Just because you get a “no” at first doesn’t mean you give up
Health care services company
A policy at the CMS Innovation Center prevented the company from unlocking millions of federal funding dollars
Regulatory strategy; relationships; message development
What We Did
An innovative for-profit health care services company came to us after trying and failing to break through with the leadership at the Center for Medicare and Medicaid Innovation (CMMI). The company saw a lack of access to the kind of capital providers needed so they could invest in the infrastructure for population care management. The company’s model filled an unmet need in the accountable care ecosystem – and they were seeking a partnership with CMMI to further expand.
We quickly assessed the situation and determined that the company had gotten into a rut with their point of contact at CMMI. By having our own conversations with CMMI, separate and apart from our client, we determined that there were misunderstandings on both sides – the company’s and CMMI’s – about the proposal and the need. The government’s interpretation of the proposal was reasonable, and they were not inclined to change their point of view.
We employed two key strategies to elevate the discussions and find a solution to the impasse. First, we contacted a parallel group at CMS outside the CMMI who had a favorable opinion of and experience with our client. We asked CMS to contact their CMMI counterparts to validate our client’s reputation. Second, we initiated higher level discussions with the CMM Ito obtain a “fresh take” on the proposal from key decision makers. These two strategies helped the CMMI model lead staff to soften their point of view on our client’s proposal, allowing for some much needed flexibility in the model’s application rules.
When the model was finalized and applications were publicly announced, our client was able to meet the criteria for participation.
The company won 10 slots in the competitive bid, allowing them to access federal investment not otherwise available to them. The company leveraged this capital to improve the quality of health care in their communities and save the Medicare program hundreds of millions of dollars.