Winning the RFP Race: Competitive Intelligence To Win

PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I ©2014
Winning The RFP Race:
Competitive Intelligence To Win

TODAY’S QUEST PANEL
Darren Huff
Regional Sales Director – East Region
Darren.Huff@QuestAnalytics.com
Linda Borths
Director of Sales
Linda.Borths@QuestAnalytics.com
John Weis
President & Co-Founder
John.Weis@QuestAnalytics.com
Robert Smith
Regional Sales Director – West Region
Robert.Smith@QuestAnalytics.com

BUILT with VISION
QUEST ANALYTICS SUITE™
The industry's only software solution that has continued to
evolve to meet the changing demands of Network
Adequacy. The Quest Analytics Suite fully integrates;
Access, Disruption, Network Adequacy (Medicare and
Custom), Address-level Geocoding and Hospital Quality
Analysis into one easy to use suite.

National Marketplace Presence

RFP Evolution

Buying Pendulum

RFP EVOLUTION
Access Analysis Request
Using the criteria below and the attached census file, please provide a Network Adequacy
for ABC Company.
 1 Acute Care hospital within 15 miles
 2 PCPs within 8 miles
2 Adult Medicine Providers within 8
2 Pediatricians within 8 miles
2 OB/GYNS within 8 miles
 2 Specialists within 15 miles
2 Orthopedic Surgeons within 15 miles
2 Dermatologists within 15 miles
2 Otolaryngologists (ENT) within 15 miles
2 Cardiologists within 15 miles
2 General Surgeons within 15 miles
2 Endocrinologists within 15 miles
This type of RFP
will add more
value and
credibility and will
provide clear and
concise network
analysis.
A WIN/WIN
Scenario

RFP EVOLUTION vs. Intelligent Design
Everything
you can do
today but so
much
more……….

P R O V I D I N G P O W E R F U L S O L U T I O N SP R O V I D I N G P O W E R F U L S O L U T I O N S

Access Standards

Standard Access
Type of Provider Number of Providers Miles From Residence
PCP 2 10
Specialist 1 15
Hospitals 1 15
Retail Pharmacy 1 5
1. Prepare a “geoaccess” report using the parameters in the table below and provide an
electronic copy. Note that it is important that you follow the exact parameters. Make
sure to include ALL employees from the census file in your report.

Standard Access

Dynamic Access
Employee Group Provider Group Access Standard
Urban General Dentists 2 providers within 5 miles
Suburban General Dentists 2 providers within 10 miles
Rural General Dentists 2 providers within 20 miles
Urban Orthodontists 1 provider within 5 miles
Suburban Orthodontists 1 provider within 15 miles
Rural Orthodontists 1 provider within 25 miles
Urban Oral Surgeons 1 provider within 5 miles
Suburban Oral Surgeons 1 provider within 15 miles
Rural Oral Surgeons 1 provider within 25 miles
Urban Endodontists 1 provider within 5 miles
Suburban Endodontists 1 provider within 15 miles
Rural Endodontists 1 provider within 25 miles

Dynamic Access

Compound Access
Please submit your network analysis using the
following parameters:
 1 Hospital within 30 miles or 30 minutes AND
 2 PCPs with 10 Miles or 20 minutes AND
 5 Specialists within 20 miles or 30 minutes AND
 1 Pharmacy within 7.5 miles or 10 minutes AND
 1 General Dentists within 30 miles or 45 minutes AND
 1 Optometrist within 30 miles or 45 minutes

Compound Access

Access Pages

Report Pages

Access Pages
 Access Overview
 Single Access – One Page
 Multiple Access – Select One, Prints Multiple
 Compound Access – Select One, Prints One
 *Option to not include map*
 Access Summary & Detail Page
 Analysis Filter
 Single Access or Multiple Access
 Access Filter
 All/With/Without/With & Without/Excluded
 Unique and Access Points
 Sum by/Subtotal/Grand Totals
 Exports will not Subtotal or Grand Total
*Turning on/off page dialogs*

Sample Dynamic RFP

Standard RFP
1. Use the census data to identify the number of employees that reside in Urban, Suburban,
and Rural zip codes. Each occurrence of a zip code represents one primary eligible and its
covered eligible.
2. For those zip codes that fall into each category, identify the percentage of members with and
without access to at least one in-network retail pharmacy within 1 mile in Urban areas, 3 miles
within Suburban areas, and 5 miles within Rural areas.
Example: 100 emp – 85 within 1 mile (85% - 85/100), 5 within 3 mile (90% - 90/100), 3 within 5
mile (98% - 98/100), and 2 without coverage (2% - 2/100). All 12 boxes must be filled in, and
press the complete button to continue.
# of Employees % Within 1 Mile % Within 3 Mile % Within 5 Mile
Urban Access
Suburban Access
Rural Access

Standard RFP

Sample Pharmacy RFP

Sample RFP
Part 1

Compare Your Network to the Market

Sample RFP
Part 1
401
227
174

Sample RFP
Part 2

Sample RFP

OUTSIDE the BOWL

Miles AND/OR Minutes
How do you respond to Time and/or Distance?

Run Time And/Or Distance Together
5 miles/
15 minutes

Maximum vs. Average
How do you answer this question?
greatest travel
distance?

Show the Min or Max Distance

Filter your Access
What is your process for this task?

Filter your Access

Sort by Options
Objective:
Sort your access analysis by most members
with access (something other than geography).
Now you can sort by multiple options…..

Ratios
Add a filter to focus on your high need areas
(ie: > 2500)

Analyses with Wrap Networks

Objective: I am a regional plan that uses a Wrap Network, how
can I run 1 report?
 2 Options: Depending on your objective
 Compound OR/ANY
 Members can access Either Network
 Standard Access Filtered by Geography
 Members have access to a networks depending on their geography

Members can access Either My Network or the Wrap Network:

Members have access to My Network or the Wrap (Leased) Network DEPENDING
on their Geography:

Impact with Carve Outs

Interactive Maps
 Labels
 Points
 Service Area
Shading
 Radii
 Cities
 Water
 HWYs
 Inset Maps
 Annotations

Provider Impact Analysis (PIA)
(aka Narrow Networks)

Provider Impact Analysis Consulting
 NARROW NETWORKS
What is the smallest network I can have?
 SERVICE AREA EXPANSION
Who do I need to enter a new market?
 MARKET ANALYSIS
How does my network compare?
 TIERED NETWORKS
How do I sway members to use lower cost/high quality?
 TARGETED PROVIDER LISTS
What location gives me the greatest coverage?

Narrow Networks: Ranked & Ordered

Narrow Networks: Don’t sacrifice
access

P R O V I D I N G P O W E R F U L S O L U T I O N SP R O V I D I N G P O W E R F U L S O L U T I O N S
RFP
Intelligence

Up Coming Webinars
Disruption: Spin It to Win It
Thursday, July 24th
Now Is The Time For Federal Programs: Medicare/Federal
Exchanges
Tuesday, August 12th
Getting Pumped For State Programs: Medicaid/State Exchanges
Wednesday, August 13th
Finding The Providers That Fit: Narrow Network Strategies and
Design:
Thursday, August 14th

Absolute Total Care
AcariaHealth
Adena Health Plan
Advantica
Advicare
Aetna
AgeWell
AlwaysCare
American Republic
AmeriGroup
AmeriHealth Mercy
AmeriHealth NJ
Ameritas
Amida
Arcadian Health Plan
Archcare
Argus
Argus Dental
Arkansas BCBS
Assurant Health
Atrio Health Plan
Aultman
Avesis
AvMed
Bay Care Physicians
BeechStreet
Benecard PBM
BeneCare
Blue Cross Idaho
BCBS Arizona
Mount Carmel
MVP Health Care
Navitus
Neighborhood Rhode Island
Network Health MA
Network Health Plan of Wisconsin
Nevada COOP
New Mexico Health Connection
NorthShore –LIJ Health System
NovaSys Health
OnPoint
OptiCare Managed Vision
Oregon Health COOP
PacificSource
Palladian
Parkview Health Plan
PatientChoice
Peach State Health Plan
Physicians Health
Physicians United Plan
Piedmont Community
Premier Access
Premier Eye Care
Premiere Health
Presbyterian Health Plan
Prime Therapeutics
PrimeWest
Elderplan
ElderServe
Encore
Evolent
Fallon Community
FamilyCare-OR
Family Health Network
Fidelis
Florida Combined Life
Florida Health Care Plus
Freedom Health
Gateway
Geisinger
GemCare
Glenridge Healthcare
Gorman
Granite State Health Plan
Group Health Coop
Guardian
Harvard Pilgrim
HFN
HHH
HSAG
Health Alliance Medical Plans
Healthfirst NY
HealthNet
HealthNow
THE QUEST CLIENT FAMILY

QUEST TEAM
Darren Huff
Regional Sales Director – East Region
Darren.Huff@QuestAnalytics.com
Linda Borths
Director of Sales
Linda.Borths@QuestAnalytics.com
John Weis
President & Co-Founder
John.Weis@QuestAnalytics.com
Robert Smith
Regional Sales Director – West Region
Robert.Smith@QuestAnalytics.com

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Winning the RFP Race: Competitive Intelligence To Win

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