Digital Services Improve CMS Call Center Operations

COVID-19 spurred a mass transition to a virtual environment, with public-facing federal agencies’ customer service phone lines experiencing large influxes of incoming queries about health care benefits. The Centers for Medicare and Medicaid Services is now using enhanced data management and automation to improve its call center modernization strategy and improve customer experience.

“With over 10,000 people aging into Medicare a day, the challenge is to maintain the high level of customer service, while expanding and improving other channels for people to get their information,” a CMS spokesperson told GovernmentCIO Media & Research. “Our call volume has been fairly consistent as a result of advanced data analytics. These analytics allow us to focus on reducing the need for repeat calls, finding and addressing root cause issues and increasing the information available on other channels.”

As agencies across government work to accommodate increased communication through online platforms, CMS experienced a new variety of challenges.

“We became more adept at handling the full range of inquiries we would typically see only through our phone channel versus the historical ‘account-related’ questions we would get online,” the spokesperson said. “For both the 1-800 MEDICARE and Federal Marketplace Call Center, providing a world-class customer experience continues to be a driving priority.”

One of the agency’s largest customer service efforts is eMedicare, which is improving the omni-channel customer experience for Medicare beneficiaries. The multi-year project is designed to bring Medicare customer service channels up to date and create a more modern, personalized and seamless customer experience.

“eMedicare is about establishing a new level of online service. It involves developing innovative new web features, adding mobile-friendly services and developing new applications that will give people more control over their Medicare information and empower them to make good care and coverage decisions,” CMS said.

The initiative is grounded in expertise and research about CMS’ customers, including demographics, channel use, website and call center analytics, customer feedback, call center representative and counselor feedback, and industry best practices from other programs.

The agency is also looking into the role of automation to see how it can support CMS’ customers. CMS’ recent enhancements to its automated system, interactive voice response (IVR), enabled the agency to deliver information to Medicare customers via text message. CMS also redesigned Medicare IVR with more self-service options.

“The goal is to improve the channel and to provide services the caller wants and/or needs, and not as a means to deflect and frustrate callers with complicated menu trees and conversations that are designed to trap them in the IVR,” CMS said. “Our focus always remains on the customer experience and ensuring we are providing our customers information they want in the way they need.”

The agency is embracing a customer-centric model to support its approach.

“We want to be able to provide services to our customers via the channels and ways in which they want to receive information — whether that be online, mobile, web chat or over the phone,” CMS said. “Having this information helps us to better tailor and personalize the information we provide to our customers.”

By harnessing this information and using data from various channels, CMS is enhancing decision support tools to guide customers as they look to retire and transition to Medicare.

“CMS continues to use data to better personalize the services we provide to our customers. Our data management approach is the foundation, which enables us to tailor messages to specific needs for people with Medicare,” CMS said.