SCAN Peer Advocates Provide Unique Member Experiences

SCAN is a not-for-profit organization that is committed to keeping seniors healthy and independent. SCAN has delivered on this mission since 1977 through SCAN Health Plan, one of the largest not-for-profit Medicare Advantage plans in the nation. SCAN also offers education programs, community funding, volunteer opportunities and other community services throughout its six-state service area.

Briefly describe the nominated organization: history and past performance (up to 1,250 characters):

Founded in Long Beach, California in 1977, SCAN is a not-for-profit Medicare Advantage plan serving over 300,000 members across six states. We prioritize care over profit, staying true to our mission: keeping seniors healthy and independent. SCAN offers specialized plans like Affirm for LGBTQ+ members, Inspire for women's health, and Connections for those eligible for both Medicare and Medicaid. Other plans support seniors with chronic conditions, home care needs, or assisted living.

Known for inclusive, innovative healthcare and a member-first approach, SCAN created the Peer Advocate role. Peer Advocates are front-line champions who use empathy and personal experience to guide members through their health journey on living healthy, independent lives. They simplify access to benefits, resolve concerns, explain plan options, and coordinate with providers and internal teams. They coach members on preventive care and introduce helpful tools and programs. Their goal: to ensure every member feels informed, empowered, and connected to the resources they need to thrive.

Outline the organization's achievements since July 1, 2023 that you wish to bring to the judges' attention (up to 1,500 characters):

Peer Advocates respond to ensure healthcare continuity during medical network disruptions, threats to local care, and natural disasters. Members affected by the 2025 Los Angeles fires and Texas flooding received expanded access to medical care, including interim doctors, pharmacies, telehealth and nurse advice lines. This included access to locations providing essential resources like shelter, food, water, and clothing. During the June 2025 Los Angeles protests, affected members were provided information about prescriptions and food home delivery, and phone access to doctors and nurses. When changes to medical groups occur, Peers contact thousands of members to ensure smooth transitions of care. Peer Advocates provide compassionate support ensuring no one navigates disruption alone therefore mitigating service gaps.

Peer advocates reach out to new members with warm welcome calls at the beginning of their enrollment, ensuring they feel supported and informed from day one. These calls offer personalized guidance by clarifying benefits, coverage, and services, while helping members understand how to use their plan effectively. Advocates answer questions, connect members to care management or community resources, and proactively address concerns to reduce frustration. They also identify cultural needs and barriers to care, creating a more inclusive experience.

Explain why the achievements you have highlighted are unique or significant. If possible compare the achievements to the performance of other players in your industry and/or to the organization's past performance (up to 1,500 characters):

Peer Advocate efforts have greatly impacted SCAN's significant results and awards as illustrated below:

The key performance indicator of a Medicare Advantage plan's success is its overall 5-Star rating score assigned by Medicare. This rating is based on members' opinions on the quality of care received including overall experience, access to care and maintaining health. SCAN has achieved 4.5-Star ratings for 7 out of the past 8 years. Ratings of 4 or more are considered excellent and result in health care entities receiving bonuses enabling them to enrich their programs.

SCAN achieved a net promoter score of 64 (likelihood of members recommending SCAN to others) for 2022 and 2023. The industry average is 30, with a score over 50 considered excellent.

SCAN's customer satisfaction ratings for 2023 and 2024 averaged an excellent 4.5 out of 5.

Peer Advocate call campaigns in 2024 yielded an average voluntary disenrollment retention rate of 7% versus a national average for Medicare Advantage plans of 17%.

As a result of the evolution of their role over the past five years, Peer Advocates' efforts have contributed to SCAN achieving numerous awards including being named to U.S News & World Report's list of Best Medicare Advantage Companies in California and Nevada (2024) and Best Workplaces in Aging Services (2022).