How one great stakeholder meeting can shape a RFP response

cartoon6797The client was a Fortune 500 health care company getting ready to bid a Medicaid RFP in Texas. I was recruited to help design and build the model and the network that would be featured in their response.

The good news was that the market was Texas, and both my consulting colleague and I had years of experience working in Texas Medicaid. We knew the players at the state agency, we knew the incumbent health plans, and we had a firm grasp on the provider and community issues our clients were likely to face.

What we didn’t know was how tolerant our client was of change. If they were going to be successful in this bid, they would have to be willing to be flexible in the design of their solution and they were going to have trust us to get them the information they needed to make the right decisions.

Other key challenges.

  • They had recently settled a federal lawsuit. The issue itself happened years before but the former CEO and CFO were recently indicted – reviving the story and putting it back in the national headlines.
  • The company was simultaneously bidding two other markets. This meant the same corporate subject matter experts had to support three large projects. They were going to be stretched thin.
  • The political climate and the RFP favored incumbent health plans. Getting key stakeholders, major provider groups, and hospital systems to meet with a relatively unknown, out-of-state health plan who happened to be embroiled in a fraud dispute, was going to be a reach.

This case study focuses on steps I took to introduce my client to the market in a way that created an atmosphere of trust.

Phase 1: Pre-Work

Before talking to stakeholders, I drafted a comprehensive New Market Brief that served as a blueprint for my client. With input from my colleague and our client’s local lobbyist, we outlined key expectations of the state, a SWOT of the current incumbents, and our recommendations for how to proceed. This document was a useful tool to keep everyone updated on our strategy as we began the road tour.

Over the course of the next several weeks, my colleague and I crisscrossed the state, meeting with providers, hospital systems, academic medical centers, advocacy groups, regulators, legislators and community leaders. These meetings provided a wealth of feedback, opinion and regional nuances that were going to be important to the design process.

Phase 2: Choosing the A-Team

Armed with stakeholder feedback, it was time to switch gears and spend time educating the CEO on what we learned and begin the process of deciding which members of his team should take part in key stakeholder meetings.

This was a critical stage.

This was the first development project in years for the CEO, and he agreed that the old approach of forcing their existing model on Texas wasn’t going to win over the evaluators. He agreed with our advice, to let the market needs dictate the solution design.

Thinking this way was a significant cultural change for the organization. The CEO knew that some of his staff was going to embrace the change and others were going to fight it. With our inputs he selected a group of senior leaders that were open-minded and willing to listen.

Phase 3: The First Stakeholder Meeting

The success of this first stakeholder meeting was critical. Handled well, the corporate executives would invest the new solution design process. If it didn’t go well, there was a good chance they would resist the new idea, creating delays in the RFP writing process that we couldn’t afford.

After careful consideration, I handpicked stakeholders for this first meeting. I chose folks who cared for the most vulnerable populations – many of whom were not fans of managed care plans. Invited were agency heads of pediatric home health providers, social service agencies, behavioral health specialists and several advocacy groups.

Representing my client were the Chief Information Officer, Senior Vice President of Health Services and several other corporate executives who were part of the Bid Team.

I started the meeting by asking each of the stakeholders to walk through their challenges with Medicaid managed care – paying particular attention to what doesn’t work. I captured their feedback and then turned the conversation to my client’s team. I asked them to respond to what they heard and what their important takeaways might be.

What followed was very powerful.

The group began to bond over possible solutions and different approaches to work together. Later, I heard from my clients that it was the first time that many of them had met providers face to face. The Chief Information Officer in particular left the meeting with several ideas on how to remove barriers to care.

The meeting concluded successfully with valuable ideas exchanged and plans for follow-up meetings and conference calls.

Results.

  • Inspired by the successful stakeholder meeting, the bid team was freed up to start thinking big.
  • Meeting attendees returned to corporate headquarters, shared what they learned, and in many cases began work to remove operational and policy barriers to accommodate not only the solution design, but also to improve operations in existing markets.
  • This stakeholder meeting and several subsequent meetings were instrumental in getting the bid team insight they needed to shape a responsive model. It gave the RFP writers compelling content that demonstrated local knowledge and regional nuance.
  • The meeting improved internal collaboration. Relationships were strengthened as people worked cross-functionally to solve problems. Large parts of the Texas solution were transferred over to existing markets to improve operations.

Although my client eventually lost the bid (there were no awards to newcomers which was not unexpected), they received praise from the state evaluators for:

  • Responses that showed flexibility and an understanding of regional nuances,
  • A care management design that was flexible and inclusive of local providers, and
  • A willingness to travel and meet with stakeholders face-to-face.

The solution design process also highlighted areas of my client’s operations that needed attention. Specific actionable follow-ups allowed the corporate team to address issues before they became problems in other markets.

Lastly and perhaps, most importantly, the face-to-face meetings were so well received by many of the providers that they elected to participate in pilots and other programs under my client’s Medicare Advantage book of business.

A win-win for everybody.