New technology initiatives may help solve the serviceperformance problems encountered in the controversial program todeliver health insurance services in British Columbia.
The B.C. Ministry of Health has levied hundreds of thousands ofdollars in fines against the government’s outsourced healthinsurance services provider Maximus B.C.
In April 2005, Maximus B.C. took over the Health InsuranceBritish Columbia (HIBC) program from the Ministry of Health, in a10-year, $324-million contract.
Provincial officials were subsequently advised that call volumesto HIBC from the public were higher than normal, and higher thanexpected, said Leslie Wolfe, executive contract manager for theB.C. Ministry of Health.
“Within the contract there’s actually a requirement for them toreport or notify if they think that they’re at risk of not meetingall of the service levels,” Wolfe said. “We weren’t totallysurprised that there could be some growing pains associated withtaking on such a big project and such a big program.”
Wolfe said new initiatives in development to help increaseaccessibility, and speed up processing times of variousadministrative services, include improving the website to allowB.C. residents to apply online for Medical Services Plan (MSP)Premium Assistance, and the implementation of new call centretechnology to improve customer service.
The contract outlines specific service level requirements,including call wait-times, which Maximus failed to meet every monththrough the first eight months of the contract.
Problems included poor service – telephone wait times takinglonger than the specified three minutes – and failure to processdocuments and applications within required timelines. As a result,fines were levied.
Wolfe would not confirm fine amounts saying that information isprotected for “proprietary reasons,” and added that the Ministryand Maximus B.C. interact on almost a daily basis.
“Health Minister George Abbott did say that it’s up to hundredsof thousands of dollars,” said Wolfe. “The fines are materialenough to motivate them to take corrective action.”
Mary Rowles, director of communications, campaigns and researchfor the British Columbia Government Employees Union (BCGEU), saidthat “proprietary reasons” are nonsense.
“That’s basic accountability for a 10-year, $324-millioncontract,” said Rowles. “Are they providing service or not?”
She said the person who assesses government services, whetherthere are risks and whether performance level requirements arebeing met is the auditor.
“And they won’t let him touch it,” said Rowles.
Rowles also questions the reason for the increase in the numberof calls.
“They keep talking about the ‘volume of calls.’ Well, I questionhow many of those calls are people who gave up the first time andare calling back.”
Health Minister Abbot has said that call wait-times improved inthe third quarter, during which HIBC received 376,000 telephonecalls from the public with an average answer time of fewer thanthree minutes.
Unlike the first two quarters which saw consecutive monthlyfines, the Ministry was pleased with improvements and “only onefinancial penalty was levied in the third quarter for missedservice levels around document processing in October.”
But growing pains were clearly anticipated; Wolfe said that whenthe contract was signed, it allowed Maximus three to five months toget everything ready so that operations could be handed over.
“During that transition period there was an awful lot to do,”she said.
“There was a big learning curve for them to understand all ofthe legacy systems and applications, fully understand all of thepolicies and procedures for all of the stuff that they were goingto take responsibility for… We also had to do a lot of recruitmentof staff.”
She said that offers were made to the approximately 230employees that were affected, a number of whom accepted employmentelsewhere or took early retirement. But 206 stayed withMaximus.
However there were layoffs as well, according to Rowles,”Apparently Maximus issued layoff notices to approximately 32employees in January. These were auxiliaries, not permanent staff,but under the collective agreement they would have some recallrights.”
Rowles added that the company then re-hired a few of theworkers. But some workers had been informed that the companyanticipates more layoffs.
“From our perspective it seems as if they are havingdifficulties planning for periodic increases in workflow.”
The length of the contract also concerns Rowles.
“Deloitte & Touche recently did a report on contracting,and they’ve shifted their opinion and are urging corporations notto get into long-term contracts,” she said. “There has been noresponse from the government as to why they won’t cancel thecontract.”
“My assumption is they want it to work, and it’s sort of likethe emperor has no clothes, they don’t want to be presented withthe evidence, because they are wedded to taking that datamanagement outside of government,” she said.
At the end of November, when Maximus claimed it was meetingservice requirements, there were still calls being placed to theSeniors Hotline, where general members of the public can call andcomplain about service, said Rowles.
She said the seniors are still placing calls on the line; asrecently as Feb. 27, there was a call from someone who said theyspent 18 minutes on the phone.
“Is that just an anomaly?” questioned Rowles.
Wolfe maintained that by the end of November, Maximus wasmeeting all service level requirements.
“By December (Maximus) met everything, and that’s why we were soencouraged, because we had every reason to believe that they weregoing to succeed in accordance with that plan, and so that’sexactly what’s happened,” she said.
B.C. citizens have really seen the commitment in Maximus aswell, because they’re part of the community now, and they want todo a good job, Wolfe said. She added that was really demonstratedin their response to the service level problem.
Wolfe said that over the next two to three years, they will beintroducing new services and new channels to the public.
Within the next couple of months, she said, they will beintroducing a premium assistance web application where people canapply online.
“This has never been available before.”
They expect more and more of these types of services to beintroduced on the web.
“These are completely new … everything so far has beenpaper-based or phone-based, and it’s been kind of a cumbersomesystem, so they’re slowly turning that around.”
She said new call centre technology has been implemented, whichMaximus will improve on over the next year with respect tointeractive voice response applications, and ultimately the publicwill benefit from the improvements and new initiatives.
“What will be enjoyed by the public will be an easier way tointeract with government programs.”
However, Rowles said that there’s still strong public oppositionto these specific services being contracted out to a privatecompany, “I think it’s the sense that the information is no longerreally in the government’s control, and the privacy commissioneracknowledged that there’s a risk of release of data, so then youhave to weigh is there a good business case for this … it’s hard togauge what the real benefit is.”
She said BCGEU has filed a Freedom of Information request tolearn what the exact performance levels are, “We’re in discussionsright now with the government, mediated by the Privacy Commissionerto make sure that we actually have all the information.” Maximusdid not return phone calls on this issue. 060770
