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MA plans score 200 points below other industries on digital satisfaction. AI is changing that.
Last updated: October 2025
Health plan members expect digital experiences that match what they get from their banks, retailers, and streaming services. But the industry isn't keeping pace. Medicare Advantage and Medicaid plans consistently score below other sectors on digital satisfaction, with clunky search and navigation driving much of the frustration.
The gap represents both a problem and an opportunity. When members can quickly find what they need—whether that's a specialist, a claim status, or plan details—satisfaction scores jump dramatically and renewal rates follow. At the same time, healthcare organizations are pouring resources into AI, with the global AI in healthcare market projected to reach between $21.7 billion and $39.3 billion in 2025.
Here are five data points from recent industry research that show why getting digital right matters now, and how AI can help close the gap.
J.D. Power's 2025 digital satisfaction benchmarks reveal a significant gap. Commercial health plan mobile apps scored 653 out of 1,000, while Medicare Advantage plans scored even lower at 597. Compare that to wealth management apps at 794, property and casualty insurance at 700, or automotive finance apps at 672 (J.D. Power 2025 Digital Experience Study).
Why it matters: Members judge your digital tools against the best apps they use daily, such as their banking apps, Amazon, their favorite streaming services. When your app falls short, it erodes trust in the entire member experience and creates friction at every touchpoint.
The dissatisfaction stems primarily from poor search functionality and confusing navigation. Members struggle to find in-network providers, understand their benefits, or track claims—all fundamental tasks that should take seconds, not minutes.
Research shows that when members can easily locate the information they need—finding an in-network provider, understanding benefits, checking a claim—satisfaction scores increase by 83 points. Yet approximately 39% of health plan digital properties fail to deliver this basic capability (J.D. Power 2025).
Why it matters: Search and navigation aren't "nice to have" features. They're fundamental to member satisfaction and directly influence whether members feel their plan is working for them. This is the single highest-impact improvement most plans can make.
Think about it: A member's most common need is finding a doctor who accepts their insurance and is taking new patients. If this takes 15 minutes of clicking through outdated provider directories with multiple dead ends, you've already lost that member's confidence, even if your coverage is excellent.
Among Medicare Advantage members whose digital experience scores reached 801 or higher, 85% said they would "definitely" renew their plan. That's more than double the renewal intent of members whose plans scored below 500 (J.D. Power 2025 Medicare Advantage Study).
For commercial plans, members with satisfaction scores of 801+ were 58% more likely to view their employer favorably. This creates a halo effect that benefits both the plan and the employer.
Why it matters: In Medicare Advantage's competitive landscape where members can switch plans annually, retention is everything. Digital experience isn't just an operational concern—it's a direct revenue driver. The math is simple: improving digital satisfaction from 597 to 801 could potentially double your renewal rate.
Consider the economics: acquiring a new Medicare Advantage member costs significantly more than retaining an existing one. Every percentage point improvement in renewal rates drops directly to the bottom line.
Global AI spending reached $500 billion by the end of 2024, up 19% year-over-year. Healthcare is leading adoption growth at 38.5% in 2024, the fastest rate among major industries.
A 2024 MGMA poll found that 43% of medical groups had begun or expanded AI use, up from just 21% in 2023. Among organizations not yet using AI, 45% planned to implement tools within the next year.
Why it matters: Plans that invest now in AI-powered search, intelligent navigation, and personalized member guidance can leapfrog competitors still relying on static directories and basic search functions. Those who wait risk falling permanently behind as member expectations continue to rise.
The technology has matured rapidly. AI can now understand natural language queries like "endocrinologist near me who takes new patients and has weekend hours," deliver accurate results in seconds, and learn from member behavior to improve over time.
A 2025 study on Medicaid digital access revealed persistent challenges: inconsistent internet connectivity, low awareness of available digital tools, and inadequate assistive technology for members with disabilities.
While AI-powered solutions—like conversational interfaces, intelligent search, and accessibility-focused design—could bridge these gaps, the technology alone isn't enough. Thoughtful, equity-focused implementation is essential.
Why it matters: AI presents a real opportunity to serve underserved populations better, but only if plans pair the technology with inclusive design and genuine accessibility efforts. Medicaid members often face the highest barriers to care, and digital tools should lower those barriers, not raise them.
Conversational AI interfaces can help members with lower digital literacy navigate complex systems. Voice-enabled search assists those with visual impairments. SMS-based notifications reach members without reliable internet access. But these solutions only work when designed with actual Medicaid member needs in mind, not retrofitted from commercial plan tools.
These statistics point to a clear conclusion: health plans need to dramatically improve their digital experiences, and AI offers practical tools to do it. But not all AI implementations are equal.
The most impactful use cases directly address the navigation and search problems driving member dissatisfaction:
Here's the challenge: while AI adoption is accelerating, many health plans are investing in AI without addressing the fundamental digital experience problems that frustrate members.
Adding an AI chatbot to a website with poor navigation doesn't solve the underlying problem—it just adds another tool members must learn. The winning approach connects AI directly to member pain points:
Instead of: "We implemented an AI chatbot"
Focus on: "We reduced provider search time from 8 minutes to 45 seconds using AI-powered natural language search"
Instead of: "Our app now has AI features"
Focus on: "Members can now ask questions in plain English and get accurate answers about their coverage"
The plans that will win in 2025 and beyond are investing in AI that makes members' lives measurably easier and solves the specific problems (navigation, search, accessibility) that drive dissatisfaction.
Medicare Advantage plans score 597 out of 1,000 on average according to J.D. Power's 2025 Digital Experience Study. This is significantly lower than commercial health plans (653) and trails other industries like wealth management (794) by nearly 200 points.
The primary drivers of dissatisfaction are poor search functionality and confusing navigation. Members struggle with basic tasks like finding in-network providers or understanding their benefits—tasks that take seconds in banking apps but minutes (or longer) in health plan apps. The complexity of healthcare information, combined with outdated provider directories and unclear benefit explanations, creates unnecessary friction.
Digital experience directly impacts retention. Medicare Advantage members with satisfaction scores of 801 or higher are 85% likely to renew their plans—more than double the renewal rate of members whose plans score below 500. For commercial plans, high digital satisfaction also improves employer perception.
The most impactful AI tools include: intelligent provider search that understands natural language, conversational interfaces that guide members through complex processes, proactive notifications based on utilization patterns, accessibility features that adapt to member needs, and automated provider data quality management that keeps directories current.
While comprehensive digital transformation can take 12-18 months, focused improvements to search and navigation can show results in 60-90 days. The key is prioritizing the highest-impact changes: provider search optimization, simplified navigation, and mobile experience improvements.
The ROI comes from multiple sources: increased member retention (reducing costly acquisition), higher Star Ratings for Medicare Advantage plans (driving bonus payments), reduced call center volume (members self-serve instead), and improved employer satisfaction for commercial plans. Plans that improve satisfaction from 597 to 801+ could potentially double their renewal rates.
Successful Medicaid AI implementations require: mobile-first design (many members access services primarily via phones), SMS/text-based options (for those without reliable internet), voice-enabled interfaces (supporting various literacy levels), multilingual support, and genuine user testing with actual Medicaid beneficiaries—not assumptions based on commercial plan members.
At Leap Orbit, we've seen firsthand how outdated, inaccurate provider data drives member frustration. When a member searches for "cardiologists near me" and gets results showing doctors who retired two years ago or aren't accepting new patients, that's not just a technical problem—it's a trust problem.
Our AI-powered provider data management solutions address the root cause of poor search and navigation:
Real-Time Data Quality: We continuously monitor and verify provider information, ensuring members get accurate results every time they search. No more calling three offices only to find none accept their plan.
Intelligent Search: Our natural language processing understands how members actually search—"pediatrician near me who speaks Spanish" or "orthopedist who takes evening appointments"—and delivers relevant results in seconds, not minutes.
Seamless Integration: Our solutions integrate with your existing member portal, mobile app, and website, improving the experience without requiring members to learn new tools or interfaces.
Accessibility First: We build with WCAG compliance from day one, ensuring members with disabilities, lower digital literacy, or limited English proficiency can easily find the care they need.
The result: member satisfaction improves, call center volume decreases, and renewal rates increase—measurably and sustainably.
Schedule a consultation to learn how Leap Orbit can help your plan deliver the seamless digital experience members expect and deserve.
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