The Role of Call Centers in bringing about Obamacare

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The Role of Call Centers in bringing about Obamacare

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How did we get to the point where the Federal Government plans a hostile takeover of one-sixth of the American economy?  Consumers abused their benefits and the providers pushed back to control costs and now insurance providers have secured their very own circle in Hell alongside stock brokers, bankers, ambulance-chasers and telemarketing lawyers.  The clues of what was coming were there and we all should have seen it coming.

According to a study conducted by the Kaiser Family Foundation in 2006, only 18% of Americans are satisfied with the total cost of healthcare and only 44% of Americans are satisfied with the quality of healthcare in America.  Another study conducted by Gallup between 2006 and 2008 found that “the United States maintains the third-highest GDP per capita ($48,000) of all OECD (Organization for Economic Co-operation and Development) countries.  However, the relative wealth of the U.S. economy does not necessarily translate into confidence in national healthcare systems. ”

So consumers are unhappy and providers take up the “us versus them” stance and don’t pay attention to the customer experience and resulting satisfaction.  And when I say do not pay attention, I mean that it’s not effectively quantified and if it is, the management TO the feedback is flawed.  And now we have the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 to address the NOISE in the marketplace.  Do you remember how satisfied the Bell Telephone customers were prior to the government stepping in (and breaking up Ma and Pa)?  Lily Tomlin as an telephone operator said, “We don’t care!  We don’t have to!  We’re the phone company!”  Do you remember how much noise was heard from customers about their utility?  How’s that de-regulation working out?  It doesn’t work to be arrogant and not listen to customers with the hope that the noise will not bring negative attention.

But now we have the combination of low confidence in the US healthcare system, increasing costs, and the possibility of a decline in the number of employers offering employer-sponsored healthcare which could have severe unintended consequences to insurance providers.  Insurance providers call center operation costs are set to skyrocket due to increased complaints, increasing call volume, longer talk times and more repeat calls.  Unless they prepare and take a proactive approach to minimize the direct cost and quality impacts of the forecasted changes and avoid premium hikes they will just pass these costs along to customers, like they have always done.

It’s vital to know how to properly apply customer experience analytics to effectively deal with both seasonal (known; planned) and unexpected changes to your business (news items, natural disasters, social media rumors):

  • Average Speed of Answer – While many Customer Experience experts (CRM included) will tell you that Average Speed of Answer should not be one of your call center KPIs, the fact is that beyond a certain threshold of customer tolerance, speed of answer becomes an issue.  This becomes especially critical during peak season(s) and atypical events when call volumes rise above normal levels.  Our proactive business partners let customers dictate what the average speed of answer target / goal should be based on the relationship between how long they waited to get to an agent and how they felt about the company and the call after the fact.  Rather than selecting an arbitrary number or an “industry best-practice” allow your customers to determine how to staff to best support their needs.  Based on all of the research we’ve done, there is often a clearly-visible satisfaction drop-off point as well as a point of diminishing return.
  • Customer Pain Points – Some of the challenges customers come across are predictable and consistent.  Some are not.  Our award-winning business partners consistently mine their customer comments to identify customer pain points and pool the organization’s resources (not just the call centers’) to find solutions.  Those solutions are then re-evaluated just prior to the next peak season to determine if changes to process, technology or people have made available new / other / better options for customers.
  • Arm agents with actions specific for peak season – Once peak season or an atypical event “hits,” our most successful business partners use predictive modeling to understand what is impacting the interaction between the agent and the customer to arm agents with the information they need to succeed.  Do customers report dissatisfaction with the agent because they took too long to get to “the meat” of the call?  Would customers walk away from the call satisfied that their issue was resolved if agents apologized less and provided more details on the solution?  What percentage of repeat calls could be avoided if agents were proactive about not only answering the question the customer had today, but the two or three questions that would logically follow?  All of these drivers of customer perception can be improved, but only if you know how to proactively detect them.

One such proactive business partner has reported that the mood in the call center he runs was far different this past peak season than in peak seasons prior.  “There are far less people walking around looking victimized.  I think that for the first time our agents believe that management has worked to prepare for peak season, to give them real solutions that they can offer customers, that we’ve put real effort into staffing appropriately and that we’re mobilizing more parts of the organization to get through this.  It feels like a partnership this time around and everyone is informed and feels empowered to act in the best interest of the customer.”





About Dr. Jodie Monger

Jodie Monger, Ph.D. is the president of Customer Relationship Metrics and a pioneer in voice of the customer research for the contact center industry. Before creating CRMetrics, she was the founding associate director of Purdue University's Center for Customer-Driven Quality.

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