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The New Member Experience Sept. 11, 2013. Setting the Context. Hannah King, Director National Service Quality. Falls Church, Mid-Atlantic States Region Adult Primary Care UBT. Our Team. Why We Focus on New Members. Welcome new members and give “WOW” experience Member retention and growth
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Setting the Context Hannah King, Director National Service Quality
Falls Church, Mid-Atlantic States Region Adult Primary Care UBT
Why We Focus on New Members • Welcome new members and give “WOW” experience • Member retention and growth • To help new members navigate Falls Church Center
Our SMART Goal Improving the care experience was our goal. The Falls Church APC UBT would improve the staff courtesy and helpfulness score from 81.5% in Q 4 of 2011 to 83% in Q1 of 2012
Example: Tours Falls Church New Member Tour 10-5-11 Basement Lab Radiology ASC First Floor Pharmacy Peds Talk about other departments available on first floor Vending machines/Kiosk review the information on scheduling appts and member services on the back of the card Direct member to garage Tour ends Estimated Length- 20-30 minutes Start- Ask new members if they want a tour of the facility Third floor Visit Primary Care Nurse clinic Talk about other departments on the third floor Second floor Member services Admin HIMS (Medical Records) Health Ed Room (for classes) Eye Care OB/GYN
Our Best Practices • Facility tours • New Member Roadmap • Medicine bags • Card sleeves • New member card • New member bags
Our Challenges • Team engagement • Teamwork and communication • Time (meetings and tours)
Our Successes • Positive feedback around tours and new member bags • Improved teamwork and communication • Improved MPS Scores
Lessons We Learned • Going the extra mile for members • Teamwork and positivity
New Member Map http://lmpartnership.org/tools/new-member-map
What We Do at CSC • Receive contracts from Sales and Account managers • Enroll employer groups (enter contract details including co-pay amounts, benefits, costs, etc.) • Interact with Sales and Accounts colleagues when we spot discrepancies This ensures new members will not face any surprises on their first visit
Our SMART Goal The CSC Contracts UBT will reduce the discrepancy rate from a baseline of 65 percent to a goal of 50 percent between June 2013 and September 2013.
“A Day in the Life of a Contract” • Two days of face-to-face meetings • Showed both computer systems side by side • A three-page guideline document of codes that everyone agrees to use
Role of Frontline • Those working on the purchaser advice (PA) and contract submission daily are most aware of the issues that need to be resolved. • Brainstorming between the two teams enable a solution. • RIM process and use of experts on the team allowed development of the workshop
Speaking a Common Language • Open communication between teams • Better understanding of the different computer systems being used • Development of a cross reference of most common terms used by both teams
Working with Other Departments • Both teams became more receptive to questions • More thorough knowledge of why we needed the information we asked for • Better camaraderie between the two teams • Understand the impact each department impacts each other • Understand and accept that systems and language differs
Our Rewards & Recognition • Part of the Hank magazine cover story
Rock Creek Medical Office, Colorado Primary Care UBT
Why We Focus on New Members • We focus on new members because we want our members to feel welcome and that we care about them
Our Goal Improve service with our new members by sending them a thank you card after their first visit
Our Best Practices • Say “Thank you” to members • Introduce ourselves to members • Make them feel welcome
Our Challenges • Short staffed • Team morale dropped
Our Successes • Supportive sponsors • Staffing levels improved • Engaged physicians
Lessons We Learned • Appropriate staffing levels • Staff and provider buy-in
Our Rewards & Recognition • LMP web story on the Golden First Visit http://lmpartnership.org/stories-videos/love-first-visit • Recognized for quality metrics
Richmond (NCAL) Pediatrics UBT
Why We Focus on New Members • Health Care Reform Anticipating more new members • The WOW effect The first year is crucial
Our SMART Goal We will increase our member satisfaction scores for new members from 88.3 percent satisfaction in 2012 to 91 percent by the end of 2013.
Our Best Practices • Tracking new members manually in a binder • Checking first to see if a new member has had a prior visit before welcoming them
Our Challenges • Manager not always available, so inconsistent folder distribution • Patient diversity, language/cultural barriers
Lessons We Learned • Teamwork is key – we need each other • Consistency • The WOW experience for all patients and members
Our Rewards & Recognition • Recognized at department meetings • Recognized by local leadership via email and at joint managers and stewards meetings • Regional UBT recognition as a best practice • Article in HANK
Closing Thoughts Hannah King, Director National Service Quality
Resources • National Service Quality website: http://kpnet.kp.org/qrrm/service2/index.html • Labor Management Partnership website: www.LMPartnership.org and search on “new member”