EmblemHealth, Doctors HealthCare Plans, Security Health Plan, & MedOrion: Rethinking CAHPS & Member Experience

In this Bright Spots in Healthcare episode, host Eric Glazer brings together payer and strategy leaders to explore a fundamental challenge in Medicare Advantage: why improving experience is not about measuring more, but managing better.

This conversation focuses on where performance is actually being lost across the member journey, not within individual programs, but in the gaps between them. Plans continue to invest in outreach, pharmacy, provider engagement, and member services, yet still struggle to translate those efforts into consistent member action and measurable outcomes.

This is a candid discussion for executives navigating rising expectations around experience, increasing pressure on Stars performance, and the need to deliver results through coordination, not just activity.

 

Our guests include:

• Dan Knecht, MD, Chief Medical Officer, EmblemHealth

• Stacey Friedman, Senior Director, Quality & HEDIS/Stars, Doctors HealthCare Plans

• Paula Jacobson, Director, Quality and Population Health, Security Health Plan

• Dave Burianek, Chief Strategy Officer, MedOrion 

 

Together, they explore:

• Where member experience breaks down across the journey, especially in the moments immediately following enrollment

• Why campaign-based outreach is no longer sufficient to drive engagement or outcomes

• How leading plans are shifting from volume to sequencing, focusing on the next best action rather than multiple simultaneous asks

• What it takes to align pharmacy, quality, and member experience into a coordinated system

• How organizations are improving performance by reducing friction, increasing clarity, and guiding members toward action 

This episode offers a practical look at how leading plans are rethinking CAHPS as a reflection of the full member journey, and what it takes to design that experience in a way that consistently drives performance. 

Panelist Bios: https://www.brightspotsinhealthcare.com/events/beyond-the-survey-how-medicare-advantage-plans-are-rethinking-cahps-and-member-experience/

Download the Episode Guide:
Get key takeaways and expert highlights to help you apply lessons from the episode. Download guide: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/April_16_Episode_Guide.docx.pdf

Key Insights Summary:
Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation, https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/04/04-16-26-KIS-Beyond-the-Survey-Session.pdf

Resources: 

Report: Redesigning Experience: Why CAHPS Performance Is Won or Lost in the Member Journey

This report examines why Medicare Advantage plans often see CAHPS results that don’t reflect the effort they put in. The issue is not a lack of activity. It’s that CAHPS reflects a year’s worth of member experience, shaped by care access, coordination, navigation, and follow-through, not isolated interactions or last-minute interventions.

Drawing on real-world examples, the report shows how improving underlying care events like annual wellness visits, redirecting care to the right setting, and strengthening member understanding directly influences CAHPS performance, and why results cannot be changed at the end of the measurement year.

Inside, you’ll find insights on:

• Why CAHPS questions act as proxies for clinical events like annual wellness visits and care coordination

• Where campaign-based engagement models fall short in shaping member experience

• How friction accumulates across touchpoints and impacts perception long before the survey is fielded

• What changes when plans shift from disconnected outreach to coordinated, journey-based design

• How aligning Stars, quality, and care delivery reduces fragmentation and improves outcomes

• Why understanding member barriers, including access, confusion, and behavioral factors, is critical to driving action

The broader lesson is operational: plans that consistently perform on CAHPS are not doing more outreach. They are designing member journeys that reduce friction, coordinate care and communication, and naturally produce better experiences over time.

To request your copy of the report, please contact show producer Jessica Tenzer at [e-mail].

Thank You to Our Episode Partner, MedOrion:

MedOrion helps health plans move beyond static segmentation by using real-time clinical, situational, and behavioral signals to drive meaningful member action. By identifying who to engage, what barriers exist, and when to intervene, MedOrion enables more precise prioritization and coordination of outreach. This approach helps close care gaps, improve adherence, reduce avoidable utilization, and drive more consistent performance across cost, quality, and experience. Learn more at medorion.com. 

Schedule a Meeting with a Senior Leader at MedOrion: To explore how MedOrion can support your organization in moving from campaign-based outreach to coordinated, signal-driven engagement, reach out to show producer Nicole Roberts at [e-mail] to schedule a conversation with a member of the MedOrion leadership team. 

 

About Bright Spots Ventures:

Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.

 

We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.