Tracking the Results of Medicare Advantage Marketing Policies Remains a Challenge

Medicare Advantage marketing practices have drawn criticism from stakeholders and regulatory changes from policymakers, but tracking the results of these policies is difficult, researchers from the Commonwealth Fund shared in an explainer.

“Medicare Advantage plans are promoted through direct mailings, telemarketing, and advertising on radio, television, websites, and social media channels. No organization, including the federal government, directly ‘markets’ traditional Medicare, although commercial insurers sell supplemental Medigap and Part D plans for people in traditional Medicare. Thus, nearly all beneficiaries are subject to some form of marketing effort,” the researchers explained.

When Medicare beneficiaries searched for information on Medicare, a fifth of the records were from agents, partners, and brokers and 16 percent were from health plans. The largest share of the records (27 percent) were from CMS.

Nearly all of the advertisements that resulted from a Medicare-related search were from agents, brokers, and partners or a health plan (55 percent and 32 percent, respectively). Only seven percent of the advertisements were from CMS.

When it comes to sourcing information about Medicare and Medicare Advantage plans, beneficiaries do have alternatives to health plans and agents. For example, CMS mails out a booklet each year to beneficiaries, State Health Insurance Assistance Programs (SHIPs) are federally funded organizations that help beneficiaries understand their benefits and Medicare plan options.

Most beneficiaries over the age of 65 received no help at all when selecting a Medicare plan—45 percent of traditional Medicare beneficiaries and 37 percent of Medicare Advantage members. Around three out of ten in both coverage types relied on insurance agents and brokers (30 percent in traditional Medicare, 31 percent in Medicare Advantage).

Plan marketing is not the major source of information that beneficiaries draw on to assess their Medicare coverage options. However, CMS reported a growing number of complaints about Medicare advertising. A few factors could have contributed to this spike, including marketing violations by robocalls and complaint classification.

CMS instituted Medicare marketing rules for insurers, agents, brokers, and healthcare providers to quell consumers’ discontent.

For example, insurers cannot compare their plans to other plans and must divide educational events from marketing events. Agents and brokers have to be forthright with beneficiaries about whether or not their information covers all of the plans available in the region and must direct consumers to certain federal resources in their marketing.

Healthcare providers are prohibited from offering marketing materials in the clinical setting, although they can discuss health plan options with their patients.

The biggest challenge is tracking the outcomes of marketing restrictions.

“Other than the rise in complaints to CMS, limited information is available about whether the marketing rules are being followed and whether beneficiaries are receiving the information they want about coverage choices,” the researchers noted.

Policymakers have advised tracking the disenrollment rate as a signal of consumers’ discontent potentially due to misleading marketing practices.

The Commonwealth Fund researchers called for more investigation of what information is accessible for beneficiaries as well as agent and broker compensation.