Successfully Expanding a Health Plan’s Access to Medicaid Markets

Our health plan client sought to retain and expand its access to Medicaid coverage regions in a state with a sizable and diverse beneficiary population. The state Medicaid agency issued a request for proposals (RFP) as part of its procurement process. Given the diversity of beneficiaries across the state’s population and geographic regions and the competitive bid process to gain access to those regions, the client requested our assistance in understanding the requirements of the RFP. The client needed a response that demonstrated the unique successes of its population health approach and differentiated it from competing bids. The RFP specified strict page limits for each response, requiring that submitters craft responses strategically and thoughtfully for maximum impact.

We used our extensive understanding of the Medicaid program and specific state markets to align the RFP’s requirements with our client’s core capabilities and the state’s priorities. We partnered with the client’s subject matter experts to identify the most valuable demonstrations of past performance and program characteristics to distinguish the client’s program from competitors in the bid submission. This process entailed not only curating content for inclusion, but also building an effective framework to present the content consistent with the restrictions imposed by the RFP (e.g., incorporating charts and other figures).

We helped our client showcase its successful performance in the existing regions and complemented those successes demonstrating its ability to serve additional regions in the state with higher proportions of rural and racial/ethnic minority populations. We also used our knowledge of the state’s Medicaid program priorities by highlighting the client’s unique capabilities to address those priorities while best serving beneficiaries. Further, we demonstrated the value those capabilities would bring to additional regions and markets served by the client.

Throughout the process, we worked collaboratively with client staff to identify and highlight the most valuable information for a strong bid submission. We partnered effectively and efficiently with our client’s experts to refine the responses through successive drafts, resulting in a final bid response that complied with the requirements, highlighted the plan’s successes, and articulated why our client would be the best option to serve the remainder of the state.

The client not only successfully retained but also expanded its Medicaid footprint in the state, gaining access to 100% of the regions for which it submitted bids.