Mastering Retention, Member Satisfaction, and Long-Term Resilience

Every health plan leader shares a common goal: Ensure easy, affordable access to healthcare. But with policy changes, rising costs, and shifting member expectations reshaping the industry at a rapid pace, achieving this goal is more complex than ever. One thing remains certain though, to succeed, health plans must stay relentlessly focused on improving the experience for those that rely on their coverage. 

In our latest webinar, Elena McFann and Jeff Yaniga shared insights on three critical challenges shaping health plans today and what “great” leaders are doing differently:

 

(1) The Growing Wave of Medicare Advantage Switching

Member movement in Medicare Advantage is accelerating—and it’s no accident. Medicare Advantage plans have created a competitive landscape that benefits members—offering greater choice, flexibility, and innovation in plan design. Each year, members evaluate their options during the shopping season, and plans are continuously evolving to attract and retain enrollees. 

For health plans, this means retention must be an active strategy.  

How leading health plans are staying competitive: 

• Designing member-centric, sustainable plans that drive long-term loyalty and satisfaction 

• Leveraging automation and a single source of truth to streamline operations, lower costs, and ensure accurate, timely member communication 

• Making it easier for members to access care and understand what’s covered—giving them confidence and trust in their choices

 

(2) Member Satisfaction—The Alignment That Drives Real Change

A positive member experience isn’t just a differentiator—it’s a business driver. Satisfaction impacts retention, Star Ratings, and financial performance, making it a top priority for leading health plans. 

Yet, many health plans struggle with disjointed processes, outdated systems, and unnecessary friction points that frustrate members. When members feel uncertain about their coverage or struggle to access care, they are more likely to switch plans. 

What top plans are doing differently to strengthen member satisfaction: 

• Investing in automation to streamline key processes such as enrollment, ID cards, and benefit updates – reducing delays and errors 

• Using data-driven insights to proactively address member needs before they escalate to dissatisfaction 

• Creating seamless experiences to ensure members always understand what is covered and how to access care 

But what does it take to actually move the needle? Building a culture of accountability that drives better results for both the organization and its members.

 

(3) The Uncertainty of a New Administration—Why Scenario Planning is Critical

With every election cycle; health plan leaders know change is coming. The question isn’t if policies will shift—it’s how quickly and in what direction. 

The best health plans aren’t waiting to react. They’re proactively preparing for multiple possible outcomes, ensuring they’re ready to adapt and lead regardless of policy changes. 

How top plans are approaching scenario planning: 

• Identifying potential policy changes and assessing their impact to prioritize preparation 

• Developing multiple strategic pathways to remain flexible and competitive in various scenarios 

• Building agility into operations so regulatory shifts don’t disrupt service delivery or member experience 

Health plans that invest in adaptability will not only avoid disruption but also seize new opportunities as they emerge. 

 

Want to hear directly from industry experts about what’s working? 

Watch the on-demand webinar now.