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What will it take to fix MNsure's call center? More tech fixes, staff, money — and time

What will it take to fix MNsure's call center?
MinnPost photo by James Nord
On its busiest days as the Jan. 1 coverage deadline approached, call wait-times topped 90 minutes, overwhelming the call center staff.

Hour-long waits … dropped calls … frustrated callers … overwhelmed staff … too many side issues …

Since early November, a litany of complaints has dogged MNsure’s call center,  a key resource in helping the public use Minnesota’s health exchange to sign up for insurance.

Three months later, MNsure still has not solved many of the major call-center issues — and now it’s gearing up for a busy last two months of open enrollment.

Despite repeated handwringing by the governor and MNsure’s governing board, the questions remain: Why can't state and exchange officials fix the frustrating wait-time and service problems?

The answers are complicated, but they boil down to continued technology problems with the exchange’s website and issues of adequate staffing, training and money.

MinnPost talked with MNsure leaders and staff, outside experts, private companies and other state-based exchanges to examine the current problems and possible solutions.

Here’s a look at callers’ frustrations — and what is, and isn’t, being done to address their complaints:

Why does it take an hour to answer the phone?

As the website launched on Oct. 1, MNsure’s call center appeared to be running smoothly, if a little slow. But beginning in mid-November, as more people explored their insurance options, the wait times jumped. In December, call volumes doubled.

The call center got a lot more calls than officials anticipated, many of them repeat calls dealing with unexpected website glitches, rather than just questions about policies and finance questions.

On its busiest days as the Jan. 1 coverage deadline approached, call wait-times topped 90 minutes, overwhelming the call center staff.

Why didn’t they increase staffing?

 MNsure did begin increasing call center staff. This is at least the third time it boosted staff. They’ve added about 25 staff members since the exchange’s launch, but there were other priorities, too.

MNsure staff members, for example, were more focused on getting people signed up for coverage than on dealing with call center issues.

And the Department of Human Services was unable to shift workers to help with the overflow because of its workload.

The call center ended up taking a lot of calls about public programs that have to be resolved at the county level or at DHS. The exchange is working with DHS to fix those issues, which should also help to decrease wait times.

Why haven’t wait times improved?

Well, actually, there have been some recent improvements, but that’s likely because fewer customers are calling MNsure right now. That will change, however, with the approach of March 31, the current deadline for most Americans to purchase insurance without facing penalties.

At its peak time just before the Jan. 15 enrollment deadline for February coverage, the call center received 2,500 to 3,500 calls a day, with wait times of more than an hour.

During the week of Jan. 20, though, wait times significantly improved. The call center received 1,000 to 1,700 calls a day, with wait times ranging from about 5 minutes to just under 30 minutes.

The goal in the weeks ahead is to keep wait times around 10 to 20 minutes. Eventually, they hope to reach the industry standard of 2 to 5 minutes.

So, what changes are they making to accomplish that?

MNsure currently is training 16 more call center staffers to answer phones. They should start in early February, joining the current staff of about 54.

Officials also are in negotiations with outside vendors to double staff capacity. At the same time, they’ve been working to fix website glitches, which should cut the number of calls about tech problems. A call center vendor could be announced Wednesday at MNsure’s board meeting.

How long does it take to train call center staff?

That depends, but in some cases, training can take up to two weeks. It could be shorter for those with more know-how. Right now, there’s a training class under way in St. Paul.

Depending on the qualifications of an outside company, training times also could be reduced.

An outside review conducted by Optum, a subsidiary of UnitedHealth Group, promised some training could be done in a day or half a day while other learning could take two weeks.

Optum also called for a significant staff boost and urged leaders to consider new ways of tackling the crush of calls and long wait times.

The report says MNsure should reorganize the initial menu that greets callers to put more frequently chosen options first. It also recommended having about 100 full-time employees working at the call center.

What is the governor doing to fix the problems?

Gov. Mark Dayton’s public criticisms of MNsure operations were likely a factor in former Executive Director April Todd-Malmlov stepping down, and the governor, beginning in December, was critical of the call center’s wait-times and staffing.

Dayton also has visited a couple of times to thank the call center staff, who have had to deal directly with frustrated customers.  But by law, the governor does not have specific authority over MNsure operations.

What is the MNsure board doing?

Tom Forsythe, a MNsure board member, has been a tough critic of the call center. He’s also said he regrets not tackling the problems sooner. The board has been pushing for contracting with an outside firm in order to get the wait times down, and it even suggested cutting the Paul and Babe MNsure ads to pay for more call center staff.

But so far, the board’s concerns haven’t translated into significant fixes or into specific decisions to hire an outside vendor or additional staff.

Aren’t there private companies the state could have handle operations?

Yes, there are, but the state says that other exchanges that have outsourced their call centers are having problems, too.

MNsure staff went so far as to say that they’re glad the state didn’t outsource its call center.

Officials are in negotiations with outside vendors to double staff capacity.
MinnPost photo by James Nord
Officials are in negotiations with outside vendors to double staff capacity.

 

Xcel Energy, which has more than 500 staff at its call center, gets about 1.2 million calls a month — compared with less than 100,000 for MNsure — and the average wait time is under 30 seconds.

Kynect, the successful Kentucky health exchange, takes about 3,300 calls a day, and a staff of 115 keeps average call wait-times to about 7 minutes. Kynect nearly doubled its call center staff in December, and Xerox may bring on additional staff to deal with high call volumes expected through March.

What are the peak times for calls?

Mondays are typically really busy, and the number of calls usually tapers off over the rest of the week. There are spikes in the morning, during the lunch hour and in the afternoon, but the number of calls drops significantly after 5 p.m., even though the call center is open until 8 p.m.

Some call-volume samples: The average number of incoming calls at 9 a.m. on a Monday is 270. Wednesdays at 2 p.m. average 224, with 110 calls at 10 a.m. Saturdays.

A staffer’s average time spent per call has topped 10 minutes over the last two months. For the first two weeks of January, there were 150 to 200 calls an hour.

Why isn’t the staff increased to handle known busy times, such as days leading up to a deadline?

That does happen. The exchange uses tools to forecast the number of calls and compare those predictions with historical information. A worker’s shift ranges from 8 to 10 hours a day, and the average number of staff changes based on the day and time.

So, for example, there are more staff working on Mondays, and that number decreases as the week goes on. On a Monday, the staff would be at its highest level.

Have there been problems with unprepared callers who don’t have the necessary documents and information?

Calls usually involve people checking to see if they’re covered or those with technical issues. About half of calls coming in used to be about technical problems — that could be something as simple as a customer’s web browser not working to something wrong with the MNsure technology. But that number has recently dropped to about 20 percent.

MNsure doesn’t take applications through the call center. But it does provide help getting through the online application, which includes helping people understand which documents they need to complete an application for coverage.

Is there adequate funding to run the call center?

It’s unclear what’s going to happen with MNsure’s budget. Right now, they’re trying to handle all the costs within their current budget, but paying more people and hiring outside companies are additions to the original budget.

If underperforming enrollment trends continue, MNsure would run a $3 million deficit over 2015 and 2016, and that’s without additional spending.

The MNsure board has said it doesn’t want to go back to the Legislature for more money. As a result, staff members are looking to see if federal grants can be used more creatively to free up where the money is spent.

Does MNsure have any advice on how to have a better experience using the call center?

Yes. Among its recommendations:

• Avoid the busiest call times, such as Mondays and weekday lunch hours.

• Try to call in the evening (the call center is open until 8 p.m. weekdays).

• Or call on Saturdays, when it’s open until 4:30 p.m.

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Comments (20)

This seems like a lot

of stuff for a system that will be going away soon.

If it were up to me, I would quit throwing good money after bad and shut down MNSure now.

I actually heard a democrat on the TV the other day saying they should have turned this all over to one of the commercial sites that already exist (ehealthinsurance dot com, etc.) and let them handle it. I suggested that almost a year ago.

Ah....

The apocryphal 'unnamed democrat'.
And of course most of the MnSure setup WAS farmed out to private corporations, which may be the problem/

ACA Alternative

What do you propose as an alternative? The existing free-market system penalizes older people, those w/preexisting conditions, low income people.

Going Away?

What do you propose as an alternative? Going back to the private sector insurance companies controlling healthcare accessibility and costs?

How will Dennis announce MnSure repeal?

....standing on an aircraft carrier, in a flight suit, announcing "Mission Accomplished"

Just Trimming a Little Hair of the Beast

Certainly the call center operation is hampered by incompetent software design plaguing the whole of MNsure; however, the call center was probably the easiest part of the overall project in terms of prevailing standards. There's nothing mystifying about a call center: they are everywhere for nearly every consumer service, and we all use them most every day. Please, no excuses or deflections of significant issues here.

"Mondays are typically really busy, and the number of calls usually tapers off over the rest of the week. There are spikes in the morning, during the lunch hour and in the afternoon, but the number of calls drops significantly after 5 p.m., even though the call center is open until 8 p.m." This is helpful consumer information. It is not, however, noted on the MNsure website as of this morning. Must be a busy Monday morning?

Attention MNsure webmaster: Please post a link to this article.

You get what you pay for.

How many people who complain about MnSure are willing to pay the extra taxes necessary to fund it properly?
There are economic problems in investing two week plus training sessions for extra staff to manage a one week initial 'surge'.

Yeah, because

$130 million is not enough to tell people which insurance policy they should buy. I wonder how much ehealthinsurance.com cost to build and maintain. A couple million?

Tried it

After several MONTHS of trying to work out the technical issues with my account - and the Governor's office was also involved in the process - we all decided it would be most efficient if I were to fill out the application on paper. The paper copy arrived within a few days and I'm in the process of filling it out.

Unless it's recently changed, this is how the application for MinnesotaCare works, you either print off a copy online or you request a paper copy in the mail. And the system works pretty well.

So why didn't MNSure just go that route? If it ain't broke, don't fix it. And don't add bells and whistles to it.

To the ACA Naysayers

What do you propose as an alternative? We've tried the private sector approach and that has given us years of travesty. How do you propose ensuring that all people have adequate healthcare coverage? Nothing new has been attempted. If we want to stop people from being denied insurance and declaring bankruptcy due to obscene medical bills, something has to be changed.

Obamacare, in all it's

Obamacare, in all it's permutations has failed to come anywhere close to "ensuring that all people have adequate healthcare coverage". The very people it was supposed to target are largely ignoring it. The young, healthy segment so vital to making this thing fly aren't interested, and of those currently uninsured "others" that do know about it, twice as many don't like it as do. Heck, MNSure still has a huge deficit of people that were cancelled vs. those that signed up. It's not even "broken even" on the damage it's caused.

You cannot force people to do what they are not willing to do, and as soon as the fines kick in, you'll simply add to the IRS's enforcement arm caseload in chasing down people that haven't got two cents to rub together.

As to bankruptcy and financial disaster, well perhaps you've not seen the Obamacare deductibles. Many are finding them completely unaffordable, which will add people that simply drop the plan to those that never sign up in the first place.

The status quo didn't serve everyone well, but it worked for the vast majority of people in this country and it worked a heck of a lot better than Obamacare.

Call centers are overwhelmed because the system is a steaming mess. It was planned to met political expectations, not human need. One can only hope that we start dismantling it after the architects are retired in November.

Temps

The call center people are temps, and they are not necessarily experienced with handling calls. I know this because I signed up for a gig with a temp agency to go there, expecting to do office work and/or handle online issues.
Instead, I was put into a pool for the call center. This was a terrible thing to do because I have a rather soft voice on the phone, often speak too quickly, and stutter when stressed. I had to beg off of the work despite very much needing the money because it was totally inappropriate for me to be doing call center work. It was very depressing to have to turn down work, but they would have found out how awful I was soon enough anyway.
This is what happens when you try to staff up something very quickly, I'm afraid, and it will take a long time to find the right people and have the system down.

All of the ingredients for burn-out

I was a customer service phone rep for almost 8 years. MNsure's call center has all the ingredients for rep burn-out already. 1.) The rep can't process the consumer's info any faster than what the computer can. If it takes 40 minutes for the computer, than the call will be at least that long. Consumers don't always understand that, and it makes them angry that they have to wait. 2.) Consumers are upset. They lost their insurance, their doctors or they need the insurance fast because they need medical care right away. The rep must spend time calming down the consumer instead of processing information. 3.) The rules keep changing and the reps might not know the most recent rule changes. Sometimes management isn't straight with the reps about what is going on, and the reps find out they are giving out wrong info.
MNsure is a mess. Shut it down.

The Republican criticize,

but they still don't have any answers. If they would put as much effort into helping people as they do working against them and our system of government we would all be better off. They have voted over 40 times to repeal the Affordable Care Act so they would look good to their constituents. It is the Republican way to keep doing the same thing over and over and expect different results. I believe the Republicans should repeal the Republican Party and come back to the citizen of the US when they have their act together. Right now, at the state and federal level, they are nothing but a mess without any purpose. They can't even manage their own party much less the country. Failed policies, failed talking points, and failed leadership defines the Republican Party. Ask who their leader is and no one can point to "the" Party leader. Their obstructionism is not the answer to Americas problems, it is the cause of many of our problems.

Excellent Report

Too many media writers (I won't call them journalists) have turned to the easy repeating of people whining. You actually investigated the problems and analyzed possible solutions. Obamacare-naysayers never talk about how deplorable HP tech support became, how the Apple Genius bar has dissolved into inanity, or how many corporate call centers are basically marketing tools to sell new services. This is hard, complex work. My advice to MNSure and the State of Minnesota: Don't outsource. Train for quality. Minnesotans deserve no less.

Evidently you haven't had a

Evidently you haven't had a family member lose their insurance, their physician or their job due to this law. They probably wouldn't describe their outrage as whining, but of course you're entitled to your opinion.

Perhaps you can understand that when your HP printer fails, and the help line offers no help, you have the option of not buying their printers again...when you're oncologist informs you his services are no longer covered by your new Obamacare plan, and the help desk is of no help, it's a *bit* more off putting.

According to the CBO report today, 2 million people will be put out of the labor market due to Obamacare...I suppose we'll have to suffer through their whining too.

That wasn't exactly...

What the CBO report said. The report predicts fewer people WORKING, with a large number CHOOSING to leave the labor force because they now don't have to rely on an employer for guaranteed-issue insurance. I actually know a young couple who are making this choice. Over time, I figure the ACA will contribute to a reduction in labor force participation; fewer 2-income households, more people choosing self-employment and such. David Brooks pointed out today that small-business formation (along with family formation) is higher in nations that have universal health insurance. The ACA is less than 2 months old, can we wait a couple of years and then assess?

Law of Holes

When you find yourself in a hole, stop digging. Instead, MNsure/Obamacare advocates will go back to the taxpayers and throw ever more dollars at it. Government is not competent to run a system as big as US health care is. Shut it down before we waste any more money on it.

So Satisfying

After struggling to speak to an individual for days on end, I finally got the auto, er , healthcare coverage I could afford. With those high deductibles I am so very very thrilled. And to think, after all the trouble to actually sign on, the bill came in just three days, not the seven I was told to expect. So something is working, and it has to do with the fleecing of the citizen.

Call Centers

From day one of the planning of the call center, they should have hired someone who has run a call center. Or at least someone who has managerial experience in doing so. Did they? It doesn't seem possible. Especially if they initially thought they'd be fine with a staff of about 30 people.
And yes, they should have budged for a larger staff initially. That now, some months after the launch, they're suggesting pulling money from the advertising budget so that they can actually handle the customer needs, suggests managerial idiocy.