Making every conversation count

Modivcare is one of the largest providers of non-emergent medical transportation, virtual patient monitoring, and personal in-home care, with more than 20,000 teammates working for the company.

Contact centre transformation underpins the company’s goal of setting a new standard for member engagement and satisfaction in the NEMT industry, as it continues to drive efficiencies at its mobility care centres. The first step in the journey started by addressing the technological limitations of its current contact centre system.

“As we looked to the future, we saw the constraints that hindered us from meeting our projected goals,” said Jessica Kral, Chief Information Officer at Modivcare. “IT tickets were escalating due to workforce management, virtual agent stability, and performance issues. It was hard to outsource activities and maximise return on investment, which resulted in the potential for lost opportunities. Modivcare saw the importance of putting our member experience first, choosing to invest in cutting-edge technology.”

Nothing left to chance

In pursuit of a resilient cloud contact centre platform, a thorough vendor selection process saw Modivcare evaluate offers from all the major players, along with other recent market entrants.

In a business environment increasingly shaped by artificial intelligence (AI), automation and evolving customer expectations, proving value needs to be an intentional, structured process that begins with discovery. Value discovery is the method of aligning people, processes and technology during solution implementations. Its goal is to identify strategic imperatives and to continually uncover inefficiencies, identify opportunities, and ultimately deliver measurable impact.

But in today’s AI era, innovation evolves rapidly. What once passed for value — with feature comparisons, compliance with “request for” checklists or basic ROI claims — has become insufficient. AI-powered Contact Centre as a Service (CCaaS) platforms based on cloud-native microservices software frameworks and agile processes have enabled many new use cases that deliver on a “rate of change” at hyper-speed.

This has changed traditional thinking about value and how value is captured. AI technology promises massive transformation. Yet, without clear use cases, strategic design and stakeholder alignment, even the most powerful solutions risk being underutilised. When value is tied to operational and strategic needs, innovation becomes a measurable differentiator.

In this article, we’ll explore ways to uncover, quantify and amplify value across an organisation using powerful AI capabilities. With innovation moving faster than ever, structured, repeatable processes are essential for discovering what’s possible, assessing readiness and driving successful transformation.

A key service differentiator is the ability to match a member’s profile to the care they require — regardless of the plan type or number of channels the member uses. While carefully orchestrating those journeys, agents can manage time to resolution and other KPIs that need to be tracked.

“We’ve elevated our ability to deliver seamless, personalised experiences that cater to the unique needs of our 34 million members, delivering more than 31 million paid trips per annum,” said Kral. “We’re one of the first NEMT companies to leverage AI plus real-time data capabilities and analytics to ensure quality performance at scale. This will be a difference maker for our members, granting them access to care at the level that best serves them.”

Digital excellence payback

With a digital-first strategy, Modivcare started with Genesys Cloud Web Messaging and has embedded a single standard widget in three applications, with two others pending.
“We quickly achieved a 2-to-1 ratio of transactions per agent with a goal of 4-to-1 once we implement Genesys Cloud Agent Assist,” said Kral. “Our call volumes halved, which has been instrumental in delivering $17 million in cost savings to date.”

The company’s Google voice capabilities (with speaker identification for regulatory compliance) and its chatbots integrated with Genesys Cloud Web Messaging cover six main member intents: reservations, capture, cancel, change, confirm, mileage reimbursement, and ride assistance.

“Around 63% more members now choose to engage through web messaging and bots,” added Kral. “Coupled with a 20% improvement in containment rates, we’ve seen revenue from digital bookings increase by 150%. It also means our agents get to more high-touch engagements with our members like VIP Services; distressed and stranded riders; escalations; and non-digital adopters.”

Genesys data tables have reduced effort, too. Agents can quickly establish member eligibility rights and create reservations on the spot — securely eliminating millions of file transfers from insurance plans.

Smarter workforce engagement and tech-enabled services

With Genesys Cloud Workforce Engagement Management (WEM), Modivcare benefits from advanced quality management tools, speech and text analytics, and gamification techniques that will soon roll out.

“Our goal has been to score more interactions for each customer service representative to assist in coaching and raise the overall experience for our members,” said Kral. “Previously, we could only score about 6,000 interactions per month, which didn’t provide the level of insight we needed. Now, with WEM, that figure has tripled to nearly 24,000, complete with conversation transcriptions, to drive more coaching and improvement opportunities for our teammates to provide better service for our members.”

Previously, 65% of IT tickets were related to hurdles with its legacy workforce management solution, and after evolving to the WEM capabilities of Genesys Cloud, that number has decreased to less than 15%, with most of the remaining tickets being “how-to-do” requests as users continue to build workforce engagement management product knowledge.

Broad KPI improvements

Nearly a year after embarking on its contact centre transformation with Genesys Cloud, Modivcare is seeing a huge upswing in its member and teammate experience indicators, including a 31% reduction in average speed of answer and abandonment rates. Service levels and quality scores have risen by 5%, with occupancy rates up 3% — and an 86% increase in teammate retention.

Importantly, those results are positively impacting front-line services, such as scheduling member transportation. For example, agents are better enabled to act earlier and prevent late arrivals, while driving out fraudulent claims, waste, and abuse within the healthcare industry.

“As our country ages and Medicare spending rises, we will address these issues with a digital-first strategy and high-quality, integrated services,” concluded Kral. “By focusing on innovation and modernising our systems, our teammates can work more efficiently, which allows them to concentrate their energy on providing the human element to our high-touch engagements.”