Let’s face it: public sector programs and projects have “customers” – people who are impacted by or care about the outcome of what you are doing. It doesn’t matter if you are preparing for the Open Enrollment milestone of the Patient Protection and Affordable Care Act (ACA) or building a bridge over a lake you have customers. Poor (or failed) communications with customers can lead to misunderstandings that have serious impacts on the outcome of a program or project. Engaging customers through timely, clear, and consistent communication promotes greater understanding between you and your customers and avoids these misunderstandings. This communication takes thought and planning.
To better communicate with customers use:
- A plan that outlines who you need to communicate with, how frequently (and when) this communication needs to occur, what messages need to be communicated, who is responsible for preparing and delivering the message, and which media (for example, on-line, television, written brochures, etc.) will be used.
- Language that is simple and easily understood by the target audience (for example, avoid the use of industry jargon or terms of art).
- A methodical approach to ensuring key ideas or messages are effectively communicated (for example, identify customers likely position before you communicate with them, what position you want them to hold after you have communicated, and what methods you will use to lead them to that destination).
- A standard template and style guide for written materials to promote consistency of formatting, punctuation, and grammar.
- Knowledge of how customers assimilate information and learn from different kinds of media (for example, when reading on-line content recognize and utilize the “F reading pattern” to structure the format of your communication).
- An active voice in both written and oral communications.
Public Knowledge, LLC helps public sector agencies with stakeholder outreach and communication services, including establishment of communication strategies, tactics, and plans. Some of our more recent work includes helping State agencies reach out to people affected by the ACA.
In recent years states have noticed a drop in responses to state Request for Proposals (RFPs). This means states have fewer choices in solutions at often higher costs. To counter this trend, states must be more aggressive in promoting opportunities to attract qualified vendors. According to agency representatives of states serving smaller health and human service program populations, there may be a perception among vendors that there is less financial gain in doing business in states with smaller service transaction volumes. Individual state spending varies considerably with some states purchasing several billions of dollars in products and services annually. Other’s attribute lack of vendor participation in procurements to states being too restrictive in either contractual terms or in specification of the procurement itself. There are high stakes involved when it comes to a state’s resource investment, making it critical for state agencies to conduct successful procurements and attract qualified vendors that will deliver value added products and services. Irrespective of the specific cause, states are considering several options for promoting interest in procurements among the vendor community. These options include:
- Hosting procurement fairs each with a specific focus (i.e., products, services, industry, etc.) to facilitate bidirectional communication between state agencies and the vendor community. This will enable states to gain a better vendor perspective and gather feedback on how states can improve procurement processes.
- Reforming purchasing practices to promote uniform procurement rules, guidelines, and tools across state agencies and create a reliable, consistent procurement infrastructure for bidders.
- Conducting pre proposal conferences to formally announce procurement projects and provide a platform to entertain preliminary questions from potential bidders.
- Announcing upcoming procurement projects in advance and provide a tentative schedule to keep the vendor community abreast of procurement milestone dates.
- Releasing the bidder’s library ahead of the RFP to provide resource materials that will help vendors gain a better understanding of the procurement project, as well as generate interest in the project.
- Establishing creative strategies for procuring products and services that can be conveyed through an RFP, such as use of “value based” procurement techniques where the focus is on the problem to be solved rather than the solution to be purchased.
- Revising procurement rules, regulations and even laws to balance the need for protection with the need for broad vendor participation.
Public Knowledge, LLC specializes in helping health and human service agencies with procurement management services including strategy development, reengineering of procurement practices, procurement planning, RFP development, requirements definition and technical proposal evaluation assistance.
Under the 2010 Patient Protection and Affordable Care Act (ACA), it is estimated that approximately three-quarters of 7 million children who are uninsured in the United States would be eligible for Medicaid, the State Children’s Health Insurance Program (CHIP) or the new premium tax credit. However, the ACA focus on insuring the newly eligible adult population provides for a potential gap in children’s coverage during the period of 2015 to 2019, as CHIP will not be funded beyond September 30, 2015.
The Maintenance of Effort clause in the ACA requires states to maintain CHIP and the Medicaid eligibility and enrollment standards, which were in place as of March 2010, through 2019. Therefore, without CHIP funding, states will need to evaluate options for keeping children currently on CHIP from becoming uninsured during the transitional implementation of ACA and the initial use of Health Insurance Exchanges.
Some options being considered by States include:
- Continuing coverage for CHIP enrollees as-is for those children that will not meet Medicaid eligibility requirements or qualify for an Advance Premium Tax Credit.
- Not continue coverage, but provide transition period with options for referrals to other programs through the Health Insurance Exchange (HIX), such as a child only policy available in the HIX.
- Define and provide an alternative benefit package to CHIP enrollees, only providing selected services.
Additionally, depending on a State’s individual budget circumstance, any unspent CHIP allotment funds for 2015, may be held over to fund the State’s CHIP in subsequent years.
Public Knowledge, LLC specializes in helping health and human service agencies with research and options analysis studies in support of the Patient Protection and Affordable Care Act and other state and federal mandates.
States that have elected to implement a State-based Exchange (SBE) instead of using the Federally-facilitated Health Insurance Exchange (FFE) are navigating new territory that reveals some unique challenges. States looking to CMS for clarification on key design and development issues are met with delayed guidance as HHS and CMS work to meet their own deadlines for the FFE. This is making it difficult for States to work confidently toward their deadlines.
Two specific questions that continue to perplex State health and human services budget offices are:
- How will States manage very sick populations and what will these populations do to the State health insurance exchange risk mix pool?
- For States that opted for the SBE approach, and initially rejected federal exchange money prior to the 2012 U.S. presidential election, how will they now fund the development and implementation of a SBE?
States anticipate that very sick populations will increase cost of health insurance premiums significantly. It is unclear whether HHS has any suggested approaches for managing this population so that premiums aren’t inflated for everyone. Similarly, States are required to submit a description of their risk adjustment methodology to HHS for review and certification, but more guidance in this area is needed in order for States to flush out their risk adjustment models. Forecasters believe that by 2014, all States, including SBE States, will likely default to a federal risk adjustment model. HHS suggests that risk adjustment models should be designed to align with the associated health insurance exchange it supports.
Regarding determining how States will pay for the development and implementation of SBEs the Patient Protection and Affordable Care Act (ACA) does not clearly address this topic. This is particularly acute for states that originally rejected federal funding. This leaves State’s to question whether they will be able to re-request federal monies that were initially turned down.
Public Knowledge, LLC specializes in helping health and human service agencies with planning and implementation activities in support of the Patient Protection and Affordable Care Act and other state and federal mandates.
Did you know you that you must be able to accept Health Insurance Exchange (HIX) applicants (new applicants or redeterminations) through the web, on the phone, in-person, AND through the mail? To be clear, in support of a new single streamlined application, you must support all four application entry points when you launch your HIX with the exception of Modified Adjusted Gross Income (MAGI) based eligibility determinations (In person interviews cannot be required for theses individuals). Most states determine eligibility via forms submitted through the mail and are not prepared for making eligibility determinations or redeterminations in person, on the web, or through a phone call. A significant restructure of policies, business procedures, and technology (like phone systems) is going to be necessary for most of our clients.
We’ve noticed a tendency for states to focus on the information technology (interfaces to eligibility systems and web sites) aspects of HIX assuming the in-person and phone processes can be easily figured out later. All of these are important and will take longer to develop than you might think, particularly as they require coordination and simplification across benefit programs. As part of HIX readiness you want to consider a comprehensive architecture for your HIX that includes not only the information technology but also other technologies (like cloud-based telephone contact center solutions), processes, and policies.
Public Knowledge, LLC specializes in developing comprehensive architectures for business needs that include not only technical considerations but also the process and policy architectures.
Just want to wish all of you a happy holiday season this year. It’s been a great year and we look forward to working with you in 2013.
– The PK Crew
One of the biggest complaints we have with the way Quality Assurance is typically performed for large systems projects is that the process is reactive rather than predictive. This means most QA consultants wait for failure to happen (for example a project deliverable has defects), report the defect occurred, and then figure out what to do about the problem after the fact. It’s an approach that evolved from financial auditing and is a bit like driving a car while only looking in the rear view mirror: all we can say is either “Everything has been OK so far” or “Oops we hit a tree back there”. The issues this raises are pretty obvious:
- You have some crisis or failure to deal with;
- Dealing with this takes time that could be better spent elsewhere;
- Relationships can be strained and trust lost; and
- You have a quality problem.
So what do we do differently? Over the years PK has developed a “toolkit” of techniques we use to help identify potential issues and avoid them. We call it “Predictive Management”. The techniques range from developing mathematical models that predict project performance and schedule delays to conducting facilitated workshops that proactively identify, prioritize, and avoid potential risks. Some of these we have developed based on our experience (declining balance work graphing) and others are industry standard tools (Failure Mode and Effects Analysis). Combined these serve as a powerful toolkit to avoid quality issues. Do they identify and avoid all issues? Of course not, you’ll never predict everything. What we have found is through the rigorous application of these techniques most major issues that significantly delay projects and raise costs can be identified ahead of time and if not avoided at least mitigated to optimize project performance.