Overview

• Overall member satisfaction dropped to 623 out of 1,000, down 29 points year over year, driven by a 39-point decline in trust in plans.
• Scores fell sharply for product fit and ease of doing business, down 33 points and 31 points respectively, according to J.D. Power.
• Only 38% of first-year members said their insurer met expectations versus 45% of established enrollees, citing problems finding in-network doctors and navigating deductibles and prior authorizations.
• High-performing plans show stronger digital engagement, with digital satisfaction averaging 98 points higher, portal use at 85% versus 76%, and website features rated very easy by 52% versus 40%.
• Financial and policy pressures frame the downturn, as UnitedHealth acknowledged underestimating medical cost trends and MedPAC projected $84 billion in higher MA spending this year, while leaders in select markets included Kaiser Permanente in California, UnitedHealthcare in Georgia and Excellus in New York.