New Press Ganey Report Reveals Why Health Plan Members Are Losing Trust—And What It Takes to Rebuild It

Clear strategies emerge to help health plans regain member trust

CHICAGO--(BUSINESS WIRE)--Press Ganey, the leader in experience measurement, analytics, and strategic advisory services for health systems and health plans, today released an insights report capturing the voices of health plan members across Commercial, Medicare, Medicaid, and Marketplace plans.

The findings show that member engagement drives loyalty, retention, and ultimately trust. Health plans that provide easier to understand benefits and better access to care and medications have a more engaged membership. Engaged members are four times more likely to report a positive experience, 3.5 times more likely to recommend their plan, and significantly more confident navigating their coverage.

The report also underscores a growing trust crisis in the health insurance industry, shaped by emotional distress, operational breakdowns, and complex member journeys that can feel impersonal and fragmented.

“Trust is earned, not assumed,” said Patrick T. Ryan, Chairman and CEO of Press Ganey. “We now have a clear view of what erodes trust, and what can fix it. Health plans that lead with clarity, empathy, and follow-through will rebuild trust, improve member experience, and deliver results that last.”

Though frustrations vary by coverage type, three emotional drivers consistently shape member experience:

• Anxiety: Driven by access and affordability – 60% of members said they could not get care when needed
• Confusion: Driven by complexity and mistrust – 50% of members say information about their plan’s coverage is not easy to understand
• Anger: Driven by social media and generational impact – 55% of millennials say deductibles are unaffordable

Building Trust Through Social Capital

Health plans can’t fix member experience with process improvements alone. To rebuild trust, they need to address the emotional drivers of discontent—confusion, anxiety, and anger—with empathy, clarity, and consistent support.

Among the most effective strategies:

• Deliver real-time, person-to-person support at moments when members are most vulnerable
• Embed emotional and situational awareness into all communications
• Coordinate seamlessly with providers to create a unified experience

These and other actions reflect a larger shift toward building social capital: the trust, mutual understanding, and shared accountability that create stronger relationships between health plans and their members.

To explore the full findings, visit pressganey.com/MXInsights25 or connect with a Press Ganey advisor.

About Press Ganey

Press Ganey partners with healthcare providers and health plans to improve the experiences of their patients, consumers, and workforce by marrying data with unparalleled technology, analytics, and expertise. Our HX platform unites and enlivens disparate data, enabling clients to gather, analyze, visualize, and act on key insights to retain talent, improve access to care, and ensure the care journey is accessible, safe, equitable, and patient-centered. We are the trusted partner to 41,000+ healthcare provider organizations globally and 85% of health plans in the United States. Press Ganey is a Press Ganey Forsta company.

About Press Ganey Forsta

Press Ganey Forsta is a leading global provider of experience technology, data analytics, and insights that help companies better understand and serve their customers, employees, and stakeholders. Press Ganey Forsta powers the Human Experience (HX) Platform – a comprehensive experience and research technology platform that brings together CX (Customer Experience), Employee Experience (EX), Patient Experience (PX) and Market Research. It serves more than 43,000 clients globally across healthcare, financial services, hospitality, market research, professional services, retail, and technology. Press Ganey Forsta is recognized by Gartner^® as a Leader in the Magic Quadrant™ for Voice of the Customer (VoC) Platforms.