Abstract

StrategicHealthSolutions is a company that was riding high as a federal contractor just three years ago. Unfortunately, the company encountered some very difficult times and, for a time, looked like it would close. Luckily, it came through the other side and is now in a time of rebuilding. The previously written communications were, at their core, very good. They spoke of accomplishments, values, and inspiring people to save the Medicare trust fund for future generations. Now, with a drastically smaller staff and a different type of audience that does not necessarily need to see public relations efforts to award contracts, Strategic has all but abandoned their communication efforts. Everything now needs to be relaunched, revised and repositioned to represent a much smaller, more humancentric point of view in preparation for additional contract work which will likely include non-governmental contracts.

StrategicHealthSolutions Communications Plan

StrategicHealthSolutions, LLC is a business that contracts with the United States government, primarily in medical records review, monitoring and compliance and education. Founded in 2005 by Peg Stessman in Omaha, Nebraska, Strategic found great success over the years to its peak in 2017 of about 275 employees and offices in three states. The company has earned certifications from the Accreditation Council for Pharmacy Education to review pharmacology material as well as the Accreditation Council for Continuing Medical Education and the International Association for Continuing Education and Training in order to offer continuing education credits to medical professionals through web-based trainings. They are ISO9000 certified and attained Capability Maturity Model Integration (CMMI) Level 3. Over the years the company has won numerous awards multiple Washington Technology Fast 50 awards, the ESGR “Above and Beyond” Award in 2012, Inc. 500 Fastest Growing Company Award in 2013, the SmartCEO GovStar Award in 2014, the SmartCEO Future 50 Award in 2015 and the Excellence in Business Award by the Greater Omaha Chamber of Commerce in 2010.

Issues

Strategic made large financial investments in staffing, training, equipment, and office space in preparation for a sizable medical review contract with the Centers for Medicare and Medicaid (CMS). In late 2015, Strategic was granted Unified Program Integrity Contractor (UPIC) status, which is a type of contract which has no monetary value in itself, but makes the company eligible for massive decade-long contracts worth potentially millions or even billions of dollars. Receiving UPIC status is a huge accomplishment which very few contractors achieve. It led to the huge investment as Strategic went hard after one particular UPIC contract. When, in 2017, the decision of who would be awarded the large contract was announced, Strategic learned they did not win. Only weeks later Strategic’s largest single contract was also not renewed, and other were set to expired. February 14, 2018 has come to be known by Strategic employees as hatchet day when 97 of 275 employees were laid off. That was just the beginning as over the next twelve months the business continued to shrink. Several times throughout that year there was every possibility that Strategic would close its doors entirely. Tough decisions were made, and a lot of very hard work was done to keep the business alive. By the start of 2019 all the office locations are closed, the business only had a few active contracts, and the last remaining 15 or so employees all work remotely from home.

Strategic never stopped pursuing new business and, by the end of 2019, had re-attained short-term stability. It had, in fact, began turning a profit, albeit a small one, again. A shadow of its former self, Strategic is still committed to program integrity and serving their contract owners. The challenge now is to reposition the company for long-term success while continuing to rebuild its portfolio of contracts.

Company Values

Strategic prides itself on the company’s eight stated core values. Each employee has had a small laminated sign posted at their desk with the core values on it and management reminds people of them often.  The core values are Respect, Honesty, Seek Clarification, Passion, Productivity, Team Player, Reliability, and Ownership. Out of these values is a slogan that Strategic has stressed to its employees for years which is “Do the right thing – all the time.” Because the government contracting business is a tough place to be successful and is often populated with operators who don’t shy away from backroom deals and shady practices, Stessman found it important that her company would be known as being one of the “good guys” in the cut-throat world of government contracting.

Mission, Vision and BHAG

Strategic’s Mission and Vision statements both revolve around the United States Medical System. Their stated mission reads, “Innovative solutions for health care” and their vision statement reads, “The ‘go to’ company for health care solutions.” While these two statements appear somewhat shallow, in 2015 Strategic released their Big Hairy Audacious Goal, or BHAG. This statement speaks to the corporation’s mission, its vision, and overall goal as a company. Coined in the book, “Built to Last: Successful Habits of Visionary Companies” (Collins & Porras, 2011) a BHAG is a clear and compelling long-term target that everyone in the organization strives for which is, unlike a typical mission statement, intended to catch on with the public. Strategic’s BHAG reads, “Redefining Health Care as a Sustainable Resource.” This statement is something that Stessman and the entire executive team backed completely. A huge amount of money was invested in creating and promoting it.

Organizational Structure

The current organizational chart is extremely flat relative to where it was just three years ago. Where once was a multi-tiered, highly complex structure of divisions and programs, all that remains is a handful of people who don’t always know who to talk to when there is an issue. See figure 1 in the Appendix for the more details. At the top of the organization is founder and Chief Executive Officer, Peg Stessman. Every major decision at and about the company falls on Peg. She also works to discover and bids for new contracts. Day-to-day she does some contract work as well. Below her would be Karen Belew, Executive Assistant, who does all sorts of administrative work but also some of the public relations and human resources tasks. Andrew Czapla’s job title is Program Manager but he does contract work as well as legal consultation, bid and proposal, much more.  There is Ted Grenen who is the Chief Financial Officer. He is ultimately responsible for accounts billable, payable as well as payroll.

Below Ted is Tara Steffen who an accountant. She does payroll but also works a bit on some contract work.

Below Andrew is all of the employees who do the day-to-day contract work. There is one set of employees on an education contract for the Medicare Learning Network, one set of employees on a medical review contract and one set of employees on a contract that works for the Office of the Inspector General.

Communications Audit

To conduct this audit, several actions were performed. First, a review of all public facing company communication channels was completed. This included company social media, company websites, public relations efforts, and a deep dive into Google to find all mentions of the company and key stakeholders online. The next step was to speak with some managers within the organization to discover their thoughts on the current state of communications at Strategic.

Social Media – Twitter

The company Twitter (StrategicHealthSolutions, n.d.) account currently has 745 followers and follows 308 accounts. It shows that the account was created in 2014 but the most recent post on the account was made on December 27, 2018. Before that time, Strategic posted, on average, 4 tweets per month which almost exclusively related to products created by the Medicare Learning Network contract. On January 1, 2019 Strategic ceased to be the prime contractor on the MLN contract and became the secondary contractor. At that time those regular education tweets began to be posted on the new prime contractor’s social media accounts. By 2019 Strategic had let their public relations team go so there was no one else assigned to create or post content to the company Twitter account. A visitor to the company page will see an abandoned site and likely assume Strategic has closed.

Social Media – Facebook

The company Facebook account (StrategicHealthSolutions, LLC, n.d.) currently has 350 likes and 362 followers. It shows that the account was created on July 12, 2013 but the most recent post was on February 6, 2018. Prior to that time the page was extremely active with many posts each month and hundreds of replies by employees and other friends of the company. Posts talked about awards the company had won, public relations efforts that the company had taken, shared videos of the company making the news, and more. It was very active. During the downsizing of 2018 the public relations team, who oversaw the Facebook page, were let go. A visitor to the company page will see an abandoned site and likely assume Strategic has closed.

Social Media – LinkedIn

The company LinkedIn page (StrategicHealthSolutions, LLC, n.d.) has the About section filled out with pre-2018 information but no other information. This page is, and was even when Strategic was at its peak, completely under-utilized as there have been no posts made on the platform by the company and no interactions on the company’s behalf. This is not a professionally populated page. A visitor to the Strategic LinkedIn page will be unimpressed.

Company Website

The Strategic company website (StrategicHealthSolutions, 2018) is a well-crafted, professionally designed site built on the WordPress platform. The home page is engaging, branded well and has all the information about a company that should be on their website. Every page is on brand in terms of content and design. On the home page a visitor can find links to business related items, as expected, but also to the company blog and other healthcare related news headlines. There is also a Resources menu item which brings a link to a Press Kit. I did not have access to the site analytics. This is a great website in every way except that all the information being presented on the site is from 2018 or before. When the company downsized in February 2018 some of the first employees to be let go was the web designer and the public relations team. Since then, the site has remained up, but has not been updated. A visitor to the site will, at first glance, see a professional looking company but with very little effort it becomes clear that this is an abandoned site. They would likely assume Strategic has closed.

Interview

I had the opportunity to speak briefly with Andrew Czapla, Program Manager and defacto day-to-day operations manager of Strategic, about communications and the future of the company.  I first asked about the current state of external communications, which are essentially non-existent.

“We are working directly with contacts within [the Office of the Inspector General],” Czapla explained, “Its always been a mixed bag with our external marketing and government contracting because the only people we ever really need to market to are the people on the Technical Evaluation Panel.” This clarifies why the lapse in current external communications has not been dealt with. Czapla went on to explain that when reviewing and making bid decisions people within the government are not swayed by public marketing efforts.

Before the downsizing event of 2018 there were discussions within the company about expanding the business into other areas including for the Department of Justice, the Department of Defense and other work for private companies outside of government. Next, I asked if future plans for the company still include these various revenue streams.

“We’re looking to grind out business with [the Office of Inspector General] in [Corporate Integrity Agreement]s and potential other business and maintain the remaining work we have with CMS.” Czapla went on to outline some plans for the future of the company. “Right now, we’re waiting to hear on two huge CIAs. If we get one or both of those, we should see some good growth and opportunities. If we don’t, then the plan will be to really start working on some private work.”

SWOT Analysis

Strengths

Strategic’s biggest strengths is the knowledgebase of its employees. Each individual on the two separate teams (monitoring/compliance and education) and at the executive level currently working have been in their current positions for no less than five years and in their respective fields for no less than a decade.  

The education team were instrumental in developing the current Medicare Learning Network content creation process as well as the designs for products created through all other contractors. CMS trusts the team and has given Strategic top marks on their Contract Performance Assessment Reports System (CPARS, 2020) grades through the previous three cycles, which is practically unheard of.

The OIG audit team is extremely well versed in the work they do and are committed to program integrity.

Weaknesses

Strategic’s biggest weakness is that the team is so small now. There less then fifteen people total in the company. Many key positions are empty causing other people to cover them, even when they have little to no experience in those areas. A few examples of how this effect the daily operations would be:

  • There is no Human Resources department. Those duties are split between a few people and no one is well versed in how to manage those functions. If someone has a question it can take quite a while to get an answer.
  • There is no Public Relations department. Those duties are simply not done.
  • There is no IT department anymore. Strategic has contracted with a 3rd party IT company to help handle this. All employees work remotely and so when there is an issue, employees must submit an email and wait for someone to get around to responding. This can cause long delays.

 The financial situation at Strategic is precarious. Throughout 2018 and most of 2019 the business was operating in the red. By 2020 the books were back in the black, however, that balance right now is still not great. Cashflow is extremely tight and there is little room for error.

Morale at the company is not great. Everyone currently on staff were at the company during the massive layoffs of 2018. They saw over two hundred friends and co-workers lose their jobs within a matter of months. Since then, the offices have all closed, contracts were lost, and jobs have changed completely. This has left people with a sort of post-traumatic stress disorder about their employment.

Opportunities

Strategic’s downsizing has focused the business into what it does best. Auditing, analytics and education. The business is now leaning into these strengths and going after work that it can be highly successful in without a large amount of investment into new technology, personnel an office space.

The U.S. government has placed a high regard on preventing fraud within the Medicare and Medicaid systems which has led to more and more contracts being used for program integrity, which is Strategic’s speciality.

Threats

As a government contractor there is a constant threat that politics, which are completely out of the control of the company, will somehow interfere with existing or up coming contracts. This could lead to loss of existing or future contracts.

The entire team now works remotely which leaves them vulnerable to technological issues like internet outages and computer failure.

Since the team is so small if even one person leaves the team it would leave the company vulnerable to a massive decline in revenue.

The overall economy in the United States has taken a downturn since the Covid-19 pandemic. As a government contractor, Strategic is dependent on the government having money available. If the economy is too bad, they will stop issuing as many contracts.

Strengths

  • Knowledge base and experience of staff
  • Education team has an exceptional reputation with their contract stakeholders
  • Monitoring/Compliance team has an exceptional reputation with their contract stakeholders

Weaknesses

  • Extremely small amount of staff available to complete the work required
  • Precarious financial situation
  • Low employee morale

Opportunities

  • The staffing is focused now tightly on their respective areas making each team even stronger
  • The United States Government has placed a greater importance on program integrity to help save money

Threats

  • Politics can affect the lifecycle and awarding of contract work
  • Remote work can be hampered by technical issues
  • Small team means losing anyone could result in a major loss of revenue
  • Covid-19 has led to an economic downturn in the United States which will eventually roll down into government contracts

Communication Strategy

Objectives

The first objective is a short-term goal to relaunch and realign all communications to reflect the current strengths and capabilities of Strategic. All public relations efforts were halted in 2018. To any external audience looking at Strategic’s online presence it looks like some sort of a time capsule from just before the company downsizing event. Strategic’s Facebook, Twitter and LinkedIn accounts all need to be restarted and maintained regularly. It is also advisable for the company to open an Instagram account. As the company regrows there may not be much in the way of contract, business, or industry awards to announce, but there is plenty of space for regular communications with the public. This can be in the form of healthcare or industry related blogs, personal stories by and/or about strategic employees, or looks inside the company. These stories will help to begin rebuilding relationships with the public and rehabilitate the company’s reputation in the contracting world.

The second goal is to refocus the existing messaging presenting in the abandoned company website from suggesting that Strategic is leading the way nationally toward a smaller, more human-centric message which will resonate better with Strategic’s new, smaller audience.

The third and final goal of this plan is to expand the Strategic message beyond only doing work for Health and Human Services. Research clearly shows that professional service firms, like Strategic, always benefit from diversification when they remain pure-service providers (Castaldi & Giarratana, 2018) as is the plan with Strategic. Contract work for the Department of Health and Human Services (HHS) has always been the cornerstone of Strategic’s business model, but if the previous two years has taught the Strategic anything, it is the need for diversification. This can happen through contracting to perform audits, analytics or to create education materials for the Department of Justice (DOJ), the Department of Defense (DOD) or for various private and public companies.

Tactics

Since there is no existing Public Relations team to rebuild the social media accounts, all existing team members will have to be tapped for content. There are experienced communicators and creative individuals on the team who are well versed for creating this type of content. This content will include articles, blogs and tweets which are focused primarily on healthcare issues. Eventually, as relationships are made, the stories can branch out into areas important to contract owners at the DOJ or DOD. Those articles can be sent to industry news outlets like The Journal of Healthcare Contracting, GovConWire.com, or the National Association of Government Contractors.

Much of the existing messaging is still usable but rather than presenting Strategic from a position of being a national leader in protecting the Medicare trust fund, the goal is to present Strategic as a small business which is working to help people retain better benefits for longer. This humanizes the company and plays to a more grounded and empathetic point of view.

The Mission and Vision statements need to be re-written and expanded to be more encompassing and thought out.

The BHAG is still phenomenal and should not change. However, rather than presenting it from a point of view that Strategic alone will redefine healthcare as a sustainable resource it should speak to how Strategic will help inspire people to think of it as a sustainable resource and encourage change where it can through the federal government.

Strategies to Avoid

In the past, Strategic approached communications from an angle of hubris. For a long time, the company seemingly could do no wrong in the eyes of the government contract stakeholders, until suddenly they could not. The reputation of the company has been tarnished and until it is rebuilt and communications that convey ego on the part of Strategic will be counterproductive to the established goals. The communications should be straight forward, fact-based and informative. They should not be intended to sell any aspect of the company.

Key Messages

The key messages will take what is currently written in the Core Values and BHAG as it relates to specific capabilities Strategic has and the needs of the HHS and focus it more on what can be done on a smaller level. Rather than addressing nationwide, billion-dollar ideas as before it will focus on doing the things Strategic specifically can do to help. This will be done by creating believable, positive and purposeful messages about the Strategic capabilities that the stakeholders within HHS can easily understand and relate directly to the needs they have. Much of this is already written and would simply need to be revised a to give it a more humancentric voice. The key areas are for medical review, education/training, and monitoring/compliance.  

Target Audiences or Markets

According to the Government Accountability Office, out of the $554.1 billion-dollar total fiscal expenditures in 2018, $157.7 billion of it went to civilian federal agencies providing services and products to the government (Government Accountability Office Blog, 2019). That is a huge amount of money but it is not all in one place. There are hundreds of agencies and tens of thousands of departments and each of those may have many layers of management that needs to be persuaded to approve a contract. An organization seeking government contracts must look beyond simply targeting “The Government.” When searching to discover who the target market is within the Federal Government, the Government Contracting Tips blog recommends first asking three important questions (Government Contracting Tips, 2011).:

  • Who are your current customers: What are you doing well right now and why do your current customers buy from you instead of a competitor?
  • Review What the Government Buys: By reviewing publicly available information you can discover what contracts have been awarded in the areas you are interested in. Align your products with what the government is currently buying.
  • Analyze Your Product/Service: Be honest about what you are selling. What differentiates you from your competition and lean into those choices.

The question then is, who is/are Strategic’s customer(s), what do they buy and what does Strategic have to offer to them? The short answer is that Strategic is targeting the Department of Health and Human Services, which reported just under 82,000 individual actions eligible for contracting in fiscal year 2019 worth a total of $24.1 billion dollars (Federal Procurement Data System, 2019). They offer many tasks including medical review, monitoring and compliance, and education/training all of which Strategic does well and has a lot of experience with.

Positioning

The government contractor market is huge and highly competitive. There are thousands of contractors competing for the same pool of money. There are a few things that can set a business apart and make it more likely to be selected for a contract. The first is being a small business, which is defined by the Small Business Administration in several different ways depending on the industry you are in but in general is a company that has fewer than 250 employees (McIntyre, 2020). The United States government has a goal of awarding 23% of federal contracts to small businesses. In fiscal year 2018 that number was exceeded with 25.05% of all federal procurement dollars being awarded to small business (SBA, 2019). Woman-owned companies are targeted for 5% of government contract dollars and are eligible for certain other set-aside contracts (SBA, 2014). Additionally, there are other categories of small business which the Government targets with contract awards. HUBZones, Small Disadvantaged, and Service-Disabled Veteran Owned Small Businesses collectively are targeted to be awarded 11% of federal contract dollars (SBA, 2014).

Past

A few years ago, when StrategicHealthSolutions was at the peak of its success, its differentiating position within the market was one of a small, woman-owned business that was doing everything right, couldn’t miss, and was headed quickly for much bigger success. It presented itself as an industry-leading, prestigious organization which was powerful and influential enough to focused on big picture, federal level problems like preserving the Medicare trust fund for future generations.

Current

Strategic is still designated as a woman-owned small business which sets it apart from many other businesses vying for government contracts. However, since the business’ “fall from grace,” the company and its capabilities have shrunk considerably. Their online presence is a confusing mix of days-gone-by where Strategic positioned itself as an industry leader and the reality of today where the company footprint is extremely small.

Optimal

Much of the principles that Strategic stood up during its hay day are just as relevant today as they used to be. Being a business which is dedicated, and celebrated for its expertise in program integrity and education. Rather than presenting itself as an industry leader who has a goal of being the one that will save the Medicare trust fund, it would make more sense for the idea to be something along the lines of being a small, woman owned business which is utilizing its commitment to and expertise in program integrity and education to do its part in preserving the Medicare trust fund.

Legal Considerations

The United States Government only awards certain contracts to companies that fall within specific categories in order to ensure that contracts are not only awarded to a handful of huge corporations. These set aside contracts are reserved for contractors with fewer than 500 employees or fewer and non-manufacturing businesses, like Strategic, with annual receipts of $7.5 million or less (SBA, n.d.). Contracts that are held out for small business are not offered to medium or large businesses. At Strategic’s peak, the company sought and was granted the status of a Medium Sized business. The government only allows a company to be re-designated once ever several years. This issue would need to be researched further to make sure the goals we are setting are not going to put us in a position where Strategic are competing for contracts that we’re not even eligible to be awarded.

Task Timeline

The first goal of relaunching the social media accounts would begin immediately. Shorter stories linking to health and industry news articles can be posted on Twitter daily beginning on the first day of the campaign. From there new tweets should be posted daily. The Facebook account can once again be used to showcase good things the company is going and the talent that works at the company. LinkedIn would be reserved for more business and industry related topics. This could be links to articles of individual stories written by Strategic employees. Ideally, all of Strategic’s social media accounts should be up and running within a month.

Strategic’s website needs to be updated and revised to reflect the current capabilities of the company. The imagery is good and does not need to change, nor does the WordPress platform it is built on. The things that need to change are the mentions of how big and successful the company is. For instance, on the About page there is an infographic which celebrates the history of the company. Office openings and certain employee milestones are shown which are irrelevant at this point. This should also be completed within the first month of the campaign.

Last goal, connecting more with publics from the DOJ, DOD, and private companies would take significantly longer. This would be an assertive effort over the course of months to research and write articles dealing with relevant topics.

Measurements and Evaluations

Social Media targets would be increasing the number of quality followers by 10% per month.

Targets for article publication would be to have one article written a month and one article published by a reputable source once a quarter.

Ultimately, the measurements would be an increase in awarded contracts and thereby an increase in company revenue.

Conclusion

StrategicHealthSolutions has been through a rough time over the last three years. From having offices across the country and being on the precipice of a ten-year, billion dollar contract to just a handful of employees and only a few contracts in just two short years. It says a lot about the company, and it is few remaining employees that they would persevere through such tumultuous times and are once again turning a profit. Now it is time to begin piecing the company’s public image back together. This begins with writing blog posts/articles, relaunching long silent social media accounts, revising existing statements to reflect a smaller, more focused Strategic, and updating the company website with fresh, new content