2025 Q1 CMS Call Center Monitoring Performance Metrics & Access Instructions
Relevant to: PDP, Part D
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.
Introduction
The Centers for Medicare & Medicaid Services (CMS) have released the 2025 Call Center Monitoring Performance Metrics for Timeliness Study, Quarter 1. This study evaluates the response times of Medicare Advantage, Prescription Drug Plan, and Demonstration Organizations’ call centers from January 6 to January 31, 2025. The study includes detailed metrics on hold times and disconnect rates, providing critical insights into customer service performance. Organizations can access their specific reports through the HPMS portal and are encouraged to review the data by April 29, 2025, for any necessary clarifications.
Key Dates and Deadlines
- Study Period: January 6 – January 31, 2025
- Deadline to Contact CMS: April 29, 2025
- Final Report Period for Quarter 4: January 27 – January 31, 2025
PACE Compliance
This memo is relevant to PACE programs because it outlines the performance metrics that Medicare Advantage and Prescription Drug Plans are expected to meet concerning call center responsiveness. While direct implications on PACE programs are not mentioned, such programs should remain aware of these standards as they continue to integrate services with broader Medicare and Medicaid objectives.
PACE organizations need to ensure that their call centers, which may provide crucial information and assistance to enrollees, adhere to similar standards of timeliness and quality to maintain compliance and service excellence.
For compliance:
- Regularly monitor and evaluate call center staff performance.
- Implement necessary changes to improve timeliness, such as staff training or system upgrades if your call center statistics show deficiencies.
- Ensure call center operations are available as per the required time frames for your specific service area.
Required Actions
1. Log into HPMS and navigate to Quality and Performance > Performance Metrics > Reports to access the call center timeliness performance metrics data and call-level raw data for your contracts.
2. Review the metrics and raw data for your contract(s) thoroughly to ensure accuracy and comprehensiveness.
3. Contact CallCenterMonitoring@cms.hhs.gov by April 29, 2025, if you have any questions or concerns about the data or require further assistance.
FAQs
- “What are the key performance metrics monitored by CMS for call centers in 2025?”
- “How can I access the call center performance metrics data?”
- “What information is available in the call-level raw data?”
- “How do I download the cumulative raw data for my contract?”
- “Who should I contact if I have questions about the call center performance metrics?”
