Inside Cognizant’s Voice of the Member Survey Insights

As health plans navigate mounting cost pressures, rising consumer expectations, and rapid advances in digital health, one thing is becoming increasingly clear: the traditional model of engagement is no longer enough. Today’s members are not just evaluating their health plans based on claims processing or network access—they are comparing their experiences to the seamless, personalized interactions they receive from banks, retailers, and digital-first wellness platforms.

Against this backdrop, Cognizant’s latest Voice of the Member (VOM) Survey, “Redefining Member Experience: A 2026 Health Plan Imperative,” offers a timely and data-driven look at how expectations are evolving—and where health plans are falling short. Now in its fifth biennial edition, the study expands its reach significantly, surveying 7,500 members across more than 160 health plans. The result is one of the most comprehensive snapshots to date of how consumers perceive their healthcare experiences across digital engagement, access, cost transparency, wellness, and customer support.

What emerges is a picture of an industry at an inflection point. Members increasingly expect their health plan to function as an always-on partner in their well-being, not just a back-end administrator of care. At the same time, persistent gaps in core experiences, such as provider directories, prior authorizations, and cost clarity, continue to erode trust.

To unpack these findings and what they mean for the future of the payer landscape, we spoke with Jagan Ramachandran, Senior Partner at Cognizant. In the following Q&A, he shares insights from the latest survey, explores the concept of the “well–sick care flywheel,” and outlines what health plan leaders must do now to remain relevant in a rapidly shifting ecosystem.

Jagan, this is Cognizant’s fifth biennial Voice of the Member survey but this time you tripled the respondent pool to 7,500 members. What prompted that significant expansion, and what did the larger sample allow you to see that previous surveys couldn’t? 

The Voice of the Member survey is a standard framework our clients use to compare their member experience against competitors, so a 2,400-member sample was no longer sufficient for robust plan-level benchmarking. Clients are really asking two questions: What are my own members telling me, and how does that feedback stack up against rival plans in my markets?

To answer both credibly, especially for our largest clients, we needed a much larger, statistically significant sample that would hold up when you slice by line of business, plan type, and key demographics. That’s why we tripled the sample to 7,500 members. The expanded sample lets us see clear experience gaps across 160-plus health plans by product, plan segment, and member cohort instead of relying on directional patterns.

Because the Voice of the Member survey has been conducted over multiple editions, what is the single most surprising shift in member expectations you’ve seen over time, and what does that tell us about where the payer industry is headed next?

The most surprising shift is the speed and consistency of members expecting their health plan to be a genuine well-being partner rather than a financial intermediary.

In 2021, 57% of members wanted their insurer involved in their overall well-being. By 2023, that rose to 83%, and today it stands at 85%. What’s striking is how quickly that expectation has become a baseline requirement across virtually every segment.

We also see a widening gap in wellness technology. Features like fitness trackers and remote monitoring are now considered important by two-thirds of members, yet satisfaction remains low. The gap between rising expectations and poor delivery is a flashing warning signal for the industry.

The report opens with a striking premise that the traditional “sick-care” model is becoming unsustainable. Can you walk us through what the “well-sick care flywheel” means in practical terms, and why you believe it’s accelerating right now?

The traditional sick-care model was built to manage acute episodes for the sickest members while largely ignoring the broader population that keeps risk pools viable. That model is now under pressure.

The “well–sick care flywheel” connects how you keep people well with how you manage them when they are sick, so each reinforces the other. When members are well, plans use data and digital tools to engage them continuously, nudging healthier behaviors and building trust. As risk increases, that same infrastructure enables earlier intervention and better care coordination.

The savings and improved outcomes are then reinvested into richer experiences and broader well-care programs, strengthening the cycle.

This is accelerating because of economic pressure, rising member expectations for always-on digital engagement, and the maturity of AI and virtual care capabilities.

The report also suggests that healthier members are increasingly engaging with a parallel digital health ecosystem built around wearables, at-home diagnostics, and subscription wellness services. How significant is that competitive threat to traditional health plans, and what must insurers do today to remain relevant to those healthier populations?

For many healthier members, the center of gravity has already shifted toward a parallel ecosystem of at-home diagnostics, subscription primary care, digital coaching, and nutrition services.

This is a structural competitive threat. If those experiences happen outside the plan, insurers risk becoming interchangeable utilities that only process claims.

To remain relevant, plans need to adopt an ecosystem-first strategy, connect those external journeys back into the plan, and turn their digital front door into a “well-care subscription” experience that bundles navigation, coaching, nutrition, and mental health alongside traditional benefits.

The Essentials Gap: Fixing the Foundation

One of the most sobering findings is that more than half of members across Commercial, Medicare, and Medicaid plans are struggling with basic processes like referrals, prior authorizations, and appeals. After years of digital investment, why are health plans still failing at the fundamentals?

More than half of members are struggling with these processes because the root causes go beyond technology.

First, stakeholder adoption remains low. Providers still default to phone and fax when faced with multiple payer systems. Second, data quality issues between claims and authorization systems create delays. Third, interoperability has not kept pace with intent.

The solution requires moving faster on AI and simplification, shifting to conversational interfaces, accelerating FHIR adoption, and rethinking benefit design to reduce friction altogether.

Digital investment without simplification is just automation of a broken process.

Provider directories scored a satisfaction rating as low as 1.6 out of 5 among commercial members and the report makes the pointed observation that “it’s a data problem, not a channel problem.” What does that distinction mean for how health plans should be investing their dollars?

When members can’t find accurate provider information, they turn to other channels, but those channels rely on the same flawed data.

Ninety-one percent of members rate provider search as highly important, yet satisfaction is as low as 1.6 out of 5. This reflects a systemic failure in how provider data is created and maintained.

The priority must shift to data integrity, establishing a clean provider master and continuously validating it through claims data, provider input, and member feedback. Fix the data, and every channel improves.

Enhancements: Where Good Intentions Fall Short

The report highlights a critical insight about Medicaid members: their needs are highly demographic-specific, yet many plans apply a one-size-fits-all approach. Can you give us an example of what a truly tailored SDOH strategy looks like versus what most plans are doing today?

Most plans treat SDOH as a checkbox, offering generic resources. But needs vary significantly by demographic.

Two-thirds of African American Medicaid members prioritize childcare, while 56% of Hispanic members prioritize language support. A one-size-fits-all approach does not work.

A tailored strategy builds purpose-driven digital experiences that connect members to hyperlocal resources with integrated case management and multilingual support, transforming the plan into a true community partner.

On cost transparency, 94–95% of members say knowing procedure costs is important; yet only 25% ever receive an estimate close to the actual bill. That’s a massive trust gap. What would it actually take to close it?

Only 25% of members receive accurate cost estimates, which creates a trust problem.

Closing that gap requires better use of AI to generate personalized estimates, simpler benefit design, and improved billing experiences.

Concepts like Health Bill 360 aim to consolidate all costs into a single, understandable view, turning billing from a source of frustration into a moment of trust.

Delight: The Opportunity to Transform

The jump in members wanting their insurer to play a role in their overall well-being is remarkable from 57% in 2021 to 85% in 2025. What’s driving that shift in member expectations so dramatically over just four years?

The broader consumer health ecosystem has changed rapidly. Wearables, remote monitoring, and subscription wellness services have become mainstream.

At the same time, the experience has become fragmented. Members are juggling multiple platforms with no integration.

Health plans are uniquely positioned to orchestrate that experience because they have visibility across claims, clinical, and pharmacy data. The opportunity is to connect everything into a seamless, integrated journey.

The survey also shows that many members who don’t use their health plan’s digital tools regularly use similar digital services from banks, credit card companies, or other industries. What lessons should health insurers take from those sectors about designing digital experiences that people actually adopt?

The issue is not member willingness—it’s experience design.

Three lessons stand out. Awareness drives adoption. Triggers matter more than features. And chat-based experiences reduce friction and drive engagement.

Until plans create compelling reasons to engage, such as better billing tools or wellness programs, digital adoption will remain limited.

Looking Ahead

The report makes a compelling business case: better member experience leads to higher Star ratings, improved HEDIS metrics, lower operating costs, and better health outcomes. For a skeptical CFO reading this, what is the single most powerful data point you would put in front of them?

Twenty-five percent of all contact center calls are driven by members who do not understand their benefits.

That represents a major cost opportunity. These issues are addressable through better digital tools and communication, reducing administrative expense and improving outcomes.

Better member experience is not a cost center. It is one of the most effective ways to reduce medical costs.

If health plan CEOs take one action, what should it be?

They need to ask whether they are still a sick-care organization or becoming a true well-care partner.

The shift is already happening. Members expect more, and those expectations are rising quickly. Plans that fail to adapt risk losing healthier members and destabilizing their risk pools.

The next step is adopting an ecosystem-first strategy, integrating external services, and aligning incentives around keeping members healthy, not just treating them when they are sick.

What’s one final point to underscore?

The shopping experience is a major opportunity. Members are switching plans not just for cost, but for better self-service and communication.

Satisfaction with shopping tools remains low despite high importance. Plans need to use AI to connect provider search, cost estimation, and plan comparison into a seamless experience that builds confidence and drives enrollment.

For more information, download the survey here.