A leading U.S. health insurance provider serving over 39 million members, employer groups, and businesses, offers high-touch support for both inbound and outbound calls to assist members with benefits, claims, and care coordination.
In 2023, the client’s member satisfaction experienced a sharp decline. Star ratings dropped to 3.5, and NPS fluctuated between 50% and 64%, reflecting inconsistent experience delivery across touchpoints.
To help the client improve star ratings and enhance member experience, Everise implemented a Performance & Experience Optimization Strategy to elevate mentorship, strengthen leadership accountability, and create a member-centric culture.
Performance & Experience Optimization Strategy
In just two years, Everise helped our client improve their Star Rating performance across its Medicare Advantage plans. They have 81% of their members enrolled in 4-Star or higher plan and 64% percent in 4.5-Star plan, showcasing Everise’s measurable gains in experience, quality and consistency.
| Annual Average NPS | |
|---|---|
| 2023 | 52% |
| 2024 | 58% |
| 2025 | 64% |
These results demonstrate how Everise’s performance-driven strategy can significantly improve star ratings, strengthen member experience consistency, and set a new benchmark for operational excellence.
