REPORT. compete with top health plans. As they achieve their objectives they continually set tougher and more ambitious

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1 INSIGHT Highly successful health plans set high standards REPORT for themselves, aligning their goals to compete with top health plans. As they achieve their objectives they continually set tougher and more ambitious April 2009 The Myers Group Call Center Satisfaction Research Results Members Call Center Experience and Overall Satisfaction with the Health Plan The Myers Group (TMG) recently conducted a research study on the relationship between a member s customer service experience and their satisfaction and loyalty to the health plan. Trends and aggregate results of TMG s Call Center Satisfaction Benchmark and the TMG 2008 CAHPS Book of Business were examined to support this study. Presented below are the key findings and conclusions from this research. The CAHPS Survey and Customer Service The CAHPS survey is currently the most comprehensive tool available for assessing consumers experiences with their health plan and affiliated providers. The CAHPS survey asks members to rate their health plan service experience and the care they received in their physicians offices. Part of the CAHPS survey includes questions regarding a member s customer service experience. These questions comprise the CAHPS Customer Service Composite, which has been identified as a key driver of overall member satisfaction and loyalty. The CAHPS Customer Service Composite provides plans with the following information: As a drill down to the CAHPS survey, TMG s Call Center Satisfaction Survey provides further insight into the member s customer service experience and the factors driving satisfaction levels The percent of respondents who called the plans Customer Service How often the plan s Customer Service provided members with the help/information needed How often the plan s Customer Service treated the member with courtesy and respect While this information is useful to the plan, the CAHPS survey is limited in providing insight into the member s customer service experience beyond these three factors. The Myers Group 1

2 The Call Center Satisfaction Survey Because many plans seek additional information and insight into their member s customer service experience, TMG developed the Call Center Satisfaction survey. The Call Center Satisfaction survey allows plans to drill down or identify further factors within the plan s Call Center which impact the member s overall satisfaction. Additionally, TMG developed a Call Center Satisfaction benchmark component to establish a consistent set of guidelines and to allow plans to compare their results with other health plans. The TMG benchmark is updated quarterly for more frequent quality measurement. The goal of the Call Center Satisfaction Benchmark was to establish a consistent set of guidelines and allow plans to compare results with other plans Call Center Satisfaction Benchmark Study Key Findings TMG examined the results of our Call Center Satisfaction Benchmark. Our research revealed several factors that can influence how a member rates their call center experience. These factors include: Reason for Call Timeliness of Problem Resolution Accessibility Member Experience with Customer Service Representative Reason for Call The reason and nature of the call can have an impact on how satisfied a member feels after they speak with customer service. For example, research revealed members who call for claims or billing issues were significantly more likely to be dissatisfied with customer service, while those calling for administrative/ other issues were more likely to have a satisfactory opinion of customer service. Timeliness of Problem Resolution The study revealed that timeliness of problem resolution shapes the member s perception of the plan. Respondents whose issues were resolved in a timely manner were more likely to be satisfied with customer service. Accessibility Research also indicated that respondents who are satisfied with customer service are significantly more likely to have had a satisfactory experience reaching a representative by phone. Experience with Call Center Representative Interestingly, respondents who were both satisfied and dissatisfied with customer service felt they were treated with courtesy and respect by the customer service representative (CSR). However, research indicated a significant difference between respondents satisfaction with customer service and 1) the knowledge level of the CSR, 2) how completely and clearly the CSR answered questions, and 3) the respondent s perception that the CSR did all that was possible to resolve the issue. The Myers Group 2

3 Making the Most of the Call Center Satisfaction Survey Many plans have elected to conduct drilldown research by administering the Call Center Satisfaction survey. In addition, TMG provides plans with several ways to more effectively gauge the member s customer service experience through: 1) Frequent administration of the Call Center Satisfaction Survey 2) Red flag alerts 3) Comparing their results with other health plans Identifying Quality Improvement Initiatives Through the administration of the Call Center Satisfaction Survey, plans can identify areas of improvement within their Call Center. For example, where results have identified low satisfaction scores regarding the customer service representative s ability to resolve an issue, additional training and increased monitoring may be required. The implementation of these quality improvement initiatives result in a positive impact on the members customer service experience. Plans conducting the Call Center Satisfaction survey can better assess the member s customer service experience through: 1) Frequent Administration Plans can survey members quarterly, monthly or even daily to assess potential areas of improvement and gauge the effectiveness of quality improvement initiatives. 2) Red Flag Alerts TMG offers timely client feedback for certain types of phone survey responses, called Red Flag Alerts. This feature provides clients with the opportunity to quickly intervene when a survey response identifies a serious concern or need for follow up by the health plan. 3) Plan Comparison/TMG Benchmark TMG has developed a Call Center Satisfaction benchmark which, updated quarterly, allows plans to compare their results with the performance of other plans. The Myers Group 3

4 Direct Impact on CAHPS Scores Improvement in customer service can have a direct impact on CAHPS composite scores including Customer Service, Claims Processing and Overall Health Plan rating. Research results continually reveal the strong relationship between Customer Service and overall member satisfaction. Identifying areas of improvement and enhancing the member s call center experience can result in increased CAHPS scores. Conclusion The CAHPS survey, while a valuable tool for assessing member experience with the health plan, is limited in the depth of information it can provide about a member s customer service experience and perceptions. Many plans, therefore, conduct additional drilldown research through studies like TMG s Call Center Satisfaction survey. Plans are able to use these survey results to identify areas of potential quality improvement within the plan s Call Center. Plans then set goals and implement quality improvement strategies to strengthen their Call Center and improve upon the member s customer service experience. As a result, our research indicates these improvements in customer service can have a direct impact on overall member satisfaction and improved CAHPS scores. The Myers Group s complete Call Center Satisfaction Research Study is available on our website at: For additional information about The Myers Group s Call Center Satisfaction Survey and Benchmark contact: Candi Charmoli Product Manager The Myers Group x1368 ccharmoli@themyersgroup.net About The Myers Group The Myers Group is a nationally recognized survey research firm located near Atlanta, Georgia offering a comprehensive package of survey products and services. The Myers Group has been a leader in health care market research and survey design since 1993, employing traditional methodologies as well as innovative technologies in data collection, analysis, and reporting. For additional information about The Myers Group, contact Clarissa Payne at x The Myers Group clientservices@themyersgroup.net The Myers Group 4

5 Pathway to Improving Customer Service and CAHPS Scores CAHPS Survey Customer Service (CS) Composite (Key Driver) % of Members Who call CS = 33%* How often CS provides help/ information needed = 77%* How often did CS treat you With courtesy/respect = 92%* CAHPS STOPS HERE For insight into Customer Drill Down Call Center Satisfaction Survey Frequent Administration Red Flag Alerts Benchmark Component Reason for Call Coverage/Benefit Claims payment/issues/ billing Service Authorization Prescriptions Referral Information Problem Resolution Same Day Less than 1 week 1 to 2 weeks Over 2 weeks or pending Experience with Customer Service Representative Courtesy and respect Knowledgeable Answered questions completely Resolved issue Accessibility Ease of Reaching Service Rep by phone Identify QI Opportunities Implement QI Strategies QI Goals Improve Customer Service Improve Satisfaction with Health Plan Improve Member Retention Improved CAHPS Scores * Based on The Myers Group 2008 CAHPS Book of Business which consists of 65 adult commercial samples The Myers Group 5