This year’s annual Medicare Marketing & Sales Summit drew 400 attendees who gathered in San Juan, Puerto Rico, to learn the latest regulatory and compliance updates, member retention strategies, and how to drive growth in an increasingly competitive market. Here are highlights from this morning’s sessions.
Inspiration from Carlos Arroyo, Puerto Rico’s sports legend
We kicked off the main conference with a fireside chat with Carlos Arroyo who took to the stage to discuss his NBA career and the pride he felt leading the Puerto Rico national team to victory in the 2004 Olympics.
The soft-spoken and humble Arroyo told moderator Nick DiMauro, director of sales for Medline, that he fell in love with basketball as a child and dreamed of playing with the NBA one day. But with no recruiters coming to Puerto Rico, his father found a family in Georgia where he could live and hopefully attract the attention of scouts from the United States. Although it was a tough transition, the move helped to launch his sports career. Recruiters expressed interest and he received a scholarship to go to Florida International University. It was a good fit because Miami’s weather, the beaches, and Latin food reminded him of Puerto Rico.
Asked about the biggest disappointment in his career, Arroyo said it was not getting drafted after college despite a great season during his senior year and promises by two teams. “I didn’t care if I was drafted like maybe the second round of the NBA,” he recalled. “I just wanted to hear my name called and have Puerto Rico and my family be proud of me and that didn’t happen.”
The disappointment motivated him to continue to train and push himself. It also helped “bring him down to earth.” He defied the odds and went from an undrafted player to spending nine seasons in the NBA. Among his many achievements: Leading Maccabi Tel Aviv to an Israeli League championship in 2009 and winning a Finals MVP award in the Turkish Super League with Besiktas in 2012. Since 2021, he has served as general manager of the Puerto Rico national team.
His most memorable career moment: Helping the Puerto Rico national team beat the United States during the 2004 Olympics. He had no expectations of winning because of the talent on the USA team. But at halftime, when they were 19 points ahead, he knew that they had a 90 percent chance of winning the game if they didn’t mess up.
“We forced USA to shoot because they had no shooters,” he recalled. “They had a bad game. We got lucky…We celebrate that game like it’s a birthday, still.”
Medicare consumer shopping and switching trends
In one of the most anticipated sessions at the event, George Dippel, president, Deft Research, presented key findings from the market research firm’s report on Medicare consumer shopping and switching. The annual report is essential to understanding senior consumerism during the AEP.
The survey, which was administered in December 2024, is based on the responses of 4,775 seniors, including 2,662 members of Medicare Advantage, 1,707 who have MedSupp, and 444 seniors who are enrolled in Original Medicare only.
The AEP for 2025 coverage was the most disruptive and had the highest switching rate since Deft has tracked the information, according to Dippel. “If this past year was an earthquake, we have an after-shock coming next year,” he warned.
Highest Medicare switch rate in eight years
Indeed, the Medicare switch rate was 16 percent, the highest Deft has recorded since 2017.
In 2017, only one in four seniors switched plans, according to Dippel. The others didn’t talk to agents and didn’t visit websites. They essentially “slept walk through the AEP,” he said. But, today, he said 50 percent of seniors shop and switch plans. “It has doubled in nine years,” he said. “Half of consumers now pay attention to what plans do.”
Dippel said that the last time there was this much disruption was in 2019-2020 when Joe Namath’s misleading Medicare commercials dominated the television airwaves and before the Centers for Medicare & Medicaid Services cracked down on advertisements. “This year the Medicare game has changed almost as much. Seniors saw stability in benefits in the last 10 years. That’s changed and it has changed the dynamic on how consumers think about health insurance and how they think about your brand,” he said.
Medicare Advantage plans need to build back trust with seniors
Those in the industry knew it would be a tough AEP because of the number of carriers leaving the market, the 1.8 million Medicare Advantage members who had their plans terminated, and plans having to water down benefits. But seniors were shocked.
“Seniors were caught off guard. They were surprised and they were upset. They have your plan on probation this year,” he said.
Dippel said that most seniors want to have a child-parent relationship with their plans. They want the plans to take care of them and get the most value out of their Medicare coverage. “They saw the business side of Medicare and they didn’t like it. It’s what has stained the relationship. If you have new members, you have to build back that relationship,” he said.
He warned attendees not to wait until September to begin their marketing efforts. The work plans do in spring, summer, and early fall will help build back relationships and their best chance to hold on to these new members.
L-R, Britt Travis,Chris Bond, Jessica Vander Zanden, and Patrick Speer
Post-AEP insights and strategies for success
During a discussion about the AEP, moderated by Britt Travis, president, Alternative Growth Strategies, panelists discussed their plans’ experiences and offered strategies to consider for the upcoming year.
Patrick Speer, managing director, Encore Health Advisors, said the statistics that Dippel discussed in the earlier session were true in all the markets he participated in. There was a lot of disruption in California as United Health pulled plans out of the market, and other plans had to raise premiums and water down benefits. “But all this disruption allowed for a ton of opportunities for plans that strategically place themselves to gain that membership,” he said.
Jessica Vander Zanden, CHC, VP, operations, Network Health, a five-star Medicare Advantage plan with 80,000 members located south of Green Bay, Wisc. Her plan budgeted for a loss in members during the AEP, but the organization actually gained members. “It was a surprise to us and a lot of the market around us,” she said.
One reason for its success is that the market required a lot of extra time and education, and her organization was prepared for it. The plan made sure there was staff to conduct events in the communities within their local counties to educate members on changes for the upcoming year. “Now we need to explain to the board why we exceeded the goal,” she said.
Like Speer, panelist Chris Bond, chief growth officer of Verda Healthcare, said that disruption in the market allowed his organization to focus on smart, targeted growth in Houston, Texas. Bond said that his organization has focused on matching members to high-quality primary care providers and facilities. Verda Healthcare assigns a “star value” to high quality PCPs in director-to-consumer carrier portals.
The panel offered several strategies for plans to succeed in the upcoming year, including:
- Consider proactive outbound call campaigns to educate members on benefit changes to prevent surprises and reduce abrasion. Keep the messaging simple so members can understand complex changes.
- Establish strategic partnerships with carriers and provider groups to facilitate enrollment and market segmentation analysis.
- Conduct strategic outreach campaigns to help retain members if a plan is pulled from the market, moving members to another plan offered by the carrier.
- Focus on retention campaigns, which are less expensive than new member acquisitions.
- Hire more staff for call centers and services areas to provide member education. The extra staff will be needed to handle the longer calls, which will increase average talk times, and avoid long wait times on the telephone for members.
- Continue outreach to members to deliver on promises made by the sales team. Encourage people to come to community sessions to ask questions.
- Invite brokers and agents to be part of the process and include them in discussions about the year ahead.
Pictured L to R, John Selby, Ron Hirasaki, Theresa Lauer, and M. Keith Peiffer.
How local and regional plans compete with national plans
Next, we learned how three organizations have had success competing with the national plans. The panel, moderated by John Selby, president of Rebellis Group, included Theresa Lauer, vice president, sales & marketing—Medicare, Independence Blue Cross in southeastern Pennsylvania; M. Keith Peiffer, vice president, senior market segment leader, Blue Cross and Blue Shield of Nebraska; and Ron Hirasaki, VP, product management & marketing sales, Christus Health Plan in Texas.
Independence Blue Cross covers a five-county area and has 42 percent market share, it’s small but highly concentrated with 10 Medicare Advantage offerings from national carriers. Lauer says the organization is the predominant leader in the regional market. Blue Cross Blue Shield of Nebraska’s market is dominated by UnitedHealth and Aetna and the state has 35 percent Medicare Advantage penetration, which is lower than the national average of 55 percent. Hirasaki said the Texas market varies in penetration depending on the area.
Blue Cross Blue Shield of Nebraska had a particularly good AEP. Peiffer said the plan started in 2024 with 7,300 members and ended AEP with 21,000 members. Peiffer said while UnitedHealth tried to move people into HMOs and Aetna changed its supplemental benefits, Blue Cross Blue Shield of Nebraska focused on stability and consistency in plan design. The plan went from eighth place to second in market share in the state.
Peiffer said the organization sought feedback from brokers and providers about Medicare Advantage, especially prior authorization, when it designed its plan for 2025. Its strategy for 2026: Stay stable and steady, capitalizing on positive momentum and high retention rates.
Independence Blue Cross has 184,000 Medicare Advantage members across group and individual plans (HMOs and PPOs). During the bid process, the organization retooled its formulary and moved from copays to coinsurance for some of its tiers. This was the only negative impact for its bid strategy in 2025. She said the plan’s main strategy was to focus on lowest cost channels while maintaining broker relationships. They also focused on operational issues to make sure they had member services in place and enough staff to answer phone calls and get member IDs issued. And as enrollments came in, the organization contacted the direct marketing agency to scale back efforts and shift focus to retention. “We pivoted early and it’s good we did because after the 12/7 dust settled, we brought in over 23,000 members once we collected all of our applications,” she said.
Hirasaki said that for the past two years Christus Health Plan had about 20,000 growth on its ACA plans, which has helped it have the right number of staff and operations in place. On the Medicare side, the organization was fairly flat for several years and then had a slight dip in 2023. Since then, the plan has experienced growth on the Medicare side. The reason for the increase? Christus shifted its focus from internal efforts to brokers. “Since we started that, we’ve seen some substantial growth, he said. “We had to focus on local brokers to make sure that they understand the product and what we do at Christus.”