Marketers know that adults 65+ spend about a third of their waking day, almost six hours, watching broadcast TV. During Medicare’s open enrollment season in the fall, they aired commercial after commercial soliciting seniors to “find out about” their Medicare benefits by calling toll-free numbers. But the seniors didn’t even have to place that call, because these same agents, brokers and other lead generators kept their phones ringing off the hook with robocalls and offers of “free” services about Medicare plan options.
And if the seniors could avoid the calls, they found their mailboxes filled with unclear and deceptive marketing material, flyers, packets and other advertisements for Medicare benefit options. As the tactics became more aggressive and frequent, so did the associated complaints.
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Unfortunately, too much of today’s Medicare Advantage marketing is inappropriate, confusing, misleading or inaccurate, misrepresenting the choices available in a program that works well for more than 28 million Americans. With its high-quality and affordable offerings, Medicare Advantage has grown to become the predominant choice of America’s seniors. Every day more than 10,000 new people age into the Medicare program – prime targets for third-party marketing organizations, agents/brokers and field marketing organizations who are tripping over themselves to cash in on this market.
Seniors have the right to select the best health coverage for themselves without high-pressure sale tactics, inaccurate information or misleading claims. Health plans have a duty to their consumers and taxpayers to be responsible stewards of every dollar spent on premiums. We cannot blame the seniors for watching television commercials, taking phone calls and reading their mail. They deserve to receive information about their health plan options that is comprehensive and accurate.
To its credit, Centers for Medicare & Medicaid Services (CMS) announced that, as of January 1, it will conduct additional oversight of Medicare Advantage or Part D prescription drug plan television advertising.
That’s a good start, but it’s incomplete.
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To ensure that Americans receive unbiased, comprehensive, actionable and transparent information when selecting their health care coverage, CMS needs to implement additional oversight and guidance of marketing practices; for example:
- Restructure agent and broker administrative compensation. By standardizing and limiting override and supplemental commission dollars, CMS can put a stop to the misaligned financial incentives brokers receive when consumers switch plans. The fact is that most consumers choose to stay with their same health plan year-after-year, yet marketers, agents and brokers get commissions when consumers switch plans. That is wrong. By establishing a standard for “fair market value” in Medicare marketing guidelines and eliminating the allowed amounts for renewal and switching commissions, CMS can remove this anti-consumer incentive.
- Flag agents and brokers with high disenrollment activity. CMS can identify outlier agents and brokers by watching for instances where a consumer is disenrolled from one plan and reenrolled in another. CMS can issue publicly available civil monetary penalties to recoup administrative compensation and deter future bad behavior.
- Provide transparency regarding the receipt and processing of complaints against agents, brokers or third-party marketing organizations. This transparency should include what enforcement processes exist and what actions are taken. CMS must lead this important work in partnership with health plans. Offloading responsibility and increasing the burden on issuers would be ineffective at addressing the root causes of misleading and inappropriate marketing practices.
Health care can be confusing enough; it does not need misleading, convoluted or deceptive marketing tactics. Seniors deserve the opportunity to be informed consumers, selecting the health coverage best suited to their individual needs.
CMS can strengthen the consumer experience in navigating the rapidly growing and diverse MA program. By creating a marketplace that empowers consumers to choose the right health care coverage for their unique and individual needs, CMS will continue to put consumers first and strengthen Medicare Advantage, already the chosen program of America’s seniors.
Photo: Dilok Klaisataporn, Getty Images
Michael Bagel is the Director of Public Policy at the Alliance of Community Health Plans (ACHP), the only national organization promoting the unique, payer-provider aligned model in health care. He is a public policy expert with more than 15 years of experience working with federal policymakers and lawmakers to advance regulatory and legislative activities across federal health care programs. Michael previously served as a senior policy advisor at the Department of Health and Human Services, attorney with the Office of Management and Budget, law clerk at the US Department of Labor and Health Policy Associate with the Senate Finance Committee. Michael received his J.D. from the William & Mary Law School, and earned his B.A. in Political Science and History from the State University of New York at Geneseo.
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