For health plans, member experience plays an important role in member retention, and ultimately in healthcare outcomes. Member support providers need to constantly monitor and mitigate member pain points that interfere with plan effectiveness and impede care.
Challenge
For a large leading health plan, a Medicare Advantage plan provider and a long-time ResultsCX client, specific call quality issues were causing significant member frustration:
- Excessive dead air, overly long hold time, and too many internal transfers
- Scripting requirements that irritated callers
- Inaccurate information, driving an excessive 4% callback rate
Solution
ResultsCX experts leveraged analytics to identify the root cause of the problems and developed tactical interventions to:
- Eliminate incorrect instructions and inaccuracies driven by the client’s learning management system
- Loosen and improve call scripting requirements to enhance empathy and politeness of support experience
- Reduce system complexity to limit periods of inactivity during calls
Results
ResultsCX was named the highest performing partner, which included outperforming client’s internal teams. Real-time agent-level improvements included:
- 11% increase in overall ultimate call scores that incorporated six key call attributes
- 12% increase in Overall NPS—from 25% to 37%
- 10% NPS score lead over the next-highest performing vendor