Earlier this month, I had the opportunity to visit with the talented staff at the The Medicare Rights Center in New York City. Heather Bates, Vice President of Client Services and Program Management, and Susan Batkin, Director of Helpline Operations and Volunteer Management, took me on a tour of their national Consumer Helpline. This is Part II of my interview. Part I: Volunteer Onboarding can be found here.
Part II: Using Metrics to Track and Communicate Value
1) Over the past eighteen months you’ve instituted a data collection system that begins to capture the value of the service you offer the public. This custom built database was done with minimal upfront costs and incorporates all of the data points that our funders require. It can also be reprogrammed in-house because it is so easy to use. Can you talk a little bit about what prompted you to strategically focus your resources on this effort?
At one point, we had five databases to capture a variety of different details. We made a conscious effort to devote some of our resources to eliminating duplication in order to increase productivity and the general experience of reporting. It is important for morale to know that all the data you enter contributes to the greater good.
We collect data for two primary reasons: first, to ensure continuity of service to clients. When someone calls, their information is entered into a database. If they call again and speak to another counselor, their information will be in our system and we can pick up where we left off with them, without interruption. There’s nothing more upsetting or time consuming for callers to have to explain their story again. Typically, callers get their questions answered within one or two calls. If not, they can be referred to a staff person for longer term follow-up.
Secondly, and equally as important, we collect data so that we can track trends and identify common issues on the helpline to inform our policy, communications and educational work.
2) I know you strongly believe in aligning your mission with program goals and activities. How did you go about deciding which outcomes to track in light of the Medicare Rights Center’s mission of “getting Medicare right?”
We have twenty years of experience through our callers who have taught us that there are certain questions everyone with Medicare has at some point in time. With experience, every organization has to decide what issues are most important to track. As stated earlier, we use the information from our helpline to inform our policy, communications and education agenda. Therefore, we try to find ways to track the types of calls we get so we can identify trends and hot button issues. We have a coding system so we can classify our calls. If the call was primarily about enrolling into Medicare, then the call will be classified as an “enrollment” call. If it was about enrollment in to Medicare and an outstanding bill, we tag it as both an “enrollment” and “billing” issue, that kind of thing. This way, we can find them when we do queries for reporters, research papers, and to review trends.
In addition to tagging case issues we also track the types of insurance people have. Most people have Medicare and something else, be it a Part D plan, a Medicare Supplement, a retiree plan, that kind of thing. We also track the call origin as it is important for our organization to know how the caller found out about our services. Additionally, since we are a national organization, it is important for us to know the state one is calling from and this can also be done by recording zip codes. We also collect other relevant demographic information to solving the problem at hand. Our volunteers do not collect Social Security and Medicare numbers as this information is not relevant to the work they are doing with callers. If we are representing the client in any way, either applying for a low-income program or we are helping with an appeal, then they are referred to staff and we have them sign an appointment of representation form, which they sign and mail back to us and we scan it and attach it to their case in our database.
For the past two years, we have made it a point to ask each and every caller if they would like to be screened for the programs that help pay for Medicare, such as the Medicare Savings Program (MSP) or Extra Help. We file Extra Help applications nationwide, but we have a deputization project for NYC MSP applications where we can batch and submit as the authorized representative to receive decision notices for more local callers. The volunteers do not get in to details about financial information but ask an opt-out question as to whether the individual wants to be screened during a follow-up call and we ask most callers this question. We track this information carefully to determine how many clients we help enroll into programs.
We also place a great deal of emphasis on case notes to tell the client’s story. We have a case notes template and it compliments the data collected. Through this process, volunteers define the caller’s presenting problem and describe their next steps in narrative format.
Since we report outcomes back to our volunteers, we believe that most volunteers now understand that our data entry efforts are aimed at helping our organization tell the stories of people with Medicare. There is need-to-know information and nice-to-know information. We try to collect only the essentials. We are aware that a system that is too complex to navigate will drive volunteers away. We walk a fine line between capturing information and ensuring that our systems are easy for volunteers to use.
3) Also, your database generates some nice looking outcomes dashboards -- very clean. visual, and easy-to-read. Can you talk about how you use them to communicate with others and what benefits they have generated so far? Have they helped you improve your program outcomes or generate more support for your program, either internally or externally?
We present individualized reports to a variety of people we work with, including elected officials, funders, partner agencies and so forth. Our database is web-based, malleable and programmed in-house so we can adapt as needed. The combinations of data points to develop reports are powerful. For every data point that is entered into our system, we are able to generate a query to lend itself to a report on a particular Medicare issue. If we want to know how many MSP applications we have assisted callers aged 65 and older with Medicaid with who also filed a Part D Appeal, we can generate a report for that, for example. Essentially, all call activity is tagged so that it is transparent and we can report outcomes.
4) In my experience, extensive forms and paperwork make volunteers pretty grumpy, and data entry requirements tend to fall into that category. How did you encourage volunteers to use the new database? Is there anything you might have done differently next time to smooth out the implementation process further?
Two years ago, we formed a stakeholder group to talk through all of the data we collected then and what we had hoped to collect in the future. This could take hours so we limited the time spent on this topic and created work flows. A year in to this process we implemented our new database, and it was a transition, but we had regular group and individual trainings. A handful of volunteers did leave after this transition, but it was not so much the database as it was a change in our philosophy of if it is not tracked, it did not happen. Most opted to stick with it and the new volunteers did not know any different so eventually, collecting the data became commonplace.
What we should have done better and earlier on was to include some volunteers in the design and development process. We did bring them in later, but earlier would have possibly gotten their buy-in sooner, but it is hard to say. We provided group and individual training for several months and we celebrated the launch of our new database with a party for staff and volunteers. When someone was having a tough time navigating the system, we provided one-on-one hands on training. Our goal was to create a user-friendly interface for volunteers so we also cordoned off some of the data points that only staff would need to collect if we were going to take on a case.
If we had to do things over again, we would have a few volunteers test-drive the system before implementing it broadly, so we could get more input on what worked for volunteers and what did not work. Now, when we implement changes to our database, we try our best to get input from volunteers before implementation. Volunteer input has been invaluable to us, and they appreciate being consulted.
5) Last question -- If an organization were to track only two main outcomes for their program which, in general, would you recommend (thinking of a wide range of org types and services)? Which do you feel have the most impact on program performance and improvement?
The answer to this question depends upon your position within an organization. Broadly speaking, it is very important for us to know that the counseling our volunteers provide is of the highest quality that it can be. There are three indicators of our counseling that are supervised in this process, 1) the caller’s presentation of the problem and articulation of the question, 2) the interpretation of the problem and the question being asked and 3) the possible solutions put forth to try. If you can track these three things in case notes or data points, it is important to do so.
Secondly, but equally as important, is to take the time and plan to call people back to find out what happened within a certain timeframe, even if you can only call a small sample. This is important to report outcomes back to your volunteers because they want to know they are making a difference. It can also help to evolve or change your counseling message, access additional resources if needed, and to determine your organizational priorities for materials, training, and supervisory needs.
Thanks Again, Susan and Healther, for sharing your wisdom!
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