3P Care Management - A call to action

2026 has squeezed every line of business. Medicaid, Medicare, and ACA each took a hit, and the pressure is coming from more directions than any one article can cover. Ryan Peterson's read at Upward Growth is the best summary of what plans are absorbing right now: https://www.healthplanweekly.com/p/early-2026-hit-medicare-advantage

I sit on the board of a health plan and I run a digital health company. From both seats, I see the same thing: there are only a few levers left to pull, and nobody is promising that 2027 gets easier.

The lever most plans overlook is care and quality management. Not more of it. A different design.

Yes, everyone is adding AI to outreach. But automating a process that already loses half the members does not fix it. Bill Gates said it years ago: automation applied to an inefficient operation magnifies the inefficiency.

Health plans need to rethink care management the way Apple rethought the retail store. That is a three-dimensional problem, not a one-dimensional technology problem. Call it 3P.

• PROCESS. For example, separate engagement from clinical work. Apple split the Genius Bar from the technicians in the back, and both got better. Let care managers manage care; give members one high-performance service whose only job is getting them to the visit, the screening, or the test.
• PEOPLE. Our members are drowning in messages. The people who reach them need service EQ as well as clinical depth. Hire accordingly, and let AI handle the timing, the prioritization, and the next best step.
• PLATFORM. Technology is the multiplier, not the whole strategy. And it has to meet members where they are: text first, phone second. Apps and portals are where engagement goes to die.

That was the tasting menu. Each P holds far more: how you give members one consolidated experience instead of a dozen disconnected outreaches; how you build a longitudinal relationship that carries a member through multiple activations, not just one; how you get members to see the plan as an ally in their care rather than a bill payer; and many more service questions like these. The point is to work all three Ps at once, because fixing one while ignoring the other two is how most transformation budgets disappear.

This drags plans outside their comfort zone. It asks them to think like a retailer, where the customer either comes back or doesn't.

I am concerned that plans that stay on a one-dimensional technology play will close 2026 crawling and meet 2027 on their knees. The ones that move to 3P thinking get something the others can't buy: members who actually show up, an MLR that drops sharply, and ratings that climb well above where they are today.

So here is the ask: before you sign off on next year's care management budget, put all three Ps on the table. Which one is your plan working on?