Aetna’s QUEST (Quality Understanding Empathy Sensitivity Trust) certification program supports Aetna Medicare’s strategic goal of taking customer service to another level by providing a positive member experience with an advocate for their needs.
Program Details
Aetna initially introduced weekly soft skill behaviors and actions in the 14-week new hire agenda. Week 6 day 4 of the new hire soft skills training includes attending an all-day Communications Skills session with a focus on empathy, caring, communication, and listening to the caller. Further reinforcing the desired skills for empathy is the Senior Sensitivity training that demonstrates to the learner what it is like to live with physical challenges usually associated with aging, such as loss of hearing and vision and impairment due to bone mass loss. Call metrics were adjusted to add empathy to Aetna’s quality standards.
Representatives left new hire training and demonstrated excellent soft skills when first handling customer calls. However, the findings after a few months of evaluation showed calls were being handled more as a transaction and not an experience. Quick sympathies were communicated to the member to accommodate the empathy call metric, but the interaction lacked an overall experience of having an advocate for the member’s needs. It was decided that Aetna needed to develop this skill set to provide to members with a more engaging and personal interaction.
QUEST is a five-session, instructor-led certification program that is awarded once the learner has demonstrate the desired behaviors. Each session focuses on an aspect of the desired customer experience, including:
- Quality: Understanding the member’s perception and expectation of the issue and providing a solution that aligns with the member’s expectation. Summarizing the call to promote first-call resolution and eliminate misunderstandings.
- Understanding: Listening techniques to gain understanding; paraphrasing.
- Empathy: Demonstrate by experiencing and thinking through the situation as the member, then providing an empathetic response. Understanding the difference between an empathetic response and a condolence.
- Sensitivity: Caring for and appreciating members and communicating that caring for members.
- Trust: Advocating for the member by addressing the unasked questions and eliminating the member having to call back by providing the “big picture” in regard to health care.
The sessions force learners to self-analyze their mindset while taking a call. They identify the difference between a “transaction” and a call where the member encounters a quality experience. After each session, learners have two weeks to practice and demonstrate the desired skill. These behaviors are encouraged through coaching from the participant’s supervisors and quality analysts with a weekly meeting to discuss best practices. During that meeting, role-plays also are used to reinforce the desired outcome.
Results
Teams that participated in the QUEST program showed progress over other teams. Certified representatives have improved customer satisfaction with survey results showing a 5 percent increase in satisfaction and an 83 percent decrease in Medicare complaints. Member survey responses to how likely they are to recommend or remain with Aetna are 10 percent higher after speaking with a QUEST representative. Overall, this improved member satisfaction is a factor in increasing Aetna’s Medicare Star rating, a key factor in new member decisions in selecting a health plan.
