Why healthcare employee experience should matter to health plan leaders
By David Shapiro, Senior Vice President and General Manager of Member Experience, Press Ganey
Health plans spend a lot of time thinking about the member experience.
They track Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores, monitor retention, analyze complaints, and invest in programs designed to improve trust and engagement. They’re also increasingly focused on access, behavioral health, and the growing number of members struggling to navigate a complex healthcare system.
But there’s another experience that deserves more attention from health plan leaders: the healthcare employee experience.
Who’s behind an exceptional member experience?
Healthcare employee engagement, at first glance, may seem like a provider issue. After all, Press Ganey’s newly released State of Healthcare Employee Experience 2026 report highlights key data and trends impacting physicians, nurses, and healthcare workers. But many of the findings will resonate with health plan leaders, because they reveal something larger about how trust, engagement, and performance are created (and lost).
Employee engagement is improving across healthcare, with scores rising at the fastest rate seen in eight years. More importantly, organizations with stronger engagement consistently outperform their peers on patient experience, retention, and workforce stability. Hospitals in the top quartile for engagement are 4.2x more likely to achieve top-quartile patient experience performance.
That should sound familiar.
New data from Press Ganey’s State of Health Plan Member Experience 2026 report shows that trust , access, and engagement increasingly define how members evaluate their health plan. Members judge plans not just by benefits or premiums, but by whether they understand their coverage, successfully navigate the system, or even get care at all. In other words, experience is becoming a performance issue.
The same principle applies to healthcare organizations. A disengaged workforce creates friction. Friction creates inconsistency. And inconsistency eventually reaches members.
Consider the teams health plans rely on every day: customer service representatives, care managers, provider relations teams, Stars specialists, pharmacists, quality leaders, and digital engagement teams. These people help members understand benefits, navigate access challenges, resolve claims issues, and connect with care.
When those employees feel supported, aligned, and invested in the organization’s mission, members feel the difference in their experience. When they don’t, members feel that too.
Strong cultures on the inside drive strong experiences on the outside
The strongest drivers of engagement all revolve around trust. Safety, organizational support, leadership alignment, and what we call “social capital” consistently separate high-performing healthcare organizations from the rest of the pack.
Health plans face a similar challenge. Many continue to operate in silos. Member experience teams work separately from Stars teams. Quality operates independently from provider engagement. Customer service, analytics, and care management often have different priorities, measures, and incentives. The result is a fragmented experience for both employees and members.
Social capital is the invisible infrastructure behind better performance. When trust, communication, and collaboration are strong, outcomes improve. When they’re weak, friction rises, and progress stalls.
That lesson applies just as strongly to health plans. Those making the greatest strides in member experience are often the same ones breaking down internal barriers, tightening alignment across teams, and ensuring employees understand how their work impacts the broader mission.
Healthcare is a single ecosystem
Ultimately, healthcare is converging around a simple truth: All experiences are interconnected.
Patient experience, member experience, provider experience, and employee experience are not separate domains. Rather, they are different expressions of the same system.
Health plans can’t truly improve the member experience without understanding the people responsible for delivering it. And, as expectations continue to rise, leaders who invest in employee trust, alignment, and engagement will be better positioned to improve member outcomes, strengthen member retention, and build lasting loyalty.
Experience outcomes are created by an ecosystem of teams working together. Health plans that strengthen trust, engagement, and alignment inside their organization are inherently better equipped to build trust, engagement, and loyalty with the members they serve.
To learn more about Press Ganey’s solutions for health plans, reach out to our member experience team.