Tag Archives: medicare

More RFP Looney Tunes, This Time from the Centers for Medicare & Medicaid Services Health Care Innovation Award Program

Having been a grant writer since before the flood, I should not be flummoxed by a hopelessly inept RFP. I wasn’t flummoxed by the recently completed Centers for Medicare & Medicaid Services (CMS) Health Care Innovation (HCI) Awards Round Two process, but I was impressed by the sheer madness of it.

This Funding Opportunity Announcement (FOA, which is CMS-speak for “RFP”) was exceptionally obtuse and convoluted. I should expect this from an agency that uses 140,000 treatment reimbursement codes, apparently including nine codes for injuries caused by turkeys.

The HCI FOA was 41 single-spaced pages, which is fairly svelte by federal standards—but, in addition to the usual requirements for an abstract, project narrative, budget and budget narrative, it also includes links to templates for a Financial Plan, Operational Plan, Actuarial Certification and—my personal favorite—the Executive Overview. The Financial Plan was a fiendishly complex Excel workbook, while the Operational Plan and Executive Overview were locked Word files.

Since the Word documents were locked, spell check and find/replace didn’t work in the text input boxes. Every change had to be made manually. Charmingly, the Operational Plan template had no place to insert the applicant’s name or contact info. So when the file is printed for review, which I’m sure it will be, and gets dropped on the floor with several other proposals, which is possible, there’ll be no way to tell which Operational Plan is which.

This could be a problem in an Operational Plan.

My vote for the most fabulously miss-titled form is the “Executive Overview.” Remember: a one-page abstract was also required, so an Executive Overview seemed redundant until I realized it was 13 single-spaced pages, with tons of inscrutable drop-down menus and fixed-length text input boxes. It seems that CMS is confused as to the meaning of “overview.”

The Executive Overview was really another project narrative, disguised as a form. If one double-spaced the Executive Overview, it would be about 26 pages long. Although the FOA nominally allowed a 50-page project narrative, the length of the project narrative was effectively much shorter because of convoluted instructions that required the project narrative file to include other documents. Our project narrative ended up at 35 double-spaced pages—not all that much longer than the so-called Executive Overview.

This FOA also included four “innovation categories” that were obtuse and mostly interchangeable. The FOA required that the selected innovation category be listed four times, once in the abstract, twice in the project narrative and again in the Overview. Since the categories were confusing at best, our client changed their selection a couple of times during the drafting process, which meant it had to be changed in four different places each time.

The grant request amount had the same problem, except that it is also included in the Financial Plan, budget narrative, cover letter and Actuarial Certification, as well as the abstract, project narrative, and Overview. So when the budget changed—which it inevitably did—each change had to occur in seven places to maintain internal consistency.

CMS, of course, never thought to link the various templates so that global changes could be made. But then again, why would they? After all, the authors of this FOA don’t write proposals and aren’t concerned with simplifying the process, which brings me back to the nine categories of turkey injury treatment. I wonder who keeps stats on turkey injuries. I would like to meet the GS-13 in charge of domestic fowl attacks at the Department of Agriculture.

Health Care Innovation Awards Round Two: ObamaCare, the Gift that Keeps Giving for Grant Seekers and Writers

Another week, another huge ACA / ObamaCare RFP announced. This time it’s Health Care Innovations Awards Round Two. There’s $900,000,000 up for grabs, with grants to $25,000,000. These eye popping numbers are big enough to seize the attention of even this grizzled grant writer.

The purpose of this very attractive RFP is to:

The second round of Health Care Innovation Awards will fund applicants who propose new payment and service delivery models that have the greatest likelihood of driving health care system transformation and delivering better outcomes for Medicare, Medicaid, and CHIP beneficiaries in four Innovation Categories.

This string of policy buzz words doesn’t really say anything other than that applicants are supposed to do something that will somehow lower undefined health care costs born by public insurance programs, while at the same time magically improving undefined outcomes. This is great news for applicants because almost anything can be proposed. It’s even better news for grant writers, as we can wax eloquently in health policy mumbo jumbo while spinning grant Tales of Brave Ulysses (I used this quote before, as well, but it just seems so damn perfect here). Speaking of quotes, I’ve cited the late, lamented Senator Everett Disksen before, but it applies here too: “A billion here, a billion there, and pretty soon you’re talking about real money.” This program is another example of the talk about sequestration and budget deficits having little effect on actual federal grant funding: the grant spigot is on at ObamaCare and it’s a gusher.

Every type of applicant is eligible: nonprofits, IHEs (Institutions of Higher Education, otherwise known as “colleges or university” but in bureaucrat-speak), Indian tribes, businesses and your Aunt Martha, as individuals are eligible applicants. Think of it as another Oklahoma Land Rush of grant opportunities.

As faithful readers know, I’ve been writing grant proposals since dinosaurs walked the earth and I can’t remember another grant program that has had so much money available, so little direction, and so broad an eligible applicant pool.

If your organization or your Aunt Martha have any bright ideas on improving Medicare, Medicaid and/or CHIP service delivery and costs, you should not let this opportunity pass. The deadline is August 15, so, for a change, there’s plenty of time to plan the project concept and write the proposal. A word of caution, however: a mandatory letter of intent to apply must be submitted by June 28. LOIs are easy to draft, so you should work most di di mau on the letter to reserve your place at this incredibly tasty grant trough.