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With so many moving parts to U.S. healthcare reform, consumers need help understanding what resources are available to them and how to access assistance as new policies go into effect.

Customer Experience Mandates:

State Agency Removes Barriers to Customer Experience Excellence

With so many moving parts to U.S. healthcare reform, consumers need help understanding what resources are available to them and how to access assistance as new policies go into effect. Under the Affordable Care Act, state agencies with Consumer Assistance Programs (CAP) can receive federal grants to provide residents with help regarding issues or questions about health coverage. One state’s Department of Insurance recently received one of these CAP grants, which contains mandates regarding customer experience delivery. It enlisted our help to create a strategy and implementation roadmap to improve the customer experience provided by its Consumer Health division.

Through consumer surveys, our team learned that only 28 percent of respondents were aware of the agency’s mission and 41 percent of those who used the agency’s services were mostly or completely dissatisfied with their experience. And, an assessment revealed that the organization lacked the required workforce and metrics to generate insight and oversee quality. The team recommended that the client measure its monthly call resolution effectiveness and change the way it evaluates other aspects of consumer interaction, such as handle time.

The team also reviewed the department’s data collection and management activities. Within the 10 disparate systems used by the Consumer Health division, 23 improvement recommendations were specified, including a consolidation of seven different customer service phone numbers into one. Streamlining the systems and processes improves the ease of use for customers as well as the ability to share data for the organization, which ultimately increases customer satisfaction.

We also determined organizational strengths and weaknesses within the Consumer Health division and recommended ways to fill the customer experience gaps in both manpower and organizational structure that prevented growth according to CAP standards. For example, we recommended that the division assign a quality manager, a reporting manager, and a bilingual contact center operator.

 

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