Remarks by
Senior Advisor to Vice President Gore and
Director, National Partnership for Reinventing Government

To the
Health Care Financing Administration's All-Staff Meeting
Baltimore, Maryland
February 24, 2000

(As prepared)

Thanks, Michael (Michael Hash, Deputy Administrator of HCFA), for that warm introduction. And thanks for all your hard work and visionary leadership here at HCFA - you're one of the real "heroes of reinvention" in the federal government.

I'd also like to acknowledge your chief information officer, Gary Christoff. I know how important his work on information technology is to your mission.

I want to salute Administrator Nancy Ann DeParle for initiating these quarterly all-staff meetings and for giving me a unique opportunity to talk with all of you. Meetings like this are powerful communications and management tools and I hope other agencies will follow her lead.

I had the privilege of speaking to some of you at a meeting down in Clearwater, Florida last summer on customer service and the Vice President's Plain Language Initiative. But it's good to be able to talk with everyone at HCFA this time around.

It's an honor to be here on behalf of the Vice President to talk with you about a subject I know to be near and dear to his heart -- customer service. It's the backbone of his National Partnership for Reinventing Government.

Since the beginning of NPR seven years ago, two of our most important goals have been:

  • Offering the best work environment for you - members of the federal workforce

  • And improving customer service.
Mike got it exactly right -- employee and customer satisfaction go hand-in-hand. That's especially true at HCFA -- not just as goals in and of themselves. But because they are so central to your mission of ensuring the general health and well-being of our nation. You provide health insurance to 25% of all Americans and are a critical part of this Administration's health care policy.

From a purely management perspective, I always like to say that you can't treat your customers any better than you treat your employees.

Thanks to our "high impact agency" partners like HCFA, we're now measuring how we're doing by looking at both employee and customer satisfaction. You'll be hearing a lot more about employee satisfaction next month when we roll out the results of our second survey. I can say that compared to last year, HCFA is one of the most improved agencies in the government.

According to what some of you told us during the survey, your managers have made solid progress, especially in terms of recognizing you for a job well done and rewarding your creativity and innovation. They made this a top priority last year and the 13% increase is testimony that it worked.

Nancy Ann introduced a number of changes:

  • She increased the amount of money in the awards program
  • Sped up the recognition process
  • Gave funds directly to managers for nominal awards
  • Re-instituted quality step increases
The bottom line: satisfied and motivated employees who are passionate about their work are the keys to satisfying customers and meeting your agency's goals.

But I want most of our conversation today to focus on customer service, because it's the necessary ingredient for restoring the public's trust in government.

It might have come as a shock to some of you when, last December, ABC's Peter Jennings introduced a segment by saying, "From Washington today, something government employees don't hear very often. You're doing a good job. Moreover," he went on, "the news comes from a survey of average Americans - the government's customers."

The national print media also took notice:

  • The headline in The Washington Post said, "'Customers' Rate U.S. Positively"
  • From the Associated Press, "Customers Satisfied With Government"
  • The Wall Street Journal, "Survey Measures Satisfaction With Federal Services."
What? The federal government and "customer service"?

What they were touting was the comprehensive government survey results issued on December 13 - the American Customer Service Index (ACSI). The verdict: Several government agencies -- HCFA included - are delivering services equal to or better than private sector organizations.

Before I get into how well HCFA stacks up against your agency counterparts, I want to give you a little history about the survey itself. The private sector has used it since 1994 - a zero to 100 scale to gauge customer service levels. In 1999, for the first time, government agencies across the board chose customer "segments" central to their mission to be surveyed.

Scores for federal agencies surveyed range from a low of 51 to a high of 87 on a 0-100 scale. For 170 private sector companies measured by ACSI, the range was 53-86.

The average score for comparable private service sectors is 71.9. The average for federal government customers is 68.6, which includes regulatory functions -- and traditional income tax filing -- that "customers" don't necessarily look at favorably.

There were some other interesting findings from the survey. For example, compared with just two years ago, 60% of the public was more satisfied with government services. Only 8% were less satisfied and 32% felt the same. And the quality of government services exceeded customer expectations by over 10%.

Another key finding: Government employees who have direct contact with the public received high marks for courtesy and professionalism.

And how did HCFA come out? Your overall score of 71 is two points higher than the overall federal government score and just two below the private sector average. That puts you in the middle range of performers. Your colleagues down the street at Social Security, for example, scored about ten points higher.

But you had exceptionally high ratings in the areas of professionalism and courtesy. There's more good news: 73% of your customers reported that they were more satisfied with HCFA now than they were two years ago.

We know that customer service is especially challenging for agencies like HCFA because of your heavy, but necessary, dependence on service partners to serve your customers. It's the same kind of challenge the major automobile companies are up against, where the vast majority of their services and products are delivered through their dealers. It's still their brand name that's on the line with their customers. Protecting your brand name means working closely with your partners to better serve Medicare and Medicaid beneficiaries.

Three years ago, HCFA reorganized itself to become more focused on its customers: health care plans and providers, states, and beneficiaries. And you are putting measures of how well they serve beneficiaries in to contracts. It was Medicare's recent beneficiaries who provided the feedback for the customer satisfaction survey.

In areas where you didn't score as well -- like making Medicare information more accessible and useful and helping beneficiaries with Medicare bills -- you're already moving aggressively to do better this year. Mike already mentioned a few of them:

  • Improving telephone customer service. I commend you for already applying specific customer satisfaction standards to your phone service.
  • Producing the Medicare & You handbook
  • Implementing the Vice President's Plain language Initiative
  • The REACH campaign -- Regional Education About Choices in Health
  • The Medicare Summary Notice
  • And using the MEDICARE.GOV and other Internet websites that give your customers the tools they need to make the right decisions for themselves and their families.
All these add up to a great beginning and a solid foundation to keep building on. But it's only that -- a beginning. It's important to keep the momentum going.

When the current reinvention effort began seven years ago, the Vice President promised that we could create a results-oriented government, and he was right. In 1992, just over a quarter of federal employees reported that their agencies focused on customer service. By 1998, that number had risen to 75%. Today, "customer satisfaction" is a catchphrase in the halls of government and we have a baseline measurement for it.

And after slipping to a disturbing low of 21% in 1994, the public's trust in government is on the rise again. It was back up to 40% in 1998.

Now that we have an objective and scientific government-wide measurement of customer satisfaction with federal services, we have a targeted goal: Scoring equal to or better than the private sector. That means raising the government's overall average score to at least a 73. HCFA is already close. And we're counting on you to lead the way again next time.

It's important to repeat the survey and show that we're making progress. To give you an idea of how serious we are about customer service, take a look at page 164 of the fiscal year 2001 budget. There, you will find the results of the customer satisfaction survey.

It says, in part, "Each participating agency has committed to improve its customer satisfaction in the coming year. The agency plans are available at the website In 2000 and 2001, agencies will repeat the survey and expand the services covered." HCFA's website - - by the way, has a direct link to the customer survey site.

Ladies and gentlemen, we might disagree on some things. But we all know if it's in the budget, it's for real. In my experience, I've found that it always helps to be armed with hard data. It gets people's attention and helps you win more battles than you lose.

The agency data is printed in the budget because we know there is a strong linkage between customer satisfaction and trust. These results mean that more Americans -- more Medicare beneficiaries -- are having the kinds of positive experiences that raise their trust and increase their feeling that government is giving them what they want and expect. HCFA, for example, scored a 74 on "trust" in the ACSI survey.

The results come at a time when the government is smaller than it's been since President Kennedy was in office -- proof positive that a smaller, leaner government can still deliver solid results.

More important, the survey is a "catalytic mechanism" -- a transforming agent -- that can help change government forever. NPR itself is in a transitional phase this year as we work toward outcomes that will hopefully make sure that reinvention as a concept continues forever. It means working with HCFA to help beneficiaries and to identify barriers to universal health insurance coverage for kids.

The most important lesson we've learned from this first-ever customer service survey is this: When we measure customer satisfaction using a third-party validator -- and share the results with the public - it gives us an extraordinary window of opportunity. It's our opportunity to move quickly on these and other fronts to improve America's trust in its government.

The customer service survey is NPR's signature initiative -- powerful, scientific evidence that our focus on customer service - going back to the beginning in 1993 - is working. It's a giant step forward in the Vice President's reinvention cause -- creating a government that works better, costs less, and gets results Americans care about.

But customer service also includes the way each of you handles written inquiries or answer the telephone. It begins at home. Each one of you has direct control over the way you interact with your colleagues and with the outside world. And that internal customer service naturally sets the stage for a focus on improving customer service to the beneficiaries of your programs.

When I was here last June, I repeated the old saying about how "the strength of a nation and its people can be measured in how they care for their parent, the aged, and the less fortunate."

Here at HCFA, you are charged with that awesome responsibility each and every day of your professional lives. Vice President Gore knows how important your work is to the people of America, because all of us -- our families, children, and parents -- are your customers.

So, on his behalf, I congratulate all of you for your commitment to your customers - the American people - and look forward to working with you to do even better year.

Thank you.

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