Rob Lourenco, VP of Client Services –

After two back-to-back years of substantial disruption in the Medicare Advantage market, the first quarter of 2026 has already brought us signals that the next year isn’t going to be any different. Executives at UnitedHealthcare found the 2027 rate proposal “profoundly negative” and stated that meaningful benefit reductions and reduced choice may be necessary next year. Elevance Health CEO stated that if funding doesn’t keep up with medical costs, they may be forced to exit geographies. CVS Health (Aetna) also may potentially shrink their footprint to protect margins in 2027. Granted, the final rate notice did announce a higher 2.48% payment increase for 2027, it is clear we are in an era where financial stability is taking precedence over growth.

Of course, there are various levers carriers have that can impact their revenue. Benefit design, disease prevention and care management for example, all have a role to play. Another one is Star rating, and the quality bonus payments insurers receive for achieving a rating of 4 stars or higher. One critical measure in the Star program is the overall health plan rating question. This is where consumers are asked how they would rate their health plan on a scale of 0 to 10. This question, along with a list of other measures, all come together to produce a Star rating that determines whether a carrier will receive bonus payments valued into the millions.

Deft Research’s Medicare Member Experience Study last year conducted a health plan rating driver analysis. In it we honed in on the factors most impactful to the overall health plan rating question. Two metrics in particular rose to the top as having an outsized impact on this measure: satisfaction with the carrier’s help in understanding coverage and satisfaction with the carrier’s help in using coverage. These two questions had the largest impact on how a consumer rated their health plan by a substantial margin. And why is that?

Medicare coverage can be quite confusing to the average senior. And there is a persistent narrative in the market that singles out insurers as the villain in the healthcare system. However, when carriers are seen as going out of their way to help their members understand and use their coverage, this narrative is flipped on its head. Consumers get better outcomes because they better understand how to navigate a complicated system and carriers are seen as their partners (not opponents) in that process.

As insurers look to right their financial ship while navigating turbulent market waters, this needs to be one of the tactics in the playbook. Helping our members use their coverage isn’t just right for the consumer, it’s also good for business.