Medicare Plan Finder Aims for Price Transparency, Plan Comparison

CMS released a new Medicare Plan Finder that helps beneficiaries compare Medicare Advantage and Part D plans.

“The redesigned Medicare Plan Finder is another example of how CMS is empowering beneficiaries with price and quality information to take advantage of lower rates and new benefits in MA and Part D,” CMS Administrator Seema Verma said.

This is the first redesign of the tool for the past decade. The new tool may help beneficiaries control their prescription drug costs and avoid out-of-network costs from pharmacies, both of which can lead to higher healthcare spending.

The Medicare Plan Finder enables beneficiaries to enter anonymously or create an account on Medicare.gov to compare Original Medicare prices, prescription drug plans, Medicare Advantage (MA) plans, and Medigap policies.

In the new version, CMS created a system that automatically populates the beneficiary’s medication list from their claims data, added a feature that identifies in-network pharmacies, overhauled the design, and made the site more mobile-friendly.

The new Medicare Plan Finder uses claims data to streamline the process. Beneficiaries can choose to see their drug costs as part of their plan comparison. The system pulls the list of their drugs from their claims data and beneficiaries can customize it if they have had a change in medication.

This version of Medicare Plan Finder also now alerts beneficiaries to nearby in-network pharmacies.

“Currently CMS releases an annual snapshot of the plan data that isn’t as detailed or as informative as a dynamic Plan Finder,” CMS Administrator Seema Verma said in a press webinar prior to releasing the tool. “We’re excited to enable the private sector to be more creative.”

Altering the design was crucial for the Medicare population, particularly on the plan comparison page. The previous version was difficult to read, both in layout and in content.

To remedy this, CMS made the text bigger and allowed for more white space so that it looked less cluttered.

The agency also made sure that the first information beneficiaries would see is the information they want to see. Premiums, deductibles, in- and out-of-network out-of-pocket maximum costs, are all crowned at the top of the page with the plan’s star rating.

With 40 percent more Medicare beneficiaries using mobile devices to explore the Medicare Plan Finder in 2018 as opposed to 2017, CMS also prioritized making the site mobile optimized. The old version was not mobile optimized at all.

The agency not only made the screen more navigable on a mobile device, but also enabled consumer feedback. This allows consumers to explain any difficulties they may have with the system and CMS can make adjustments.

“I think we look at quality improvement always as a work in progress,” said Administrator Verma. “I think that this had not been refreshed in 10 years and so it creates a situation where there's a backlog of changes. We don't want to get into that type of situation again.”

However, she also noted that, while the agency will continue to seek feedback, the tool itself is ready for implementation.

“It is ready to go,” Administrator Verma said. “It's actively being used right now by our call center and people can use it for the plans that are available right now.”

The new Medicare Plan Finder fits into the administration’s eMedicare initiative which seeks to help beneficiaries make informed decisions through providing better technological tools. The tools aim to fulfill President Trump’s stated goal for greater price transparency for beneficiaries.

Despite these updates to the system, studies show that beneficiaries do not tend to use price tools. In the webinar, CMS noted that the site had 20 million visitors last year; however, the agency has 60 million beneficiaries total, making that statistic look slim.

Awareness seems to be a key issue in attracting beneficiaries to utilize these tools. A study by HealthMine showed that only 32 percent of Medicare Advantage beneficiaries with chronic conditions know about Medicare Advantage Star Ratings.

Nonetheless, CMS’s changes seem to be in step with the industry trends and the beneficiaries' needs and the new version of Medicare Plan Finder could help set the tone for tools that center around patient experience.