Why Member Support Is the Backbone of Health Plan Performance

Member support isn’t just a service function — it’s a core driver of how healthcare plans retain members, boost Star Ratings, and grow enrollment. In today’s healthcare environment, where patients expect both clinical care and exceptional customer service, your ability to deliver timely, compliant, and compassionate support can make or break your plan’s success.

Let’s break down how member support directly impacts your performance metrics and why outsourcing it may be the smartest move you can make.

Member Experience Drives Retention and Loyalty

Members who have a positive experience with your support team are more likely to stay. They remember how easy or difficult it was to resolve an issue, understand their plan benefits, or schedule an appointment.

• Friction in support = frustration. Long wait times or poor resolution quality leads members to explore other plan options.

• Ease equals trust. When members can quickly get help — whether via phone, email, chat, or SMS — it builds confidence in your organization.

  
  

Outsourcing to a partner with multichannel capabilities and trained healthcare agents ensures consistent, empathetic service delivery — especially during high-volume periods like open enrollment.

Star Ratings Depend on Service Quality

For Medicare Advantage and other CMS-rated plans, customer service is a core metric in the Star Rating system. Poor support can directly lower your Star Rating, limiting your ability to market to new members and qualify for quality bonuses.

Outsourcing your contact center to a HIPAA-compliant, healthcare-focused partner helps ensure:

• Professional, timely interactions

• Fewer dropped calls or unresolved tickets

• Member satisfaction scores that reflect quality support

And higher Star Ratings mean greater visibility, better reimbursement, and increased enrollment.

Operational Efficiency = Competitive Advantage

Many in-house teams struggle to scale during peak demand — especially with workforce shortages and rising admin costs. By outsourcing member support, you gain:

• Scalable capacity during open enrollment or plan changes

• Advanced technologies like AI chat and smart routing

• Data insights to refine processes and improve first-contact resolution

This allows your internal staff to focus on strategic goals while your outsourcing partner handles the day-to-day interactions.

Outsourcing Member Support = Better Performance Across the Board

When done right, outsourcing doesn’t mean sacrificing quality — it means elevating it. A strategic partner like Magellan Solutions USA provides customized contact center solutions that:

• Enhance member satisfaction

• Reduce costs and overhead

• Ensure full HIPAA and CMS compliance

• Help you meet and exceed quality performance standards

Whether you need help navigating open enrollment, managing claims calls, or improving retention, outsourced support turns customer service into a measurable business asset.

Ready to Strengthen Your Member Support?

If your health plan is ready to elevate member satisfaction, increase Star Ratings, and unlock operational efficiency, it’s time to explore outsourcing your support services.

Learn more about Contact Center Outsourcing for Healthcare Plans →