Monday 24 February 2014

ObamaCare headaches at health insurers driving Panviva’s business

Julie M. Donnelly

Confusion over new ObamaCare health plans has health insurers’ phones ringing off the hook — a sound that is music to Panviva’s ears.

The privately-held Australian provider of cloud-based call center software, with U.S. headquarters in Burlington, Mass., expects revenue to grow at least 30 percent in 2014, much of it related to the implementation of the Affordable Care Act. Stephen Pappas, the firm's senior vice president of North American operations, declined to pinpoint 2013 revenue, but said it was in the range of $10 million to $20 million. Panviva’s customers include Western Massachusetts insurer Health New England.

Pappas said the 120-person company is now bringing on a new customer every three to five weeks. Six months ago, that was happening every seven to nine weeks.

"I had a health insurer call this morning who said that call times have grown to an hour and a half - between wait time and talk time," Pappas said in an interview. "They are calling with open head wounds, saying, please help me."

Panviva’s product, called SupportPoint Cloud, helps users navigate step-by-step through procedures and processes to provide customer service in person or on the phone. The product is sold to customers in a variety of industries, including telecommunications, manufacturing, utilities and government. Health care is its fastest-growing business segment in the U.S., accounting for 80 percent of U.S. revenue and 40 percent of global revenue. The company is looking to expand its customer base to hospital networks and integrated hospital-insurer organizations. The company also plans to expand the functionality of the software to include wellness programs and care coordination.

Pappas said that one challenge for insurers in states outside of Massachusetts is the large number of new health plan members that have never had insurance before. They not only need a number of questions answered, but they often need customer service representatives to go a step further, helping them to identify members’ questions for them. Pappas said there are two groups of insurers — those that prepared for the ACA, and those that didn’t. He said some insurers who predicted call volumes to rise 25 percent, have instead seen calls grow by 75 percent.

Pappas said another challenge for insurers is to find ways to differentiate themselves, now that federal health reform regulations have created a homogenous slate of Gold, Silver and Bronze health plans. He said the desire to provide stand out customer service is also boosting business for companies like Panviva.

Pappas said insurers’ woes will worsen following the March 31 federal deadline to enroll in ACA-compliant plans, for two reasons: New enrollees will have questions about their explanation-of-benefits forms and those who failed to make the deadline may be scrambling to enroll once they figure out they might have to pay a penalty for going without insurance.

In Massachusetts, there is also likely to be a new wave of high call volume following June 30, which is when the last federal extension expires for Massachusetts residents with subsidized plans .

Source Boston Business Journal

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