Medicare writes prescription for customer centricity

New government agencies have been under a harsher light this year than Medicare. When it launched the second year of a new and complex prescription drug plan for seniors in May 2006, not only were its 40 million beneficiaries in need of information, the very heart of its customer-centric approach was at stake.

Most of the plans offer more than 50 coverage options and several levels of payment plans. A recent quote in the Maine Times was typical: "Poor seniors. I dread explaining all of this to them," said Michelle Matt, senior advocate at Goodall Hospital, in Sanford, Maine.

Despite public sentiment to the contrary, the Medicare program, which is administered by the Centers for Medicare and Medicaid Services (CMS), is structured around its citizen-customers. According to Mary Agnes Laureno, director of the office of beneficiary information services, the entire agency restructured in 1996 around 10 verticals that align with citizen-customers' needs, including the Center for Beneficiary Choices and the Practice Administration Center. Laureno said the emphasis is on making sure citizen-customers get access to and maximize their benefits.

"We are very customer-centric," she said. "Our staff is interested in helping people resolve any problems they have, and solving them is something we talk about all the time. It's not something we save for a meeting."

The new plan administration and enrollment was one of the biggest challenges to face CMS in the past 10 years, Laureno said. Media and online information dissemination were key tactics to inform the public about changes in the new plan. But the main focus was on the contact centers. The 71 Genesys Labs-staffed centers employ about 500 customer service representatives (CSRs) during an average week. After the new Medicare policies were announced in September, that number spiked to 7,800 agents to deal with the avalanche of calls that grew from 800,000 per week to 600,000 each day. Having onsite staff enabled the execution of the process and clear scripts helped each agent.

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CMS was able to staff to this level and have such high call resolution numbers because of its thorough training program. Every Genesys CSR who works on the CMS account receives a minimum of three weekly training sessions to gain command of the complex prescription plan, get a sense of typical inquiries and complaints, and study the results of citizen focus groups. Agent training for the May 2006 implementation of the prescription drug benefits started in August 2005. One-hour refresher and update training is mandated once a week.

"This isn't a typical outsourcing relationship," Laureno said. "It's not about call time or a threshold of resolution. It's about making sure agents are ready to help our beneficiaries."

Reprinted with permission from 1to1 Media. (c) 2006 Carlson Marketing Worldwide.