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What vendors want: Vendor decision process in answering requests for services

By: Julie Allen, Marnie Hudson,

Mary Corley has worked with Medicaid fiscal agent services for almost 30 years as a claims supervisor, documentation specialist, business analyst, and contract compliance analyst. She has more than 25 years of experience in all aspects of the RFP process including go/no-go analysis, content development, including managing all written content  from multiple team members and compiling into one document, proofreading, formatting, and production/delivery.

Mary Corley,

Misha Mosher is an experienced legal professional with proven project management, research, and analysis skills. She brings knowledge of the legal industry, trade publications, government regulations, procurement, intellectual property, technology licensing, privacy and security, and risk management.

Misha Mosher
10.09.20

Read this if your agency is planning to procure a services vendor. 

Every published request for services aims to acquire the highest-quality services for the best value. Requests may be as simple as an email to a qualified vendor list or as formal as a request for proposal (RFP) published on a state’s procurement website. However big or small the request, upon receiving it, we, or a potential vendor, triages it using the following primary criteria:

  1. Scope of services―Are these services or solutions we can provide? If we can’t provide the entire scope of services, do we have partners that can?
    As a potential responding vendor, we review the scope of services to see if it is clearly defined and provides enough detail to help us make a decision to pursue the proposal. Part of this review is to check if there are specific requests for products or solutions, and if the requests are for products or solutions that we provide or that we can easily procure to support the scope of work. 
  2. Qualifications―What are the requirements and can we meet them?
    We verify that we can supply proofs of concept to validate experience and qualification requirements. We check to see if the requirements and required services/solutions are clearly defined and we confirm that we have the proof of experience to show the client. Strict or inflexible requirements may mean a new vendor is unable to propose new and innovative services and may not be the right fit.
  3. Value―Is this a service request that we can add value to? Will it provide fair compensation?
    We look to see if we can perform the services or provide the solution at a rate that meets the client’s budget. Sometimes, depending upon the scope of services, we can provide services at a rate typically lower than our competitors. Or, conversely, though we can perform the scope of services, the software/hardware we would have to purchase might make our cost lower in value to the client than a well-positioned competitor.

An answer of “no” on any of the above questions typically means that we will pass on responding to the opportunity. 

The above questions are primary considerations. There are other factors when we consider an opportunity, such as where the work is located in comparison to our available resources and if there is an incumbent vendor with a solid and successful history. We will consider these and other factors in our next article. If you would like to learn more about our process, or have specific questions, please contact the Medicaid Consulting team.
 

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Read this if your agency is planning to procure a services vendor.

In our previous article, we looked at three primary areas we, or a potential vendor, consider when responding to a request for services. In this follow-up, we look at additional factors that influence the decision-making process on whether a potential vendor decides to respond to a request for services.

  • Relationship with this state/entity―Is this a state or client that we have worked with before? Do we understand their business and their needs?

    A continuing relationship allows us to understand the client’s culture and enables us to perform effectively and efficiently. By establishing a good relationship, we can assure the client that we can perform the services as outlined and at a fair cost.
  • Terms and conditions, performance bonds, or service level agreements―Are any of these items unacceptable? If there are concerns, can we request exceptions or negotiate with the state?

    When we review a request for services our legal and executive teams assess the risk of agreeing to the state’s terms and compare them against our existing contract language. States might consider requesting vendors provide exceptions to terms and conditions in their bid response to open the door for negotiations. Not allowing exceptions can result in vendors assuming that all terms are non-negotiable and may limit the amount of vendor bid responses received or increase the cost of the proposal.

    The inclusion of well-defined service level agreements (SLAs) in requests for proposals (RFPs) can be an effective way to manage resulting contracts. However, SLAs with undefined or punitive performance standards, compliance calculations, and remedies can also cause a vendor to consider whether to submit a bid response.

    RFPs for states that require performance bonds may result in significantly fewer proposals submitted, as the cost of a performance bond may make the total cost of the project too high to be successfully completed. If not required by law that vendors obtain performance bonds, states may want to explore other effective contractual protections that are more impactful than performance bonds, such as SLAs, warranties, and acceptance criteria.
  • Mandatory requirements―Are we able to meet the mandatory requirements? Does the cost of meeting these requirements keep us in a competitive range?

    Understanding the dichotomy between mandatory requirements and terms and conditions can be challenging, because in essence, mandatory requirements are non-negotiable terms and conditions. A state may consider organizing mandatory requirements into categories (e.g., system requirements, project requirements, state and federal regulations). This can help potential vendors determine whether all of the mandatory requirements are truly non-negotiable. Typically, vendors are prepared to meet all regulatory requirements, but not necessarily all project requirements.
  • Onsite/offsite requirements―Can we meet the onsite/offsite requirements? Do we already have nearby resources available? Are any location requirements negotiable?

    Onsite/offsite requirements have a direct impact on the project cost. Factors include accessibility of the onsite location, frequency of required onsite participation, and what positions/roles are required to be onsite or local. These requirements can make the resource pool much smaller when RFPs require staff to be located in the state office or require full-time onsite presence. And as a result, we may decide not to respond to the RFP.

    If the state specifies an onsite presence for general positions (e.g., project managers and business analysts), but is more flexible on onsite requirements for technical niche roles, the state may receive more responses to their request for services and/or more qualified consultants.
  • Due date of the proposal―Do we have the available proposal staff and subject matter experts to complete a quality proposal in the time given?

    We consider several factors when looking at the due date, including scope, the amount of work necessary to complete a quality response, and the proposal’s due date. A proposal with a very short due date that requires significant work presents a challenge and may result in less quality responses received.
  • Vendor available staffing―Do we have qualified staff available for this project? Do we need to work with subcontractors to get a complete team?

    We evaluate when the work is scheduled to begin to ensure we have the ability to provide qualified staff and obtain agreements with subcontractors. Overly strict qualifications that narrow the pool of qualified staff can affect whether we are able to respond. A state might consider whether key staff really needs a specific certification or skill or, instead, the proven ability to do the required work.

    For example, technical staff may not have worked on this particular type of project, but on a similar one with easily transferable skills. We have several long-term relationships with our subcontractors and find they can be an integral part of the services we propose. If carefully managed and vetted, we feel subcontractors can be an added value for the states.
  • Required certifications (e.g., Project Management Professional® (PMP®), Cybersecurity and Infrastructure Security Agency (CISA) certification)―Does our staff have the required certifications that are needed to complete this project?

    Many projects requests require specific certifications. On a small project, maybe other certifications can help ensure that we have the skills required for a successful project. Smaller vendors, particularly, might not have PMP®-certified staff and so may be prohibited from proposing on a project that they could perform with high quality.
  • Project timeline―Is the timeline to complete the project reasonable and is our staff available during the timeframe needed for each position for the length of the project?

    A realistic and reasonable timeline is critical for the success of a project. This is a factor we consider as we identify any clear or potential risks. A qualified vendor will not provide a proposal response to an unrealistic project timeline, without requesting either to negotiate the contract or requesting a change order later in the project. If the timeline is unrealistic, the state also runs the risk that the vendor will create many change requests, leading to a higher cost.

Other things we consider when responding to a request for services include: is there a reasonable published budget, what are the minority/women-owned business (M/WBE) requirements, and are these new services that we are interested in and do they fit within our company's overall business objectives?

Every vendor may have their own checklist and/or process that they go through before making a decision to propose on new services. We are aware that states and their agencies want a wide-variety of high-quality responses from which to choose. Understanding the key areas that a proposer evaluates may help states provide requirements that lead to more high-quality and better value proposals. If you would like to learn more about our process, or have specific questions, please contact the Medicaid Consulting team.

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What vendors want: Other factors that influence vendors when considering responding to a request for services

Read this if you are at a state agency looking to implement or improve your 988 Suicide & Crisis Lifeline. 

Between 2015 and 2020, one in four fatal police shootings involved a person with a mental illness, and an estimated 44% of people incarcerated in jail and 37% of people incarcerated in prison had a mental health condition. In addition, the recent COVID-19 pandemic has adversely impacted the mental health situation in the country. 

Many people experiencing mental health distress call 911 because it is a widely known emergency number and easy to use. Recent data has shown that people using 911 to get help with serious mental illness do not get the right care at the right time and some even end up in law enforcement custody, rather than being seen by a mental health professional.

The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) is the new three-digit, nationwide phone number that is locally operated and offers 24/7 access via call, text, and chat to trained crisis counselors who can help individuals experiencing mental health-related distress. Mental health-related distress can include substance use crisis, suicidal thoughts, depression, or any emotional distress. The 988 Suicide & Crisis Lifeline is also available for individuals worried about a loved one who might need crisis support services. Its goal is to provide accessible and immediate crisis intervention and support to every individual in need. 

988 state implementation and top challenges

As of August 2022, 23 states have passed legislation to facilitate the implementation of the 988 Suicide & Crisis Lifeline. Colorado, Nevada, and Washington enacted legislation with user fees to support 988 operations and provide financial sustainability for the system. Several states have established advisory groups or planning committees with representatives from state agencies, health providers, law enforcement, emergency medical services, and other partners to better coordinate the system and identify policy levers. 

Implementing a three-digit number for behavioral health emergencies in every state and providing 24/7 primary coverage through in-state call centers have presented certain challenges to states across the nation. As states prepare to launch the 988 hotlines, they have encountered key issues around infrastructure, workforce, 911 integration, readiness of the crisis care continuum, cultural competence, and performance management.  

Solutions for state agencies

To address these key issues, states should consider the following to aid in the successful implementation of the 988 Suicide & Crisis Lifeline:

Assess the states’ needs to successfully implement the 988 Suicide & Crisis Lifeline

Despite meeting baseline requirements for the implementation of the 988 Suicide & Crisis Lifeline, state agencies are struggling to implement the 988 Suicide & Crisis Lifeline. 

By performing a structured needs assessment, state agencies can evaluate their infrastructure, policies and procedures, funding, and workforce needs to better understand their readiness to implement and capability to sustain the 988 Suicide & Crisis Lifeline. This assessment provides insight for state agencies to understand their strengths, challenges, and areas of opportunity, and it should evaluate: 

  • State infrastructure
    Behavioral health leaders acknowledge that infrastructure supports are necessary to make the 988 Suicide & Crisis Lifeline work across the continuum of care. It is important to assess the infrastructure across the crisis care continuum to help ensure a smooth transition for individuals who need care quickly. Successful implementation should take certain considerations into account during the planning process, such as including all the interested parties representing diverse populations.
  • Workforce
    In the current labor market, workforce availability and retention are top concerns for sustainable and effective 988 Suicide & Crisis Lifeline operations. States are struggling to hire the extra staff needed to launch the 988 Suicide & Crisis Lifeline as well as to recruit qualified persons. To realistically implement the system, innovative workforce development and supporting wages to recruit and retain a specialized workforce are critical considerations for the states. Critical components to include in the assessment should include, but are not limited to:
    • Training
      Staff training and proper supervision will be crucial to effectively manage the 988 Suicide & Crisis Lifeline, and states need best practices models for how to best train crisis responders and the call center staff. States should assess the existing training infrastructure to identify ways early on to support the mental health of their 988 Suicide & Crisis Lifeline counselors to reduce the risk for burnout and post-traumatic stress disorder. 
    • Capacity
      Adequate capacity is a key factor to workforce. The assessment should identify the number of qualified workforce available for in-person staffing. In the current labor market, it will also be important to consider including the identification of the number of qualified staff able to work remotely. If states would like to consider remote capabilities for the call centers, it will also be important to assess the available technology necessary, as well as the development of standards and expectations, including strong communication. 
  • Readiness of the crisis care continuum
    Apprehension about the readiness of the crisis care continuum (e.g., mobile crisis teams through diversion services and lower levels of care) exist. Federal officials have stated they expect up to 12 million calls/texts/chats in the first year of the 988 Suicide & Crisis Lifeline, and research suggests approximately 20% of those calls/texts/chats will require some level of in-person response. States are questioning whether mobile crisis teams are prepared for the increased demand while also identifying connections and access to upstream services. In addition, states can consider the needs and experiences of the system’s end users to help address equity. The assessment can help to assess the readiness of the various components across the crisis care continuum.

Establish a strategic plan of action to implement the 988 Suicide & Crisis Lifeline 

With the implementation of the 988 Suicide & Crisis Lifeline, state agencies have an opportunity to strengthen crisis care. The best way to begin strengthening crisis care is to develop and implement strategic plans that optimize the 988 Suicide & Crisis Lifeline and the following services. Building on the strengths and opportunities identified in the needs assessment and the associated recommendations, strategic plans can establish priorities and identify sustainable solutions that build capacity, promote equitable access to care, and promote continuous quality improvement. Collaborating with key stakeholders to develop a strategic plan can help identify a roadmap for how the state should approach the implementation, maintenance, and sustainability of the 988 Suicide & Crisis Lifeline, including, but not limited to, the following areas:

  • Data and performance management
  • Stakeholder engagement
  • Health equity
  • Voice of the customer
  • Financial sustainability

Maximize available funding streams

Historically, behavioral health has not had sufficient funding to adequately address mental health and substance use disorder prevention, treatment, and recovery services across the continuum of care. The COVID-19 pandemic exacerbated behavioral health challenges for many individuals struggling and highlighted the challenges with the infrastructure and workforce. In the last couple of years, the federal administration has continued to allocate additional funding to supplement existing and ongoing federal funding. States should begin by evaluating the existing federal funding opportunities to support the implementation of the 988 Suicide & Crisis Lifeline. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 988 Convening Playbook for States, Territories, and Tribes, below are a few examples of funding sources that can be leveraged for the implementation of the 988 Suicide & Crisis Lifeline. 

  • SAMHSA 
    • Transformation Transfer Initiative
    • Community Mental Health Services Block Grant
    • Substance Abuse and Treatment Block Grant
    • Mental Health Block Grant Set-aside
    • State Opioid Response Grant
    • Tribal Opioid Response Grants
  • American Rescue Plan Act (ARPA) of 2021—for Mobile Crisis and Crisis Line Services
  • Medicaid
    • Early, Periodic, Screening, Diagnosis, and Treatment (known as EPSDT)
    • 1915(a) waivers
    • 1915(b) waivers
    • 1115 SMI/SED Service Delivery Waiver

The implementation of the 988 Suicide & Crisis Lifeline is critical to supporting the community and meeting their needs at a time where they need community support the most. If you have any questions, please contact BerryDunn’s behavioral health consulting team. We’re here to help.

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Components of successful implementation of the 988 Suicide & Crisis Lifeline

On the first episode of the Let’s Talk Parks with BerryDunn podcast, we spoke with Shane Mize, the Director of Parks and Recreation for the City of Pflugerville, Texas, and members of the BerryDunn Parks, Recreation, Libraries team about innovative ways to plan, engage, and serve their communities.

For those not familiar with Pflugerville, the city is situated between Austin and Round Rock, Texas. It has been listed as one of the fastest growing cities in the nation. They have a population of roughly 80,000 and their parks and recreation system is made up of over 55 miles of trails, with over 900,000 visits to their park system annually.

On the podcast, Shane talks about the challenges and opportunities of being surrounded by cities that have great parks and recreation departments. Never one to be upstaged, Shane uses innovation in his program, to increase community engagement and ensure the highest level of service to Pflugerville. The end goal: Being the best parks and recreation department in the country.

So let’s take a look at five innovative things the department is doing:

1. Rethinking the master plan

Shane told us that he's not a huge fan of how typical master plans are done. When he realized that he needed one to qualify for grants, he agreed, but on his own terms.

Shane shared his experience in seeking a consulting firm to help with the process, “I just decided that we were going to do things differently and was fortunate to find a firm [in BerryDunn] that … had enough park and rec professionals on it …and was young enough in some of their philosophies.”

He continued, “I think I was in the right place at the right time to push my agenda, which was to have a master plan that looked 100% different than any of the master plans I'd ever seen, and to feel confident and comfortable, not only standing before council, but standing before anybody in my industry.”

BerryDunn’s Jason Genck, the project manager on the master plan project, said, “They expect a high level of service, and they want us to push the envelope quite a bit, and I'm particularly excited about this project because I tend to be attracted to projects that are really creative, certainly innovative, and pushing the envelope.”

When starting the process, Shane told Jason that he wanted the plan to be “the most creative and engaged master planning process the country has ever seen.” Jason and his team completely agreed with this philosophy for Pflugerville and could see applications for other cities and towns.

Jason said, “I think this planning process is disrupting the traditional way of planning because the entire project team is constantly adjusting and re-thinking approaches to maximize the benefits to the Pflugerville community. Yes, we have our standard practices, but, we are having a lot of fun while being inspired to really push innovation in everything we do. While the Pflugerville team and the consultant team are true partners and everyone has such great expertise, we are also learning together how to help create the most vibrant future possible for the community.”

2. Going beyond benchmarking

Shane’s vision for the plan included local feedback as well as feedback from around the country. Jason Genck explained how this is different from what is typically done, “It's not just doing benchmarking, for example. Benchmarking is very common in a planning process, to look at how one organization might be performing against other, similar size, similar scoped organizations—and of course, we do that, and it's always an interesting discussion to reflect on what that is—but in the case of Pflugerville, that wasn't enough.”

“It was, 'Hey, let's take that benchmarking, let's get a think tank together. And you know what? We don't want a think tank of just local leaders. We’d also like you to do a think tank of regional and state leaders. Oh, and by the way, let's actually do a think tank of the best minds of the nation.' And that's just one example of many instances throughout the team's planning processes that are really just taking the traditional services that you might expect to another level.”

3. Constantly evaluating satisfaction

As the team started the master planning process, at the top of the list was getting feedback from the community, which was nothing new to the Pflugerville team. Proactively seeking customer satisfaction is something they do regularly. Another creative example:

Shane shared, “I actually have a staff member that pulls Yelp, Google, and Wedding Wire [reviews] for our wedding event site, and they pull those numbers quarterly and we can see if we've dipped up or down in every single park in the last quarter and any new comments are captured.”

4. Bringing in celebrity voices

This one is for all the fans of the TV show Parks and Recreation. As a way to gain visibility for the master planning process and to get the attention of their constituents, the Pflugerville team had a creative idea. Using the social tool Cameo, they hired actor Jay Jackson, who played character Perd Hapley on the show, for a brief “in character” video message (which you can see on Pflugerville’s Facebook page here). Here’s the message:

Perd: And hello there everyone. Jay Jackson here, aka Perd Hapley. And welcome to, 'You Heard with Perd!' We have some breaking news right now. And that news that is breaking is this: Right now, Pflugerville wants to hear from you as they develop a 10-year parks and recreation master plan. Your participation is very important, so go to pflugervilletx.gov/parksplan to learn more about it. And now that you heard, get involved. I'm Perd Hapley.

The video was widely shared and gained nearly 10,000 views—getting the master planning message out to potentially new audience members.

5. Meeting people where they are – on the road or online

On the podcast, BerryDunn’s Jason Genck described one of his favorite outreach vehicles (literally) that Pflugerville is using to engage citizens all over the city. “Let's pull a 15-foot-wide chalkboard all over the community, which has logged over 120 miles to date, to get into every nook and cranny in the community to make sure everyone knows what's going on with the future parks and recreation and has the opportunity to provide input.” Community members were encouraged to finish the sentence, “Parks matter because…” on the mobile chalkboard as a way to gather feedback on what was important to park users.

The chalkboard is just one way that the team is gathering feedback. Their website has a master planning section, linked to an engagement platform hosted by BerryDunn, where community members can provide ideas and vote for ideas from others. Meeting constituents where they are is helping make this project one of the most engaged planning processes the BerryDunn team has seen.

What’s next? Robots?

Well, maybe! The Pflugerville team has been looking at robots for lining their sports fields, so it can save their staff time and their employees can get back to doing what they do best. Nothing is off the table!

Shane explained that to be successful at innovation, you have to take some risks. He said, “If you're waiting until it's somewhat successful in the public sector, you've missed the mark of innovation. You've missed the mark of doing anything new.”

Listen to the full podcast here:

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How Pflugerville and BerryDunn are pushing the envelope on parks and recreation innovation

Read this if you are at a state Medicaid agency.

The uncertainty surrounding the end date of the COVID-19 Public Health Emergency (PHE) has made it difficult for state Medicaid agencies to plan and prepare to transition to pre-pandemic operations. Upon the federal declaration of the PHE, states and territories were forced to react quickly to reduce the impact on the Medicaid program and its enrollees. Many states and territories took advantage of the emergency authorities through the Centers for Medicare and Medicaid Services (CMS) to implement temporary policy changes such as the removal of prior authorization requirements, increased payments to providers, removal of cost-sharing, and the expansion of telehealth services. 

While many of the emergency authorities will terminate on or around the end of the PHE, states and territories may elect to make those temporary changes permanent due to the positive impact for both enrollees and providers. Take telehealth, for example. The broad flexibilities allowed during the PHE permitted providers to meet the healthcare needs of enrollees in a time where in-person visits were not recommended, nor available. To increase access to testing and vaccinations in pharmacies, pharmacy technicians and interns were permitted to administer COVID-19 vaccinations when supervised by an immunizing pharmacist.

So what comes next for states and territories once the PHE ends? Taking a proactive approach to plan out next steps will assist states and territories to be better prepared upon conclusion of the PHE. The US Department of Health and Human Services (HHS) has committed to providing at least a 60-day notice prior to the official end date of the PHE. CMS encourages states and territories to communicate changes to enrollees, managed care plans, counties, providers, and other stakeholders.

As we await the declared end date of the PHE or notification of another extension, states and territories can begin taking actions to prepare for the resumption of normal operations. We have learned new ways to prevent disruptions in meeting the needs of enrollees, developed enhanced methods of communication to stay in touch, and used technology to its fullest capacity. While our new normal is very different than pre-pandemic times, we can all use what we have learned to strengthen our tactics for any future PHEs. BerryDunn is here to assist and support states and territories as they prepare for the eventual end of the PHE.

If you have questions or would like to discuss further, please contact the Medicaid consulting team. We're here to help. You can also read more BerryDunn articles on the PHE unwinding here.

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Looking beyond the Public Health Emergency: What's next for states

Read this if you are looking to improve retention at your organization. 

Does your organization have a well-thought-out, up-to-date, and effective onboarding program for new hires? If you don’t, it may be time to start. According to research from Brandon Hall Group, organizations with a strong onboarding process: improve retention by 82% and productivity by over 70%. In addition, the report also noted that 93% of employers indicated a positive employee onboarding process was a key driver of retention.   

Why is onboarding a driver of retention? 

Research shows that an employee’s desire to stay with a company—or second guess their decision—starts minute one of their first day of employment. Employees who virtually or literally walk into an environment that has a detailed and supportive onboarding plan begin to feel a sense of belonging and dedication to the organization and are ready to make a difference.  

A successful onboarding strategy prioritizes employee engagement and supports the individual’s learning and development. Generally, an onboarding plan should be in alignment with the strategic planning efforts of the organization—and demonstrate a coordinated effort with a training and development committee to ensure relevance and accountability.  

A tactical approach to provide greater access and enhance training efforts is to create a knowledge management system where documentation, forms, and templates are readily available. In an era of information overload, highlighting and organizing the most relevant resources helps employees make timely and informed decisions. 

Organizations that prioritize the employee experience through onboarding and knowledge management empower and ultimately retain employees.  

Employers focused on retention and effective onboarding should also consider: 

  • Employee journey mapping
    Conduct a detailed review of the employee experience, from recruitment through offboarding, to identify barriers and processes that limit progress or cause challenges. 
  • Training and development assessment
    Determine education needs of current and new employees through formal and informal review, such as surveys, focus groups, and one-on-one conversations. 
  • Strategic planning
    After reviewing current skill sets, compare them with your organization’s strategic plan and vision to identify gaps in knowledge and skills that will prevent you from achieving your goals.
  • Training and development committee
    Bring together a dedicated committee of employees, including an executive sponsor, to identify and deploy training content.  
  • Develop knowledge management system
    Compile and organize your most relevant and helpful resources, training, and templates in a way that is easy to find and access. Track visitation and usage overtime. 

BerryDunn’s team of consultants are happy to assist you with evaluating your process and provide recommendations for improvements to your employee onboarding.

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Effective onboarding to improve employee retention 

Read this if you are working on a well-being program at your organization. 

When looking to develop or enhance well-being programs at work, many organizations don’t know where to start. A well-being survey is a smart first step to solidify your organization’s approach to supporting a thriving workforce. An effectively designed well-being survey will not only provide valuable insights to the needs of your workforce, it will also be repeatable so you can measure the success of your well-being efforts over time. Here are five tips to help you create a successful well-being survey.  

  1. Include questions about organizational culture. It is unlikely you will engage every single employee with well-being programs and benefits. Some people just like to do their own thing. However, organizational culture is something that influences everyone and is the ultimate source of empowerment for employee well-being. Including at least a couple of questions that assess how effectively your workplace culture promotes well-being will give you the broadest sense of whether you are on the right track with your well-being efforts. 
  2. Carefully consider wording. There is a big difference between the question “How well does our organization support your well-being?” and “How satisfied are you with our organization’s support for your well-being?” For instance, an organization may invest heavily in mental health, but that support may not be resonating with employees. The second question will provide clear insights into how well the organization’s well-being efforts are connecting with employee needs. 
  3. Have a strategy to promote engagement. Your survey response rate can be influenced by who sends the survey and who sends the survey reminder. While it may be logical for the survey to come from Human Resources, we suggest having the survey come from either the Chief Executive Officer or Chief Operations Officer (or equivalent). This signifies that your organization views well-being as a business strategy. Survey reminders tend to be most effective when sent from department managers. This reinforces the messaging about well-being being a business strategy and signifies commitment at all levels of leadership. 
  4. Include space for open comments. Multiple choice and basic ranking questions can help keep a survey direct and are easy to respond to. They also provide data that is easier to analyze and compare year over year. However, it’s not possible to anticipate every need with multiple choice questions, and some of the best suggestions and ideas, as well as some of the most constructive remarks, will come in the form of open commentary. 
  5. Keep it anonymous but collect some demographic data. An anonymous survey will not only result in more candid feedback, but it will also avoid inadvertently collecting personal health information that may be disclosed (particularly in open comments). Having optional questions to self-identify department, office, or work arrangement (hybrid, remote, in person) can help identify high-risk groups ('high risk' meaning those who have a low perception of their well-being and the organizational culture). Making these questions optional reduces the risk that an employee will abandon the survey due to fear of being identified based on demographic responses (e.g., an employee who is the only remote employee in their department). 

A well-designed well-being survey can serve as a launchpad for a transformational well-being initiative, especially if your organization is prepared to report and act on results. For more information on how your organization can create and deliver a well-being survey, or if you have other well-being program questions specific to your organization, please contact our Well-being consulting team. We’re here to help.

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Five tips for employee well-being surveys that work

Read this if you are a Medicaid agency or attended MESC 2022.

As I depart Charlotte and fly home and MESC 2022 closes out, I understand why Charlotte is referenced as the Queen City. The people make it so, as we were welcomed with open arms in this beautiful place. Our appreciation and gratitude go out not only to Charlotte, but also to NESCSO for providing us with a place to meet, share ideas, get inspired, and deepen our relationships.

In the coming months, our team can sift through what we learned during our four days at MESC. It will be up to us to transform the ideas spawned from presentations and conversations into tangible action, and grow the new relationships we developed. Here are my key takeaways and themes from the conference that I will continue to ponder:

  • The conference is in full swing on the other side of the pandemic. MESC was sold out, as 1,700 people attended.
    • MESC established a new annual award for collaboration. This year the award went to the Public Sector Technology Group's (PSTG) Medicaid Information Technology Architecture (MITA) workgroup. CMS is optimistic that the MITA workgroup's efforts will help improve Medicaid and that the resulting toolkit will be the future of MITA. Thank you to this group, and congratulations on a well-deserved award!
  • Modernization efforts:
    • The reality of managing modernization efforts is settling in. States and territories are beginning to get clear on their approach, acknowledging that each has unique needs, and consequently, can customize their approach. It will be a long haul requiring good upfront strategizing, planning and execution.
    • Many states and territories recognize a need to examine and adjust their internal structures to manage multiple procurements and strategies.
    • Data and data governance is foundational to the modularization and modernization effort.
  • Unwinding is weighing on everyone's mind, but participants discussed other forward-looking topics. 
  • CMS continues to solicit input from states, territories, and vendors
    • This was CMS' first in-person conference since the pandemic's start—it was so great to have their energy and participation.
    • It was fantastic to be in sessions where CMS asked: How can they do better? 
    • Efforts on outcomes, streamlining certification, consistency, and accountability continue to be CMS themes
    • Brent Weaver, CMS' new Data and Systems Group Director, outlined four of CMS' goals at MESC:
      • Strengthen state and territory partnerships
      • Get input from vendors on unwinding
      • Identify ways to improve data quality
      • Find ways that will help CMS become better partners
  • Ensuring health equity and leveraging social determinants for health is a priority for states and territories.
  • New solution vendors are coming into the Medicaid space, and want to learn about Medicaid and the broader enterprise as they look for ways to adapt their systems.  
  • There continues to be mergers and re-shuffling of the more established vendors as they look to adapt to and serve the needs in the Medicaid space.
    • This was BerryDunn's 17th conference. We have broadened our services and maintained our values. I'm grateful that BerryDunn continues to have a stable presence at the conference.  
  • Our Medicaid Practice Group mission statement (see below) aligns with the CMS Data and Systems Group Director's reason for being in his role. 

Additional thoughts: Asking "why," change, and education

I also appreciated conversations within our Medicaid community based on the “why": Why are we doing what we do? Why focus on modernization? Health equity? Social determinants of health? 
The "why" drives what we do by providing us with our North Star, helping us with strategy, and giving us our roadmaps for proceeding. By starting with the purpose and outcome we strive for, we can align the changes we need to make.  

Change can be a source of fear, and there is a risk of venturing into the unknown. Medicaid leaders understand that the work they are responsible for is critical to their members, providers, and taxpayers. Lives depend upon our work, and the potential of "change" can have positive or negative consequences. Effective planning can mitigate the risks and help alleviate staff, member, and provider fears about change. 

Education also plays a big part in the mitigation equation. After tying the purpose to the vision, roadmap, and phased plans to modernize our programs, there needs to be an education plan to bring everyone up to speed and build confidence in those who will be impacted.

Conclusion

I am grateful that the BerryDunn Medicaid Practice Group's mission complements the goals of CMS and the direction in which states and territories are moving. We are honored to participate in this vital work and join all in the Medicaid community as we work on the initiatives before us. I leave you with our mission statement and invite you to share your organization's mission with us.

BerryDunn's Medicaid Practice Group helps Medicaid agencies improve the health and lives of individuals by empowering, inspiring, and partnering with our clients—we innovate, share deep expertise, and provide an independent perspective to resolve challenges. We are the success partner for Medicaid agencies, building healthier communities and stronger futures.

I look forward to seeing you all again next time in Denver! Let's make it a great year!

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MESC 2022: Reflections from 30,000 feet

Read this if you are at a state Medicaid agency.

The COVID-19 PHE has raised many questions for Medicaid programs across the country. The Centers for Medicare & Medicaid Services (CMS) and other healthcare organizations have been providing guidance on how to best manage the PHE since it began. In particular, CMS has provided recommendations on how Medicaid programs can implement new processes and rules into their Medicaid Enterprise Systems (MES) for individuals to remain under continuous enrollment until the end of the PHE. 

Strategies for MES

BerryDunn has been working with many states and territories to develop strategic plans to comply with specific rules and requirements throughout the PHE. Some of these strategies involve changes to the original designs of the MES. Examples include:

  • Updating system rules to maintain individuals enrolled in continuous coverage throughout the PHE
  • Retesting system rules to confirm systems are working properly once PHE rules are removed
  • Revamping system notifications so reminders keep individuals informed about ongoing changes
  • Training staff on the new system updates so they can manage calls and orient individuals on changes regarding their eligibility

CMS continues to release updated guidance on how Medicaid programs can best prepare for the end of the PHE in order to resume normal operations. These recommendations indicate that Medicaid programs adopt strategies to maintain coverage of eligible individuals as the continuous enrollment requirements come to an end, following the conclusion of the PHE, while allowing coverage for ineligible individuals to terminate. Medicaid programs must ensure their systems are prepared for the transition, but some of these updates and changes to the systems may pose greater challenges: 

  • Since there are no precedents to compare with the current PHE unwinding event, Medicaid programs will need to execute changes within a limited timeline and work with the issues that may arise as they execute unwinding
  • For some Medicaid programs, system rules, both current and updated ones, are not able to run simultaneously
  • Medicaid programs may need to hire additional staff, train new employees, and retrain or cross train current employees within a small window of time
  • Medicaid programs will need to perform additional MES testing to confirm those systems are working as required
  • Medicaid programs will incur additional costs to cover additional operational efforts
  • System vendors will incur extra work that may affect project timelines and other priorities

If you have any questions or would like to learn more about how BerryDunn can assist you with the PHE unwinding efforts, please contact the Medicaid consulting team.

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Design, Development, and Implementation (DDI) and project impacts resulting from the Public Health Emergency (PHE)

Read this if you work for a not-for-profit organization. 

Our annual not-for-profit Recharge event provides attendees with an opportunity to hear about hot button issues in the not-for-profit industry. We polled registrants from across the country to see where they are focusing their attention in the current landscape. 

Employee retention

Overwhelmingly, employee retention is a number one concern for organizations, with 78% of respondents saying they were strongly focused on it in 2022. Not surprisingly, financial stability (67%), cybersecurity (50%) and concerns about access to government funding (43%) were of common concern among respondents.


 
Remarkably, employee retention in 2022 weighed more heavily on respondents than concerns around the remote workplace in 2021. While over 57% of respondents were concerned about the remote workforce in 2021, employee retention did not even make it into the top four concerns for organizations. This shift is consistent with what we are seeing in our client base, as organizations embraced hybrid and remote working arrangements and are well into codification of and adherence to the policies in place. Organizations reported taking significant efforts toward employee retention, most commonly looking at increasing salaries and allowing hybrid and flexible work arrangements as methods to help retain employees.

Financial stability

The concern around financial stability is slowly starting to decline. While financial stability was a top concern for 83% of organizations in 2021, that percentage dropped to 67% of respondents listing it as a top concern in 2022, While multiple factors certainly contribute to these results (availability of COVID relief funds, for example), the decline is significant, especially in this time of inflationary growth and demands on the labor market. This decline may be reflective of the continued transition away from short-term emergency response and toward a more future-oriented mindset. 

Other concerns

Both cybersecurity and government funding concerns held relatively steady in 2022 compared to 2021, with 45% of respondents concerned with cybersecurity and government funding in 2021, compared to 50% and 43% in 2022, respectively. 

Participants also reflected on the perceived top concerns for their board members, with employee retention and recruitment and overall financial stability leading in top importance. These mirrored concerns are of no surprise, but speak to the continued need for regular and reliable reporting to boards to allow for continued rapid response by those charged with governance.

If you have any questions about your specific concerns or situation, please don’t hesitate to contact our not-for-profit team. We’re here to help.

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Employee retention and other concerns: NFP outlook for the year ahead