The end of absorption

Part 1 of a three-part series
Editor’s note: This is the first of a three-part series that explores how Medicare Advantage plans can turn the post-V28 landscape into an opportunity for growth. From capturing clinically complex members to optimizing engagement and transitioning populations into the right plans, we explore how integrated clinical and marketing strategies can drive both better outcomes and stronger margins.

From revenue recovery to margin discipline in the 100% V28 era

The era of absorbed losses is over. For two years, Medicare Advantage (MA) plans shielded members — and market share — by taking hits to their own margins under The Centers for Medicare & Medicaid Services (CMS) V28 risk adjustment model.¹ 

As of January 1, 2026, that buffer is gone. The 100% V28 phase-in is live. Plans can no longer offset shortfalls with temporary measures. Margins are exposed, and every decision (marketing, clinical, operational) carries direct financial consequences. 

This is a defining moment. Plans that cling to old playbooks will struggle. Those that synchronize clinical insight, member intent, and engagement will capture high-acuity demand, and expand margins, like never before.

What is the V28 risk adjustment model?

In 2023, CMS finalized Version 28 of the CMS-HCC risk adjustment model, which assigns risk adjustment factors to hierarchical condition categories (HCCs) to predict a plan’s cost of managing members based on demographics and health conditions.² 

V28 introduced major changes that limit the impact of coding intensity and curb excess payments, eliminating roughly 2,000 ICD-10 codes from HCC mappings. CMS phased in the model over three years (2024–2026), giving plans time to adjust.³ But that transition period is now complete. 

The absorption era is over. Plans must now adapt to the full financial reality of V28, which puts high-complexity members — and your approach to acquiring, retaining, and managing them — squarely in focus.

Personas 

Personas are detailed archetypes representing key audience segments interacting with your website, such as:
Prospective patients researching symptoms, treatments, or care locations

• Existing patients seeking follow-up care
• Referring providers evaluating specialists
• Caregivers coordinating care for family members

Effective personas go beyond demographics to capture behaviors, motivations, anxieties, and decision triggers. For example, a cardiac patient researching treatment options may prioritize clinical expertise and outcomes, while a caregiver seeking pediatric care may focus on trust, convenience, and reassurance.

To create effective personas:

• Engage stakeholders across the organization. Gather input from marketing, service line leaders, clinicians, access teams, and operations to capture diverse perspectives on patient needs, care pathways, and the unique challenges associated with specific conditions and services.
• Ground personas in data and research. Use market research, surveys, interviews, and behavioral analytics to inform each persona. CRM platforms and patient encounter data can provide valuable insights into who is actively seeking care in your market and how they engage across channels.
• Bring personas to life through narrative. Frame personas using first-person storytelling that reflects real patient motivations, concerns, and decision triggers. This approach helps teams empathize with patients and better understand the context behind their healthcare needs.
• Capture the full consumer lifecycle. Include relevant demographics, motivations, barriers, digital behaviors, and healthcare needs across the continuum — from early research through treatment, follow-up care, and long-term engagement.

Understanding these differences informs design, messaging, content hierarchy, and functionality across the website. 

Journey maps

While personas define who your audiences are and what they need, journey mapping reveals how people actually move through healthcare decisions, from early research through scheduling and care delivery. When mapped visually, these journeys often expose gaps (and opportunities) across every stage of the experience. For example:

• Educational content exists, but doesn’t guide visitors to relevant specialists
• Provider profiles lack meaningful differentiation
• Scheduling tools are difficult to find or inconsistent across service lines

Identifying these friction points allows teams to prioritize improvements and design interventions that remove barriers to care and better guide visitors toward the next step. 

Just as importantly, journey mapping also provides a shared view of the consumer experience across departments. By visualizing how individuals interact with your organization across multiple touchpoints, teams — from marketing and digital to operations and access — can align around where improvements will have the greatest impact. When applied effectively, journey mapping transforms the website from a collection of pages into a connected experience designed to guide, reassure, and convert care seekers.

Step 3: Identify universal problems and high-impact opportunities

Detailed journey maps reveal where experiences succeed — and where critical gaps exist. When multiple journeys are analyzed together, patterns quickly emerge. Certain barriers tend to appear across many experiences, such as:

• Difficulty finding the right provider
• Confusing navigation between services
• Lack of clear “next step” guidance
• Content that informs but doesn’t convert

These are universal problems, and solving them delivers the highest return. For example, improving provider search and profile experiences often unlocks impact across multiple journeys, from orthopedics to oncology to maternity care. Prioritizing these shared opportunities helps marketers:

• Deliver visible improvements quickly
• Demonstrate ROI to leadership
• Build momentum for broader digital transformation

Equally important is ensuring the website integrates with CRM, marketing automation, and analytics systems, enabling your organization to measure how digital engagement translates into appointments, referrals, and downstream care.

Step 4: Curate and optimize content strategically

Content drives both digital experience and patient action. Yet most healthcare websites suffer from content sprawl: years of well-intentioned publishing that have created thousands of pages — many now redundant, outdated, or disconnected from patient decision-making.

A high-performing website requires intentional content curation, not simply more content. Start by evaluating content through these three lenses:

• Relevance: Does this page help someone make a healthcare decision?
• Clarity: Does it clearly explain conditions, treatments, or provider expertise?
• Actionability: Does it guide the visitor toward a meaningful next step?

Take a critical look at what exists: which pages inform, inspire, or enable action — and which create friction or confusion. Align updates with your positioning, journey maps, and prioritized opportunities. 

Make sure content:

• Supports care seekers, existing patients, and provider audiences
• Maintains clinical accuracy, accessibility, and compliance
• Highlights differentiators such as outcomes, expertise, and experience
• Leads naturally to scheduling, referrals, or deeper engagement

Forms, scheduling tools, and interactive features should also be treated as core, strategic experience elements, not afterthoughts. 

When content is curated and optimized thoughtfully, the website becomes more than a publishing platform. It becomes a central hub for guiding action, strengthening engagement, and capturing value.

Step 5: Future-proof for the AI-driven digital front door 

The AI-driven digital landscape is here. Each website visit matters more than ever, as AI and large language models (LLMs) answer questions before users arrive. In this environment, the website must function less as a destination and more as a decision platform.

When someone lands on your site today, they are often further along in their decision journey. That raises the bar for what the website must deliver:

• Clear differentiation of expertise and outcomes
• Seamless navigation to relevant specialists and services
• Personalization based on intent and context
• Connected experiences across channels

Forward-looking healthcare marketers and leaders are also evaluating how their websites support structured data, content authority, and integration with broader digital ecosystems. This ensures their expertise remains visible within AI-driven discovery environments. The goal is not simply traffic. It is high-value engagement that converts intent into care. 

Positioning your website as an adaptive, connected experience ensures it drives value in today’s AI-driven healthcare ecosystem.

Final thought

Launching and maintaining a website is no longer simply a technical project. It is a strategic growth initiative. When built with product marketing principles, a healthcare website becomes far more than an online brochure. It becomes a platform to: 

• Guide individuals through complex care decisions
• Reinforce clinical differentiation and brand trust
• Connect digital engagement to measurable outcomes

In an increasingly AI-mediated healthcare landscape, organizations that treat their website as a strategic experience platform will have a clear advantage. The result: a digital front door that supports journeys, reinforces your brand, and generates measurable impact. 

Could your website be driving more impact? Connect with our experts to evaluate whether your site is truly guiding patients to care — or simply providing information — and identify the opportunities to unlock greater performance.