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In trying to clear a block about a specific assignment, I reviewed several client documents that were a model for the assignment. The problem: they just were not like any prior models I have seen for this type of work. I couldn’t quite get oriented around the issue of “what really belongs in this category?”
But I got a (quick?) flash. The real issue is that the model document used certain words in a different context than the one with which I was familiar. That context – sadly – existed completely outside the model document.
There are two lessons here.
One is to define context in the work you create. Context can dramatically modify meaning. Without it, your audience (readers, viewers, whatever) are bumping into walls – or falling off a cliff. (Possible exception – thrillers, a la Alfred Hitchcock, where withholding context can be essential to creating mystery and preserving suspense.)
The other is – when you’re trying to work with new models – is understanding exactly what everything is supposed to mean. Words, symbols, what have you. What is intended? How should the reader or viewer understand that element?
Considering those can dramatically improve the user’s experience – and simplify your work in creating new or derived products.
This occurred to me in the course of posting a reply to an inquiry on another board. I suspect it’s just a difference in each person’s approach to solving problems.
The inquiry was in the general category of “should I make format choice X or format choice Y in developing a document.”
And, as one might expect, several people jumped in to offer answers. Some were excellent; others were based on old and incorrect information regarding the psychology of readability.
But thinking about this lead me to ask “why would this person post the question in the first place?” From time to time, we are in the position where we want the quick answer, the fast solution to the thing we need or want to do right now. I wonder, though, whether this approach, taken to extremes, becomes a habit, and limits capability.
For example, what happens two hours later, or two weeks later, when the same person has another question in the same domain? Do they simply post again? Or give up if no instant solution is offered?
What happens if the answers they were given are simply wrong for the actual context in which they intend to apply the information? (Because it’s a special case.)
Instead, I want to know about the fundamental principles. What is the general body of knowledge and research that underlies the thing I’m trying to do? That doesn’t mean I need to go get doctoral-level expertise right now, but I would want to have read some basic articles – hopefully a few that are complementary, and some contradictory – so I have an understanding of the basic principles and foundation for this area.
In the case of the query I mentioned above, I seemed to remember that a couple posts made assertions that have been disproven by newer research in the field. While I didn’t have time to dig out the journal articles, I figured someone on the net had collated this work. So, turning to Google, I searched something like “X versus Y” and was able to (politely) post to suggest that there was some additional information on the subject. And, I refreshed my memory as well.
Perhaps it’s just a difference in internal wiring, interests, and proclivities. But I think that looking for the fundamental principles can help build depth and expertise - and help in solving more difficult classes of problems.
Or perhaps it’s just a rationalization for spending too much time on Google and reading books. 
Different organizations, based on different cultures, have different limits on their acceptance of project management theory and practice.
In health care, the limit seems to be Earned Value Management (EVM). Despite being a neat tool for analyzing project performance, I’ve learned through experience that a normally energetic class will be asleep within 15 minutes of beginning that topic. I now cover it only in an advanced class.
For human services, it seems to be Critical Path Method (CPM) scheduling. People learn it and actively participate in the class and exercises, but ask “when would I ever do this?” I continue to teach it, but primarily with the hope that the class will recognize the need to understand dependencies between tasks, and how that affects the overall timeline.
What’s the limit in your experience?
Shameless plug: we have what I consider to be a pretty good class in project management for health and human services. (More here.)
As with other training in project management, there is a lot to absorb in a short time. In three days, we cover manytopics, and conduct individual and group exercises to help people understand and retain the material and see the real-world application of the techniques. This isn’t all that different from many seminars and classes out there. Sometimes, being in class is like drinking from a fire hose – it’s all coming at you very quickly, and you can’t swallow fast enough.
Usually, with all this new information, the student leaves the class energized, and looks forward to the application of new ideas to his or her work.
Then Monday morning arrives. And it’s more of the same – eight crises, twenty-eight phone calls, fifty-eight new messages with demands, and a partridge in a pear tree. (Maybe not the partridge.)
Quickly, it becomes Thursday, and the student has not yet applied the material learned in the previous week. It’s fast receding into the distance…
To use the project management training effectively, we have to overcome the barrier of trying something new, unfamiliar, and perhaps complex — and banish the fear of making mistakes. Guess what – it’s likely that we’ll make some. Maybe even a lot.
It’s natural to resist trying these new things, because we just don’t want to look like fools – particularly in front of our coworkers, and especially with our boss. However, one of the nice things about the project management training is that frequently our coworkers and sometimes our boss will have been in the same class. So – there is a shared experience and level of understanding regarding the new tools and techniques.
Here, then, is what I advise people in our class: don’t try to apply everything at once. It’s just too hard to remember, and you will need to practice each new technique a few times before it makes sense. Also, you might have to make some adaptations to the technique or tools to make it work really well for your environment. (Or just to simplify it so you can get started.)
Instead: when you’re faced with the situation where one idea seems applicable, use it. And doggedly pursue it, learning as you go.
Here’s an example: many organizations have problems with meetings – lack of focus, wrong attendees, no clear purpose, and no results. So we recommend creating an agenda, specifying the meeting objectives and attendees, defining the time limits for each topic, designating a leader, facilitator, timekeeper, and recorder, and conducting the meeting according to your plan and certain rules.
So, if your organization has problems with meetings – make that agenda, designate the roles, clarify the purpose, stick to the agenda. No one said it’s going to be easy. Likely, it will be hard – for four or five meetings, you will still have the individual who wants to ramble on regarding topics not on the agenda, or produce meeting minutes that did not capture critical action items. That’s just the nature of learning – you got the tools and ideas in the class, and you have to force yourself (and perhaps others) to apply them over and over until they become second nature.
Musicians have to contend with this constantly. I play a couple instruments – clarinet and guitar. Currently, I’m working on correcting some difficulties I have with playing in the third register of the clarinet – the altissimo -all the really high notes. (I’ve been referring to it as the peeling paint register.) It’s obnoxious, and I tend to resist doing it, because, at least at the moment, it’s not very much fun. More squeaks, out-of-tune notes, and general irritation.
But – when it’s working – it’s fabulous – and I can appreciate the new freedom and flexibility. The key is usually to break things down into small parts – “I’m going to work on only this group of six notes today” – and practice those over and over until they sound right.
The same can happen for project management and your work environment. You just have to insist – to yourself at first, and then to others – that you’re not going to continue the old habits.
Get started – by persistent application of one idea you’ve learned. Master it, then add another.
At the end of an intense and arduous proposal effort, you – and the team – may feel that you’ve put forth your best effort. Designed a great solution for the customer, pulled out all the stops, written compelling text and included gorgeous pictures depicting the utter beauty and elegance of your solution….
And then:
You win.
Or, worse, you lose.
Why?
We Won!
Be careful what you wish for – now you have to implement! (Didn’t make any promises you couldn’t keep, right?)
Why did you win?
- You were cheap. In public sector bids, we see price trump almost everything. Why almost? Well – many requests for proposal that we see have scoring or evaluation criteria that weight technical capability above price. Others flatly say: if technical capability is equivalent among competitors, or technical capability is simply adequate – lowest price wins. And we saw a rather surprising one recently, where pricing was included in the same binder as the technical proposal. (Instead, these are usually requested as separate sealed envelopes or binders.) What’s the evaluator going to do? Turn to the numbers first.
- The customer loves you. What kinds of relationships did you build before the request for proposal (RFP) came out? If it’s for a state agency, were you telling everyone that would listen – governor, legislators, agency directors, community leaders – why you would be good for them, and for their constituents? What did you give back, in terms of community services?
- You have a clearly superior solution. We have become jaded about this – but occasionally, someone offers something so unique and compelling that it raises the bar for the competition. Have that thing – and make it hard to match.
- Your proposal made all of this so obvious that it was an easy decision. Evaluators have other things to do besides read proposals. Make yours enjoyable, easy, and compelling.
We Lost!
Unfortunately, now begins the search for scapegoats.
What’s not so obvious to those on the search is that many of those scapegoats were in plain sight before the proposal was submitted.
Here are some reasons why you might have lost:
- Your price was too high. This is pretty easy to detect in public sector competitions, but may be hard to know beforehand. But – I have seen instances where a losing bid had a price seven to ten times that of the winning bid. Did both firms read the same request for proposal?
- The customer hates you/doesn’t know you. Perhaps your reputation precedes you. How are you doing on other contracts for this customer? Or, someone associated with your team said the wrong thing at a legislative hearing, agency meeting, or bidder’s conference.
- The customer hates one of your subcontractors. What’s the saying about “being known by the company you keep?”
- Your solution is inadequate. Did you read the requirements?
- Your solution contains elements that the customer cannot believe. For example – and I have seen this in the realm of medical claims payment systems - you claim that information system ABC can be easily adapted to look exactly like information system XYZ. The customer says: “you’re dreaming” and writes off your bid.
- Your proposal was incomplete, unclear, hard to read, etc. The customer cannot find what they are looking for, or have to work so much to understand what you’ve said – and whether it meets their requirement – that they finally just give up.
That list is just a start, of course.
Here’s another tip: most likely, you did not lose because the word “the” was misspelled as “teh” on page 267. In fact, more of the public agencies are including language in their requests for proposal that allow the agency the right to overlook “inconsequential errors” or “immaterial errors” or something similar. While you want to work hard to try to eliminate those mistakes, they pale in comparison to having the wrong price, program, or relationship with the customer.
At the end of an intense proposal project – or any intense project – everyone on the team is spent. Sleep deprivation, poor eating habits, no fresh air, and lack of exercise conspire to create fatigued team members. Who, while interested in doing a good job, are not thinking clearly.
This leads to mistakes. Team members miss required elements, or they make decisions because of expedience or because the chosen path makes perfect sense in a muddled brain. Or, they just plain overlook incorrect information.
Unfortunately, in a proposal, these errors might cost you the contract. If it is another kind of project – for example, an information system – these errors might lead to an outright failure, or simply an operational issue that will require lots of cleanup work.
What is needed? The person with a clear head. Someone who can look at the product, or the issue at hand, and make a sane, objective decision.
Who is that person? They must have extensive subject matter expertise and experience. So – if it’s a healthcare proposal – you’re looking for another experienced, capable proposal manager who is not involved in this proposal – and is not involved in a mad stampede on another proposal project. If it is an information system – you need another experienced project manager, or perhaps a systems engineer, with knowledge of this kind of project.
For a proposal, of course, your “designated thinker” will need to review the existing Request for Proposal (RFP) and probably some other project documentation (decision lists, assembly sheets, style guides, whatever) to orient them to the project. For an information system, your chosen individual will need to review requirements, project plans, and other documents as needed to achieve familiarity.
Then – the proposal or project manager can ask this person to review selected problems or decisions:
- “Here’s what I’m thinking – does this seem right to you?”
- “We put all the materials for the proposal in a folder on the network – would you check and make sure that we included everything that is required?”
- “Someone just found this error on page 372, but it will take two days to get the right information. What should we do?”
- “This screen used to work but doesn’t now. How critical do you think it will be for go-live?”
Find some candidates for this role early in the project, and make sure they are aware of your expectations and are committed.
“There’s nothing new under the sun.” Well, not quite. Imagine the Apple iPhone a hundred years ago…
Here’s the problem. Due to requirements, inertia, and just “staying in the comfort zone”, most health plans are offering relatively similar solutions to states. The states want more. Virtually every Medicaid RFP we see explicitly asks for innovative solutions. Yes, there are many regulations that bind us, and make it easy to stay “comfortable.” Nevertheless, if you offer what everyone else offers, and the competitor’s price or perceived risk level is lower – you lose.
But wait – your health plan has fifteen differentiators!
Really?
We find that many of these “innovations” don’t hold up to examination. So – do your evaluation – then determine what you can offer that is truly groundbreaking, innovative, and will help the state achieve its objectives. And if it is hard to replicate – so much the better.
Here is an experiment to help you assess whether your differentiators are real. Choose three to five things that your plan touts as competitive differentiators. List those down the left hand side of a table. Then choose competitors – list those across the top of the table.
|
Program
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Us |
Competitor 1 |
Competitor 2 |
Competitor 3 |
Competitor 4 |
| Medical SuperProgram 5 |
✔
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✔
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N/A
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N/A
|
✔
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| Claims Data Mining Accelerator |
✔
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N/A
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✔
|
✔
|
N/A
|
For each competitor and differentiator, put a check mark in the box if the competitor has a relatively similar feature to the one you list. By relatively similar, we mean a feature where the average consumer would likely not notice an appreciable difference. You can get information on the competitor’s features in many ways: Google, health plan websites and provider manuals, presentations at conferences, and FOIA requests of competitor proposals.
How many boxes are checked? Are you truly different? If so, more power to you! But if not – time to start conducting research and development.
Now the RFP is out. Great, let’s just steal some stuff from the last eight proposals and slam it into a new Word document, then ship it!
Not so fast.
You need to carefully consider what the state is asking for – sometimes just expressed as part of the scope or work, or more directly in a question – and answer the question – completely and concisely. Repeating the requirements is not helpful and considered non-responsive. Saying “what” you will do is, in the end, just repeating the requirements. Instead, you need to answer the question with “how” and “why”. “How” you will do the work, “why” your way is better. Neither are easy.
Regarding “how”: one of the most significant issues we encounter in proposal development is the lack of a clear and detailed business solution to the requirement. If you don’t have this clear and detailed solution, it will be hard to answer the question – and it will show. There are a variety of different elements that can go into operational solution planning. Here are three key ones.
- First, you should be able to explain who is going to perform the work for a particular function. Who are the people, what are their job titles, what skills and qualifications must they have, how are they organized, who is accountable, and so on?
- Second, you need to have a detailed business process for a particular function. What are the inputs, what are the outputs, what are the steps, what are the decision points, who performs each step, how do you correct problems, and so on?
- Third, you should know what information systems support the process. What systems are used, how do they connect, what features support the business process, how do you eliminate multiple lookup and data entry, and so on?
If you have these all well-described – and if they are tuned to the needs of the Medicaid population and the state requirements – then you will be much better prepared to write the proposal.
Once you have defined “how” you will accomplish the work, you need to explain “why” your way is better. This is where we get into techniques of argument – rhetoric. “Our solution is better because of x, y, and z.” And then explain each of x, y, and z. Show data, true stories (de-identified as appropriate), charts, graphs, comparison tables, and so on. Make sure that data you use is relevant and comparable for the case you are trying to prove.
If you don’t have data – you need to start capturing and using it now, well before the RFP comes out. In fact, scanning several RFPs will likely give you some ideas about key numbers that you will want to have – and those often correspond closely to the operational reports the state will require anyway.
You have picked the opportunity. Now what?
You have to develop the opportunity – build the relationships and create your brand and position in the market and with the customer, long before the RFP is released. If you are the incumbent – and this is a rebid – that obviously means doing the best work possible. Show that you’re doing good work – how do your HEDIS and CAHPS numbers look (for health plans)? What are your call center statistics? What percentage of clean claims are paid in 10, 15, 30 days?
And make sure you’re not leaving a mess – are there a pile of appeals on a regulator’s desk? Is some other disaster unfolding? How do you fix it, and make sure that it does not break again?
Suppose you are not the incumbent. Now what? We suggest that plans spend one to three years in the market, prior to the RFP, building relationships. You need to talk to:
- Providers
- Community agencies and leaders
- State agencies (Medicaid, Insurance)
- Legislators
- Governor
- Consumers
Position yourself, using a consistent message with each constituency. Maintain regular contact – don’t just show up once and then disappear for a year. Furthermore – what are you giving the state? Why should they care who you are? Do you have an associated charitable foundation you can use to help make a difference?
Also, as you develop relationships in the state, you might likely be considering partners who will be part of your bidding team. Be sure to vet them carefully – it’s no fun to find out after the bid is in that a particular vendor or partner has some questionable history with the state – and is therefore a liability. In the same regard, remember that state Medicaid directors talk to one another – do you have skeletons in the closet that will be revealed?
In the end – you need to build the buzz – and goodwill – before you bid.
How does your organization choose opportunities?
In an economic downturn, the panic response is to try to sell everything to everybody. The result – other than the occasional stroke of dumb luck – is that nothing is sold to anyone.
Remember that there are also several competitors out there, who are trying to meet their sales, revenue, and profitability projections. Your organization has limited time, resources, and energy. And, it’s possible you may have even fewer resources now than you did one or two years ago.
To be effective, then, you need to focus your attention on opportunities where you can win. Why?
- You can devote enough energy to the face-to-face relationship building you will need to establish your credibility with the customer and the market.
- You can work to develop a superior – and innovative – technical solution.
- You can fine-tune your pricing – which goes hand-in-hand with that technical solution.
Bottom line – don’t shoot at everything that moves.
Here are some things to consider when choosing opportunities.
First, what is your company’s sweet spot?
I have a question I ask when I interview people for jobs. It is “what do you do better than anyone else you know?” If they give a clear and articulate answer, I know at least that they have thought about it and understand their singular strength. What is the answer for your organization? Are you the at-risk health insurance king? Superlative at chronic health care? Expert at Administrative Services Organization agreements?
Here is the corollary question that I ask: “what should I never give you to do because you are terrible at it?” Think about that. Unless you’re primed to try to enter a new market (and have the resources to burn to do it), answering that second question can help keep you from wasting time on opportunities that are not a good match.
Consider some examples: who do you think of for economy cars? (e.g. Honda and Toyota) Who builds consumer computers? (e.g. Apple) Who builds business computers? (e.g. Dell, IBM, HP) Yes, there are exceptions to those rules, but the fact that we have strong associations of those names with particular solutions is important. It isn’t any different in the health and human services market – buyers make associations, based on information they gather, and influence purchasing decisions accordingly.
What message are you sending? How well are you positioned in a particular market? Remember that every opportunity you choose costs time and money, consumes resources, and prevents you from working on something else. There really are not ten “priority one” projects. Instead, you end up with ten “priority ten” projects – and the results follow accordingly.
In 1993 I started working with a client on a large federal healthcare bid where the organization had directors, VPs, and C-level executives pursuing the opportunity and writing the bid. No proposal expertise, no federal expertise. Furthermore – because they were spending all their time working on the proposal – the operations numbers went awry. The medical loss ratio climbed, claims backlog increased, and so on.
Focus is critical.
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