Medicare Advantage Headwinds: Why You Should Proactively Engage MA Plan Members

Christian Bagge, VP of Payer Strategy

To say there is a lot going on within Medicare Advantage these days would be a massive understatement. In my role of payer strategy here at Get Well, I recently attended the 14th annual Medicare Star Ratings, HEDIS®, Quality Assurance and Risk Adjustment gathering a few weeks ago in California, where many of these headlines – and headwinds- were discussed. Starting with the 2025 Final Ruling released in April and continuing through the recent legal victories by SCAN and Elevance Health, change is definitely in the air! When you add the fact that there is a Presidential election happening in November, uncertainty rules the day. 

One thing that will remain constant, no matter what happens, is that members will still be members. They’ll continue to have needs, questions, and expectations of their Medicare Advantage (MA) Plan. With that being the case there is also an opportunity for MA Plans to communicate what is happening, how they are addressing these changes, and what that impact will have on a member level. 

I believe strongly in getting out in front of something and anticipating the question before someone gets a chance to ask it. MA plans should use this time to provide “value” to your members by educating them. They’ll likely appreciate this tactic as it is outside of the standard “why is this bill so high” or “please schedule your screening” questions and conversations that typically happen between members and plans.

By taking the initiative to get out in front and communicating these changes in plain language, you are giving members a level of empowerment through education. They will appreciate it and MA plans can use this as an opportunity to showcase all of the positive things that members will see in the future. Better access to Behavioral Health services, help with finding resources that will meet their SDOH needs, improved supplement benefits, amongst others.

Yes, change is hard and uncertainty isn’t comfortable for an MA Plan or their members. Look at all that’s happening as an opportunity to better connect with your members by letting them know that you have their back, are here to walk with them through whatever happens next and will be making decisions with their best interests in mind. They’ll thank you for it!