Building long-term success with a vendor begins with a Request for Proposal (RFP) that clearly defines a project’s requirements, which allows health plans to determine if a new solution addresses all regulatory, market, clinical and quality needs. But what exactly do you include in your RFP as requirements, and how do you frame requirements in a way that evaluates vendors equally and gauges current and future needs? We’re taking the guesswork out of this process.
Last week, the first in the series addressed the challenges of selecting a digital health partner with an RFP. Now, we’re digging deeper into specific services a health plan should require from a vendor.
The industry continues to evolve as do the federal and state requirements. The Centers for Medicare and Medicaid Services (CMS) is leading health plans to build programs and measures that embrace the voice of patient. A health plan partner needs to use technology and innovation to always put the patient and their care journey first while being mindful of current regulations, and being able to build towards those on the horizon.
Here are four areas to get a feel for during your RFP to ensure partners are as focused on your members as you are.
Personalize Communication to Diverse Communities
Your health plan covers a diverse population and your vendor must understand the member’s unique needs and how to best serve them. One communication channel or one-size-fits-all campaign outreach can’t effectively engage the diverse or vulnerable communities in their healthcare.
Members who are more digitally inclined may prefer emails, text messages and smartphone apps for communicating with their health plan. Members experiencing housing insecurities or homelessness may still have access to internet services, making digital engagement vital for connecting them with care and resources. In contrast, members with lower incomes or in rural areas may rely on mailers and phone calls. Allowing members to choose their communication preferences is key to successful member engagement.
Additionally, a technology solution that tracks the results of member communications will help you identify what initiatives are working, what needs to be tweaked and leave no surprises around plan performance at the end of the year.
Motivate with Relevant Rewards
Reward programs boost members’ interest in completing healthy activities, which close care gaps and improve a health plan’s data sources. Determine if your potential partner can offer rewards and incentives, and understand the capabilities within those reward programs.
Gift cards are convenient rewards but you need to ensure a vendor knows the multitude of rules that dictate what a plan can offer. A reward program with an option to earn fitness trackers or items that promote a healthy lifestyle can fill a technology void for low- or fixed-income members.
To address specific social determinants of health (SDOH) in the member population, a plan needs to have tailored healthcare rewards. Verify if a vendor knows how to motivate members. For example, the program could offer population-specific rewards. Members who have children or recently gave birth could be motivated to complete well-child visits with diapers or other pediatric-related needs.
It’s the responsibility of the plan to recognize the complex needs of vulnerable and diverse populations. A flexible rewards program acknowledges the challenges SDOH creates while empowering members to make healthy choices.
Measure and Report with Digital Tools
Identifying the diverse communities with a health plan requires a vendor partner that can deploy the right digital tools. To ensure you’re using data-driven quality improvement strategies, define reporting standards within your RFP. Look for a vendor that monitors clinical, quality and financial performance and knows what data to collect, especially when it comes to all-important member sentiment surveys.
Member feedback is one of the most important tools for successful plan performance. Keep a pulse on how your members are feeling about their plan with a well-designed survey that’s in alignment with industry standards of success including federal, state, Consumer Assessment of Healthcare Providers and Systems (CAHPS), HEDIS and other quality measures. Ask for real-time dashboards to monitor performance. Member feedback data, in conjunction with other dashboard features and member profiles, should tell a story and guide appropriate interventions.
A Helpful Partner in Education
An RFP should help define a vendor’s ability to work as a partner in project execution and member education. Health literacy is an important aspect of care and encouraging members to take control of their health. Providing members with resources that are relevant to their health journey is one step towards improving outcomes, and improving member sentiment.
Members who have limited English proficiency face a different set of challenges. They can be further removed from accessing and understanding the care they need. Language preferences and translation are essential, especially in highly diverse populations. An experienced vendor supports language translation for communications in member preferred languages and assist in your community specific engagement strategies.
Deliver a Seamless Experience to Reach Health Goals
Navigating rewards and outstanding health actions, and providing feedback to their health plan should not be a challenge for members. Look for a partner that understands how to make accessing information easy and can provide members with straightforward guidance on how to use available plan tools.
Tools should be simple and seamless, providing an easy experience for members of all ages, comfort levels with digital resources and diverse backgrounds. The tools, rewards and incentives need to focus on achieving the goal of improving member health and closing essential care gaps.
To move a plan from insights to action, look for a vendor that can incorporate the right digital tools to drive data driven improvement strategies. A strong suite of digital solutions can centralize data aggregation, outreach and rewards. Offered on a single platform, those assets can help your plan expand access to equitable and quality healthcare.
Learn More and Prepare
In the coming weeks you can delve deeper into other important aspects of how to write an RFP to get the level of service your health plan deserves. We’ll share more information about the importance of finding a vendor ready to deliver in the following areas:
- Performance measurement and reporting. A tech savvy partner capable of simultaneously monitoring and managing every element of improvements. Skilled in measure computations, summary ratings, and Reward Factors while offering strategies to address long standing issues and collect new, more accurate data.
- Supportive account management. Able to relieve staff from manual processes so they can focus in their areas of expertise. Support that fosters improved operational efficiency for staff.
- Technical infrastructure and security. A digital-first mentality needs a strong base of data security practices and impeccable privacy protocols.
If you’re ready to get started now, download the Healthmine RFP guide and checklist. Refining the healthcare RFP process enables health plans to efficiently identify the right digital health partner to help them overcome critical regulatory and clinical challenges with member-centric solutions.
Get insights on the important questions you can ask to ensure your health plan is paired with a vendor that can deliver the necessary qualities for improvement.
At Healthmine, everything we do builds an improved relationship between members and their health plan. Our robust rewards and incentives program allows you to choose regionally relevant rewards for your members who complete health actions, with end-to-end fulfillment, for a seamless experience for you and the member. And with personalized education and the ability to communicate to members in more than 170 languages through print email, email, text and in-app notifications, we’re making sure no corner of your membership is untouched or uncertain of how to control their health.
Healthmine is the leading member engagement and rewards solution focused on empowering people to take the right actions to improve their health.
Download the RFP Guide and Checklist
- Improve Star Ratings with Strong and Strategic Provider Relationships
- Understand CMS’ Sanction and Penalty Rules
- The Financial Impact of Medicaid Quality Scores
- How to Improve Plan Performance with Your CMS Bid
- Healthmine and Press Ganey Work Together to Enable Predictive Member Experience Insights for Health Plans