By Jeffrey Meitrodt and Jackie Crosby
A major boost in manpower is still weeks away at MNsure's overwhelmed call center, which continues to keep customers on hold for 30 minutes or more while the state health exchange tries to regroup from a variety of problems that have slowed enrollment.
Call center industry veterans, and one MNsure board member, said the agency should have solved staffing problems at the call center three months ago, when it became obvious the agency had underestimated the number of operators needed to handle the deluge of calls.
Some callers have waited as long as two hours to speak with a MNsure representative since the exchange launched on Oct. 1. The industry standard for call centers is 30 seconds.
"Anybody could get it wrong up front, but what was everybody [at MNsure] doing while all of these people were on hold?" said Fred Weiner, president of The Connection, a Burnsville company. "What were they doing in October, November and December?"
Weiner said his company is one of three vying for an outsourcing contract with MNsure that agency officials expect to finalize within the next week. The contract is expected to allow MNsure to add up to 100 external customer service representatives to its call center, which currently has 65 operators.
The additional workers are expected to be in place just as the agency prepares for its next major test: a crush of consumers rushing to meet the March 31 deadline to buy health insurance under the Affordable Care Act, which requires most Americans to have coverage or pay a tax penalty.
MNsure officials said they are confident their call center strategy will work because other technical problems are decreasing, and more applicants are enrolling successfully. "We are reacting right," said Brian Beutner, MNsure's board chairman. "Would we have liked to have done it sooner and more timely? Maybe."
The state originally expected about 135,000 consumers to use MNsure to enroll in private and government-subsidized health plans by the end of open enrollment in March. But only 27,775 people have bought coverage, according to the latest data through Jan. 22.
As of Thursday, MNsure was planning to cap its hiring at 50 additional external operators. But the agency decided to double its goal after the Star Tribune asked why it wasn't following the advice of the health care IT company Optum, which analyzed MNsure's operations.
Optum, which is credited with fixing widespread problems with the federal health exchange, told MNsure in January that it should hire 100 operators to boost customer service and eliminate long wait times.
In a written statement on Sunday, MNsure told the Star Tribune that it decided to boost staffing beyond 50 operators "after looking more strategically" at the call center's needs.
With the additional workers, MNsure officials said average hold times should drop to two minutes, compared to an average of 36 minutes in January. On busy days, MNsure officials acknowledge, callers could be on hold for 10 minutes. "In the call center industry, 10 minutes is considered a huge failure," said Pete Hainey, president of Customer Elation, one of the largest call center operators in Minnesota. "No business would accept a 10-minute hold as their norm."
Even though MNsure more than doubled its call staff in December, it hasn't been enough. Last week, callers waited up to 40 minutes to speak to an operator. "Is it taking way too long to fix? Yes," said Tom Forsythe, a MNsure board member. "I have not been as aggressive as I should have been. ... The response was inadequate."
When state officials started laying the groundwork for MNsure in 2011, they planned to hire a consultant to assess its call center needs. But a consultant was never hired.
MNsure officials came up with their own estimates, based on information they gathered from health insurers and others. Those estimates were considerably off target.
Instead of handling 900 calls per day, as initially projected, the call center was taking an average of 2,174 calls per day by December, with operators bogged down with consumers stymied over technical issues while signing up for coverage.
In fact, callers were on hold so long that half hung up before reaching a live operator. By comparison, the industry standard is 3 percent.
Ben Merrill estimates he has spent more than three hours on hold over the past few weeks. He gave up twice after waiting for 20 minutes. Another time while on hold, he ran an errand while staying connected. He got through after nearly an hour, only to be told the call center could not help him.
"It's a tremendous waste of people's time," said Merrill, 41, of St. Paul, who eventually got insurance through the system.
MNsure officials defended their original projections, saying the exchange is operating in uncharted territory.
"This hadn't been tried before," said MNsure interim CEO Scott Leitz, who replaced MNsure's former chief executive in mid-December. "The state exchanges have a level of complexity that is far different from checking on the status of a shipment from Nordstrom."
Call center veterans agreed that MNsure faced some unique challenges, but they said the agency made a critical mistake by not hiring professionals to design the operation. Last June, after watching MNsure leaders outline plans for the call center, a former representative of Avaya, a $5 billion telecommunications company, wrote an e-mail to several board members warning of problems ahead. MNsure "is not set up to handle the pending onslaught of traffic the exchange is going to generate," wrote Johan Aasheim, then of Avaya.
Other experienced call center firms said they tried to get the state to consider hiring an outside vendor to take at least some of the calls.
"They made it clear they had all of the infrastructure they needed," said Hainey at Customer Elation. "The government went in with an arrogant attitude of, 'We know how to do this better than business.' And clearly they don't. ... This is one of the worst customer service experiences I've seen executed in my career."
Industry experts said MNsure could have fixed the call center's problems in October or November. With more than 400 call center companies in Minnesota, there was plenty of excess capacity.
"It's one thing to have a problem -- it's another to not fix it," said Donna Fluss, president of DMG Consulting in New Jersey, a research firm focused on the call center industry. "And this is very fixable. You have some great [options] in Minnesota."
MNsure's chairman agrees that mistakes were made with the call center. "Things will go wrong," Beutner said. "That is the nature of starting something from scratch."
In November, the agency tried to work out a deal with an outside vendor, but the deal collapsed when the parties couldn't agree on the price, said Erik Larson, MNsure's chief operating officer. "Their cost numbers were quite out of line," he said.
This time, MNsure is negotiating with three companies, including Optum.
A new vendor will enable MNsure to offer a service that is standard at other call centers dealing with high volume -- callers will be allowed to schedule a return phone call. MNsure has been equipped to do that since Oct. 1, but the agency hasn't had enough workers to make those calls, Larson said.
Forsythe, the MNsure board member and General Mills executive, said he remains critical of the state's decision to create a primary call center for MNsure instead of directing most calls to an experienced operator. That decision was made before MNsure's board took over in August.
"I think the strategy was upside down," Forsythe said. "As a result, we were not positioned to outsource volume to a vendor and reduce these call wait times."
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