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Case study
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Healthcare case study

Quick call volume response increases patient collections

The MetroHealth System call center suddenly faced skyrocketing call volume and a staggering abandonment rate. After implementing operational best practices, customer satisfaction improved and abandonment scores decreased within six months. 

At a glance

Industry
Healthcare

Challenge
Implement a strategic and sustainable operations solution to support business changes.

Products and services
Cognizant Revenue Cycle Management Workflow

Success Highlights

  • Addressed doubled call volume with minimal staff expansion
  • Achieved full recovery of customer satisfaction rates by the end of Q1 2023
  • Restored abandonment rate to the 2022 average by Q3 2023
  • Restored hold time to the 2022 average by Q3 2023

The challenge

MetroHealth, a large safety-net healthcare system in Ohio, and Cognizant have collaborated on revenue cycle solutions since 2013, including staffing of its financial counseling call center. In January 2023, MetroHealth saw a 100% increase in inbound calls month over month at its Patient Access Financial Counselor call center due to a change in self-pay pricing in the pharmacy, which significantly increased the scope of the financial assistance application process. This pharmacy update was not anticipated or communicated ahead of time. As a result, inbound calls doubled almost overnight, causing the average call hold time to spike from 48 to 250 seconds. Additionally, call abandonment rates increased by 14%, and customer satisfaction scores dipped 10% almost immediately. 

Our approach

The MetroHealth team partnered with Cognizant to provide a solution to these operational challenges. First, the team needed to understand the change in scope for operations and track the long-term impact on the call center. While there was an option to allocate additional staff to lower call times and abandonment rates, that was not the most effective approach to mitigate the issue, especially since the 40% call volume increase had become a permanent operational reality. MetroHealth needed a strategic and sustainable operations solution to support the growing challenge.

A man presenting graphical data in a meeting.

The first step to implementing operational best practices in the MetroHealth call center was to collect and analyze data. Once data became available, the team created a list of opportunities and prioritized action items, including engaging with other impacted departments and gathering staff input. 

Analyzing the data allowed the team to identify technology solutions, streamline workflows and determine necessary staffing for peak call periods and long-term needs based on time of day, time of week and holiday seasons. In MetroHealth’s case, analysis showed that an additional full-time employee was necessary. When the new employee was onboarded, Cognizant and the MetroHealth team used leadership change management tactics to assess training, policy and process documentation. Measuring trending metrics allowed them to gain insights into call center operations and improved morale by fostering engagement and celebrating improvements. 

By June 2023, six months after the initial call center partnership was initiated, Cognizant had streamlined the previous process for patients to request the documents they needed to apply for financial assistance. The updated workflow focuses on a document request log, which is housed on MetroHealth’s shared drive, allowing Cognizant and MetroHealth to have a real-time view of the request to work on throughout the day.

“Going through our call center really helped us get patients we may have never had records of before because they were paying cash. It allowed us to help them in other areas, too, because our financial assistance rating program is just not for pharmacy; it's also for their medical visits.”

Charvatte Figard, Professional Billing Manager, MetroHealth

Business outcomes

After reviewing technology and phone system functionality, as well as clarifying call agent scope of work and managing team performance, Cognizant brought average hold times and abandoned call rates down to acceptable thresholds. Average call center abandonment rates for the healthcare industry are 6.91%, but after the new operational procedures were implemented, the MetroHealth call center was once again far better than average at 4.25% in Q3 2023. 

Customer satisfaction scores also recovered despite a sustained increase in call volume from the previous year. Before the changes, the average annual score was 4.37 out of 5, and despite the dip in Q1 and Q2, the call center managed to increase the score to 4.49 in Q3, bringing their yearly average back to the same level it was at in 2022.

In addition to improved metrics and data, Cognizant’s solution increased patient collections. Billing Manager Charvatte Figard explained, “Going through our call center really helped us get patients we may have never had records of before because they were paying cash. It allowed us to help them in other areas, too, because our financial assistance rating program is just not for pharmacy; it's also for their medical visits.”  

Because patients were now calling in, collections increased and the call center was able to offer additional value to those who may not have known that MetroHealth offers more than pharmacy services.

A man working at his desk in office wearing a headset
Conclusion

When the calls started to come in, Cognizant ensured the team had scripting to make a uniform statement across the board to determine eligibility and avoid confusion for both the patients and the call center staff. 

Cognizant sent customer satisfaction survey reports weekly, and for surveys with lower scores, the call center team conducted an in-depth analysis to assess whether the messaging was contributing to the lower rating.

Ultimately, Cognizant addressed the abrupt spike in call volume quickly and according to best practices. Using data-driven decision-making was key to ensuring long-term success for the call center rather than a temporary fix that would be ineffective in weathering the next big change. 

About MetroHealth

The MetroHealth System operates five hospitals, four emergency departments and more than 20 health centers throughout Cuyahoga County, Ohio. It serves more than 300,000 patients annually, two-thirds of whom are uninsured, or covered by Medicare or Medicaid. MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.