PegaWorld iNspire 2023: Blue Cross Blue Shield Michigan & EY – Improving Customer Satisfaction via CMS Star Ratings (Presentation)

A key metric of customer satisfaction is defined by a health insurer’s star ratings, as determined by the Centers for Medicare & Medicaid Services (CMS). Blue Cross Blue Shield of Michigan (BCBSM), which provides health benefits to over 4.3 million members, was experiencing a decline in its star ratings due to operational and technical issues within its Grievances and Appeals process. With a potential impact of hundreds of millions of dollars in lost revenue, discover how BCBSM engaged EY to assess the situation and initiate an extensive remediation program to address the issues and improved their customer satisfaction star ratings.