The Hidden Driver Behind Member Retention
Retention fails when vendors overlook the caregiver guiding the member’s decisions.
When care decisions involve older adults, duals, or chronically ill patients, the member is rarely acting alone. Plan enrollment, appointment scheduling, and benefit selection are often managed by spouses, adult children, or others in their support circle who influence what gets chosen, followed through on, or dropped.
Too many health tech vendors still design engagement around the individual. However, that approach often overlooks how decisions are actually made, especially with the rise of the sandwich generation, which manages care for both their own children and their aging parents.
When caregivers or family contacts are confused, left out, or unsupported, the result is missed care, silent churn, and lost revenue. The vendors pulling ahead are those that adapt to that reality. They’re building with generational retention in mind because the member may not be the one deciding whether to stay, switch, or engage.
This article examines how family influence affects member retention, identifies where most vendors fall short, and offers guidance on developing systems that keep members engaged long after enrollment.
1. Retention Requires Designing for Both the Member and Their Support
If you’re selling into Medicare Advantage, DSNP, PACE, or complex care coordination, your product is already touching members who don’t make decisions alone. Aging adults, duals, and high-need populations often rely on others to interpret, manage, and act on their care options.
Sure, the member might hold the insurance card, but someone else is comparing plan materials, scheduling visits, setting up accounts, or deciding what’s too confusing to bother with.
Care decisions, such as enrollment, provider choice, and benefit utilization, are often shaped by the family. Yet most vendor workflows ignore them entirely.
And when influence isn’t mapped, outcomes suffer. Here are some examples:
Your engagement strategy tracks log-ins and response rates, but the actual usage (or lack thereof) is coming from someone else entirely.
Your onboarding flow works well for the patient, but not for the daughter who booked the visit and can’t find clear next steps.
Your emails go to the enrollee, but the person who makes the plan decision wants everything in one portal and doesn’t want to manage two sets of logins.
Designing only for the member, while ignoring the family and caregivers who shape real decisions, leads to weak performance in the outcomes that health plans care about most: utilization, care coordination, and behavior change.
2. Disengagement Starts When the Caregiver Isn’t in the Loop
Member disengagement often stems from targeting the wrong audience. The person responsible for follow-through wasn’t the one your product actually reached. Caregivers often get overlooked in outreach, left out of the workflow, or treated as passive observers, despite being the ones who frequently make the decisions.
You’ve seen it before:
A care management platform sees a steady drop-off. The daughter managing her mom’s calendar never got looped in, so no one followed up after the welcome call.
A supplemental benefit launches, but utilization stalls. The caregiver had questions but couldn’t easily find answers and chose not to bother.
A plan loses a 68-year-old member. Her son handled enrollment and wanted to see and manage all her benefits in one portal, so he moved her to a different plan.
If you’re not reaching the person responsible for follow-through, it doesn’t matter how well the product works in theory.
When someone is overworked, under-informed, and just trying to keep their parent out of the ER, the little things become make-or-break moments. Clarity, access, and timing aren’t simply UX preferences. Instead, they could be the difference between whether care happens or not.
If you want to go deeper into how to drive adoption in the first place (so retention doesn’t start at a disadvantage), read Selling to Health Plans Isn’t Enough. Members Also Have to Use It.
3. What It Looks Like When Caregiver Support Is Built In
The standout vendors here aren’t bolting on caregiver engagement as an afterthought. They’re treating it as part of the product’s core design, and it shows up in the results.
Here’s what it looks like when caregiver engagement is built in from day one:
Onboarding workflows with simple ways to add a caregiver or delegate
Outreach scripts that ask who else supports the member and get permission to include them
Educational Materials written for clarity and trust, especially for adult children managing care
Notifications, dashboards, and reminders designed to include family decision-makers
Reporting that tracks not just member behavior but household-level engagement
For Medicare Advantage, dual-eligibles, and high-need members, caregiver involvement is the norm. Health plans are not judging vendors by generic engagement metrics. They are watching who meaningfully improves follow-through, care coordination, and retention.
📋 Product Check: Questions to Strengthen Caregiver-Centered Design
Many solutions are built as if the member is acting alone. But in Medicare Advantage and other high-need populations, key decisions often involve spouses, adult children, or caregivers.
Use this quick review to test whether your product supports the people who actually influence care coordination, benefit use, and long-term plan retention:
Who makes decisions alongside the member, and are we designing for them?
What does the caregiver see, receive, or interact with across the experience?
Is our onboarding built for the member or the person helping them use it?
Do we assume that the member manages scheduling, reminders, and benefit use independently?
Could a family member understand what our product is for if they were to stumble upon it?
If the answers reveal gaps, treat them as design inputs. If your product depends on member engagement, you’re already depending on someone else. Design accordingly.
Final Thought
Retention problems are often misdiagnosed as product issues. But the real failure isn’t technical, it’s relational. Behind every disengaged member is a support system that was left out of the experience.
If your solution depends on behavior but ignores the people who shape it, no amount of optimization will close the gap. The smarter path isn’t better messaging or stickier features, but rather designing for the full context of how care decisions are actually made.
Because in every line of business where support systems shape decisions, the member isn’t really acting alone. And if you keep building like they are, you’ll continue to miss what matters most.
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About the Author
Ryan Peterson writes Upward Growth, where he shares practical insights on selling health tech into the payor market. With 15+ years in healthcare growth leadership, he focuses on helping vendors translate their value into traction with health plans.
🟦 Connect with him on LinkedIn.