Improving the Financial Impact of Your Call Center

By Rebekah Temple and Giustina Parisi

June/July 2005

As medical call centers become contact centers, organizations can capitalize on the mutually beneficial relationship by transforming relationships with callers from one-dimensional, transactional exchanges to transformational interactions that offer meaningful information and initiate ongoing dialogues.  Hospitals struck oil (though some still may not know it) with the call center.  From a business standpoint, what they created was a direct line to the right customers and a repository of valuable information.

Call centers increasingly are becoming the crossroads for all communication touch points.  While they house more information than ever, many are unsure how to wield it.  By merging contact center data with data from across the enterprise and market, contact centers can use Customer Relationship Management (CRM) to invest in key relationships by improving the customer experience.

Nearly two out of every three U.S. hospitals operate a contact center, together triaging thousands of calls each day.  CRM leverages these connections, enabling contact centers to relate and transform their behavior.  One study found that up to 40 percent of callers and Web visitors are new to systems.  The same research also revealed that 25 percent of individuals who contacted a center came in for a visit within 12 months.  Since contact is often a precursor to clinical activity, how the interaction is managed is just as important as the connection itself, if not more so.

Anticipating Individual Needs: Catalogue companies are masters at up-selling and cross-selling products and services.  Websites swiftly seized up-selling and cross-selling, taking it to an entirely new level.  The case example is Amazon.com.  Purchase one book and the site skillfully prompts a buyer to consider others in the same genre.  In 2004, just its seventh year as a publicly-held company, Amazon.com boasted net sales of $6.92 billion, an increase of 31 percent over 2003 sales.

Because information is the enabler, the same concept easily is applied to medical contact centers.  CRM anticipates a caller's needs.  For example, a caller inquiring about obstetric services is informed about upcoming pregnancy and baby-care classes.  Another caller seeking a physician is asked if anyone else in her family needs a physician.  Predicting health needs is more complex than selling retail goods.  CRM uses what is known as predictive modeling to boost knowledge.

Predictive modeling uses internal data and combines it with market statistics and projections to foretell a person's likelihood of using as well as needing certain medical services as defined by the major diagnostic categories (MDC), specific diseases within the ICD-9 (International Classification of Diseases, Ninth Revision), and diagnostic related groups (DRG).  The more data used, the stronger the prediction.  Modeling run on patient information, therefore, will yield stronger results than on non-patients.

This information, for the contact center, provides instant insight into a person's needs, providing the opportunity to enhance the call.  It also engages callers with their health needs and bonds them with the organization.  Ideally, the interaction results in the caller scheduling an appointment or enrolling in a class.  Even if that's not the outcome, with CRM the foundation for ongoing dialogue is set.

Becoming a Two-Way Conduit: Customer interaction does not stop when a call is completed, but instead initiates post-call follow-up opportunities.  CRM allows contact centers to place outbound calls to continue conversations with callers, as well as to deliver and capture vital information.

Contact centers can make calls to previous callers with pertinent, high-value information.  Continued communication might involve providing callers with relevant educational opportunities, new service and physician announcements, as well as recommended screenings and immunizations.  With CRM technology, contact centers not only know when patients are due for immunizations and screenings, such as a mammography or colorectal, but also who should be screened because their health history indicates they're susceptible to disease.

A South Central United States hospital's contact center realized the value of outbound calling when a physician abruptly resigned.  The contact center quickly used a telemarketing campaign to prevent patient loss.  By pulling patient information from the CRM database, the contact center gave patients alternative physician recommendations.  The contact center contacted 1,400 households and the effort resulted in a 100 percent conversion.

Applying HIPAA: How does the Health Insurance Portability and Accountability Act (HIPAA) apply to contact centers using CRM to enhance patient care?  Contact centers that are part of a health care entity's operations, such as a hospital's internal call center, are governed by HIPAA.  However, outsourced contact centers are considered business associates of health care providers under HIPAA and must have a business associate contract that assures the center's activities adhere to the law.

Under HIPAA, marketing is defined as making "a communication about a product or service that encourages recipients of the communication to purchase or use the product or service."  A covered entity, under HIPAA, is not engaging in marketing when it communicates to individuals about:

• Participating providers in a network and the services they offer,

• The individual's treatment, or

• Case management or care coordination, such as directions or recommendations for alternative treatments, therapies, health care providers, or settings of care.

Since the HIPAA requirements protect core health care functions, contact centers, which prove their value, will continue to play an indispensable and valuable role in health care operations.

Proving Return on Investment: During a time of increased health care expenses and tighter budgets, today's contact centers are under increased scrutiny.  Yet, research shows that few use information captured during a call and even fewer use it to prove return on investment (ROI).  However, for centers that are integrated with a CRM database, it is tough to argue against the contact center's role in converting prospects to patients.  By simply tracking inbound and outbound calls, a contact center can go from a cost center to a profit center.

To track contact center ROI, health care organizations can analyze database activity.  This  includes the number of annual calls, type of calls (physician referral, general information, calls from specific campaigns), and number of service encounters linked to calls and the financial impact of those encounters.

When a Midwestern health system's contact center was under scrutiny, it used its CRM system to prove the center's value.  The health system demonstrated that after one year the call center increased inbound calls by 10.8 percent, earned $1,395,856 in revenue from 817 new patients, and $22,363,800 in revenue from 4,160 existing patients for a total of $23,759,665 in revenue for the year.

Health care organizations that use contact centers to connect and relate with callers, anticipate individuals' needs, and capitalize on post-call opportunities will improve patients' satisfaction and increase call center revenue.  With a CRM system to measure inbound and outbound activity, they also have the tools to prove it.

Rebekah Temple is a PR/Marketing Communications Manager.  Giustina Parisi is a Marketing Database Manager. Both are located at Middleton, Wisconsin-based CPM Marketing Group. They may be reached at marketing@cpm.com or 800-332-2631 x221.