Project Overview

When Congress passed the Affordable Health Care act in 2010, this state knew that it had to create an effective platform for connecting its uninsured population with the most appropriate state-covered and private health insurance providers. The state turned to Eventus to implement contact centers that could handle high volumes and deliver a stress-free customer experience.

Client Challenge

The Affordable Care Act carried with it a number of unknowns, but how to efficiently serve the millions of uninsured people expected to seek coverage was one of the biggest.

No process roadmap
Each state was tasked with implementing its own solution for connecting the uninsured with a range of insurance providers. No roadmap was available to guide contact center processes or technology investments. At the same time the exchanges were launching, legislation continued to change requiring an agile environment to incorporate new changes.

Budget and staffing limitations
Budget constraints, a lack of developed processes and technology, and the need to train agents all stood as hurdles in the way of a successful customer experience.

Rather than waiting for someone else to take the lead, this state set out to invest in a holistic contact center approach and implement the nation’s first functional contact center supporting the Affordable Health Care Act.

Approach

Eventus planned and implemented a comprehensive contact center solution from the ground up.

Setting the stage for success
Planning was the critical first step. Eventus supported the state health benefit exchange with budget creation, labor analysis, training and technology to determine where best to allocate the skilled resources to support the members calling into the contact center.

Adopting flexible solutions
Eventus identified those contact center labor and technology solutions that would help the state best stretch its budget, while being able to provide the support needed as contact volumes ramped up over time. Eventus also advised on all technology purchases and helped with client negotiations creating over $40M in cost savings over 5 years.

Building support processes
Eventus developed and helped implement more than 200 operational processes to support the initial health exchange launch as well as ongoing contact center operations. This included exhaustive contingency planning to better prepare for the unexpected.

Operations and ongoing support
Eventus supported the state in its contact center and technology launch, but didn’t stop there. The team also led the state through a stabilization phase that allowed for continuous improvement during the exchange’s first three years of operations.

In the first year alone, three million people enrolled—surpassing the state’s call volume projections but delivering nothing the contact center couldn’t handle.

Results

With Eventus’ guidance, this state had its Command Center fully functional 45 days prior to the launch of its health benefit exchange. This successful implementation helped pave the way for a satisfying customer experience for millions of enrollees.

Technology cost savings
Over the first three years of operation, Eventus’ technology solutions saved the state health benefit exchange an estimated $18 million.

Under-budget operations
Eventus’ contact center stabilization work added $9.2 million more in savings in the first year of operations.