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.
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.