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Case Studies > Prescription benefits manager drives healthy gains in the call center

Prescription benefits manager drives healthy gains in the call center

Technology Category
  • Analytics & Modeling - Predictive Analytics
  • Application Infrastructure & Middleware - Data Exchange & Integration
Applicable Industries
  • Healthcare & Hospitals
  • Pharmaceuticals
Services
  • System Integration
The Challenge
As the point of contact for mail-order prescription issues, this client’s call center fills a critical organizational role. With a 40% attrition rate, and the exorbitant hiring and training costs associated with that metric, it was also the source of significant budget drain. As such, it had been identified as an area ripe for cost-cutting… with a catch. The cuts absolutely could not come at the expense of service quality. Customers contact this center regarding the most important and sensitive aspect of their lives: their health. Often, they’re experiencing some degree of anxiety. In some cases, they’re quite literally calling about a matter of life or death. So it was imperative to the client that calls be handled not only quickly and efficiently, but with a high degree of interpersonal skill and effectiveness. These customers don’t just need to be taken care of; they need to feel taken care of. Like most organizations in recent years, this client was being pushed to do more with less. They turned to Mattersight to help them meet the challenge.
About The Customer
The customer is a leading U.S. pharmacy benefits manager with over 7,000 retail locations and 3,000 Customer Care Representatives across seven sites. As a major player in the healthcare industry, the company handles a significant volume of mail-order prescription issues through its call center. The call center is a critical touchpoint for customers, often dealing with sensitive health-related inquiries. The company faced a high attrition rate of 40%, leading to substantial hiring and training costs. Despite the need for cost-cutting, the company could not afford to compromise on service quality, given the nature of the calls, which often involve anxious customers and sometimes even life-or-death situations.
The Solution
Mattersight identified Predictive Behavioral Routing as the solution best able to meet this client’s need for an affordable way to lower call center costs while elevating customer experience. Mattersight® Predictive Behavioral Routing identifies an individual caller’s personality type based on collected behavioral data. It then routes that call to the available agent who is best able to successfully communicate with that personality type, based on their past performance data. This personality-based approach pairs callers and agents who are most likely to have a natural, effortless rapport. As a result, their conversations are shorter, more effective, and more satisfying. Mattersight® Predictive Behavioral Routing was deployed to an initial subset of the client’s users. Once it was switched on, the impact was instantaneous. Call quality immediately began to change, and call length began to drop. Within two weeks, the client saw a 13% reduction in Average Talk Time (ATT) for calls routed by PBR vs. calls that were routed using their default method, with a weighted net impact of 8%. While ATT improved for all agents, it was most significant among those who had previously logged the longest calls. And it all happened without any negative impact on member satisfaction scores.
Operational Impact
  • Mattersight® Predictive Behavioral Routing was deployed to an initial subset of the client’s users, and the impact was instantaneous.
  • Call quality immediately began to change, and call length began to drop.
  • Within two weeks, the client saw a 13% reduction in Average Talk Time (ATT) for calls routed by PBR vs. calls that were routed using their default method, with a weighted net impact of 8%.
Quantitative Benefit
  • 58 SECONDS Average time saved on PBR-routed calls
  • 13% Reduction in ATT on PBR-routed calls
  • 13% ATT improvement among lowest-ranking agents

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