MA underwriting margins went negative in 2024 for the first time in five years. -0.7% composite, per Milliman.

The financial defense that used to happen at the end of the deal now happens in the first meeting.

Old sequence: the VP of Stars or Risk Adjustment liked your pitch, advanced it internally, finance handled the financial defense at the end.

New sequence: that same VP is constructing the financial defense as part of the operating evaluation. They're either pulling finance in early or building the model themselves from finance-supplied templates.

That's why the first call goes well, the follow-up gets scheduled, and then the cycle slows down in a way you can't quite read. Your champion didn't lose interest. They likely hit a CFO question they couldn't answer with the materials you handed them.

The article has the one-page champion brief format that gives your operating buyer the language they need for the finance conversation they're going to have anyway.