Is Your Provider Network Ready for Your RFP?

BY TOG Network Solutions | Dec 22, 2020

Last month, the Ohio Department of Medicaid (ODM) released a request for applications (RFA) to lead Ohio’s next-generation managed care program supporting more than 90% of Ohioans receiving health care services through Medicaid. In addition, the state also issued an RFA for its OhioRise Managed Behavioral Plan. Adding to new business opportunities, the state of California has release and RFI for Dental ASO and both Oklahoma and North Dakota have released Medicaid Managed Care RFPs.

Winning lucrative government contracts such as these requires a smartly crafted RFA or request for proposal (RFP) that balances cost while also clearly differentiating your service approach from the competition.

These five tips will give a competitive edge to win your next government contract bid.

1. Know Your Product Differentiators 

Make your proposal stand out from the competition by demonstrating how working with your company provides notable advantages over your competitors. Provide in-depth details regarding your service approach and commitment to the wellness of the patients you’ll ultimately be serving.

Collect compelling case studies and client testimonials to demonstrate the advantages of choosing your provider network experience over the competition. Explain critical elements that differentiate your plan over close competitors – you could include the availability of such “carve-out” vendors as skilled nursing, NICU specialists, dental and pharmacy access.

2. Consider Demographics

Ensure the health care plan you’re proposing clearly acknowledges and addresses the needs of the population you’ll serve. Suppose the specified community has a higher than average need for pediatricians or behavioral health specialists. In that case, it is essential to make it clear how your provider network will be configured to address these provider care needs.

3. Adequacy Check

Before embarking on the RFP process, it is wise to verify that your provider network meets adequacy standards-compliant with the regulatory rules for the geographic location you’ll be serving. To adhere to basic adequacy standards, a delicate balance of maintaining the minimum enrollee-to-provider ratio, maximum travel times to the closest provider, and the average number of enrollees in service areas must be consistently met to be safe and avoid risk. Adequate standards are the basic minimum requirements, but what is the right marketable network to provide you with the best competitive advantage?

TOG Network Solutions specializes in network analysis and development to assure our clients avoid costly network adequacy fines and the unwelcome public scrutiny that can follow such actions.

4. Ensure Data Is Streamlined

Having clear, easy-to-access provider network data will hasten the often time-consuming RFP response process. Provider network databases often feature inaccurate contact information or duplicative entries that can make it challenging to respond to an RFP and avoid costly regulatory fines when awarded the contract.

5. Consider Us a Resource

As a certified woman-owned business, TOG Network Solutions offers its health care partners a competitive edge when responding to a highly sought after government contract. In addition to being able to help fulfill required set-aside allocations, TOG offers the industry gold standard solution to ensuring your data is streamlined and meets all regulatory requirements.

TOG Network Solutions has simplified the traditional model of building health care networks. Leveraging connections, knowledge, and data, TOG Network Solutions can help you build the right network at the right price. Consider us a resource if you have questions on how to best position your provider network to win your next government contract.

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