Kaiser Permanente Call Center Employees Received Bonuses to Limit Patient Phone Time, Doctor Appointments

Until recently, telephone service representatives at three Kaiser Permanente call centers in Sacramento, San Jose and Vallejo were given financial bonuses if they reduced the amount of time they spent talking with each patient and limited the number of doctor's appointments they scheduled, among other actions, the Los Angeles Times reports. According to internal company documents, from January 2000 to December 2001, telephone clerks could earn a bonus of up to 10% of their salary, with a maximum of $625 per quarter, if they met three of four criteria:

• Handling English language calls in less than three minutes and 45 seconds and foreign language calls in less than eight minutes and 30 seconds;
  
• Scheduling a doctor's appointment for between 15% and 35% of callers;
  
• Transferring calls to advice nurses less than 50% of the time during normal business hours or 60% of the time on nights and weekends; and
  
• Spending an average of at least 75% of the workday answering calls.

Kaiser spokesperson Jim Anderson said the bonuses, which were a joint program between Kaiser and Service Employees International Union Local 250, were intended to "reward good service" and not to deny patients access to care. "This was a pilot program, and it was discontinued because it was determined that it wasn't working," Anderson said. About 505 registered nurses surveyed by Kaiser at the three call centers, which serve about three million Northern California subscribers, said they had "a serious concern" that callers were made to wait too long to receive doctor's appointments. The nurses were not part of the bonus program, the Times reports. According to the California Nurses Association, the "main problem" with the call centers is that telephone service representatives, who do not have health licenses, evaluate patients' medical conditions when making appointments, a task that state law restricts to medical personnel. The Department of Managed Health Care said it is investigating the issue (Ornstein, Los Angeles Times, 5/17).