Management Contract (TQMC)

The Defense Health Agency (DHA), DHA Contracting Activity (DHACA), Managed Care Contracting Division (MC-CD), awarded a Firm Fixed Price (FFP) Contract extension for TRICARE Quality Management Contract (TQMC) services to Keystone Peer Review Organization, Inc. (KEPRO), Harrisburg, PA on February 29, 2024 under contract HT9402-16-D-0002.

This contract extension was issued as a sole-source bridge in accordance with Federal Acquisition Regulation (FAR) 6.302-1, only one responsible source and no other supplies or services will satisfy agency requirements.

The period of performance will be from March 01, 2024 - June 30, 2024 with an option to extend services through February 28, 2025. The total potential period of performance is March 01, 2024 - February 28, 2025. The extension is necessary to prevent a gap in support to mission critical DHA requirements until a competitive follow-on contract is awarded and the awardee completes transition-in.

The purpose of TQMC is to assist DHA in decreasing unwarranted variation in the quality of medical care, implementing proven clinical and business practices, and creating an environment for learning and continuous improvement across the MHS. This contract also supports DHA with the management of clinical quality performance measurement to validate the quality of care.

This contract meets the regulatory requirements of TRICARE's Quality and Utilization Peer Review Organization Program, 32 Code of Federal Regulations (CFR), Section 199.15; and DOD Instruction and Manual 6025.13, Medical Quality Assurance and Clinical Quality Management in the Military Health System. TRICARE quality monitoring is accomplished through a variety of tasks supporting the direct care and purchased care systems.

These 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. The total estimated value of this four (4) month contract extension is $1,966,268.66, with a potential twelve (12) month value of $4,521,479.04.