Health New England (HNE) is a managed care organization based in Springfield, MA. HNE was recognized as one of the Top 10 Health Plans in the country and has achieved a 5-Star rating from CMS for their Medicare Advantage plans. Against a backdrop of unprecedented hurdles, growth was an imperative for HNE. Unemployment in their area was at 12%, compared to a national rate of about 8.5%. Their primary business was commercial, but no new companies were moving into the area. That meant minimal growth. They had an aging population base, so expansion into Medicare and Medicaid was a natural solution for both HNE and the community.
“With Panviva we have reduced our CSR headcount and grown our business by 20 percent over two years.”
Member Services Manager, Health New England
- Growth and diversity of products while capping agent hiring and decreasing training times
- A need to increase FCR and decrease AHT and reduce agent errors
- Meet new Service Level Agreements
- Maintain Top 10 status
- Increased employee productivity
- Achieved 20% growth without incremental staff
- Reduced training time and costs
- Met or exceeded SLAs and increased engagement, accuracy and completeness scores
- Five Star rating for Medicare Advantage achieved
According to the Member Services Manager at HNE, “With 120 commercial benefit plans to support, our call center business was already challenging. With the introduction of the government programs, it became much, much more complex. We took on new benefit plans, new regulatory requirements and strict service level agreements. If we didn’t meet or exceed those requirements, we would have to cut the customer a check, instead of the other way around. As important were our commitments to maintaining our very high levels of customer service.”
The problem? The challenges of keeping information sources and customer service reps up-to-date so they could provide correct, timely answers to customers became increasingly difficult and costly. There were literally hundreds of applications and documents in multiple online repositories, plus big binders on every shelf and yellow stickies everywhere. With the new programs on-board, training times soared and key stats declined. Extra staff were hired to “band aid” the problem, but it was a temporary means to outrun the wave.
HNE knew it had an information management problem, and undertook a formal search for a solution. Many solutions were paraded past the sponsors – CRM, IVR, SharePoint and Document Management systems – but few helped with the information management problems or were appropriate for in-call use. Then they found Panviva.
In a year of few project investments, an exception was made for Panviva. According to the Information Management and Training Specialist for HNE, key performance metrics are stellar. “90 percent of our calls are now answered within 30 seconds; our average speed to answer a question is 10 seconds; abandon rates have fallen to about 1.5 percent and average talk time is down to 240 seconds. Employee engagement scores have gone up an entire point on a scale of 1-5, while accuracy and completeness of information ratings have risen a full 2 points. All SLAs and guarantees have been met or exceeded.”
Panviva has also had a major impact on training. Prior to Panviva, it took 3 trainers 20 days to train new agents. Now it take one trainer 14 days. Before Panviva they had to go through every procedure, rule, guideline, and script, which took time. After the one day of training, the rest of the time is spent on how to find the procedures, rules and guidelines in Panviva. There is no need to train on content, but on how to find it. If you walk into their call center today you will not find a binder or a sticky note anywhere.
Asked about cost savings HNE responded, “When you look at headcount reductions in agent staff, reductions in trainers and training time, the financial benefits of improved KPIs and customer satisfaction, it must be several hundreds of thousands. That’s a big deal for a small health organization and it drops straight to the bottom line.”
HNE’s already very high scores continue to improve; they have employees who are engaged, with systems that sustain and enhance their very efficient processes so that everyone can perform at their best. Those same systems will carry them into a bright future in which the ability to adapt and change rapidly, while providing superior customer services, will continue to win the day.