Vytra HMO Call Center Case Study

Summary

Vytra Inc. reduced its call center costs by over $500,000 (+16%) and improved numerous service quality dimensions. They now know the exact cost of each service, product and customer for accurate pricing, profit forecasting and product design. This case study explains the background, activities and achievements of their AIM – Activity Information Modeling project.

The Organization

Vytra Inc. is a New York HMO with over 200,000 customers and 30 basic product lines. They are noted for providing high benefit programs for executive groups. They have used Six Sigma since 1997.

Jim Karagiorgis, Chief Transformation Officer for Vytra, is responsible for determining the changes that are needed and leading Vytra’s teams to achieve new results. Jim is a Six Sigma Master Black Belt.

Kerry Edwards is Director of Customer Services and responsible for any interaction with members –including inbound calls, correspondence and maintaining strong customer relationships. She is the Six Sigma Project Leader for member loyalty and a Six Sigma Green Belt.

The Challenge

“One of the biggest obstacles to implementing Six Sigma is determining the cost of quality”, Jim Karagiorgis stated, “especially when you’re trying to determine the costs resulting from not doing something correctly and then re-doing it.”

“This is critical to Vytra, because we are a ‘customer- intimate’ company, providing value-added services rather than being the lowest-cost provider.” According to Jim, “Vytra must provide excellent service to keep our customers. We have to balance adding value to customers’ experiences with the Six Sigma philosophy of reducing costs and adding value. Under that system, every cost improvement must generate more than enough savings to justify the initial expense.”

Jim’s focus was the “voice of the customer” – call center handling of customer inquiries and problems. “Some of the issues that made cost and quality calculations impossible were the result of multiple variations of plans issued under Vytra’s basic lines of business. While Vytra has about 30 basic lines, its hundreds of employer clients have created literally hundreds of variations of health benefit programs. The total number of different combinations and permutations is staggering.”

The Approach & Solution

The AIM Data Fields & Variables

Activity
Call Category (life cycle)
Specific call type (process)

Service nature
Assistance needed
Line of business (product)

Resolution category (quality)

Phase 2 The Data Collection

A 4 week data collection effort was then launched with all employees in the Call Center. Employees were randomly sampled 2.5 times per hour. The AIM sample form took employees 7 to 10 seconds to complete.

Orient Point Consulting was engaged to make recommendations and build Activity Information Models (AIModels) of the Call Center operations that would help Vytra executives.

They interviewed executives to determine:
1. The problems and goals
2. The decisions and changes that were needed
3. The new information executives needed to make these decisions.

Orient Point designed an AIModel and configured their data collection system to populate it. The technology and AIModel were tested for 5 days with a small group of expert Call Center employees who provided suggestions that perfected the AIModel and data collection application.

Phase 3 The Analyses

Upon completing the data collection phase, Orient Point Consulting prepared analytical reports and analytical tools. They led Vytra executives through review and analyses sessions where the focus was their specific concerns and interests. Observations, findings and some scenarios were documented.

Next, Orient Point led the Vytra executives though analyses of a wider range of AIModels that discovered performance related findings that had not been known or contemplated. These too were documented.

Finally, executives were led through the list of findings with what-if scenarios that blueprinted the impacts of potential solution scenarios for the executives’ considerations. Some decisions were made during the last scenario analyses while other transformation and implementation decisions required further approvals and were made shortly thereafter.

The analysis was conducted over a 2 week period.

The Results

After AIM’s implementation, Kerry Edwards reports, “The initial results were very interesting. We were able to identify right away, which lines of business cost more than others and why. We also had some surprises. Certainly the models confirmed the areas we thought were costly, but they also showed us other high-expense areas that we either only suspected or had not even had a clue about!”

“Some of our biggest surprises were in the area of benefit inquiries. We were shocked to find that some simple benefit inquiry calls were among our most expensive. The cost came from the time staff needed to put a call on hold to get help from a more experienced or knowledgeable colleague.” Jim agreed and added, “AIM identified, for each line of business and call types, where these higher expense calls were occurring and why. By analyzing specific customers and their call types, it became clear that certain clients and client segments generated much higher costs. This pointed out the need to add more communication channels, such as web site content, that would allow these clients to find the information they needed quickly and eliminate the call.”

Kerry added, “We have made some corrections now, but many more are coming. With information provided by AIM, we now track inquiries, claims and complaints for every one of our services and quickly identify the exact areas that need to be reviewed and addressed. With our accurate and real-time information we quickly institute new training and procedures… and we quickly see new results.”

Jim Karagiorgis confirmed the project’s value. “Before, we had no way at all of knowing our costs for inquiries or claims for all of our different services, line of business, type of calls or by customer types. Now, because of AIM coupled with Six Sigma, we know our costs for those down to the cent and we know what we can do to reduce them. Having the exact costs also means that we can align our pricing by customer and product segment – which we’re doing now. Plus, by saving FTE expense on incoming calls, those resources are being used for outgoing calls to support the customer intimate/high value-added effort to create high customer loyalty.”

Kerry Edwards summarized the benefits. “By using AIM we have saved over $500,000 in our Call Center. We now price our call services to accurately reflect what they really cost. We have been able to pinpoint training and support issues that have cut costs and improved service.

“AIM tells us what we’re doing that’s not efficient and make it possible for us to see, in time and cost, where problems or mistakes are occurring.”

“It’s a great tool to learn more about everything in your business environment in depth. We can track and trend quickly and make better, faster business decisions.”

“It only requires a minimal amount of effort, and it’s such an easy tool to understand your costs.”

This article was written by Andrew Chiodo and published in Direct Marketing.

Can A Call Center Simultaneously Improve Its Customer Service Quality and Reduce Its Costs?

Andrew Chiodo, Professor, Franklin University, Business & Technology MBA Program

Summary

Vytra reduced its call center costs by over $500,000 (+16%) and improved numerous service quality dimensions. They now know the exact cost of each service, product and customer for accurate pricing, profit forecasting and product design. This case study explains the background, activities and achievements of their project.

Introduction

James Karagiorgis, Chief Transformation Officer for Vytra, is responsible for determining the changes that are needed and leading Vytra’s teams to achieve change results. Jim is a Six Sigma Master Black Belt.

Kerry Edwards is Director of Member Services and responsible for any interaction with members– including inbound calls, correspondence and maintaining strong customer relationships. She is the Six Sigma Project Leader for member loyalty and a Six Sigma Green Belt.

AIM-Activity Information Modeling is a tool that models cost and quality metrics so managers thoroughly understand their causes and can easily solve complex problems. It was invented by Gary Meyer, President of Orient Point Consulting LLC and has been used by more than 200 organizations in the USA, Canada, Europe and Latin America to model service operations including call centers.

Why the Improvement Project Started

“One of the biggest obstacles to implementing Six Sigma is determining the cost of quality”, Jim Karagiorgis stated, “especially when you’re trying to determine the costs resulting from not doing something correctly and then re-doing it.”

“This is critical to Vytra, because we are a ‘customer- intimate’ company, providing value-added services rather than being the lowest-cost provider.” According to Jim, “Vytra must provide excellent service to keep our customers. We have to balance adding value to customers’ experiences with the Six Sigma philosophy of not increasing costs. Under that system, every cost improvement must generate more than enough savings to justify the initial expense.

Jim’s focus was the “voice of the customer” – call center handling of customer inquiries and problems. “Some of the issues that made cost and quality calculations impossible were the result of multiple variations of plans issued under Vytra’s basic lines of business. While Vytra has about 30 basic lines, its hundreds of employer clients have created literally hundreds of variations of health benefit programs. The total number of different combinations and permutations is staggering.”

“Until we implemented activity modeling, all we could do was derive an average cost per call (about $3.00) with information from our Automated Call Director. But there was no way to determine if there were some calls and some customers that were more costly than others, and why, short of doing a (lengthy, disruptive and very expensive) full-blown activity costing process.”

Using A New Tool to Discover New Knowledge

AIM provided the solution. It collected over 60,000 data points in four weeks. It only required Customer Service (call center) personnel to answer 3 brief questions per hour that randomly appeared on their computer screens. States Jim Karagiorgis, “Our result was a clear picture of costs per call- by call type, product, line of business and customer types. The time to complete the project was extremely short and the cost was minimal. We determined that AIM delivered its information at plus 99% confidence level.”

Finding Cost Opportunities In Poor Quality

Kerry Edwards’ experience focused on customer service, mostly in the call center. She knows that customer service is constantly going through change, with the most successful organization being the one that adapts best. AIM was implemented in the Member Service Call Center because it is the largest part of customer service. According to Kerry, “There was a great need to understand the costs of incoming calls and what caused those costs. We were relying on an average cost per call, and that was misleading us. We knew, for instance, that costs for claims calls had to be larger than benefits inquiries because of the relative length of the calls. This was very important to determine because 50% of the calls from our single largest group was for claim issues. We knew that quality problems raise costs so finding and understanding our quality problems was critical to finding our cost opportunities.”

New Information Achieved New Results

After AIM’s implementation, Kerry reports, the initial results were very interesting. “We were able to identify, right away, which lines of business cost more than others and why. We also had some surprises. Certainly the models confirmed the areas we thought were costly, but they also showed us other high-expense areas that we either only suspected or had not even had a clue about!”

“Some of our ‘biggest surprises’ were in the area of benefit inquiries. We were shocked to find that some simple benefit inquiry calls were among our most expensive. The cost came from the time staff needed to put a call on hold to get help from a more experienced or knowledgeable colleague.” Jim agreed and added, “AIM identified, for each line of business and call types, where these higher expense calls were occurring and why. By analyzing specific customers and their call types, it became clear that certain clients and client segments generated much higher costs. This pointed out the need to add specific content to the Vytra website that would allow these clients to find the information they needed quickly and eliminate the call.”

Kerry added, “We have made some corrections now, but many more are coming. Other information showed that some costs were not a result of Vytra’s actions, but our member employers’ HR managers. Some employers weren’t providing our HMO benefit information to their employees and this was causing lots of calls about basic benefits. We eliminated those by helping our largest clients provide better orientation programs about their healthcare benefit programs.”

“With AIM we now track inquiries, claims and complaints, for every one of our services and identify exactly the areas that need to be reviewed and addressed. We have real information so we institute re-training, new procedures and re-pricing strategies quickly and see results very quickly.”

The Bottom Line

Jim Karagiorgis confirmed the project’s value. “Before, we had no way at all of knowing our costs for inquiries or claims for all of our different services, line of business, type of calls or by customer types. Now, because of AIM we know our costs for those down to the cent and we know what we can do to reduce them. Having the exact costs also means that we can align our pricing by customer and product segment – which we’re doing now. Plus, by saving FTE expense on incoming calls, those resources are being used for outgoing calls to support the customer intimate/high value-added effort to create high customer loyalty.”

Kerry Edwards summarized the benefits. “By using AIM we have saved over $500,000 in our Call Center. Vytra now prices its services to accurately reflect what they really cost. We have been able to pinpoint training and support issues that have cut costs and improved service.”

“AIM tells us what we’re doing that’s not efficient and makes it possible for us to see, in time and cost, where problems or mistakes are occurring and what’s causing them.”
“It’s a great tool to learn more about everything in your business environment in depth. We can track and trend quickly and make good business decisions.”
“It only requires a minimal amount of effort, and it’s such an easy tool that we don’t even document all the issues that it’s allowed us to fix.”

Customer Service & Six Sigma Metrics

Vytra collected, analyzed and measured these service and Six Sigma metrics in its Call Center:

First call resolution (incidence, time and cost) of every call type in 22 quality dimensions.
The quality metrics and process times of all 8 services the Call Center provides.
The quality and process time of the center’s 61 call type procedures.
The quality and service metrics for each of its 31 customer segments.

These were metrics that Vytra needed for its Six Sigma effort but could not determine without granular activity information. Now they have models that show the cause and effect of quality and that help them predict the impacts of changes they’re considering.