"Colorado is a vibrant state with a population that values physical activity and wellness,” said Governor John Hickenlooper in response to the United Health Foundation's latest America's Health Rankings report, an annual study that evaluates public health state by state. Colorado ranked seventh this year, demonstrating the state's drive to become the healthiest state in the nation.
United Health Foundation determines its rankings by looking at how several factors — community behavior, overall environment, care practices, outcome data, and healthcare policies — all converge to impact public health. It's a holistic approach that mirrors not only the industry's current “total health” trends, but also the strategy behind Colorado's health and human services programs. “The health of individuals depends on all sectors working together to promote policies and activities that support health. From jobs that provide a living wage and health insurance, to zoning and land use planning that creates healthy neighborhoods and areas for recreation, health is everybody's business,” said Dr. Larry Wolk, Executive Director and Chief Medical Officer at the Colorado Department of Public Health and Environment (CO DPHE), in response to the same study. Wolk's beliefs set the tone for not only the department he serves, but also the many sister organizations, including Colorado Department of Health Care Policy and Financing.
In 2012 with the passage of the Affordable Care Act (ACA) and its resulting healthcare reform, Colorado saw an increase in the number of its residents eligible for Medicaid, one of the many programs run by the Colorado Department of Health Care Policy and Financing (HCPF). At the time of the ACA's passing, HCPF's 10 agents managed phone calls, emails, and inquiries about the Department's portfolio of services for its customers statewide — 800,000 of whom were eligible for Medicaid.
“Our mission is to improve healthcare access and outcomes for the people we serve while demonstrating sound stewardship of financial resources,” said Christine Comer, Client Services Division Director at Colorado HCPF. “This means that we work to make our members healthier while getting the most for every dollar that is spent.” Scaling to support more customers without sacrificing quality of service, all in the light of new legislation, was imperative to HCPF's success.
Comer and team took this as a call-to-action, and began translating their mission into four key initiatives that focused each and every scalability effort on customer-centered performance management:
- Delivery systems innovation: Health First Colorado (Colorado's Medicaid Program) members can easily access and navigate needed and appropriate services.
- Tools of transformation: The broader healthcare system is transformed by using levers in the Department’s control such as maximizing the use of value-based payment reform and emerging health technologies.
- Partnerships to improve population health: The health of low-income and vulnerable Coloradans improves through a balance of health and social programs made possible by partnerships.
- Operational excellence: The Department is a model for compliant, efficient, and effective business practices that are person- and family-centered.
At the same time, CO HCPF received funding from State Legislature to fund improvements to its contact center, which had been running on an Access database. After comparing its current capabilities to the four initiatives they had established, Comer and team decided that migrating to the cloud would give contact center agents the modern, digital tools they needed to increase service capacity.
- Fast: Comer and team configured the platform to streamline processes by creating a number of custom workflow rules. Inquiries submitted via HCPF's website are automatically turned into tickets in the case management system. Those tickets, as well as ones created by agents answering phone calls and emails, are then routed and assigned according to their various fields and tags. Response time is tracked (or flagged) as teams work to resolve a case, with specific learnings or insights noted for future reference. The result: faster service and better outcomes using fewer resources.
HCPF's customer contact center made the team more agile, more scalable, and more efficient, maximizing its grant funding in a way that is of benefit to its members.