Procuring appropriate health cover for an IGO's personnel in the US
A global, self-insured IGO with regional headquarters in 5 continents and many 000's of employees
Run an RFP to challenge the existing supplier of in/out patient health and dental care in the US for ~5000 employees
The client’s North Americas division was looking to reassess their use of long term medical and pharmaceutical network suppliers, as they were increasingly frustrated with service levels, especially around data access. To do this, it asked MGG to support the running of an RFP with some new aspects of cover and service. MGG's task was to review their solution requirements, suggest which players should be invited to bid, ensure each one understood the client’s needs, assess each's response and real live performance with benchmarks, recommend a winner and design a transition plan.
MGG worked closely with the client to redesign their US requirements and create the 2 extremely detailed RFP documents to which selected suppliers had to respond. These were: a) a technical response and b) a financial response. The key requirements of the technical response related to: the suppliers’ in- and out- patient networks, service levels (including their claims handling ability, their cost-containment skills, member communications, and data reporting), and their population health management/wellness and telehealth offerings. In the bidders’ financial response, each had to re-price the previous years claims and price 3 different service level scenarios, highlighting the discounts they could each achieve in their medical and pharma networks. MGG participated in reviewing the bidder presentations and created a scoring mechanism to score each supplier’s response. Finally, MGG analysed the responses and presented the final assessments to the client’s board.
The RFP came down to a close race between two final bidders (from 6). Ultimately, the client chose the medical incumbent and was able to secure much-improved terms over its previous arrangement, such as guarantees on annual price increases, improved network discounts and service level guarantees (especially around data management and reporting). IT selected a new Pharma partner with significant savings obtained through a better but cheaper formulation for the necessary drugs. The client was very happy to achieve this complex process within a 5 month period in a very fair and compliant way.