Medicare Customer Support Services This customer experience profile is from 2020. To view this year’s profile, click here. User Interactions Customer Feedback Social Media Presence Customer Experience Indicators Executive Summary By 2030, about 80 million Americans are projected to become eligible for Medicare, underscoring a need to make services easy to use for widespread adoption.1 In 2019, satisfaction with aspects of Medicare’s customer support remained high, including assistance from the 1-800 MEDICARE contact center. CMS also launched a multiyear eMedicare initiative to modernize the health care experience for patients online, on the phone and on other channels. The agency made significant upgrades to online customer options, such as a tool to help people find the best Medicare plan for their needs—making it easier for customers to explore and understand plan options. When the coronavirus pandemic hit in early 2020, CMS successfully transitioned more than 2,000 Medicare contact center employees to telework in just a few weeks—a process that agency staff estimate could normally take up to eight months—largely without hindering its ability to provide customer service. Based on insights from customer research, CMS found it can be hard for caregivers to access claims information and health care records needed to help manage the Medicare benefits of people they support. The agency is planning an option for caregivers to create their own online accounts that link to the account information for the people they assist—potentially allowing them to manage benefits for multiple people (e.g., both their parents) with one login. Data at a Glance of callers to the 1-800 MEDICARE line rated their experience as “very good” or “excellent” in fiscal 2019 people were enrolled in Medicare as of June 2020 More Profiles Airport Security Screening and Passenger Support Services Citizenship and Immigration Applicant Services Customs Airport Security and Screening Services Farm Loan and Conservation Service Federal Student Aid Individual Taxpayer Services Medicare Customer Support Services Outdoor Recreation Reservations for Federal Lands Passport Services Veterans Education and Training Benefits Veterans Outpatient Health Care Services Service Overview Primary Customers Individuals enrolled or seeking to enroll in Medicare, and their caregivers. 64 million people were enrolled in Medicare as of June 2020 (60 million as of Sept. 2019). Key services Answers to questions about medical services, tests and drugs Medicare covers. Help with understanding coverage options and shopping for, comparing and enrolling in Medicare health plans, Medicare prescription drug plans or both. Information about Medicare premiums. Assistance with finding and comparing Medicare health care providers. Assistance with coordinating Medicare benefits. Information and answers to questions about claims and payments. People Interact With Medicare By (All data for fiscal year 2019 unless otherwise noted) CALLING THE MEDICARE CONTACT CENTER 25.4 million calls (23.8 million in fiscal 2018)2 VISITING ONLINE >72.2 million visits to Medicare.gov (92.8 million in fiscal 2018)3 AVERAGE WAIT TIME FOR CALLS ~4.5 minutes (3.5 minutes in fiscal 2018) VISITING A FIELD OFFICE N/A Medicare does not have field offices. Customer Experience Insights Click tabs to expand Medicare plan options became easier to understand and choose from in 2019. The agency rebuilt its online Medicare Plan Finder to deliver a better, more user-friendly customer experience. The new, mobile-optimized tool features faster information processing and webchat capabilities and enables users to enter more personal information such as the medications they take to make informed choices. After the revamp, customer satisfaction with the tool increased by 10%, according to Medicare officials. Customers have good experiences when contacting 1-800 MEDICARE for support or information. Even with slightly longer wait times, Medicare was able to maintain rapid service and high levels of customer satisfaction with its contact center over the past year. This quality of service continued even as the agency quickly transitioned customer service staff to telework during the coronavirus pandemic. 94% of callers rated their experience as “very good” or “excellent.” Webpages on Medicare coverage and the process for filing appeals are easy to navigate and understand. Webpages that explain which tests and services are covered under Medicare, and what the process is for filing an appeal if a claim is denied, received an A in our analysis. Click to see full results of our website experience analysis Website Experience: How easy is it to navigate and understand online information? Reviewers looked at the pages from the perspective of people seeking to answer two questions: How do I know if a medical test or service is covered under Medicare? https://www.medicare.gov/what-medicare-covers What is the process for filing an appeal if my Medicare claim is denied? https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal CMS Grade A Strengths Language adheres to plain language principles such as using active voice, defining acronyms, using short sentences and presenting information in lists. Content speaks directly to the user through personal pronouns in a conversational yet professional tone. Difficult terms are defined in blue boxes that appear when the user hovers over text. Consistent use of white space and clear, action-oriented headers help the reader find information for completing tasks. Standout feature: Medicare coverage search tool We searched for multiple tests and medical conditions, and the site delivered easy-to-understand results on what is covered and what the co-pay costs are. The agency also launched a mobile app, called "What's Covered," that provides the same content and data available on the website. Figure: Clear, task-oriented page on filing an appeal (https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal) Figure: “Hover over” definitions make it easy for the user.(https://www.medicare.gov/your-medicare-costs/costs-for-medicare-advantage-plans) Figure: Easy to find information about what tests are covered (https://www.medicare.gov/coverage?coverage_search=covid%2019) It became easier for some people to pay their Medicare premium in 2019. While many people get their Medicare premiums deducted from their Social Security payments, more than 2 million people need to pay premiums directly to Medicare because they are not yet receiving Social Security benefits. Previously, these people could not pay their premiums online, or see their payment history and details about how their payments had been calculated. In February 2019, Medicare launched an online option for people with Medicare to pay their premiums. Users quickly took advantage of this new feature. In the first year, people with Medicare made more than 1 million payments, and the program received positive feedback from customers. The tool also reversed a trend of increasing calls to the 1-800 MEDICARE line about premium payments, enabling agents to focus on other issues. Granting caregivers access to online accounts could make it easier for caregivers to help manage benefits for people with Medicare. Some people get help from caregivers in managing their Medicare benefits—whether family members or nurses, aides or other professionals. It can be hard for caregivers to access claims information and health care records on Medicare.gov, since only a Medicare beneficiary can set up an account on the site. In the future, CMS plans to add an option for caregivers to create their own accounts that link to the information for those they assist—potentially enabling them to manage benefits for multiple people (e.g., both their parents) with one login. It can be difficult for some customers to decide when to enroll in Medicare, an important decision since there may be penalties for enrolling late. While many people are automatically enrolled in Medicare when they retire and apply for Social Security retirement benefits, individuals who continue working need to decide when to apply. This can be a complex decision, involving factors like their current health care needs and what medical coverage they currently have. To help people decide, CMS has been conducting customer research to understand how people approach this situation and what information they would like to know. Based on this research the agency is updating its online information about signing up for Medicare and has plans to create digital tools to help people decide when to enroll, based on their circumstances. Key Improvement from last year Ongoing challenge Connecting on Social Media CMS has a social media presence for the Medicare program that keeps people updated on benefits and program changes. For example, social media posts highlight new online tools; inform customers about accessing Medicare services when abroad; educate people about Medicare fraud schemes; provide reminders to get flu shots; and inform and update people about COVID-19. As of September 2020, the Centers for Medicare and Medicaid Services’ social media presence related to Medicare customer support services included: Twitter (@MedicareGov) Joined: June 2011 Followers: 40,800 Total tweets: 7,777 Facebook (@Medicare) Joined: February 2015 Followers: 442,400 Total likes: 436,800 Social media practices Posts almost daily?Yes Responds to customers?Yes – occassionally Includes multimedia content?Yes For background information on these metrics and our full methodology click here. How Medicare Adjusted Services During COVID-19 Most people who receive Medicare are 65 years old and above and at a higher risk for complications from the coronavirus. When the pandemic began, the agency received a flood of questions on whether Medicare covered coronavirus tests, and what telehealth services were covered. Officials added information to the agency’s website and social media accounts and trained call center representatives to inform customers that Medicare covered tests related to the virus and had expanded its coverage to telehealth services. Staff members at the Centers for Medicare & Medicaid Services also worked to protect people from identity theft. Scammers sought to defraud Medicare recipients by offering free coronavirus tests—with the intention of stealing Medicare account numbers. CMS launched an advertising campaign alerting people to the scam and reminding them that CMS (or the government) will not call to ask for their Medicare numbers. Tactics included public service announcements on iHeart Radio—a podcast and radio streaming service—and promotional videos and ads through partners such as AARP. With 117 million media impressions, the campaign may have prevented many people from being scammed. CMS transitioned about 2,000 Medicare contact center representatives from across the county to full-time telework, without disrupting customer service. This was a noteworthy achievement, as telework had not been allowed prior to the pandemic. With more employees working from home, call centers could set up physical workspaces with social distancing to accommodate the employees who were unable to telework. 1-800 MEDICARE continued to deliver quick and helpful services, with average wait times remaining between three and five minutes, and customer satisfaction rates between 93% to 95%. Indicators that the Customer Experience is a High Priority Click buttons to expand. Commitment to Customer Experience CMS: Includes high-quality customer experience in its strategic goals. Yes Customer experience improvements are included in several of Medicare’s 16 strategic initiatives. Improvement from 2019. Specifies customer feedback as a key measure of the organization’s performance. No While CMS does not publish customer feedback on Medicare as one of the agency’s overall performance measures, it does use customer feedback when measuring the performance of Medicare customer service programs. Has a senior executive with the responsibility and authority to lead efforts to improve customer experience across the organization. Partially CMS coordinates customer experience efforts across the agency through its Office of Communications, and the head of this office has customer experience as one responsibility. Shares meaningful customer feedback data with the public. No Possibly due to restrictions imposed by the Paperwork Reduction Act. Customer Service Basics For the most common services provided, customers can: Complete frequently used transactions online. Yes Customers can go online to shop for and enroll in Medicare plans, and get information about covered costs and services. Easily find information to call an appropriate CMS representative. Yes Schedule in-person appointments. Yes Obtain status updates. Yes People can go to MyMedicare.gov for information on the status of their Medicare enrollment and to check personal information, such as the status of their claims. Find standardized and consistent information and guidance across channels. Yes Medicare communication channels—such as website, email, social media and call centers—all use the same cleared language as the basis for their communications, which can be modified to fit their unique needs. Customer Feedback The agency collects and analyzes data and information on customer perceptions: Of specific interactions, including website visits, phone calls and in-person appointments. Yes Of a customer journey through a series of interactions or multistage processes that build toward a specific goal. Yes Of the overall service the organization provides. Yes Through qualitative research, such as customer interviews, focus groups, analysis of social media comments or direct observation. Yes Through a structured analysis of comments about the service left on social media channels. Yes More details about our methodology Footnotes and Methodology Footnotes 1 Medpac, “Report to the Congress: Medicare and the Health Care Delivery System.” June 2015. Retrieved from: https://bit.ly/2GQEf4X 2 Centers for Medicare & Medicaid Services Performance Data, 2019. 3 Medicare officials attributed this decrease to users accomplishing more tasks in a single session as opposed to making multiple visits. Social media review methodology To assess how agencies use social media to interact with customers, we examined three social media best practices identified through conversations with experts: posting frequently, delivering engaging content and responding to questions. We analyzed the most active Facebook or Twitter account by selecting specific months to examine trends throughout the year, including changes to social media activity during the coronavirus. The team defined posting almost daily as meaning the agency posted for at least 25 out of 30 days on average in September 2019, December 2019, March 2020 and May 2020. Includes multimedia content is defined as whether the agency posted a range of multimedia content with interactive elements beyond just static images. Responds to customers is defined as whether or not agencies respond to questions through the direct message feature on Facebook or in the comment section of posts. To assess this, we examined September 2019, December 2019 and April 2020 (or another month when data was not available). “No” indicates the agency never or rarely responds to comments; “Yes – occasionally” indicates the agency responds sometimes, but there does not appear to be a consistent pattern over time; and “Yes – regularly” indicates the agency responds to comments on a frequent and consistent basis over time. The number of tweets, likes, posts and views reflect the total activity since the social media account was established. Website experience methodology For each agency, we selected for review a set of webpages that customers would theoretically visit to seek answers to frequently asked questions, vetted with each agency. We partnered with the Center for Plain Language to conduct this review. The center followed the same methodology it uses to assess plain language for its annual ClearMark awards for a range of organizations and its annual Federal Plain Language Report Card for the government. Two plain-language experts individually and independently reviewed and scored each set of pages, using five plain-language criteria to assess each site. They rated each criterion on a five-point scale: Information design and navigation. Pictures, graphics and charts. Style or voice. Structure and content. Understanding of audience. The reviewers then met to reach consensus on strengths and weaknesses of each site and to assign a letter grade based on their ratings. Customer experience indicators methodology The Partnership and Accenture developed the following list of indicators to understand how agencies prioritize the customer experience, and steps they can take to improve. The list is based on research about effective customer experience practices in both government and the private sector, and aligns with practices in a customer experience maturity self-assessment for agencies developed by the Office of Management and Budget. Leaders who participated in the Partnership’s federal customer experience roundtable provided input. Commitment to customer experience The agency: Includes high-quality customer experience in its strategic goals. Criteria: 1) customer experience with the agency’s services is listed in the strategic plan as one of the organization’s top priorities or a supporting goal of one of the priorities 2) the strategic plan provides specific actions the agency will take to improve customer experience. Specifies customer feedback as a key measure of the organization’s performance. Criteria: There is a performance measure included in the agency’s strategic plan, annual performance report or agency priority goals that is based on feedback directly from customers Has a senior executive with the responsibility and authority to lead efforts to improve customer experience across the organization. Criteria: Based on a review of the agency organizational chart and online descriptions of leadership positions, the agency has an executive who meets the following criteria: 1) customer experience is his or her primary responsibility 2) he or she reports to the head of the organization or a deputy 3) his or her work spans all major service delivery channels (e.g., online services, contact centers, face-to-face services). Shares meaningful customer feedback with the public.Criteria: In alignment with the Office of Management and Budget’s guidance on customer experience measurement, the agency publishes customer feedback that: 1) represents multiple service delivery channels 2) provides details into different aspects of the experience (e.g., beyond overall customer satisfaction) Customer Service Basics For the most common services provided, customers can: Complete online frequently used transactions.Criteria: Based on a review of the agency’s website, customers can complete major services or transactions online. Easily find information to call an appropriate representative.Criteria: Does the agency’s website provide a clear explanation of which number to call for specific issues or provide one number that customers can call to get routed to the appropriate person. Schedule in-person appointments. Criteria: Based on a review of the agency’s website, customers can schedule appointments for in-person services. Obtain status updates.Criteria: Customers can get current updates through an online or self-service channel that includes estimated timelines on items such as submitted applications or benefit disbursements. Find standardized and consistent information and guidance across channels. Criteria: At least two service delivery channels have integrated knowledge management systems so that when content for customers on one channel is updated, it is updated on the other channel. Customer Feedback The agency collects and analyzes data and information on customer perceptions: Of specific interactions, including website visits, phone calls, and in-person appointments. Of the customer journey through a series of interactions or multi-stage processes that build toward a specific goal. Of the service provided by the organization overall. Through qualitative research, such as customer interviews, focus groups or direct observation. Through a structured analysis of comments about the service left on social media channels. This customer experience profile was produced in collaboration with Accenture Federal Services.