An analysis of three large, online broker insurance plan selection tools found that, on average, each included less than half of the available Medicare Advantage products and fewer than two-thirds of the applicable Part D plans.
Just 43% of available Medicare Advantage products, and 65% of Part D plans, were showcased on broker plan selection tools, according to a report released by The Commonwealth Fund on Thursday. Additionally, when researchers searched online for health coverage options, they found that web results primarily showcased information directly from health plans — not from neutral government, or third-party, sources. After looking through multiple large brokerage sites, researchers found one page that included information about Medigap plans, and only 18% of those available benefits were showcased.
This fragmented information system underscores the need for greater transparency in the gatekeeper role agents play in helping seniors pick their Medicare plan, said Riaz Ali, lead author of the study.
"How are we making sure that when people are going through the process, whether it's through a Google-type experience, or any other digital-first shopping experience, that they understand the source that they're turning to?" Ali said. "When there is an expectation of objectivity and transparency, but they're not necessarily getting it, I think that's where there's really the rub."
As more individuals become Medicare eligible, and enrollment in private Medicare Advantage plans climbs, the impact agents have on the healthcare system is growing, Ali said. Because they serve as a primary point of contact in helping consumers choose which health coverage to purchase, transparency around which options they offer—and the quality of service they provide—is critical in ensuring equity and access to the right coverage for the right individuals, he said. Nearly 96% of all Medicare Advantage and Part D plans contract with agents to help prospective beneficiaries understand their coverage options, the report said.
Because agents are not required to partner with every plan in their market, they may not advertise that certain plans are available. Ali said this impacts an individual's healthcare experience, overall healthcare costs and what plans survive the competitive Medicare market. Some analysts have pointed to a lack of local broker relationships as a reason why some insurtechs have failed to gain traction. While the study noted brokers' reliance on industry accreditation creates a natural interest in complying with CMS standards about how they promote plans, Ali said there were still opportunities for greater transparency in how the process works.
The report called for agents to showcase the portion of plans they work with, how they are paid, their training and more. The Consoliated Appropriations Act 2021 mandates that agents reveal to employers purchasing coverage about their financial ties to plans — since most are paid directly by plans, which some say presents a conflict of interest — but did not address this transparency measure in the individual market. The study recommended that government organizations create a Yelp-like Medicare agent marketplace that rates their performance and continue to invest in Medicare.gov. Although ads by agents and health plans made up 87% of search page ads, Ali said he was heartened to see that ads by Medicare.gov showed up in consumer searches.
Researchers also added that continued support for existing public and not-for-profit outlets that focus on educating consumers about how Medicare works, and helping them navigate the marketplace, could be helpful in smoothing seniors' transition into Medicare. The current agent model focuses primarily on helping a patient choose a plan, rather than decide what type of Medicare is right for them, Ali said. This presents an equity issue for those who don't have access to tools for understanding the differences and trade-offs between plan types. Ali believes that state health insurance programs and volunteer-run education organizations should be promoted more prominently.
"I think the understanding of the broader journey, transitioning into Medicare, and what does that mean?" Ali said. "Understanding what the trade offs are between whether a Medicare supplement or MA plan is right. For me personally, these are some big categorical decisions that sometimes get lost when you're going straight to the plan choice."