Hey, well. Thank you to Robert. And welcome back everyone.
I hope you had a pleasant, if not short break. I'm excited to share with you, morning plenary presentation.
In this, pre recorded session, I had the pleasure of interviewing Ariel Faber.
To gain insights into our vision for a connected CMS customer experience. Ariel Fever currently serves as the first Chief Experience Officer for The Centers for Medicare and Medicaid Services, CMS.
She leads the design of consistent, connected. And sustainable care experiences delivered across the country with dignity. How are you the full scope?
Oh, CMS experience portfolio translating what the public and the agencies workforce need feel and value.
Into opportunities to co-create. Best in class products, services, programs and policies. Prior to this role, Area was a presidential innovation fellow.
At the General Services Administration GSA across 2 administrations where she led Federal wide initiatives focused on human-centered IT modernization.
Digital health and building the future. Oh, work through a culture of care. Earlier on, Ariel worked across a startups, small businesses, non-profits and corporations specializing in experienced design for healthcare and life services.
So, please enjoy this pre-recorded interview with Arya myself and I will do a rather quick wardrobe change in that in that time.
So we're gonna show you that, pre recording.
In the cloud.
All right. Okay, well, great to meet you, Ariel. If you'd like to make a quick introduction of your role, that will be fantastic.
This is this is a recording for our world usability day. And the topic is about collaboration and cooperation and Ariel Faber who is the CXO for CMS is join us today and if you as I said if you'd like to make an introduction that'd be great.
Thank you. Absolutely. Thank you so much Howard. So my name is Ariel Faber.
I am the Chief Experience Officer in the Office of the Administrator at CMS. And I'm so happy to be here to celebrate.
World Usability Day and talk about the broad theme of collaboration and cooperation and more specifically connect the dots between our customer experience efforts across the enterprise and beyond in federal government and this groups work.
So really excited to just jump in and see where the conversation leads. Excellent, thank you. So what to kind of, kind of kick us off here, I was kinda wondering, I know you've been, you've started this initiative that we've been involved in.
Could you talk a little bit about what that initiative is in terms of how you've had to collaborate across.
Pretty much the CMS enterprise. Absolutely. So I would say first off, just framing my role.
So I came into CMS. In about a year and a half ago, a little, a little more than that, I came in with the charge of establishing our enterprise-wide customer experience capability.
And to me, what that means is really just making sure that we're Making healthcare more human and it isn't a single initiative.
It isn't a single project or even a single product at CMS. It's How can we make sure that across the agency We are.
Ensuring the design of consistent, connected, and sustainable care experiences that are delivered across the country with dignity.
And there are a lot of words. In there, so I wanna break that down a little bit. So consistency, right?
What is unique about designing better experiences in healthcare and especially across the US. The ability to make sure that we are prioritizing safety at all times.
So that that term consistency to me we might also interpret especially in the context of our center for qualities work as a direct Connect with reliability and making sure that We are creating experiences that are consistent across all CMS products, services, programs, policies.
And embedded in that is that they are reliable. In terms of connected. This is a word that I think, you know, just as in terms of what we're delivering, it's how we're delivering.
So oftentimes We might hear the term digital health and to me. In the world of designing better care experiences where we across the CMS enterprise as well as in this broader healthcare ecosystem in the country.
We have a sense of a shared a shared understanding of what the different journeys are that people are going through when they're seeking.
Access to high quality affordable healthcare. So that might be early on, so to speak, in terms of accessing insurance.
It may be at the point of care, it may be well just because someone has insurance, are they able to actually use it and get the care they need in a given facility and then be able to go home and get that continuous support that they need.
Not only from a clinical care team, but with with a caregiver within the context of a family.
So that word connected to me is more than. The digital implications it's making sure just like I've said this to some folks I'm sure that are here today that we're operating more like a relay race rather than a marathon and we know where baton passes are that are here today that we're operating more like a relay race rather than a marathon passes are throughout a given system.
And then sustainable. So making sure that we are designing sustainable care experiences at CMS to me has multiple implications.
First off. When we think of sustainability, how do we make sure that anything that we are building is built to iterate and change with people's needs and anticipate their needs.
But built to last. And this I think is particularly important when we're talking about collaborating within and between components.
CMS, but then also across the agency and operating divisions of HHS and across government because if we are seeking to at the end of the day with in the early phase of a human center design process bake in the voices of the people we serve into everything we do and have that drive data-driven decision-making, we need to make sure that we are creating operational feedback loops that are sustainable to get
from the point of the voices of people we serve and also the voices of our own workforce to eat our own dog food to that point of using that information, translating it into actionable insights, identifying which insights are truly actionable from with CMS levers.
And then last but certainly not least, upon that implementation being able to
Close the loop with those that contributed their experiences and acknowledge We heard you, we were able to translate this feedback or we heard you and we weren't able to.
It because XYZ policy or operational challenge exists however we still are listening and we care about what you're saying.
So that is big picture when I think about what does it mean to do. Customer experience work at CMS and in healthcare, you know, top line is we have to always prioritize safety.
And then within that, we also have to make sure that if the care we're delivering is truly human and human and humane then that that last piece of delivering with dignity is really critical because regardless of where we sit at CMS.
It's not always about our direct interaction with a beneficiary or a consumer or a clinician, it's also how we treat each other.
We're a consumer or a clinician. It's also how we treat each other. And that might sound a little cheesy, today's celebration.
It's how do we make sure that just as we are trying to drive aspirationally towards the best health outcomes in the world.
How do we also make sure that how we are working aligns with what we are delivering and that how is absolutely through making sure that we are first and foremost operating as 1 one team, one CMS.
Regardless of geography, roles, responsibilities, etc.
Thank you. That's, very insightful. And then so with those examples of like, Kind of key elements.
What do you what have you noticed within that within your period of time in terms of like, what are maybe examples of How are you actually been able to, you know, on the road to achieving that, what if you could have noticed in terms of, you know, examples of collaboration and corporation across, you know, enterprises or within certain specific agencies.
I love that question and I appreciate the call out. Within CMS and then between other agencies. So.
My day today. Work is very, very dynamic. So no day is the same. And in working in an environment that is also hybrid.
That brings about Challenges and opportunities. So I would say when I first started in this role I was fully rerooded.
Many folks around me were fully remote and that actually opened a lot of doors in terms of and and reduce barriers to entry so to speak in various rooms across government so I feel very fortunate to have actually come into this work when I did because I think that, fortunate to have actually come into this work when I did because I think that that also made it a little more approachable than I did because I think that that also made it a little more approachable and a little easier to understand what was going on at the
same time a big challenge and something that I think being in person and being able to see and meet real humans in real life has done is afforded us the chance to also
Have a kind of multi-sensory, empathy building experience. So there's some things that when you're connecting with someone and whether it's through a workshop or through a briefing.
There are certain things you just pick up in a room and through a briefing. There are certain things you just pick up in a room and I want to acknowledge that too because I think a really key piece to the We are.
Working with topics that can sometimes be really sensitive. If we are talking about folks direct interactions with their health and healthcare.
Now, I also want to acknowledge there's there are plenty of areas across CMS where that's that we're not talking about that right we are looking to enable best in class care delivery and what that might look like, right?
We are looking to enable Best in class care delivery and what that might look like or feel like could be anything from migrating from physical data centers to the cloud being able to empower application developers in their work in making sure that we have safe and reliable infrastructure.
To even operate as an organization. To go back more directly to your question how Howard I think that there are a few examples that I found in ways of working that been really effective this year.
So first. I'm one of a handful of chief experience officers across government. So it is not lost on me that it is a small and mighty and growing group, but making sure that I'm building on what already exists.
So at CMS, one of the first things that we did at the enterprise level was recognized that this role has internally facing responsibilities and externally facing responsibilities.
I committed with our executive leadership team to really focus on the internal for the first year plus because I believe that if we have a culture that is carrying in collaborative internally and between components and we are on the same page about what we're driving towards that makes it then easier to be able to lean into our influential role at CMS in the broader healthcare ecosystem.
So the first activity that we really took on as an enterprise in this room that required a substantial amount of collaboration across components was establishing what is our CMS experience portfolio.
So to do that. It was a very iterative exercise of working with all human center design communities of practice.
All of the components. At the staff manager and executive leadership levels. As well as collaborators with CMS so contracting partners and also other federal, contracting partners and also other federal, agencies.
To help us frame out this, what has become the first iteration of a an experience. Accountability framework.
So we break it up into 2 pieces. Accountability framework. So we break it up into 2 pieces.
So part one is building customer experience capacity. That includes elements such as. Customer understanding. Customer experience measurement.
Culture and organization and these these examples I'm providing come from actually the office of management and budgets.
Customer experience capacity building assessment that they require annually all agencies and or operating divisions within departments conduct on an annual basis.
So capacity building at CMS. In our first year was really, really focused on, and I hate to use the word governance, but on governance, helping us understand where is there really fantastic work already happening in user research in Measuring to drive results on the delivery front, but also in how we are working.
There are folks across CMS that are really, really good at codifying and documenting what themes that we're seeing across different, customer segments, so to speak.
So that really was year one on capacity building. Going forward as we're in. Fiscal year, 2024.
The focus this year is all about CX measurement. So we want to drive the agency towards In a direction where regardless of what our maturity is at in divisions and components as an agency we have some shared by the end of the year some shared objectives and queue results.
And some shared ways of measuring. Not only to what extent did we incorporate the voice of the people we serve into what we do every day.
And that is inclusive of our workforce. But also what changed and how are people's lives better, ideally.
And that's a really tall order, right? But. By shifting from kind of that initial focus on overall, what does it mean to even build capacity at CMS and customer experience last year to this year where we're focused really on measurement.
The hope is that that also brings folks together around something that is a common theme. The one other element I will add here is kind of the part 2 facet of the CMS experience portfolio which is focused on CX delivery.
So that is that in year one was broken into 3 categories and we've evolved since then. So when we first started.
Customer experience delivery meant really everything that the public sees and interacts with as opposed to kind of the meta-layer that we're all building of how we do this.
So it's the what versus the how. In the delivery bucket, we've got 3 areas.
First, inter-agency life experiences. So a lot of that work is around how we can boldly shift how we operate across the federal government from a place of individual beneficiaries or families.
Seeking services and having to go to different agencies. To an operating model where the government anticipates the moments that matter in someone's life where they are most likely to need services and dare I say bundled, you know, integrated benefits.
That are easy for folks to find so In my first year at CMS. Across the enterprise.
We were we were also working in close partnership with operating divisions across HHS and beyond around the 3 life experiences of approaching retirement.
Facing a financial shock. As well as having a child in a low income household and what that upbringing looks like from birth to 5.
The second delivery area that we focused on. In our first year. With this model. Where customer experience commitments.
So these are commits that were established by SCX executive order in, 2,021.
And so this was a way of saying across the Department of Health and Human Services, how can we drive towards better experience delivery.
With the policy levers also that we have available to us. And then the third delivery bucket. Is one that some of you may be familiar with, some may not be, and they're called hisps or high-impact services.
So CMS is really unique in customer experience across government because we hold the keys so to speak. To leading 3 high impact services, Medicare.
Gov, meta-kiduv, and healthcaregov. And the why it matters is Hi impact services were selected by executive leaders across.
The federal government, including the president's management, the president's management council. To ensure that We are putting particular emphasis on improving how the public interacts with some of our, highest.
Programs and services so The key takeaway here for all of our delivery areas is These are the places that touch points, the journey phases that the public is most likely to associate with their lives.
That may not mean that they even know CMS. Is in from a service blueprint model right behind the scenes enabling or trying to improve each touch point.
But that is kind of how our capacity building and why we've even care about bringing the voice to the customer into what we do connect with then what we deliver.
One other thing I'll say here is as we focus this year on CX measurement. This is not only at CMS, but across the Department of Health and Human Services.
As well as across government as we think about health and healthcare. So. When we are looking at delivery.
I believe that it's not solely about, frankly, these. These. Initiative or discrete activities that may or may not get a press.
So folks may or may not be familiar with the delivery items I mentioned are found on performance. Gov I think slash CX.
They're very they are public-facing. But at the end of the day. Each day in each interaction we have on our, but on our discrete product services programs, etc.
Our opportunities where we can still bring that perspective of What would this mean for a family member? What would this mean for someone out in the world?
Would they even know that this work is happening? And if the answer is yes, that's great.
If the answer is no, that's okay too, but. Being able to recognize when we're building our muscle as an agency and our capacity.
In collaborating towards shared identification of user needs. And identifying levers that we have to address those is really a new way of working.
And it will take practice. So my hope is that that is where we head this coming year. Excellent.
Thank you, Ariel. That's appreciate it. Just kind of wondering, you know, kind of building on what you, set there.
You know when you discuss the sit kind of the CMS folio and you know one of the one of the first task was really about like I suppose you know as a CX, expert, you're kind of, you want to understand what's the what's the landscape before I touch it you know looking at the environment as it stands and you said you spoke about a few things under the first initiative which
was We need to do with capacity. Culture. You know, understanding metrics, whatever there's and I'm obviously identifying some of those kind of Really good examples of, you know, good teams and I'm.
I know like with any kind of culture there are some great examples of good teams that really work well. What examples of you seen or notice in terms of either in specific agencies?
Or you know teams they're off Oh, what you've seen like, you know, good kind of collaboration.
And then what, what kind of expressions were those? Of good collaboration? What did what did you experience?
That is a really insightful question. So. Something that I've noticed, especially in the last say 3 to 5 years at CMS, is this.
Proactive and intentional movement towards this one CMS model, right? It's not.
It's not just words, it's also a really intentional effort at every level. The agency to live into it.
Recognizing their tensions, right? It's really hard to show up as one agency. When you have such a large workforce such a diverse portfolio of work and So I wanna acknowledge that.
That one CMS mentality. To to actually live into it. I think this is where that role of better workforce experience also fits in.
So some of the intentional. Ways in which our agency and this is bottom up so to speak and top down has self organized to make collaboration easier includes our communities of practice which are not actually solely around human-centered design, right?
However, I will give credit and kudos to those center that those. I mean, of practice because they actually then influenced the development and establishment of communities of practice around artificial intelligence around data and around a number of other topics and has really influenced how CMS works.
The second layer. That I would say is kind of how we organize to collaborate more effectively. Is in our, centers of excellence.
So acknowledging that CCSQ has the first center of excellence around human-centered design that really motivated and made it possible to then say from the Office of the administrator perspective, what does this look like?
At the enterprise level? How can we elevate what CCSQ has already learned and and what's working, what didn't work.
To drive the whole agency together towards some. Clear capacity building tools, techniques. Support structures.
Another layer that we have at CMS in terms of effective collaboration and kind of breaking down barriers and silos.
Is through our strategic blueprint process. So this actually is something that is driven through our office of strategy performance and results in the It is a way in which to look across all components.
Particularly with senior leadership and say, what are we all measuring towards what are we driving towards that is not solely about one component.
So how this translates, especially at the staff and manager level is through. What we've called in Cm's.
A public facing strategy with key pillars and initiatives are the initiatives. They are called cross cutting initiatives or CCIs.
And there are 3 CCIs that are particularly critical and have been in the last couple of years to driving forward better customer experience.
And stakeholder engagement more broadly. So the first one is around elevating stakeholder voices. The second is around.
Driving a data-driven decision making. And then the third is around the 3 M's or integrating the.
The operations and collaboration and awareness. Between Medicare, the marketplace, and Medicaid. So those are just 3 examples from a CCI perspective, but wanted to share that because all that is on TMS.
Dot gov. We may not always. Again in our communities day today as we're doing this work.
Have that moment to ask ourselves why does this matter or how does this fit into a bigger picture. I would say one other lever that we have for structured collaboration at CMS beyond these.
Communities of practice centers of excellence and cross-cutting initiatives. Are in the less.
I wanna say this is almost like the less formal side, right? But how folks are reaching out to each other between divisions, groups and components.
For support. So what we found as we've been standing up the first CMS customer experience center of excellence for the enterprise and as we've been doing that and trying to also.
Share what we're learning across HHS, we found that not just at CMS but even across operating divisions across our sister organizations like NIH, FDA, CDC, a lot of us are asking similar questions.
How do we make it easier to share actionable insights from the perspective of a research repository.
What does it mean to reach
A product or solutions. Best version of itself is it totally through satisfaction are we also measuring trust and those sorts of questions are not unique to CMS so being able to leverage the delivery facets of our portfolio.
So to speak, I mentioned those life experiences even. Those have been spaces where I like to think of it as never go into a meeting alone, right?
And I try not to think of it as never go into a meeting alone, right? And I try not to do that.
How do we make sure? I like to think of it as never go into a meeting alone, right? And I try not to do that.
How do we make big or small of something that we're working on together. Excellent. Thank you.
That's very insightful. I think, probably have maybe a couple more questions. One question is obviously, you know, through the experiences of, collaboration, you know, across the enterprise.
You know, one thing, you know, in human-centered design and from any kind of human experiences such that, you know, we always have challenges and barriers.
And you know pain points as we as we prescribe them. What have you noticed in terms of What are some of those kind of pain points not just like internally as you may have experienced, but also like, you know, aspects or attributes from an external standpoint from our customers itself.
So this kind of an A and B part of that question. What have you seen kind of internally?
And then what have you noticed are some of the barriers to a for our kind of a US citizen customers.
And just to clarify, so more stressors. As it relates to the actual experience of. Of care delivery and or also on the collaboration front kind of the way of working.
So I'll actually take the first one and acknowledge, you know, One of the
One of the biggest challenges in even talking about establishing voice of the customer programs or making sure that the Bringing the voices of people we serve is embedded in every facet of what we do.
There are a few stressors that I hear frequently from. Folks across CMS as well as at other agencies.
Some of the stressors are. It takes so much time and effort to get those voices in the room, right?
So as an example, a paperwork reduction act is often referenced as, oh man, the barriers to entry, so to speak, are really tough.
How do I know when to go through a certain process? So that was actually last year, one of the first areas that with these emerging CX centered excellence at CMS we tackled over the course of 6 to 8 months where we did a deep dive of how customer experience and paperwork reduction act intersect at CMS.
And put together a playbook for how folks at least that are within the CMS ecosystem could better navigate that process.
So that's an example where there was a stressor. This was identified by many staff. By many design researchers but also by folks.
On the policy side of the house saying, you know, well, where's this feedback coming from, right?
And how do we use it? And that was something where there's always more work to do, but I'm really proud of.
The team that had that worked to do but I'm really proud of the team that had that worked on that that was particularly in collaboration with Osora and the team that had that worked on that that was particularly in collaboration with Osora and the digital service at CMS.
Another stressor that has come up. Has been. How do we How do we make sure that when we are gathering feedback, qualitative or quantitative?
That it is funneled to the right place at the right time. So at CMS, this is a stressor and it has been a stressor because we actually do so much broad stakeholder engagement whether it's the open door forums, whether it's through listening sessions.
In the field research. There are many, many ways that we are. Doing our best to not only listen actively to what communities are saying and what they need.
But also internally trying to further engage our workforce and the people we work with in helping to drive. You know, what our day to day work experiences like.
And I think what we found there is It's really important to be clear on number one. Why is the feedback valuable number 2?
What decisions do we hope that feedback will inform? And number 3, what are the constraints? Of the feedback as we're receiving it because This is.
Relevant both internally and externally that on the one hand We are saying and I am championing that we need voices of the people we serve at the table.
And that nothing about us without us that comes from the disability community at the same time we really need to make sure that folks are feel heard and are being heard on issues that they truly can move the needle on.
So I'll acknowledge as an example. You know, there are at the end of the day certain laws or policy constraints.
Around what CMS can and can't do. So we may identify a stressor that beneficiaries may have in their day-to-day lives.
And it's not that we don't wanna make that difference. It's that it's simply not within our our levers.
That doesn't mean that we don't do anything. Necessarily. We then have a choice, you know, is it actually better to acknowledge the feedback and say, you know, this actually isn't in our wheelhouse.
And or can we route it to an appropriate team? That team may be in another agency. So hopefully those are 2, concrete examples.
I will also acknowledge, you know, as an agency, I think we work really hard to. To recognize the stressors as they come and prioritize them.
So in my job It's a work in progress, but another item that I took on early on last year was trying to Elevate some of these common stressors and prioritize them almost like in a backlog, right?
How do we have an enterprise-wide backlog around experience. So that we acknowledge what we need to do, what we need to fix, what we can fix, and then also recognize that it can all happen at once.
And so I really appreciate the patience of the community here today, especially as it relates to I think a realm that is very, very, tightly tied to better experiences, which is around inclusively and beyond usability accessibility and making sure that We are bringing the principles of.
Having all of our all of our artifacts and the work that we are producing in an accessible fashion so that everyone can access what we the work the process just as much as the outputs of our design work the process just as much as the outputs of our design work in particular.
One other thing I'll say on that is you know. Almost a way to put the bow on everything we've been talking about.
Whether you use the word customer stakeholder beneficiary, consumer, employee, partner. All these words are ways to simply say we're trying to care about each other and make that care materialize.
In a way that people. Can see the differences can feel the differences and can.
It can see what they value. Is being acknowledged. In our workplace and I think that if we are consistently going into every room that we work in together with that mindset of with the person who's sitting or standing in front of you, you know, how can we support each other?
How can we make each other say a little bit better? That is actually a way of building a habit.
That ultimately drives really big change and optimism. Thank you. Thank you, Ariel. That's a that was a good, final statement.
Thank you very much indeed. So, I don't have any more questions. You've answered everything I have.
So I'd like to thank you very much for your participation today. Our world usability day.