What Gets Measured Gets Done
Release Date:
Building a CX program from the ground up can be a challenge, especially in a field such as healthcare. Where do you start? What’s most important to customers? How do we develop a customer – or “member” – centric culture? Host Steve Walker welcomes Gratia Carver, vice president and chief experience officer at Blue Cross Blue Shield of Kansas City, or “Blue KC”, for why measurement is such a crucial practice to building a customer-centric culture.
Gratia Carver
Blue KC
Connect with Gratia
Highlights
What gets recognized gets repeated
“The next thing was to create the measurement program. And this is part of learning from from prior roles and knowing what didn’t work. And I knew that if I created the measure more measurement portfolio next, that that would even further embed a foundation that we could build upon because what gets measured gets done and what gets recognized gets repeated.”
Using the right measurement
“In health care, by and large, the consumer’s not making the choice. And we saw that in comments again… I would see that in [the] question; members would say, ‘I didn’t choose. You can’t recommend you.’ I also knew, Steve, that after spending 20 years of my career explaining Net Promoter Score to people over and over and over again, that it would not drive behavior change. And part of my job is to create a culture and evolve a culture.”
Transcript
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Steve:
For a customer experience program to thrive, you're going to need data in the kind of data you gather is important.
Gratia:
So we created that definition. The next thing was to create the measurement program, and I knew that if I created the measurement portfolio next, that that would even further embed a foundation that we could build upon. Because what gets measured gets done and what gets recognized gets repeated.
Steve:
Using CX measurement as a way to influence behavior and culture on this episode of The CX Leader Podcast.
Announcer:
The CX Leader Podcast with Steve Walker is produced by Walker, an experience management firm that helps our clients accelerate their success. You can find out more at walkerinfo.com.
Steve:
Hello, everyone. I'm Steve Walker, host of The CX Leader Podcast and thank you as always for listening. It's never been a better time to be a leader. And this podcast explores the topics and themes to help leaders like you leverage all the benefits of your customer experience and help your customers and prospects want to do more business with you. Building a CX program from the ground up can be a challenge, especially in a field such as health care. Where do you start? What's most important to customers? How do we develop a customer or member centric culture? Well, our guest today has firsthand experience in such a scenario, and she's going to tell us why measurement is such a crucial practice to get things going. Gratia Carver is a vice president and chief experience officer at Blue Cross Blue Shield of Kansas City. Or, as they like to say, "Blue KC". Gratia, welcome to The CX Leader Podcast.
Gratia:
Hi, Steve. Honored to be here.
Steve:
Well, I'm so glad to have you here. You know, it sounds like this this podcast is right up my alley because I kind of come at this practice sort of from a measurement background. And then as our company has evolved, health care is a huge practice for us and it is just such an interesting business. You know, it just and it's so rich with with experience data. So I'm really looking forward to having you on the show and I appreciate you willing to come on and share your story. You know, just before we get into the topic that we kind of teed up, I think it's always interesting for our listeners to hear about their colleague's journey to become CX pros. So if you could just give us a little bit of background on your kind of professional development and how you ended up being the chief experience officer at Blue Cross Blue Shield.
Gratia:
Oh, happy to do that. So it's really interesting because my background is really not health care. I did work for my dad, who's a physician in my first few years of college as his insurance person. So that's kind of a neat connection. But beyond that, I do not have a health care background. My background is consumer products and services, everything from box chocolate to natural gas to Mickey Mouse ears. And before Blue KC worked for security products company that really led me into the CX practice. So it's been good in that I can bring the consumer lens to this role, which is highly important, especially in the complicated field of health care, because health care is not simple. It is really not known to be consumer oriented and that needs to change. So I think that lens that I've brought with me is really helped.
Steve:
Yeah, and actually that's interesting. I think that's one of the paths that people take is customer experience is kind of in some ways almost embraced or kind of become a part of marketing in a lot of organizations. So because it has to be pervasive in the organization, just like marketing. And so anyway, interesting background. And then I think people are mostly familiar with Blue Cross and Blue Shield, but maybe just a little bit of the data on Blue KC and just where your service area is, how many members you know, how many employees, that kind of thing there.
Gratia:
So Blue Cross Blue Shield of Kansas City serves 32 counties, two in Kansas and 30 in Missouri. We have about a million members, a very established health plan, 85 years in the running, very community and local based, not for profit organization that really exists to serve our members and simplify their health care and create an environment and a membership that improves the lives and the health of our members as well. So it's a very purpose driven organization and really the reason that I'm here.
Steve:
Yeah. And how many employees are in Blue KC?
Gratia:
Oh, just under 1500.
Steve:
Okay. But you're still a complex organization and a million members and I would guess thousands of employers or companies plans that are those members are parts of. Right.
Gratia:
Yeah.
Steve:
Yeah. Again, I guess just for our our CX pros out there, I like to kind of give them a little context of kind of the overall scope of your your program. So appreciate you sharing that. All right. Let's get into it. So I kind of assume you were brought in to really improve the CX practice there at Blue KC. What was it like when you got there and how did you start in terms of enhancing what they were already doing?
Gratia:
Yeah, great question. It was really an interesting entry. So I learned about the opportunity through a recruiter, completely unexpected. I had just lost my mom to a very surprising and tragic diagnosis of pancreatic cancer. And it just it just felt right. If I could be part of an organization whose purpose is to improve the health lives of our members. So that really interested me a lot. The organization asked me to come in and really build a CX practice. It was to create a dedicated team to that to that effort. And, you know, it's interesting because as I got into the company, I actually found that there had already been some really good work being done by great people who were also trying to do another job. So I think it was that classic story of someone recognizing a need, trying to build a practice off the side of their desk and the organization, realizing how important it is and deciding to create a dedicated team. So I came in, started that process, determined what the organization should look like, and that's kind of where we begin.
Steve:
It's kind of a common theme we hear, you know, a lot of companies, even though they don't have a formal program, if they're successful organization, they're already doing some good things by their customers. Could you just give us one or two examples of some of the things that you saw that were already in place, that were going good?
Gratia:
There was already a really good kind of survey methodology going on, which allowed me to kind of use that as a launching pad to to tweaking that and creating our measurement practice, which I know we'll go into detail here on that topic. But and there was already some really good work going on in the customer service organization around interaction design and things like that. So good work just again, somebody trying to do the right thing off the side of their desk. And and it's really hard to create a robust, full strategy and program when you're in that situation. So I had the opportunity to do that. Also, I'd say a lot of good research. So when I walked in the door, I was gifted two people. One was a researcher and one was an analyst. So I kind of had a head start in terms of the organization and people who could help me. They understood the history that that was a true gift.
Steve:
Let me make a hypothesis that so it was interesting and probably a nice surprise that you found there was some good work already being done with the measurement, but I'll hypothesize that it wasn't widely shared or high awareness throughout the organization, right?
Gratia:
Yes.
Steve:
So classic. Classic. So that was probably one of your first things was just getting out there and telling the story and showing some of the managers what kind of data you already had. Right?
Gratia:
Yeah. I will tell you, I went about that in a in a pretty intentional method. And I will tell you that my approach when I walked in the door was really formed in my mind because of lessons learned in past roles. Right. And what worked? What didn't work? And so when I came into Blue KC, I really wanted to be intentional about where to start. And it's interesting and I'm sure CX professionals listening can relate to this, but the customer experience definition or what that means to people is, is all over the place. You know, there there are definitions in people's mind around customer experience that says it's customer service, that says it's brand image, that says it's marketing, kind of everything but what it really is. And when I walked in and I just started talking to some of the key leaders there, I thought, Hmm, I think we need to sit down together and co-create the definition of what customer experience means to Blue KC. And so I started in March. I actually just celebrated my four years this month, started in March and learned kind of who the key stakeholders were at the VP, senior VP level. Yeah. And in April put together a two hour lunch meeting where we co-created the definition of customer experience together. And…
Steve:
Can you share the definition?
Gratia:
Sure. Yeah. It's really our customers perceptions about their touchpoints, relationships and connections with Blue KC. That's kind of the meat and potatoes of our definition.
Steve:
I love it.
Gratia:
But what I wanted to do was make sure that we all knew what this practice was going to be about and that there weren't any misconceptions. I knew if we did that together, then I would have. We had about 12 people at the session again, VP, senior VP across…
Steve:
Cross functional.
Gratia:
…the company. And I knew I would have 12 ambassadors walk out of the room.
Steve:
Yep.
Gratia:
And that's what happened. And it. Really helped kind of lay the foundation for everything else that we built.
Steve:
I mean, I just want to reinforce this for our audience because I think you created an event where these other key leaders could be a part of what you were building. And I just see so many organizations, you know, they just they kind of moan and groan that nobody understands what they do and blah, blah, blah. And sometimes you just have to you have to create a shared experience where people can feel like that, not only feel like, but they they're buying into it. So I know it probably took a lot of work. It probably took hours of work to put together that two hour thing. But in the long run, it's probably saving you a lot of time.
Gratia:
Yeah.
Steve:
Let's talk a little more about the measurement. Why is measurement such an important part of of your program?
Gratia:
Yeah, and that's a perfect segue too, Steve, because that was the next thing I did. So we created that definition. The next thing was to create the measurement program. And this is part of learning from from prior roles and knowing what didn't work. And I knew that if I created the measure more measurement portfolio next, that that would even further embed a foundation that we could build upon because what gets measured gets done and what gets recognized gets repeated. You know, I will tell you, that was a process. It probably was eight months and I'll tell you why. So as I thought about the measurement portfolio and thinking through how we create a relationship level measurement program, so there's tons of touchpoint and interaction measurement processes the company has. But I wanted to make sure we were measuring CX at the relationship level right, regardless of a touchpoint, so I could understand how our members felt about us in any stage of their journey with us. So as I started to think about that night, I reflected on my past and what worked and what didn't work. You know, Net Promoter Score was one of those measures that you think about, right? And I'm actually an NPS fan. I just have used it in both B2C and B2B environments and I know where it works and doesn't work in certain cases. And in health care, there's there's a bit more of a complexity to it because NPS is really based on consumer choice.
Gratia:
Right. They selected the product or the service. Would you recommend me? Right. Yeah. In health care, by and large, the consumer's not making the choice. And we saw that in comments again. There was already a survey process going on here. And I, I would see that in that question. Members would say, I didn't choose. You can't recommend you. Right. I also knew, Steve, that after spending 20 years of my career explaining Net Promoter Score to people over and over and over again, that it would not drive behavior change. And part of my job is to create a culture and evolve a culture. And the only way culture evolves or changes is through behavior change. It has to be driven by behavior change. So the more I thought about that, the more I started reflecting on what are some other measures that would really drive behavior change. I think NPS still has to be there – long story why. But I knew if I really wanted to create a portfolio that NPS just needed to be a piece of it and I really needed to look at that behavior change how we drive simplicity. So we aligned our strategy to our mission members first, and then we lassoed to part of our vision of creating simple experiences and simple health care. Which health care is anything but.
Steve:
Yeah,
Announcer:
But we think about consumers today. They're comparing all of their experiences right to everything else. Oh, I just ordered something from Amazon.
Steve:
Amazon.
Gratia:
Right?
Steve:
Uber, Netflix.
Gratia:
Yeah, Netflix. Right. The list goes on and health care is anything but those things. But we have to start evolving to that. That's their expectation now, and rightly so.
Steve:
Yeah. Every time I have a conversation with a client about their kind of their digital experience and they I say, well, you know, it's not Amazon. And they go, Oh, but it's really, really good. I go, It's not Amazon.
Gratia:
So yeah, it's just, you know, it's so, so true. And we have to, we have to face that as an industry. But we really lassoed a lot of our thinking to simple.
Steve:
Yep.
Gratia:
And so as I was thinking about that and I also talked to about 30 of our 36 blues to see what they're doing and what's working and what's not working, which really helped me even further frame up this thought. But I ended up creating a portfolio of four relationship measures. The first is, and I called it customer effort score with a little bit of a tweak on what people think of that. But it really the question is, is Blue KC an easy company for you to work with? And then it doesn't matter. Their last touchpoint with us, their last interaction. It's just the top of mind. Are we easy in your life or not? Right. So is are we effectively meeting your needs? Are we a company you can trust? And would you recommend us if asked? So we've had to tweak that question because again, most of our members are not choosing us. Really four simple questions, relationship level. We do it monthly with a third party. So we are objective.
Steve:
So it's an ongoing tracker.
Gratia:
Ongoing tracker. And the other thing is we post all of those results on our internal intranet and in every monitor in our building, we talk about it, our CEO talks about it in every all hands.
Steve:
But so it's just like, just like your other key operating metrics that you track. It's ongoing. Beautiful.
Gratia:
Yeah. Yeah. And to that point, as a matter of fact, I was also able to get approval from our CEO and our board to add it as part of our annual bonus. So 20% of our annual bonus is tied to our customer effort score. Is Blue KC, an easy company to work with. And guess what that does? If something touches your wallet, it gets personal.
Steve:
It gets measured and it gets rewarded. You said it earlier.
Gratia:
And now so now our conversations have changed. In meeting rooms. We constantly hear people saying, Well, that's not really easy for the member. I mean, it has really changed conversation and behavior and it has worked. I will tell you, when I joined the organization, because they were already measuring ease, our results were 57% were now at 73.
Steve:
So for years you've you've moved it up about a third. So yeah.
Gratia:
The other thing I will tell you and this was very interesting, but we got a call from J.D. Power in 2020 and they measure NPS and said, you know, your NPS score popped up nine points, this year, what are you doing? And I was like, Oh, and so I have some thoughts around that. But, but what really cemented that for me was the association called me a week later and they do a completely different brand strength measure survey for all the blues. And they called and said, You're NPS went up eight points this year.
Steve:
Yeah, there's valid nine.
Gratia:
And I was like, What?
Steve:
No, it's a validation, right? These are some things that you have no control over and it's showing up so that you were making real change happen. And again, I wish I could bottle this story because, you know, I see so many companies that just measure, but they don't do the work to actually you know, it's my joke is it's like I'm going to start working out next Monday, you know, or it's like the person that weighs themself every day, but they don't exercise and they don't watch what they eat. And then they're surprised when they don't get any results. It's you know, that's similar analogy.
Steve:
My guest on the podcast this week is Gratia Carver. She's a vice president and chief experience officer at Blue Cross and Blue Shield of Kansas City, or Blue KC, as we like to say. And she is giving us a literally a masterclass in how to drive change, customer focused change in a very complex area, being health care insurance and providing that to almost a million members in the Missouri and Kansas, the greater Kansas City area. Gratia, obviously you've done a really nice job in four years of putting this together and driving some change that was actually recognized by outsiders. So you really are doing it. How do you keep the momentum going? And you mentioned like you have top management buy in. And so just how do you go do that to make sure that that this keeps going and people don't get complacent?
Gratia:
Yeah, that's such a great question. So just to kind of build upon the measurement program, so we've got it very, very well in place. It's very structured, it gets a lot of attention. But every year I do go through a statistical process to build the incentive range from kind of threshold to difficult attainable.
Steve:
Yep.
Gratia:
And we do a lot of math with our third party statistical firm. I actually work with their chief statistical intelligence officers. This title, which he is, he is all of that which is good.
Steve:
I think I know a few people like him.
Gratia:
So yeah, and I'm not so..
Steve:
Me neither.
Gratia:
…but he helps me understand the likelihood of us reaching certain levels of that measurement based on our past performance and based on what we know is going to be done. So we have a very significant improvement program, Steve, that I'd love to take you guys through some time, but we developed a methodology and a framework around how we're going to look at improvements and driving feedback we get from members through the organization to fix pain points. And so he takes all of that into account and then I can build kind of a recommendation for our executive council that reports to our CEO and our board to say, here's the range that we're recommending for this year and here's the likelihood of us reaching it so that we're not setting a measure that's too easy or too difficult. But we know we have to stretch and do these things which continues to drive that behavior. Right. Members, personal improvement in terms of kind of making it fun and keeping it alive for employees. We have an entire CX awareness program that I talk about, but one of our pieces in that is called Random Acts of Easy. And I love it because it just and it's simple stuff, right. But I'll give you a couple of examples. Every CX day we rent a golf cart and our parking lot is huge. So we go and we pick people up at their cars and drive them to the building entrance. And on the ride we talk about what are we doing to make things easy for our members? We wanted to make your morning easy by picking you up and taking you to the door.
Gratia:
Right. So we want we want our employees to feel it, feel it, sense it, know what it feels like to have something made easy for them. We also do like ice scrapers and umbrellas, so if we have bad weather, we'll go down to the parking lot area and we'll hand out umbrellas and ice scrapers and they're all branded. We've branded our program The Power of X, the power of experience. And it's so funny because they'll say, Well, how did you know? I mean, they're just totally confounded by how we planned for this in advance. And we say we anticipated your needs, right? That's what we need to be doing for our members. So we try to bring in the fun wherever we can. And then this last CX day will be my last story. This last CX day, which was my favorite so far, is that we honored our very first member 85 years ago, a woman named Betty Jackson, who was very accomplished for her time as a woman. She was a controller for a company called Wolferman's Bakery, our first member. We have pictures of her all over the company. I have one in my office, but we honored her and sent every employee a basket of Wolferman's muffins. And then we we built these little story cards that we sent to everyone. And then we put a plaque in every single one of our conference rooms honoring her with her picture and telling her story and reminding everyone that our members come first.
Steve:
Well, thanks for sharing all that. That is just I hope our listeners can take some of that and put that into their organization. And we'll we'll do that here in a minute with take home value. But I did want to ask you again on terms of recognition that your your team won several awards through Awards International, which is an organization that we're sort of interested in at Walker. You know, the state of customer experience doesn't get any better if we're modest, right? We, you know, we need to keep promoting why this is so important. But just your your experience with Awards International and what kind of prompted you to enter into that?
Gratia:
Yeah, that is a fun story to and I'll have to start at the beginning. So I am a member of the local chapter of the CXPA here in Kansas City, and we had a lot of the companies in this area come to Blue KC for one of our local chapter sessions, and we were sharing some things that we were doing. And and one of the members, a colleague of mine, said, you know, I, I know about this. And it was actually North America Customer Experience Awards. I know about you guys should really think about applying. And I was like, oh, and my, my thought process really, Steve was if we did that, because you have to go through pretty stringent processes, it might give us some ideas to be even better. It was more of a learning opportunity for us than anything. Yeah. So we went ahead and applied. We, we were very fortunate and honored to win that the first time in several areas and then it kind of went viral from there. I started getting invitations and one of them was the international award. And so we applied in last year, we applied in four categories and we won a level in every single one of them and we won gold. This is international, Steve. And when I think about that, I mean Blue KC is in the world like this and just the companies that we're representing, I still get chills thinking about it, but we, we won gold in best CX measurement. I just I still today, you know, I just it blows my mind. So we've been very, very, very fortunate.
Steve:
Well, I'll tell you, just getting to know you here and a half an hour of recording a podcast, I can imagine, because you really have done a really, really nice job with what you've put together there. And that's sincere from someone who's been doing this for 40 years and is literally seen thousands of companies try to tackle CX Well, Gratia Carver we have reached that part of the show that I ask every guest to provide their best tip, their take home value. And this should be something that our listeners could take back to their programs. You know, still later today or tomorrow or next Monday, like we talked about for my exercise program. But what is your best tip, what you want them to take away from session on the podcast today?
Gratia:
You know, I've thought about that question. There's so many things that go through my mind. I will tell you to Steve that we are so lucky here at Blue KC because we have this from the CEO and the board down, right? So I've got that support and I know a lot of people don't and they're trying to create a CX program, you know, kind of by themselves. And and I guess what I would say there is don't give up, find a way to drive behavior change and find a way to to make an impact and tell the story. And once the organization starts seeing that impact and through your stories, it will take hold. So you can drive it at a grassroots level if you are able to demonstrate. And maybe it's as simple as random acts of easy, you know, or some other program that you would call that would be fitting to your company and start there.
Steve:
I think, again, you did a lot to create that environment. I would say it's hard to replace the top down support, but I think again, if people listen to your story and they're having a little trouble with that, they could implement a few of the things that you did. But anyway, Gratia Carver, thank you for being such a great guest on The CX Leader Podcast and if anybody would like to continue the conversation, I know I found you on LinkedIn, so I know you're out there, but if you want to give any other contact information.
Gratia:
Oh yeah, LinkedIn is a great place to start and anyone's welcome to reach out to me and my email is gratia.carver@bluekc.com And Gratia is spelled G R A T I A. Sometimes it gets a little C in there but welcome to help anyone I can.
Steve:
Thank you. And if you want to talk about anything else you heard on the podcast or about how Walker can help your business customer experience, feel free to email me at podcast@walkerinfo.com. Be sure to check out our website cxleaderpodcast.com to subscribe to the show, find all of our previous episodes podcast series. We organize them by topic and subject and speakers and all that. We also have our contact information so you can let us know how we're doing or suggest a future program. The CX Leader Podcast is a production of Walker. We're an experienced management firm that helps companies accelerate their XM success. You can read more about us at walkerinfo.com. Thank you for listening and remember, it's a great time to be a CX leader. Appreciate you tuning in and we will see you again next time.
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Tags: culture Steve Walker healthcare Gratia Carver Blue KC measurement