As the Medicare Advantage market continues to grow and regulatory demands increase, health plans are navigating rising expectations across cost control, compliance, and consumer satisfaction.

According to McKinsey & Company, 93% of Medicare Advantage executives say the right vendor partnerships are critical in operational success. But legacy vendors and manual systems often can’t deliver the agility, member experience, or insights that modern plans require.

To future-proof operations and drive outcomes, Medicare Advantage plans need technology partners that offer more than just point solutions—they need real-time infrastructure, seamless integration, and member-first design. This guide breaks down the four most important considerations in choosing a technology partner who can truly support your plan’s long-term success.

Step 1 – Define Success in a Real-Time, Member-First World

Before evaluating vendors, plans must define what success looks like in today’s digital healthcare ecosystem. For leading Medicare Advantage plans, this means faster onboarding, streamlined benefit delivery, and member-facing solutions that mirror best-in-class experiences from industries like banking or retail.

Ask yourself:

• Can this vendor consolidate our fragmented systems?
• Will this partner help reduce administrative friction and manual work?
• Can they power a consistent, branded experience across all channels?
• Will the solution work seamlessly with existing systems?
• Can the vendor’s solution grow with your member base and evolving needs?

Lynx Tip: Use an internal assessment across teams—operations, member services, IT, legal—to map out current friction points and gather input on must-have vendor capabilities and features. Where do members get stuck in the onboarding process? Do membership cards get in members’ hands on time? Are members consistently able to access their supplemental benefits? Lynx often helps plans identify missed opportunities for automation, compliance monitoring, or real-time data insights that can immediately move the needle on satisfaction and efficiency.

Step 2 – Evaluate Vendors with a Future-Focused Scorecard

To fairly compare vendors, Medicare Advantage plans need a consistent scorecard that aligns to the realities of today’s regulatory, operational, and consumer-driven environment. Taking a structured approach to this process ensures evaluation consistency across multiple categories.

Top Evaluation Criteria for Modern Health Plans:

• API-First, Modular Infrastructure: Does the platform easily integrate with your claims, eligibility, payments, and reporting systems via secure, flexible APIs?
• Scalability & Personalization: Can the solution scale with your membership while tailoring experiences by population (e.g., duals, chronic conditions)?
• Compliance Built-In: Does the vendor meet HITRUST, HIPAA, and CMS audit requirements with minimal burden on your internal teams? Only 34% of healthcare organizations say their current vendors meet all compliance requirements. Do they have processes in place to help stay compliant over time?
• Member-Centered Design: Do they offer a white-labeled app or portal that gives members real-time access to claims, balances, rewards, and eligible services?
• End-to-End Administration: Does the partner eliminate the need for multiple vendors (claims, benefits, e-commerce, reimbursements) or provide one seamless platform?
• Support and Training: Will the vendor assign an implementation team to assist with rollout? Does the vendor provide onboarding, training, and ongoing support?
• Track Record and Experience: Has the vendor successfully partnered with other Medicare Advantage plans before? If so, what where the outcomes?

What Sets Lynx Apart: Our API-driven infrastructure means faster launches, fewer IT headaches, and easier integrations. We help plans unify fragmented experiences and reduce total cost of ownership while improving time-to-market.

Step 3 – Look Beyond Cost: Measure Long-Term ROI

While pricing is a critical factor, forward-looking Medicare Advantage plans are evaluating vendors based on operational impact, automation potential, and long-term ROI. Organizations the prioritize ROI in vendor selection see a 15% increase in operational efficiency over time.

Key Areas of ROI to Consider:

• Reduced Admin Overhead: Automate reporting, claim resolution, fulfillment, and member communications
• Operational Savings: Consider efficiency gains, reduction in support burden, faster/easier member onboarding, less manual labor required to manage large vendor network and complex processes
• Improved Member Experience: Support real-time inquiries and transactions to reduce call volume and boost satisfaction
• Star Ratings & Retention: Deliver personalized, streamlined access to benefits to improve CAHPS scores and keep members engaged
• Compliance Assurance: Minimize costly audits and delays with built-in regulatory controls and transparent, self-service reporting

Health Plans Using Platforms like Lynx Have Achieved:

• A significant increase in OTC product approval rates
• $ millions in member benefit utilization
• Same-day card activation and member access before the plan effective date

Step 4 – Test the Member Experience Firsthand

Getting a first-hand, in-depth look at demo environments can help uncover strengths—and plans for innovation—not previously considered. Medicare Advantage leaders should take a critical look into the member and admin experience before making a full investment. Engaging with platform demos and test environments allows health plans to assess the member experience and user-friendliness.

What to Look for During Testing:

• Member experience across mobile, web, and live support
• Admin dashboard flexibility and drill-down reporting
• Speed and accuracy of benefits adjudication
• Real-time troubleshooting and vendor responsiveness

The Lynx Difference: Lynx supports full sandbox demos and targeted implementations, allowing for a fully customizable platform rollout, so your team can experience the simplicity and power of our infrastructure.

Why MA Plans Choose Lynx as Their Technology Partner

Lynx works with Medicare Advantage plans nationwide to simplify benefit delivery, streamline operations, and elevate member experience. We offer:

• One Vendor, One Platform: Unify all supplemental benefits (OTC, transportation, rewards) with real-time visibility and support in one seamless member experience
• Rapid Time-to-Value: Launch in weeks, not months—with white-labeled solutions ready to support enrollment periods
• Real-Time Benefits Access: Members get instant visibility into their balances, order history, and benefit usage
• Built-in Reporting: Self-service tools enable your teams to drill into transactions by member, merchant, or category in real time
• Regulatory Confidence: HITRUST, SOC 2, PCI-DSS, and CMS-aligned features support full compliance from day one

Simplify Selection with the Right Partner

The vendor you choose today will shape your plan’s member experience, operational efficiency, and ability to scale in tomorrow’s Medicare Advantage market.

Schedule a personalized demo with Lynx to see how our unified, API-powered platform delivers on all three—and why more plans are switching to Lynx for long-term success.