Colorado Health Care Policy and Financing IS A TRAILBLAZER

Colorado Health Care Policy and Financing’s Investment in a Digital Contact Center Is an Investment in Its Mission


Colorado's government embodies the core of the industry…

"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.

…while also adapting to changing legislation.

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.

A modern, digital platform delivers tools that transform the mission.

CO HCPF launched a new customer contact center, built on Salesforce Service Cloud, in just three months. It enables agents to deliver better service faster, opens up new service channels, and gives the Department as a whole a single platform that connects Medicaid clients and applicants, service providers, community partners, local government, larger public health programs, and more.

  • Open, innovative platform: The platform integrates with HCPF's eligibility systems and interactive voice response system, with plans to integrate with its budget system. This gives agents access to more information that might be pertinent to the question at hand, turning time spent putting customers on hold while they dig through forms into time spent answering questions, resolving issues, and helping the next in line. Knowledge, a feature of HCPF's Service Cloud deployment, surfaces relevant articles, FAQs, and information based on frequency of use, key search terms, recommendations, and more, giving agents fast answers to common questions.
  • Trusted: Bringing all sources of data together does more than empower agents — it also breaks down data silos that can otherwise mask the context typically relevant to a holistic, value-based program model. HCPF's new contact center platform unlocks historical data housed in back-office systems, adding a richness to the case at hand. It allows agents, management, and executives to run reports on outcomes, helping staff spot catalysts, isolate best practices. and more. It provides a degree of transparency and reliability that is especially critical to the value-based programs prioritized in HCPF's four initiatives.

Colorado Is in the Cloud

Christine Comer, along with several of her colleagues in other departments and agencies across the state, shared more information about the strategies, practices, and benefits of working in the cloud. 
  • 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.

Measurable results with holistic impact.

While the benefits for HCPF's customers were of course the priority, the impacts were felt on a broader level. “Now, agents can complete a process in seven seconds that used to take seven minutes,” said Comer. “We can measure every transaction, define how long it takes, and then use the technology to maximize efficiency.” Agents were given visibility into the impact their day-to-day has on the Department's mission, the wins, and really on the livelihood of the Colorado community.


Best Practices from HCPF’s Success

In its migration to the cloud, CO HCPF demonstrates some key best practices that serve as an example for other departments and agencies looking for ways to modernize the tools that transform the mission.

Programs are easier to connect, right at the point of contact between customer and mission. “If citizens are a member of PEAK [an online application tool that allows citizens of Colorado the opportunity to apply for benefits and manage their case once approved] they can chat directly with an agent, which helps them get answers faster,” said Comer. “Chat is far more efficient than calling because agents can handle five chats at a time.” Call-handling time was cut in half, going from an average of 12.5 minutes to six minutes. This correlated with call abandonment rate, which dropped from 54% to 12%, further signaling that the tool was helping agents reach more customers in a timely manner. Tasks that once took hours were reduced to minutes, and tasks that once took minutes were reduced to seconds.

CO HCPF's investment in innovation is an investment in its mission.


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