I fondly remember a time when health plans reveled in high member retention. It was a simpler calculus: keeping an individual insured for more than a year allowed for a greater investment in their health and longevity. It was a virtuous circle—satisfied members led to higher STARs ratings, which fueled better care.
But that circle has been upended.
Data from the annual enrollment period (AEP) reveals an alarming shift. Medicare Advantage plans, once focused on the long-term value of a member, are moving toward a strategy of forced disenrollment and "favorable selection." We are seeing plan executives use refined actuarial science to play a high-stakes version of Whack-a-Mole—identifying and exiting counties encumbered with "too many sick old folks."
The numbers are staggering. The mean forced disenrollment rate for MA beneficiaries jumped from a steady 1% (2018–2024) to 6.9% in 2025, and is projected to hit 10% in 2026. In seven states, forced disenrollment has exceeded 40%. That is a ten-fold increase in less than a decade.
In this climate, our health care industry views retention as a marketing problem. But you can't "brochure" your way out of a systemic lack of engagement. When we treat members as rows on a spreadsheet to be optimized or offloaded, we miss the "Retention Dividend" found in whole-person care.
If we want members to stick around—and if we want them to be healthy enough to remain viable—we have to flip the script. What if the single best retention tool wasn't a clever ad campaign, but a warm meal and a genuine check-in?
At Healthrageous we’ve spent four years testing this hypothesis with a national Medicare Advantage Plan, focusing on a program that combines nutritional support with 52 weeks of personalized health engagement. We believed that serving the whole member, and not just their claims, would yield dividends.
The results provide a sharp contrast to the industry's current trajectory:
Inflation in US healthcare expenditures will always exceed CPI because every year on earth for adults is one year closer to physical breakdown and increased medical costs. Health plans are dangerously adept at tracking the costs of being sick, but seemingly inept at keeping people healthy. At Healthrageous, we invest in nutrition and engagement in order to build a pipeline of trust. That trust is what makes a member adherent with their treatment plan and, ultimately dampens medical spend.
Let’s stop thinking about meal programs as an administrative cost and start recognizing them as another form of pharmaceuticals; hence, food as medicine. The plans that win the next decade won't be the ones most skilled at "Whack-a-Mole" disenrollment; they will be the ones that figured out how to see their members as people worth keeping.
Want to dive into the data? Get the full case study here to see how Healthrageous is setting a new standard for Food as Medicine and member engagement in Medicare Advantage.
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