Winning the RFP Race: Competitive Intelligence To Win

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

2. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 TODAYS QUEST PANEL Darren Huff Regional Sales Director East Region [email protected] Linda Borths Director of Sales [email protected] John Weis President & Co-Founder [email protected] Robert Smith Regional Sales Director West Region [email protected] 3. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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. 4. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 National Marketplace Presence 5. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 RFP Evolution 6. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Buying Pendulum 7. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 8. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 RFP EVOLUTION vs. Intelligent Design Everything you can do today but so much more. 9. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 10. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Access Standards 11. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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. 12. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Standard Access 13. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 14. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Dynamic Access 15. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 16. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Compound Access 17. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Access Pages 18. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Report Pages 19. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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* 20. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample Dynamic RFP 21. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 22. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Standard RFP 23. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample Pharmacy RFP 24. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample RFP Part 1 25. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Compare Your Network to the Market 26. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample RFP Part 1 401 227 174 27. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample RFP Part 2 28. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample RFP 29. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sample RFP 30. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 OUTSIDE the BOWL 31. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Miles AND/OR Minutes How do you respond to Time and/or Distance? 32. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Run Time And/Or Distance Together 5 miles/ 15 minutes 33. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Maximum vs. Average How do you answer this question? greatest travel distance? 34. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Show the Min or Max Distance 35. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Filter your Access What is your process for this task? 36. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Filter your Access 37. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Sort by Options Objective: Sort your access analysis by most members with access (something other than geography). Now you can sort by multiple options.. 38. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Ratios Add a filter to focus on your high need areas (ie: > 2500) 39. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Analyses with Wrap Networks 40. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 41. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Analyses with Wrap Networks Members can access Either My Network or the Wrap Network: 42. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Analyses with Wrap Networks Members have access to My Network or the Wrap (Leased) Network DEPENDING on their Geography: 43. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Impact with Carve Outs 44. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Interactive Maps Labels Points Service Area Shading Radii Cities Water HWYs Inset Maps Annotations 45. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Provider Impact Analysis (PIA) (aka Narrow Networks) 46. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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? 47. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Narrow Networks: Ranked & Ordered 48. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Narrow Networks: Dont sacrifice access 49. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 50. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 51. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 52. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 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 53. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 QUEST TEAM Darren Huff Regional Sales Director East Region [email protected] Linda Borths Director of Sales [email protected] John Weis President & Co-Founder [email protected] Robert Smith Regional Sales Director West Region [email protected] 54. PROVIDING POWERFUL SOLUTIONS I Since 2003 I www.QuestAnalytics.com I 920.739.4552 I 2014 Please Provide Feedback