Obamacare Website Failure Stresses Government Call Centers

No matter what side of the political fence you’re on, the colossal failure of the Patient Protection and Affordable Care Act, aka Obamacare, Website can be agreed upon by all.

There has been much finger-pointing at contractors, particularly the IT company CGI, which has been accused of poor design, failure to vet the site before launch, and lack of preparedness for the overwhelming traffic the site received. Consumers faced the burden of having to call government call centers in order to enroll in insurance plans, a situation which was met with mixed results.

“I don’t think any commercial brand could have afforded that kind of publicity or situation, because people would have moved elsewhere,” says James Norwood, chief marketing officer at KANA Software. “With our retail customers, they never would go live with something without being 100 percent sure [it worked]. Their business would be decimated by delivering a bad initial experience.”

Call Center Math

The call centers charged with handling consumers are divided into different organizations. According to The Kaiser Family Foundation, there are 17 state-based marketplaces, seven partnership marketplaces, and 27 federally facilitated marketplaces. The federal call centers are operated by Vangent, a subsidiary of General Dynamics, which was awarded a $28 million contract by the government. Vangent has been charged with supporting multichannel operations that respond to inquiries and provide information and services through not only the call center but also postal mail, email, TDD/TTY, fax, and Web chat.

According to a blog post by U.S. Secretary of Health and Human Services Kathleen Sebelius, as of October 24, the call center handled 1.6 million calls. Following the President’s speech after the Web site was criticized, contact centers handled more than 120,000 calls that day. As a result of the Web site problems, the federal call center upped staffing and now has more than 10,000 trained customer service representatives.

“People defaulted to the costly channel, the phone,” says Norwood. “That was throwing good taxpayer money after bad because you have to bring in more agents and get them up to speed. They were bringing on people that weren’t trained on the same level of the [other] call group. Consumers were not only annoyed by the time they got to the phone because they got these 404 error pages, but the agent they spoke to didn’t have the necessary training,” says Norwood.

The Health and Human Services Web site points out that:

  • Average wait times for calls is less than 30 seconds, and three minutes for Web chats.
  • States that have taken the most calls are Florida, Texas, Pennsylvania, North Carolina, and New Jersey.
  • 40,000 calls have been taken in Spanish and other languages.
  • There are 500 calls per hour in peak times.
  • Approximately 200 calls are taken per hour during nonpeak times.
  • Average handle time is 12 minutes for English and 11 minutes for Spanish.

Mega M&A Deals Do Not Necessarily Make for Good Contact Centers

Part of the larger picture may be that healthcare organizations were busy with giant mergers and acquisitions but “still have no idea what the impact of Obamacare is going to be on them,” says Donna Fluss, founder and president of DMG Consulting.

“For the past two years, [healthcare companies] have been spending a tremendous amount of money trying to figure out what they need to do. They’ve been merging and putting together contact centers in anticipation of Obamacare,” says Fluss. “The healthcare industry doesn’t have a lot of experience doing these kinds of mega mergers.”

Among the mergers was the WellPoint acquisition in 2012 of Amerigroup, a managed health care company, for $4.9 billion.

"This is an opportunity to capitalize on the strengths of both companies to better serve our members and position our companies for future growth as the health insurance industry changes and as we prepare for health insurance exchanges," said WellPoint CEO Angela Braly in a statement.

Another big merger happened in June 2013, when Tenet Healthcare acquired Vanguard Health Systems for approximately $4.3 billion. The companies said in a statement that the deal “increase[s] the benefits we expect to realize under healthcare reform.” With the companies’ combined operations, Tenet now has five health plans and six accountable care organizations.

“Healthcare companies have been spending a lot of money, but they really don’t know what they’re doing,” Fluss says. “They have no idea of what the impact of Obamacare is going to be on their value. It’s been a challenging time period for them.”

Outsourcing Call Centers

On top of this issue, in many cases, while administrators managing call centers know the healthcare business, they don’t necessarily know about contact center operations, says Fluss.

“The operational ramifications are huge for these companies, [which] are struggling to try to figure out what it is that they need to do, but each day is a new experience. They’ve been given very high-level guidelines at best. So far, it’s been pretty much a worst case scenario.”

Healthcare companies are also reaching out to large consulting companies. However, even though healthcare companies have been outsourcing call centers  to consulting firms, a lot of unnecessary money is being spent due to a lack of direction, Fluss says.

“It’s always a mistake to take something that you don’t have good control over and outsource it and think that the outsourcer is going to fix it. The things that you want to outsource are things that you have a really good understanding of so that you can manage it effectively. Even if you outsource something, it’s still your responsibility,” she said.

Can the Obamacare Customer Experience Be Fixed?

While KANA Software provides customer service technology for more than 250 government agencies, it’s not involved in call centers for Obamacare. Nonetheless, Norwood has some suggestions.

“We’re not lobbying for big government IT contracts, but our advice would be is that they must maintain consistency of information, not just across channels but also across the agents,” he says.

Norwood also believes that there needs to be a seamless transition across Websites. For example, when you log into the federal Website and you’re immediately directed into a state-run Web site, the transition can be jarring.

“The site you are directed to looks completely different and doesn’t flow the same,” Norwood points out. “Once you leave that marketplace [the government site] and you go into a state Website, it’s almost like you are starting again. There’s got to be a seamless transition. The government is not exempt or immune in having to offer a good, quality customer service experience. “

When fed-up customers do resort to calling the contact center, KANA recommends that agents offer empathy. KANA also suggests that government call centers agents employ some basic rules: Agents should make every attempt to resolve the issue on the first call; don’t force customer to transfer between agents and channels; and if an issue can’t be handled at that point, the agent needs to provide a path of resolution and outline what next steps and actions will be needed.

Fluss believes that hiring agents from other business sectors, such as finance and insurance, who are used to dealing with sensitive information, may also help Obamacare call centers.  

“The healthcare companies need to bring in expertise in the area of customer service, sales, and support with their strategies and building their operations,” Fluss says. “While these people may not know healthcare, they bring lots of experience, and combined with someone who knows healthcare, can help these companies build a foundation so that they’re better positioned to handle what will be unquestionably a very substantial influx of interactions.”

A Call Center Agent Should Never Talk to Sean Hannity on the Radio

No matter what, a contact agent dealing with Obamacare, or any other issue, should never, ever, allow themselves to be recorded on the radio.

Just days the official launch of the government Website, radio personality Sean Hannity called into the Obamacare contact center. Even though he advised the agent that she was on the radio she still answered questions about the problems she had encountered, how the contact center worked, and was even persuaded to read her script. Unsurprisingly, the agent was fired. Hannity expressed remorse, offered her a year’s salary as compensation, and promised to find her a new job.