Solving Healthcare’s Biggest Challenges: Why Member Intelligence and the Member Journey Matter More Than Ever
Payors and healthcare leaders are experiencing shrinking margins, rising CAHPS/HOS pressure, and increasing member expectations. Predict Health just released new results showing how health plans are using member intelligence, AI, real-world data, and advanced analytics to improve Stars, reduce churn, and strengthen retention.
Arlington, VA, December 02, 2025 --(PR.com)-- Healthcare costs are climbing, resources are stretched, and every health plan faces a hard truth: member trust and engagement now directly determine financial performance. Margins are under pressure, and measures like CAHPS, HOS, and member retention have become as critical as growth. Many leaders are even consolidating and scaling back their Medicare Advantage footprints in high-cost or low-margin regions (Reuters). Meanwhile, early results of improved Star Ratings from leading industry organizations (MarketWatch) underscore how seriously these metrics are being prioritized.
At the same time, consumer expectations are rising. Members expect seamless experiences, personalized communication, and genuine support across every stage of their healthcare journey.
It’s no surprise that many executives are asking the same question: “Where can we find solutions that improve performance across the entire member journey?”
The answer lies in actionable member intelligence.
The Predict Health Difference
Predict Health (Predict) combines real-world data, advanced analytics, and AI to help health plans predict and stratify risk, prevent churn, create strategic growth, and drive measurable increases in Star Ratings, all while improving financial performance.
“Our clients don’t need another point-solution vendor; they need a partner who understands their goals, their pressures, and their members,” said Predict Health CEO, Mike Doyle. “When strategy aligns with the member journey, growth follows. We help health plans turn predictive insights into measurable improvements in quality, retention, and margin performance.”
Real Results That Drive Impact
When a Medicare Advantage plan struggled to improve member experience and boost its Star Ratings, Predict provided the predictive insights and strategic partnership to redesign key program elements. The result:
- 4.5 Stars achieved (vs. 3.12 market average)
- $9.8M in CMS Quality Bonus Payments (QBP) generated
- Recognition as the #1 market performer in quality and member experience
In another case, a health plan was missing a key segment at high risk for churn. Using Predict Health’s intelligence platform, the plan identified at-risk members and deployed proactive outreach, improving retention and achieving a 12.7x ROI on margin performance.
And when a Medicare Advantage plan needed to optimize its sales channel strategy, Predict accurately identified 94% of e-broker member churn before the annual election period (AEP), revealing actionable insights for smarter acquisition. The outcome: a 24.7x improvement in channel economics and significantly lower acquisition costs.
Turning Data Into Action
What sets Predict Health apart is not just the technology, it’s how Predict transforms complex data into clear, actionable recommendations. Predict Health’s platform employs advanced analytics and AI to build predictive models that optimize every phase of the member journey, from acquisition through retention and Stars/quality improvement.
For Predict’s clients, that means:
- Measurable gains in Star Ratings and quality performance
- Stronger retention and member satisfaction
- Sustainable growth and improved margins
For plan members, it means:
- Personalized engagement and improved access to care
- Enhanced benefits and better overall experiences
- A relationship that feels supportive, not transactional
The Future of Member Intelligence
Together, we can build sustainable margin, elevate your plan’s reputation, and create a future where every decision begins and ends with the member experience. Predict Health is the trusted partner to help you turn that vision into measurable results.
Learn more about the solutions and results: Predict Health Solutions
Media Contact
Predict Health, Inc.
Email: info@predicthealth.com
Website: www.predicthealth.com
About Predict Health
Predict Health is a leading healthcare intelligence company empowering payors and health systems with real-world data, AI, and advanced analytics to drive member acquisition, retention, quality, and Stars improvement. Our platform delivers actionable insights that improve member experience, optimize financial performance, and enable sustainable growth across the healthcare ecosystem.
At the same time, consumer expectations are rising. Members expect seamless experiences, personalized communication, and genuine support across every stage of their healthcare journey.
It’s no surprise that many executives are asking the same question: “Where can we find solutions that improve performance across the entire member journey?”
The answer lies in actionable member intelligence.
The Predict Health Difference
Predict Health (Predict) combines real-world data, advanced analytics, and AI to help health plans predict and stratify risk, prevent churn, create strategic growth, and drive measurable increases in Star Ratings, all while improving financial performance.
“Our clients don’t need another point-solution vendor; they need a partner who understands their goals, their pressures, and their members,” said Predict Health CEO, Mike Doyle. “When strategy aligns with the member journey, growth follows. We help health plans turn predictive insights into measurable improvements in quality, retention, and margin performance.”
Real Results That Drive Impact
When a Medicare Advantage plan struggled to improve member experience and boost its Star Ratings, Predict provided the predictive insights and strategic partnership to redesign key program elements. The result:
- 4.5 Stars achieved (vs. 3.12 market average)
- $9.8M in CMS Quality Bonus Payments (QBP) generated
- Recognition as the #1 market performer in quality and member experience
In another case, a health plan was missing a key segment at high risk for churn. Using Predict Health’s intelligence platform, the plan identified at-risk members and deployed proactive outreach, improving retention and achieving a 12.7x ROI on margin performance.
And when a Medicare Advantage plan needed to optimize its sales channel strategy, Predict accurately identified 94% of e-broker member churn before the annual election period (AEP), revealing actionable insights for smarter acquisition. The outcome: a 24.7x improvement in channel economics and significantly lower acquisition costs.
Turning Data Into Action
What sets Predict Health apart is not just the technology, it’s how Predict transforms complex data into clear, actionable recommendations. Predict Health’s platform employs advanced analytics and AI to build predictive models that optimize every phase of the member journey, from acquisition through retention and Stars/quality improvement.
For Predict’s clients, that means:
- Measurable gains in Star Ratings and quality performance
- Stronger retention and member satisfaction
- Sustainable growth and improved margins
For plan members, it means:
- Personalized engagement and improved access to care
- Enhanced benefits and better overall experiences
- A relationship that feels supportive, not transactional
The Future of Member Intelligence
Together, we can build sustainable margin, elevate your plan’s reputation, and create a future where every decision begins and ends with the member experience. Predict Health is the trusted partner to help you turn that vision into measurable results.
Learn more about the solutions and results: Predict Health Solutions
Media Contact
Predict Health, Inc.
Email: info@predicthealth.com
Website: www.predicthealth.com
About Predict Health
Predict Health is a leading healthcare intelligence company empowering payors and health systems with real-world data, AI, and advanced analytics to drive member acquisition, retention, quality, and Stars improvement. Our platform delivers actionable insights that improve member experience, optimize financial performance, and enable sustainable growth across the healthcare ecosystem.
Contact
Predict Health
Jessica Walder
1-888-802-4747
predicthealth.com
Jessica Walder
1-888-802-4747
predicthealth.com
Contact
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