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San Francisco HSS reports improved open-enrollment responsiveness and plan migrations
Summary
HSS reported increased open-enrollment activity in Oct–Nov 2015 with faster call handling and low abandonment rates; staff also projected retiree and active-member migrations into a new Medicare Advantage PPO and discussed continuing efforts to add SFGH to provider networks.
The Health Service System told the Health Service Board on Dec. 9 that open-enrollment operations met industry standards for speed of answer and abandonment rates despite significant year-over-year increases in activity.
Darek Sokoram, the HSS operations manager, said October open-enrollment applications rose by more than 1,600 from the prior year and inbound calls rose 14.2 percent; the department nevertheless met its speed-to-answer goal of 30 seconds and kept abandonment below the 3 percent target. "Even though it was an increase of over 1,600 open enrollment applications ... we actually still met those standards," Sokoram said.
Sokoram also reported projected migrations tied to the new Medicare Advantage PPO: roughly 957 members were projected to enroll in the new retiree plan, accounting for about 1,300 lives moved from Blue Shield, City Plan and Kaiser equivalents. The board asked for and was promised more detailed membership demographics in a February report.
Director Catherine Dodd had earlier introduced new staff (Elaine Gee, Sharmini Batneger, Vish Shenoy) and highlighted operational savings (an $80,000 postage reduction) and expanded flu clinics (26 clinics and more than 3,300 shots). Dodd also said HSS has begun discussions about including Zuckerberg San Francisco General Hospital in benefit networks while acknowledging further rate and capacity analyses are needed.
Commissioners praised staff for meeting operational targets during a busy enrollment cycle and asked for more granular data on plan-member flows and call-center request volumes. Dodd and the operations team said they will return with a demographics report in February that will break down membership changes and the sources of migration.
