CUSTOMER SERVICE CENTER OPERATIONS UPDATE. Prepared for Operations Committee March 2015

Transcription

1 CUSTOMER SERVICE CENTER OPERATIONS UPDATE Prepared fr Operatins Cmmittee March 2015

2 Tpics Current Frecast Backgrund Frecast Primary cst drivers Cst reductin activities Next steps 2

3 Backgrund Current apprved budget fr service center is $14.9M $0.3M Apprved in December 2014 fr additinal HCPF resurces $0.9M Apprved in Nvember 2014 fr CGI/C3 due t changes in SCLSP $13.7M Apprved in initial budget $14.9M Ttal apprved budget Thrughut the fall, staff presented frecasts fr FY2015 f between $15.2M and $17.9M, but recmmended the Bard apprve incremental increases t allw us t cntinue t lk fr ways t reduce csts ver time. At the February peratins cmmittee meeting, staff recmmended an additinal $2.8M t fund the service center thrugh FY2015. The cmmittee: - Denied the request - Asked staff t prvide a recmmendatin in March fr additinal funding needed t supprt the service center thrugh April Asked staff t prvide an update in April n activities being taken t reduce service center csts fr the remainder f FY2015 and FY

4 Current Custmer Service Center Trend FY2015 $25 M $6.2M gap between frecast and budget fr FY2015 $20 M FY14 Actual FY15 Budget $4.13M Gap between budget and actual Frecast thrugh April 2015 ~$18.37M $21.14M $17.71M $15 M FY15 Trend $14.88M $10 M Ttal inviced thrugh Feb 2015 ~$14.9M $5 M Actual Csts Csts incurred but nt inviced / paid Fixed csts plus frecasted variable csts JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN 4 Key Assumptin: We culd reduce budget frm FY14 thrugh efficiencies and maintain current ASA, AHT and abandn rates thrughut FY 2015.

5 Increase in frecast 350 February frecasts f $18.11M have increased t $21.14M Revised frecast the $18.11M frecast assumed that we culd reduce ttal head cunt t apprved budget levels beginning in February. Given vlumes f calls, s, new tax questins and escalatins, this wuld result in an unsatisfactry level f service fr custmers. Ttal Service Center FTE Cunt Ramp dwn f service center staff started n 3/2/ February Frecast 150 Current Frecast February Average March Average April Average May Average June Average Activities driving need fr >100 ttal call center staff at end f pen enrllment: Prjected 2-4K/mnth LCE requiring supprt Onging SES and RMC challenges Verificatins activities RRV utbund calls 1095 questins Ptential SEP in April fr tax filers SHOP enrllments, changes and invicing Supprt fr peratinal activities such as simultaneus enrllment and carrier recnciliatin

6 Custmer Service Center Cst Drivers $25 M $20 M $15 M $10 M FY14 Actual FY15 Budget FY15 Trend $21.14M $17.71M $14.88M $5 M JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN Pre-OEP Cst Drivers Life change events (4K/mnth) Ntices abut changes in APTC due t market dynamics (Oct-Nv) Open Enrllment Cst Drivers Eligibility determinatin issues Medicaid/CHP+ questins 1095 questins Cmpleting enrllments Renewals Life and accunt changes Pst OEP Cst Drivers (current and prjected) Eligibility determinatin issues and backlg cleanup Medicaid/CHP+ questins Cmpleting enrllments 1095 questins RRV questins Simultaneus Enrllment utbund calls Verificatins prcessing Life and accunt changes Ptential Special Enrllment Perid in April fr tax filers 6

7 Call analysis and cst drivers Call Details Nn Financial Assistance Custmers (based n sample f ~100 calls) Average call time 30minutes 19secnds Breakdwn f calls t the Individual Sales (based n survey f call center representatives wrking the individual queues) 7,425, 8% 42,075, 47% 40,500, 45% Nn-Marketplace (i.e., Medicaid) Marketplace - Financial Assistance Marketplace - Nn Financial Assistance Call Details - Financial Assistance Custmers (based n sample f ~100 calls) Average call time - 1hr 19minutes 54secnds Average SES cmpnent f calls 35minutes 3 secnds Nn-Marketplace calls and chats Service center representatives reprted that between 65% and 70% f all chats serviced by the service center were fr custmers wh are eligible fr r receiving Medicaid, CHP+ and ther HCPF prgram benefits Service center representatives reprted that between 40% and 45% f all calls serviced in the Individual New and Individual Sales queues were fr custmers wh are eligible fr r receiving Medicaid, CHP+, and ther HCPF prgram benefits Additinal Cst Driver: Reslutin f issues encuntered by custmers while enrlling in a QHP with financial assistance During the 2015 Open Enrllment Perid, the service center received and reslved between 8-10K incidents (reprts f issues nt the same as custmers) fr custmers wh had prblems/questins either with their eligibility applicatin r with using their eligibility result t shp n the Marketplace. Reslutin f these incidents ften required crdinatin between service center representatives, IT resurces, backffice staff and HCPF cntractrs and tk between 3-4hrs n average. 7

8 Planned activities t reduce csts fr FY2015 Wrk with HCPF t determine apprpriate allcatin f csts due t eligibility issues and number f Medicaid calls Clsely mnitr call vlumes and csts and scale dwn FTEs earlier if pprtunities arise, while wrking t maintain an SLA clser t 80/90 (in prgress) Lk at using lwer cst resurces (e.g., Tier 1 resurces) fr simple calls and tasks (impacts being evaluated) Reduce number f QA staff by 1 (part f planned ramp-dwn beginning in March) Clse ur custmer service center n weekends beginning 3/7 t eliminate utility and staff csts fr ptential f up t ~$80K savings fr FY 2015 (nt started) Shrten service center hurs during wrk week (impacts being evaluated) Streamline back-ffice prcesses fr prblem reslutin (impacts being evaluated) Review technlgy csts fr ptins t reduce (nt started) Cntinued review f call drivers and call scripts t reduce AHT (in prgress) Tighter resurce frecasting t reduce use f vertime hurs (in prgress) 8

9 General actins t reduce csts fr FY Renegtiate cntract Tighten SLAs Imprved frecasting fr predictable transactinal activities Renegtiate rates and ther cst factrs Determine apprpriate mechanism fr recvering csts spent serving Medicaid custmers Lk at ther ptins fr handling SHOP back ffice and custmer service functins Imprve technlgy integratin fr custmer service center functins Incident infrmatin available t custmers? hcentive and OCX integratin fr key data? IVR self-service and authenticatin? Review and ratinalize end-t-end cntact management prcess fr cmplex custmer-facing activities Lk at call trends ver last tw years and determine if hurs f peratin need t be mdified

10 Specific actins t reduce csts by area ~10% f csts SHOP Activity: Invicing Manual changes t supprt emplyee changes Transactins Passwrd reset Questins and general supprt Sme easy accunt changes Verificatins prcessing Mailrm ~35% f csts Case Activity ~55% f csts Eligibility issue reslutin Sme enrllment issues Life changes that cannt be cmpleted nline 10

11 Other thughts? Re-evaluate expectatins arund the rle f a Service Center in a Marketplace nt a typical call center 11