برنامج File Recovery
Cherly Fleitas
For health plans, the number of people with outstanding customer service problems can be significant. In 2017, approximately 18 percent of members of Medicaid health plans and 13 percent of members of Medicare health plans reported "never" or "sometimes" when asked whether the plan's customer service gave them the information or help they needed.1
Most health plans and physician practices have some sense of the cost of replacing a lost member or patient. But many are not aware of how powerfully the "grapevine effect" can affect their reputations. Several marketing studies have confirmed that only 50 percent of unhappy customers will complain to the service organization, but 96 percent will tell at least nine or ten of their friends about their bad experience.
The "grapevine effect" can become an even more powerful force when your members and patients take advantage of the Internet to voice their complaints. Many Internet sites allow patients to evaluate their experiences with a doctor, group, or plan and post written comments online. Several health plans also publish ratings of patient experience as part of their online provider directories, and a few are starting to include anecdotal reports as well. Consider the influence that consumer ratings have on restaurants, books, and other products.
In the same way that it can be helpful to remember that some problems or difficulties will always be with us, it is important to acknowledge that complaints are inevitable. Health care organizations are caring for people who are almost always anxious and afraid, so the stakes are higher. What differentiates member- or patient-focused organizations from others is whether and how they handle these incidents to ensure that unhappy members or patients feel like their concerns have been addressed and that the organization values them.
Service recovery is the process used to "recover" dissatisfied or lost members or patients by identifying and fixing the problem or making amends for the failure in customer or clinical service. Excellent service recovery programs are an effective tool for retaining members or patients and improving their level of satisfaction. Good service recovery programs can turn frustrated, disgruntled, or even furious patients or members into loyal ones.
Service recovery is about restoring trust and confidence in your ability as an organization to "get it right." When members or patients repeatedly experience breakdowns in service, they begin to lose confidence in the care they receive. If you cannot get the small things right, how can they trust that you will do well with the complicated processes required to deliver high-quality care?
National experts in service recovery recommend a well-tested process for service recovery. This 6-step process details how to handle a range of problems from the mildly irritated to the malpractice case in the making.
Service recovery can range from listening to an upset patient to giving free parking to patients who have to wait more than a specified time for their doctor visit. It can also mean providing solutions or making amends for problems that the patient created. Making sure that someone gets to see a doctor when they show up on the wrong day is an example of the kind of customer service patients never forget. Service recovery programs ensure that patients never hear, "I can't help you with this. It's against our policy."
Perhaps the most important step in the recovery process is listening to the person and letting them vent their frustration and blow off steam. Letting the person tell their story and describe the impact of the failure is essential.
Involve the person in helping to solve the problem. However, this does not mean that the first question should be, "So what do you want me to do about it?" Work cooperatively to come up with a solution that makes the person feel like part of the problem solving and that acknowledges his or her needs.
Research on service recovery indicates that the only effective solution when a person feels like they have been unfairly treated is extreme apology and atonement. When a situation like this occurs, the patient or member is a prime candidate for overt retaliation.3 Communication about what went wrong and compensation or atonement are essential in these situations. From the patient safety movement, we know that a critical component of resolution in these kinds of situations is letting the person know that you and your organization will make sure this never happens to the patient or anyone else again.
Complaint management is also an important aspect of service recovery. Complaints can be a useful source of information about the organization; improvements in customer service depend on the organization's ability to elicit and monitor customers' complaints. In particular, service recovery cannot take place if the provider does not know that the member or patient is unhappy. Many people would rather "switch than fight," especially in a health care environment, where people fear that complaining could jeopardize the quality of the clinical care they receive. Also, minorities and people from underserved communities tend to avoid complaining, even though they may have significant problems with the delivery of care.2,3
Health care organizations that are truly committed to improving the member's or patient's experience of care can make this commitment obvious to their staff and their members by encouraging complaints and offering members and patients multiple ways to give you feedback and help you improve your service. If you make it hard for members or patients to complain, you will continue to miss important service failures that shape your reputation in the community and the quality of care. There are many tools for cataloguing patient or member complaints that allow you to track the problems by CAHPS composite or other typologies that support linking the qualitative complaints to improvement activities.
As indicated in the table below about complaint management, good service recovery programs go beyond the "quick fix." They include a process for tracking problems and complaints to help identify the source of the problem so the right improvement can be put into place. Some complaints arise from experiences with a specific person in the service process, which reflects a training problem, while others are the result of system problems that require a totally different process to resolve. The tactic of assigning complaint letters received by the CEO to middle managers for resolution as if they all reflect a one-time event or an employee that needs disciplinary action is outdated, and will never result in permanent solutions to long-term problems. Many staff know immediately which situations or patients will end up in the CEO's office. Organizations with good customer service and service recovery programs are proactive and let the CEO, clinic manager, or chief medical officer know about these situations right away so that the person can be contacted before they have the time to file a formal complaint.
Studies indicate that when customers' problems have been satisfactorily handled and resolved, their loyalty and plans to use the services again were within a few percentage points of those who had not experienced a problem.4
In other service industries, service recovery has proven to be cost-effective. Also, retention benefits the bottom line: Because of their word-of-mouth referrals and willingness to purchase ongoing services and premium products, customers retained over five years can be up to 377 more profitable than a "revolving door" customer who uses your services once.5
Internet Citation: Strategy 6P: Service Recovery Programs. Content last reviewed April 2022. Agency for Healthcare Research and Quality, Rockville, MD.
-improvement/improvement-guide/6-strategies-for-improving/customer-service/strategy6p-service-recovery.html
This is NextGenerationEU. This is more than a recovery plan. It is a once in a lifetime chance to emerge stronger from the pandemic, transform our economies, create opportunities and jobs for the Europe where we want to live. We have everything to make this happen.
The rest of the funds from NextGenerationEU are being disbursed to EU Member States by several EU programmes: the Recovery Assistance for Cohesion and the Territories of Europe (REACT-EU), Horizon Europe, InvestEU, European Agricultural Fund for Rural Development or the Just Transition Fund (JTF).
The EU budget is not and has never been about giving and taking. All Member States benefit from being part of the single market, addressing together the common challenges. EU funds, for instance under the cohesion funds or Horizon Europe, go to all corners of the EU.
In the interinstitutional agreement from December 2021, the European Parliament, the Council and the Commission agreed to work towards introducing sufficient new own resources to cover the repayments of NextGenerationEU.
In December 2021, the Commission thus proposed three new sources of revenue to the EU budget, to help repay the grants part of NextGenerationEU. This proposal would also contribute to the financing of the Social Climate Fund, aimed to make sure the transition to a decarbonised economy leaves no one behind.
On 20 June 2023, the Commission completed its proposal for a next generation of own resources. The final package includes a new temporary statistical own resource based on company profits. Following the political agreement on the Fit For 55 package, which seeks to make sure EU policies contribute to the climate neutrality of our continent, the Commission has also adjusted the own resources proposals based on the Emissions Trading System (ETS) and Carbon Border Adjustment Mechanism (CBAM) compared to the original proposals from December 2021.
On 27 May 2020, in response to the unprecedented crisis caused by the coronavirus, the European Commission proposed the temporary recovery instrument NextGenerationEU, as well as targeted reinforcements to the long-term EU budget for 2021-2027.
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