The Sales Playbook For Health Solutions: Beyond Features to Financial Impact

Medicare Advantage (MA) has proven remarkably resilient. Despite risk adjustment model changes and periods of modest capitation rate growth, the industry continues to see positive growth. Alongside, we clearly see increases in membership, expanded supplemental benefits, and more health solutions entering the crowded market.

?The New Challenge: Adaptation and Innovation

MA plans don’t have the luxury keeping their head down and holding onto the status quo – they’re having to focus on speed. ?With the 2025 Medicare Stars ratings, the need to adopt and implement innovative approaches to health equity are paramount to not only how the beneficiary views their desirability but also, the lifeblood levers of risk adjustment and reimbursement.

?MA Plans Want What Your Have – Now Frame It For Them

Here's the crucial insight: It's no longer enough for health solutions to simply demonstrate proof of concept. They must deliver concrete, plan-specific impact scores and reimbursement projections.

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Winning with Analytics-Driven Sales

Success requires moving beyond anecdotes to real-world evidence. Modern health solutions must:

·????? Map revenue and savings opportunities

·????? Create plan-specific forecasts based on unique population characteristics

·????? Develop custom models that make solutions compelling, not just interesting

The Path to Becoming the Next "Silver Sneakers"

Every health solution aspires to achieve that level of brand recognition and trust that opens doors to other plan partnerships – but only if they can justify the investment to their MA partners through clear ROI models.? So, how do you create a sales strategy that will yield traction and conversion? Here's the framework for accelerating your business development:

1.??? ?Strategic Plan Targeting - Focus on plans struggling with measures related to your solution. Don't spin your wheels chasing 4+ Star plans in your solution area – they're not your immediate market.

Starting off any discovery call asking them how their fairing in your solution area is a non-starter. As a solution that is to add value to that plan, its your job to know how their rating and be ready to lay out their best plan forward.

2. Right-Size Your Implementation - Define clear targeting parameters based on your target plan’s population along with realistic engagement metrics.

Have clear metrics showing at what level of targeting & engagement your solution will begin see effective results.? The impact of targeting 10% v. 40% of a plan population will have a huge delta - be ready to show them how many of the enrollees need to be targeted.

?3. Revenue Modeling is Non-Negotiable - Financial stakeholders need hard numbers, not stories. Your pitch must include:

o?? Clear PMPY (Per Member Per Year) revenue projections

o?? Realistic utilization metrics

o?? Specific targeting criteria

o?? ROI timeline and milestones

?The Net / Net on Health Solution Sales Strategy

Long term viability of any health solution within the Medicare Advantage landscape requires a precise blend of innovation and analytics. The winners will be those who can translate their solution's value into concrete financial impact for their plan partners.

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#HealthTech #MedicareAdvantage #HealthcareInnovation #ValueBasedCare #HealthEquity