EXECUTIVE DIRECTOR S REPORT Peter V. Lee, Executive Director November 17, 2016 Board Meeting

Transcription

1 EXECUTIVE DIRECTOR S REPORT Peter V. Lee, Executive Directr Nvember 17, 2016 Bard Meeting

2 ANNOUNCEMENT OF CLOSED SESSION 1

3 OVERVIEW Executive Directr s Reprt Cvered Califrnia Plicy and Actin Items Individual Eligibility and Enrllment Regulatins Emergency Readptin Enrllment Assistance Regulatins Cnsidering Future Issues fr Cvered Califrnia Panel Discussin Panel 1: Natinal and State Health Care Landscape and Trends Panel 2: Imprving Wellness, Ppulatin Health, and Cnsumer Engagement 2

4 UPDATE: PROPOSED 2017 BOARD MEETING DATES Fllwing are the prpsed 2017 dates fr the Cvered Califrnia Bard meetings. All meetings will be held at Cvered CA Headquarters (1601 Expsitin Bulevard Sacrament, CA 95815) with the ptential f ff-site web-participatin by bard members. All meetings are n the third Thursday f the mnth. January 26, 2017 February, 2017 (n meeting this mnth) March 2, 2017 April 20, 2017 May 18, 2017 June 15, 2017 July 20, 2017 (pssibly n meeting this mnth) August 17, 2017 September, 2017 (n meeting this mnth) Octber 5, 2017 Nvember 16, 2017 December 21, 2017 (pssibly n meeting this mnth) 3

5 OPEN ENROLLMENT

6 2017 OPEN ENROLLMENT: EARLY PROGRESS FOR NEW SIGN UPS 44,885 Individuals have selected health care plans as f Nvember 15, This enrllment reflects a perid in which Cvered Califrnia did nt cnduct media r enrllment prmtin until after Nvember 12 th. Cmpares t apprximately 50,700 fr same perid 2015 (when Cvered Califrnia had cnducted extensive media and bus tur effrts t prmte enrllment). 5

7 2017 RENEWAL IN PROCESS Apprximately 1.3 millin Individuals that are ging thrugh renewal, by December 15 cnsumers will: (1) be renewed in existing plan; (2) select new plan; (3) been fund eligible fr Medi-Cal due t incme change; r (4) chsen nt t renew. Additinal renewal statistics will be available in early

8 2017 RENEWAL COSNUMERS WHO HAVE TAKEN ACTION 263,462 Cvered Califrnia member renewals frm Oct. 1 t Nv. 15, reflect bth changes f plan and cnsumers wh affirmatively renewed with their existing plan. 7

9 HIGHER ENGAGEMENT AND BETTER SERVICE IN OPEN ENROLLMENT AND RENEWAL COMPARED TO 2016 Calls t Service Center Nv. 1 Nv. 15: 270, % Handled by Integrated Vice Respnse 113, % Handled by Service Center Representative 141, % Average speed f answer 4 mins. 4% faster Calls answered in 30 secnds 42% + 6% Chat assistance 20, % cmpared t same perid last year 8

10 VISITING SOME OF THE THE 800+ STOREFRONTS ACROSS THE STATE Lcatins pictured: 1) Qute Selectin Services (Huntingtn Beach) 2) Ortiz and Assciates (La Puente) 3) Cuntrywide Health Insurance Services (San Dieg) 4) Freeway Insurance (Nrwalk) 5) Ssa s Insurance Slutins (Huntingtn Park) 9

11 GETTING THE WORD OUT FROM THE GROUND UP Lcatins pictured: 1) AltaMed (Ls Angeles) 2) KCAL Insurance Slutins (Hacienda Heights) 3) KESQ Televisin (Palm Dessert) 4) Eisner Pediatric (Ls Angeles) 5) Price Chapel (Ls Angeles) 6) Omni Family Health (Bakersfield) 10

12 RECENT MEDIA STORIES Since Nv. 1, we have cnducted mre than 60 interviews with Televisin, Radi and print bth natinal and lcal. 11

13 NEW TOOLS FOR CONSUMERS HELP ON DEMAND New Uber-style call back tl fr cnsumers launched tday Call back within 5-10 minutes New enrllments nly Certified Expert Enrllers with prven success Includes Agents, Navigatrs, and Certified Applicatin Entities 12

14 2017 OPEN ENROLLMENT AND RENEWAL: KEY DATES Key Dates: Nvember 1 st December 15 th Key Activities: Open Enrllment began Last day fr pen enrllment and renewal plan selectin fr January 1, 2017 cverage January 15 th Last day t enrll fr cverage effective February 1, 2017 January 31 st Last day f pen enrllment 13

15 COVERED CALIFORNIA: DATA AND RESEARCH ANALYTICS At Nvember Plan Advisry Cmmittee, Cvered Califrnia prvided and verview f the Healthcare Evidence Initiative which will use utilizatin and claims data t: Prvide actinable infrmatin supprting Cvered Califrnia s peratins and plicies t imprve care, lwer csts and fster better health; and Prvide evidence t infrm public and plicies s that purchasing strategies and benefit designs can imprve quality, access and value thrughut the health care delivery system. That verview can be fund at this (click here) and cmments were slicited n ur plan t be prvided by December 1, 2016 Cvered Califrnia will cntinue t update and supplement ur data bk describing the nature and scpe f ur services, including: Infrmatin n clinical services by regin (e.g., hspitals and physicians serving Cvered Califrnia cnsumers thrugh cntracted plans) Infrmatin n enrllment supprt services by regin (e.g., certified licensed insurance agents, navigatrs and certified enrllment cunselrs) Pst-Open Enrllment 4 Plan Selectin Prfile t describe enrllment acrss race, ethnicity, gender, incme, FPL, metal tier selected and mre Updates planned t the Cvered Califrnia Active Member Prfile, reflecting effectuated enrllment 14

16 APPENDIX COVERED CALIFORNIA FOR SMALL BUSINESS UPDATE 15

17 COVERED CALIFORNIA FOR SMALL BUSINESS Current Grup & Membership Update (10/31/16) Grups: 3,979 Members: 29,544 Average Grup Size: 7.4 members Infrmatin Technlgy Update: Renewal Prtal Launch: Nvember 2016 Emplyer Prtal Launch: Q Operatins Update (9/30/16) 99% f New Grups set up in 3 days r less 100% f New Grups sent initial invice in 3 days r less 93% f Accunt Maintenance issues reslved in 3 days r less

18 APPENDIX SERVICE CHANNEL UPDATE 17

19 ENROLLMENT ASSISTANCE PROGRAMS Uncmpensated partners supprting enrllment assistance effrts. ENROLLMENT ASSISTANCE PROGRAM ENTITIES COUNSELORS Certified Applicatin Cunselr 389 2,244 Certified Plan-Based Enrller 12 Plans 1,488 Certified Medi-Cal Managed Care Plan 2 Plans 36 Certified 18

20 OUTREACH & SALES ENROLLMENT SUPPORT: KEY METRICS Data as f Nvember 8, ,580 Certified Insurance Agents 17% Spanish 7% Cantnese 7% Mandarin 4% Krean 4% Vietnamese 1,546 Navigatr: Certified Enrllment Cunselrs 63% Spanish 4% Cantnese 3% Mandarin 3% Vietnamese 2% Krean 2,244 Certified Applicatin Cunselrs 59% Spanish 5% Cantnese 4% Mandarin 1% Vietnamese 1% Krean 1,488 Certified Plan Based Enrllers 45% Spanish 10% Cantnese 2% Mandarin 7.5% Vietnamese 7.3% Krean 36 Certified Medi-Cal Managed Care Plan Enrllers 44% Spanish 36% Cantnese 31% Mandarin 1% Russian

21 APPENDIX WEBSITE UPDATE 20

22 24 MONTH COVEREDCA.COM ROADMAP UPDATES As f Nvember 1, 2016: CalHEERS launched the applicatin fr Open Enrllment #4 On the main website, a new lead capture / pt-in fr news and reminders was launched Almst 200 new strefrnts were added t the strefrnt search Activities planned fr the remainder f Nvember include: Cmpletin f annual renewals Additin f Help n Demand that will prvide cnsumers the ability t get a near real-time call back frm a Certified Enrller 21

23 24 MONTH COVEREDCA.COM ROADMAP UPDATES The first release fr 2017 is planned fr February 13, 2017 is planned t include: Translatins f Eligibility Ntices int Additinal Threshld Languages Enhancements t infrmatin shared with the SAWS MAGI incme infrmatin passed t the SAWS ( Business Rules Expsure ) Enhancements t the Incme Sectin f the On-Line Applicatin Adding the ability fr Certified Enrllment Cunselrs t maintain delegatins t cnsumer accunts Enhancements t allw Service Center Representatives t better assist cnsumers n accunt verificatins (re-printing and r ing functins) Enhancements fr the Service Center t allw imprved assistance t cnsumers (deferred frm the September 2016 release) Autmated wrkflw Ability t crrect cnsumer r ther errrs independently (withut reliance n submitting tickets and waiting in queue) 22

24 APPENDIX SERVICE CENTER UPDATE 23

25 SERVICE CENTER UPDATE Imprving Custmer Service Custmer Appreciatin events Refresher training Enhancing Technlgy Slutins Added IVR verbiage t encurage cnsumers t self serve fr Passwrd Reset n the website Curtesy Callback wrking as designed Cnsumer Relatin and Reslutin Branch- instituted verbal withdrawal prcess t streamline the appeal prcess fr the cnsumer Staffing Updates Ramping up Surge Vendr Staffing 24

26 SERVICE CENTER OCTOBER 2016 SERVICE CENTER DETAILS* Octber 2016 Call Statistics Calls t IVR Calls Offered t SCR Des nt include utbund, SHOP, r internal cnsults Abandned % Calls Handled ASA AHT Service Level % Ttals 398, , % 211,895 0:02:15 0:18: % Tp 5 Call Dispsitins 1. Individual Current Custmer Applicatin/Case Status Inquiry/Assistance 2. Individual Current Custmer Renewal Inquiry/Assistance Renewal 3. Individual Current Custmer Renewal Cmplete Enrllment 4. Individual Current Custmer Cnsumers Online Accunt Passwrd Reset/Unlck 5. Individual Current Custmer Disenrllment/Terminatin Requesting t be Terminated *Perfrmance metrics are measured mnthly. 25

27 OCTOBER 2017 SERVICE VOLUMES Ttal calls ffered t the IVR: 398,906 (cmpares t 289,243 fr Octber 2015). Callers handled by autmated system respnding t specific inquiries with recrded messages: 173,886 (cmpares t 125,102 fr Octber 2015). Calls handled by Cvered Califrnia Service Center Staff: 211,895 (cmpares t 150,221 fr Octber 2015). 61.2% f calls were answered within 30 secnds (cmpares t 65.2% fr Octber 2015). Average Handle Time fr Octber was 18 minutes and 20 secnds (cmpares t 16 minutes and 48 secnds fr Octber 2015). 26

28 QUICK SORT VOLUMES Octber Weekly Quick Srt Transfers Week 1 Week 2 Week 3 Week 4 Week 5* Ttal ,942 QuickSrt Transfer Octber 2016 * Partial Week Octber Cnsrtia Statistics LRS 33% C-IV 19% Calls Offered Service Level Calls Abandned % ASA C-IV % 0.46% 0:00:09 CalWIN % 1.09% 0:00:21 LRS % 1.80% 0:00:10 CalWIN 49%. 27