Harder to Leave: Why Member Experience Is Driving Cost and Performance in Health Plans

More calls. More pressure. More disconnected steps across enrollment, onboarding, and member support. For many health plans, it doesn’t feel like one big problem it feels like everything, all at once. And over time, those breakdowns start to impact both member experience and cost-to-serve.

What’s Driving Rising Cost-to-Serve in Healthcare

Rising volume isn’t always new demand. It’s often repeat interactions members calling back because they didn’t get what they needed the first time. That leads to:

1. Higher call volume
2. Longer handle times
3. Increased operational cost
4. Strain on healthcare contact center performance

Why Member Experience Drives Performance

In health plans, experience directly impacts:

• CAHPS scores
• Star Ratings
• CMS funding
• Member retention

Every interaction shapes performance whether you see it immediately or not.

Where Things Start to Go Wrong

Most issues don’t start in the contact center. They start earlier:

• During enrollment
• During onboarding
• During member communication

When these moments aren’t connected, small issues repeat and costs build quickly.