Welcome! The Health Care Financing Administration and 27 other high-impact government agencies recently received scores on the American Customer Satisfaction Index survey. Please click on one of the topics below to read about HCFA's results.
OVERVIEW
FACT SHEET
CUSTOMER SERVICE IMPROVEMENT PLAN
QUESTIONS AND ANSWERS
HCFA'S PRESS RELEASE
Who was surveyed?
HCFA chose as its customer segment Medicare beneficiaries who had enrolled in Medicare from January 1, 1998 to December 31, 1998 and filed a claim for medical services from January 1, 1998 to December 31, 1998 as a Part A (inpatient) encounter.
American Customer Satisfaction Index: 71
What were they asked?
What customer service activities were done well?
What is the experience of Medicare beneficiaries over time?
73% of beneficiaries are more satisfied now than two years ago.
What activities are planned to improve customer satisfaction?
What other information is available about customer satisfaction?
Contact for more information:
Chris Peacock, Press Officer
Phone:202-690-6145 ;Fax: 202-690-7159
Email: cpeacock@hcfa.gov
HCFA Customers:
Each Agency was asked to choose a major customer segment. In order to reach the broadest customer base, HCFA choose Medicare beneficiaries who had enrolled and had a claim for Part A services during calendar year l998. The survey was conducted by telephone in August, l999.
Services Surveyed:
The survey asked how easy it was to enroll in Medicare, how easy it is to get information about Medicare and Medicare benefits, the usefulness of information from Medicare, and the courtesy and professionalism of Medicare staff.
HCFA Findings and Index:
HCFA had an overall customer satisfaction index of 7l. The national index for all services in the private sector is 72. It is important to note that the score is an index which is weighted statistically to account for numerous factors and not a percent of individuals surveyed. Specifically, beneficiaries rated the ease of enrollment very highly (88) as well as the courtesy and professionalism of Medicare staff (85). Beneficiaries did find that Medicare information could be more accessible and useful (73). Beneficiaries also found their actual experience with Medicare surpassed their expectations.
HCFA's Customer Service and Outreach Strategy:
HCFA has numerous customer service initiatives underway and planned which both address the specific findings of the ASCI survey as well as the overall education and information needs of beneficiaries. Efforts within the HCFA Customer Service Program include:
Medicare has become an indispensable program for over 40 million Americans. At the Health Care Financing Administration (HCFA), the Federal agency charged with administering Medicare, we are keenly aware of our responsibility to provide excellent customer service to this large segment of the American public. HCFA works with many other organizations and individuals who understand our customer service orientation to continuously improve service to beneficiaries. Initiatives currently underway include a new format for providing beneficiaries with easy-to-understand billing information, national outreach and education programs, and measures that will ensure customers receive accurate and courteous service over the telephone. To help coordinate all these activities and institutionalize HCFA’s customer-service focus, the agency’s Center for Beneficiary Services is implementing a new Customer Service Program.
Click HERE to read about how HCFA’s current and planned service improvements that address the results of the ASCI survey.
Click HERE to read about other HCFA customer service and outreach plans.
Click HERE to see HCFA’s High Impact Agency performance objectives.
Click HERE to go directly to HCFA’s Beneficiary and Customer Service web site
HCFA’s IMPROVEMENT PLANS AND THE ASCI SURVEY
HCFA, as one of the thirty-two High Impact Agencies, participated in the ASCI survey in order to have a national baseline against which to measure and improve customer satisfaction as well as to validate the results of ongoing customer information improvements. HCFA also saw this as an opportunity to confirm the results of its current customer input activities, which include focus groups and surveys. HCFA used the ACSI to study information activities in three areas--enrollment, benefit information and customer service (courtesy and professionalism). We scored well above the national index in enrollment and customer service and slightly below in the area of benefit information. HCFA is committed to improving its performance in all three areas, but has recognized the special need for improvements in information about benefits and currently has three major initiatives underway or planned to improve the billing and inquiry process:
(l) Medicare Summary Notice
Medicare beneficiaries have over 600 million service encounters per year. In the past, beneficiaries generally were mailed a written notice, the Explanation of Medicare Benefits (EOMB), each time they received a service. Beneficiaries often found these notices hard to understand and were unable to reconcile them with the bills they received from providers of services or other insurers. Based on what beneficiaries told us, HCFA has undertaken a major and ongoing effort to improve notices about bills. HCFA is implementing a new notice to help beneficiaries understand the medical bills they receive. A new notice called the Medicare Summary Notice (MSN) is now replacing the EOMB.
The Medicare Summary Notice (MSN) provides beneficiaries with a monthly summary of all the bills submitted on their behalf, including the type of service, dates of service, and the amounts paid by Medicare, much like a credit card statement. To design the MSN, HCFA used feedback from Medicare contractors, beneficiary groups (such as the American Association of Retired Persons (AARP), and conducted nationwide focus groups of beneficiaries. HCFA also worked with the Office of the Inspector General to help design messages that would better enable beneficiaries to identify any potential fraud or abuse of the program. The result is a simple, easy-to-read format, which all users agree is the most useful tool developed to date to inform beneficiaries about actions on their Medicare claims. When fully implemented, it will replace the current, multiple format, Medicare benefit notices with one standard format.
The MSN contains the following key features:
HCFA has also made major efforts to ensure that the introduction of the MSN to the beneficiaries will be as smooth as possible. Before introducing the MSN, all HCFA carriers (the insurance companies which process Part B claims for HCFA under contract) mailed a brochure about the new form and how to use it to all beneficiaries. This publication was also developed with input from the consumer, beneficiary, advocacy and private sector communities. Also HCFA required each carrier to carry out extensive outreach efforts, such as health fairs, newsletters, local and community press announcements, about the introduction of the new form.
*Note: The MSN has been implemented at approximately 80 percent of Medicare contractor sites. In FY1999, it was necessary to delay implementation of the MSN at 15 remaining contractors due to Y2K workload demands until after millennium compliance is reached. HCFA is currently scheduled to complete national implementation in October 2001. Therefore, beneficiaries in some areas of the country may be receiving MSNs along with the older benefit notices (i.e., Explanation of Medicare Benefits (EOMBs).
Click HERE to see sample of the Medicare Summary Notice and full explanations of how each piece of information can be used by the consumer.
(2) Telephone Service
When they need information, the majority of Medicare beneficiaries use the telephone as their principal source of help and information. Medicare receives over 15 million telephone calls per year with questions about billing and understanding the Medicare program.
To continually review, renew, and improve our approaches as new activities emerge, HCFA developed an overall Medicare beneficiary telephone customer service strategy that also includes standards and performance measures to evaluate the effectiveness of customer service. The strategy incorporates feedback on customer service goals and expectations from: beneficiaries, HCFA staff, carriers, and fiscal intermediaries, Peer Review Organization (PROs), State Health Insurance Assistance Programs, and the Social Security Administration (SSA).
The following initiatives are in various stages of implementation:
The following initiatives are in the planning stages:
Click HERE to view the Medicare Handbook, "Medicare & You" which contains the telephone numbers of all of the important sources of Medicare information for your area.
(3) Contractor/Performance Management
HCFA has begun to require Medicare intermediaries and carriers (Medicare’s fiscal agents which process Medicare claims) to develop an annual customer service plan and submit quarterly progress reports. These plans will help HCFA monitor improvements in Medicare contractor customer service, identify opportunities to coordinate activities, and disseminate information about best practices.
HCFA is working to meet our Government and Performance Results Act (GPRA) performance goal to increase the percentage of beneficiaries who are satisfied with the health care services they receive through the Medicare program. To do this, HCFA is providing comparative performance information to beneficiaries that can help them make more informed health care choices. For example, beneficiaries can use Medicare Compare on the Internet at www.medicare.gov to guide their selection of a Medicare managed care plan. In addition, baseline telephone customer service data is being collected in FY2000 for the establishment of future telephone customer service standards.
HCFA will be using the Medicare Current Beneficiary Survey to help meet another GPRA performance goal: To improve the effectiveness of dissemination of information to Medicare beneficiaries and those acting on their behalf. Survey results will help determine the percentage of beneficiaries who were able to obtain information about their health plan choices when they needed it.
HCFA is working to set standards for communicating accurately and clearly with beneficiaries using plain language. Existing publications and communication products (for example: the "Medicare & You" handbook, Internet and call center communications) have been or are being revised.
Click HERE to read about HCFA’s GPRA performance plan.
OTHER HCFA CUSTOMER SERVICE AND OUTREACH INITIATIVES
HCFA is deeply committed to reaching out to its customers with information about the Medicare program. As a Federal Agency, HCFA’s mission is to assure health care security for Medicare beneficiaries. Protecting and improving beneficiary health, satisfaction and understanding of Medicare is central to this mission. HCFA believes that accurate and easy to use information about Medicare is vital to assuring that beneficiaries are fully able to exercise their rights to choose how they wish to receive their health care and to use their benefits. HCFA is engaged in numerous outreach efforts to educate Medicare beneficiaries and the public about Medicare and to listen to and learn from the concerns expressed by beneficiaries about Medicare services. A summary of several of these efforts follows below:
National Medicare Education Program
The aim of the National Medicare Education Program (NMEP) is to educate Medicare beneficiaries so that they can make informed health care decisions. HCFA is building alliances with national, state and local organizations to leverage customer service, educational efforts and resources. Currently, HCFA has 126 partners that reach approximately 40 million senior citizens. We are providing these partners with information through meetings, conferences, and partnership communication kits.
REACH
The Regional Education About Choices in Health, or REACH, is the local aspect of the NMEP. HCFA’s messages are tailored to beneficiaries’ particular needs and preferences by delivering Medicare+Choice information at the local level. REACH activities include conducting public presentations, training, and strategy sessions with partners, participating in health fairs and distributing materials to beneficiaries through partners. There are also a large number of innovative mass media activities such as radio talk programs, cable television programs, and newspaper "Question and Answer" columns.
1-800 Medicare
Nationwide access to 1-800-MEDICARE provides one number for beneficiaries and their family members to call to access Medicare information. 1-800-MEDICARE is a general Medicare helpline where the customer service representatives can answer general Medicare questions, order publications for callers, including disenrollment forms for managed care plans, and offer referrals to Medicare partners who can answer more in-depth questions.
Medicare Customer Service Access Pilot
HCFA has piloted the Medicare Customer Service Center (MCSC), which is designed as a desktop multiple database access tool to facilitate a one-stop shopping approach to Medicare beneficiary telephone inquiries. Since customer service representatives at MCSC locations have access to a comprehensive array of individual Medicare records, beneficiaries and their family members may take care of their entire Medicare information needs with one phone call to the MCSC. HCFA is beginning to deploy the MCSC desktop at selected call centers based on performance, quality and cost criteria. We will also begin to tie the call centers into the national 1-800 Medicare Network so Medicare beneficiaries will be able to dial anywhere in the U.S. to get answers to their Medicare questions.
Medicare & You - Information Strategy/HCFA publications
HCFA has created a two-tier information strategy that consists of basic and specific information Medicare & You is the source of basic Medicare information that all beneficiaries have access to through (l) the annual Fall mailing of the publication and (2) a monthly mailing to all new enrollees. Medicare & You references numerous publications that provide specific, more detailed information on topics of interest to certain beneficiaries. For example, these tier two publications include information on the home health benefit, hospice benefits, Medigap insurance, a worksheet to help beneficiaries choose the health plan that is best for them, and many more.
Click HERE to view a listing of Medicare publications and information on how to order publications.
HCFA has learned through surveys, correspondence review and beneficiary focus groups that understanding the limits of Medicare coverage is an important issue for beneficiaries and we have incorporated a number of key messages in our publications to respond that need. Medicare & You has incorporated a number of messages, including "Medicare does not pay for all of your health care costs" (page l). This message is repeated through Medicare & You 2000 including other statements such as "Some things are not covered, like prescription drugs," and "There are many types of private health coverage that pay some or all of the health care costs not covered by Medicare." We have added a section that describes in detail the services and items that Medicare does not cover in both Medicare & You ("What is not paid for by Medicare Part A and B") and the l999 Guide to Health Insurance ("What are the gaps in the Original Plan") to clearly explain what is not covered in our two major publications that assist with health care decision-making. The tier two publications that provide specific, more detailed information on topics of interest to certain beneficiaries also include a section that lists what is not covered by Medicare. For example, The Medicare Home Health Care brochure answers the question "What doesn’t the Original Medicare Plan cover?" following a list of covered home health care services.
Initial Enrollment Package
HCFA has hired an international communications firm to redesign the information package that is mailed to newly eligible beneficiaries three months before their Medicare coverage is effective. This welcome package currently contains a beneficiary’s Medicare card, instructions for declining Part B, and a number of small informational brochures on a variety of topics. HCFA’s goal is to streamline this information into a simplified educational product that is easy for new enrollees to read and understand. A follow-up mailing of the Medicare & You handbook will continue to provide more detailed Medicare information. Prototypes of the redesigned package will be completed early in 2000 and will be pilot tested with new beneficiaries.
Web Site Feedback
HCFA maintains two major web sites: hcfa.gov contains information about Medicare program administration and HCFA as an Agency; and medicare.gov which is tailored to the beneficiary with information about the program from the beneficiary perspective. Visitors to the www.medicare.gov Web site can send comments via the guest book about their experience with the web site. The www.medicare.gov web site receives guest book comments on three distinct parts of the site—the overall site, Medicare Compare, and Nursing Home Compare. Feedback trends are regularly disseminated HCFA-wide to keep staff informed of beneficiaries’ interests and needs.
CUSTOMER SERVICE PROGRAM
HCFA’s Center for Beneficiary Services (CBS) has developed a Customer Service Program to coordinate all the many beneficiary-centered activities that are underway or planned. The program aligns with HCFA’s Strategic Plan objectives to improve beneficiary satisfaction with programs and services; increase the usefulness of communications with beneficiaries; and improve access to services for underserved and vulnerable beneficiary populations. The project’s aim was to identify and implement a strategy and approach for optimizing how HCFA and its partners provide customer service to Medicare beneficiaries. Together with HCFA’s Regional Offices and customer service partners—intermediaries and carriers, State Health Insurance Programs (SHIPs), Professional Review Organizations (PROs), the Social Security Administration (SSA)—a team consisting of CBS staff and Arthur Andersen experts set the following goal and visions for customer service:
Goal: "We continuously improve Medicare customer satisfaction through the delivery of high quality and cost-effective customer service."
Visions (what HCFA customer service should be known for):
The program incorporates key elements, such as Information Accessibility, Prompt Personalized Service and New Service Development, which will focus attention on ways to make the overall goal and visions a reality. Focus groups and discussion sessions involving beneficiaries, front-line employees and managers/staff provided input and validated these key components.
Q1. Why was HCFA chosen to participate in the ACSI study?
A. The Health Care Financing Administration administers the federal Medicare program which serves over 40 million beneficiaries. NPR requested HCFA to participate in the ACSI because HCFA is one of the thirty high impact agencies that touch over 90% of the American public. HCFA readily agreed to participate in order to have a national baseline from which to measure and to improve its customer service activities and to validate the results of ongoing customer service information activity.
Q2. Why did HCFA choose to study Medicare Information Services?
A. HCFA’s mission is to assure health care security for beneficiaries. HCFA believes that accurate and easy to use information about Medicare is vital to assuring that beneficiaries are fully able to exercise their rights to choose how they use their benefits and receive their health care. Protecting and improving beneficiary health, satisfaction and public understanding is central to our mission as a federal Agency.
Q3. Who did HCFA survey?
A. The ASCI surveyed HCFA beneficiaries who had enrolled in Medicare between January 1, l998 and December 31, l998 and who had received at least one inpatient Medicare (Part A) service. HCFA selected this sample group in order to ensure that beneficiaries who had recent exposure to the full range of Medicare information services were included in the survey.
Q4. What was HCFA’s score?
A. HCFA’s index score was 71. Most private sector companies and government agencies score between 50 and 80. Our score compares very favorably to the current national index for the private sector of 72, and our scores in the particular areas of customer service and enrollment services far exceeded the overall national index.
Q5. How was HCFA’s score calculated?
A. The ACSI asks each Agency to select particular activities for study. HCFA choose three activities of information services—enrollment information and services, benefit information and services, and customer service or the courtesy and professionalism of employees. HCFA scored very well in the areas of enrollment services and customer service and less well in the benefit information category. The final score is a composite index based upon the particular weighting system and methodology employed by the ACSI.
Q6. How does HCFA’s score compare with other federal agencies?
A. HCFA's score of 71 fell slightly above the overall government-wide index of 68.6. The scores of other agencies that pay claims or benefits ranged from 82 for the Social Security Administration to 61 for the Veterans Benefits Administration.
Q7. What is HCFA doing to improve its score?
A. HCFA scored very highly in the areas of enrollment information and customer service or professionalism and courtesy and less well in the area of benefit information. HCFA will focus its efforts on improving information services by continuing ongoing efforts and implementing new programs in three areas: (l) Continued phase in of the Medicare Summary Notice which explains Medicare handling of billing for medical services; (2) Improvement of telephone services and response to questions about bills; and (3) Working with the insurance companies that help us administer Medicare to improve information services. Of course, HCFA will remain dedicated to maintaining its already high levels of customer satisfaction with enrollment and customer services.
Q8. How will HCFA know if services have improved?
A. HCFA routinely conducts internal studies of its information services by using focus groups and ongoing telephone and written surveys to improve its products. HCFA sees the results of this ACSI survey as a way of both validating these efforts and establishing a baseline from which to measure customer satisfaction with Medicare information services. HCFA will maintain its strong commitment to improving these services and will participate in the second round of the ASCI along with the other High Impact Agencies.
Customer Satisfaction Results Announced for the
Health Care Financing Administration
Results just released by the 1999 American Customer Satisfaction Index highlight the Health Care Financing Administration=s excellent customer relations skills and commitment to beneficiary services.
A
HCFA=s results are both a salute and a challenge,@ said Nancy-Ann DeParle, HCFA Administrator. AThese results salute HCFA=s courtesy and professionalism in enrolling and serving our Medicare beneficiaries. At the same time they challenge us to provide better billing information and clearer explanations of benefits. I am proud to say that major improvements in these areas are already underway.@
In order to establish a federal benchmark for customer service quality, Vice President Gore=s National Partnership for Reinventing Government (NPR) and the President=s Management Council asked 30 federal services located in 29 government agencies to take part in the annual American Customer Satisfaction Index (ASCI) in 1999.
Since 1994, the ASCI has measured customer satisfaction for 170 private sector corporations as well as for the Internal Revenue Service and the U.S. Postal Service. This year=s national index for all private and public sector ASCI participants is 73 (on a scale of 0-100). The national database contains the results of more than 300,000 customer interviews. HCFA received an overall index score of 71. Of particular note were the outstanding scores HCFA received in two particular areas, 88 for ease of the Medicare enrollment process and 85 for courteous and professional customer service.
The American Customer Satisfaction Index is not a percentage or ratio, but instead an index formulated from the evaluations of customers. Customers are interviewed over the telephone and asked about their expectations as well as the quality of the services or products they received from the agency or company. This input is subsequently measured as a customer satisfaction on the 0-100 scale. Each participating federal service used 260 completed interviews to derive its results; private sector companies use a similar methodology. The ASCI is conducted as a partnership between the University of Michigan Business School, Arthur Andersen, and the American Society for Quality.
HCFA=s customer segment for the ASCI index was a representative sample of beneficiaries who had enrolled in Medicare in 1998 and who had a Part A (inpatient) claim filed during that same year. In a telephone interview the Medicare beneficiaries were asked:
The Medicare beneficiaries interviewed expressed great satisfaction with the ease of the enrollment process as well as the courtesy and professionalism of the customer service provided. On the other hand, they gave average ratings to the accessibility and usefulness of the information available regarding benefits and billing.
HCFA already has launched a number of initiatives to improve Medicare benefit and billing information services. These improvements include a complete revision of the Medicare billing notice format, making it much easier to read and understand. This improved format is being phased in across the country. It reflects input from beneficiary advocates such as senior organizations as well as focus groups of Medicare beneficiaries.
Medicare contractors receive over 15 million calls per year regarding billing and benefits. HCFA has launched a comprehensive strategy to improve the quality of the telephone customer service system and to improve training for call center service representatives. In addition, HCFA is working with its Medicare intermediaries and carriers to implement annual customer service plans and share information about best practices. For more information about these and other customer service improvement initiatives go to: www.hcfa.gov.
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Last Updated December 16, 1999
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