Call Center performance can boost your CMS Star Rating

Jennifer Barros
CMS Five Star Rating…do we dare say those words? Each year there are teams of associates and executives across health plans evaluating measures and outcomes, eagerly holding their breath while the Five Star needle moves up and down.

There is an everyday pressure that surrounds the CMS Five Star Rating and it certainly isn’t the most enjoyable playground to being playing on. Too often, you are guided through the metrics and outcomes, told which areas need to increase the rating, and actions are assigned with an update due at the next meeting. Is that enough? At times, plans are being reactive versus proactive in finding a solution that may be staring them straight in the face.
Have you taken a step back and reviewed what may be sitting at your fingertips? How is your Call Center performance when it comes to TTY and Foreign Language Translations? When was the last time you reviewed your Call Center strategy?
Ensuring your Call Center truly understands what the CMS Five Star Rating means and how its daily responsibilities contribute to the plan’s success can be a powerful tool in boosting that rating. Supporting your agents with training and coaching is both empowering and inspiring.
How is your relationship with your secret shopper vendor? How often are you communicating?
How often are you speaking with your foreign language interpreter vendor?
Who is tracking the number of calls? Issues? Timeliness? Resolution?
Was your team trained on how to properly handle TTY calls?
When was the last time you had a calibration session?
Are your agents comfortable with communicating their findings?
Is your call center excited for CMS Secret Shopping?
Do you have a lead on your team spot checking the CMS calls?
There are many actionable items that can be executed and done successfully. MCS has expert resources that have years of experience and a proven track record in increasing star ratings within a Call Center. Let us help you reengineer your Call Center strategy and support your team in moving the CMS Five Star needle in a positive direction.

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