Broker Incentives and Their Influence on Medicare Plan Selection: A Comparative Analysis of Medicare Advantage and Part D

Authors

  • Madhu Mahesh IT Solution Architect, Henry Ford Health System, USA Author

Keywords:

Medicare Advantage, Medicare Part D, broker incentives

Abstract

The burgeoning complexity of Medicare plan selection necessitates a thorough examination of broker incentives and their influence on beneficiaries' decisions, particularly in the context of Medicare Advantage (MA) and Medicare Part D plans. This research paper delves into the mechanisms through which brokers, as intermediaries in the Medicare landscape, exert significant influence over the selection of healthcare plans by beneficiaries. As Medicare enrollment increasingly shifts towards private plans, understanding broker incentives becomes critical for policymakers, healthcare providers, and beneficiaries alike.

This comparative analysis encompasses a systematic review of existing literature alongside empirical data to elucidate how broker compensation structures, including commission-based models, impact the distribution of plan enrollments. The paper explores various dimensions of broker engagement, including the educational role brokers play, the information asymmetry that may exist between brokers and beneficiaries, and the potential conflicts of interest arising from commission-based incentives.

Furthermore, this study investigates how brokers' recommendations correlate with the characteristics of MA and Part D plans, examining the extent to which broker preferences align with the best interests of Medicare beneficiaries. This investigation is grounded in an analysis of quantitative enrollment data across different regions, supplemented by qualitative interviews with brokers and beneficiaries to provide a nuanced understanding of the decision-making process.

Additionally, the paper addresses the regulatory environment governing broker practices, assessing how current policies may mitigate or exacerbate the influence of broker incentives on Medicare plan selection. It emphasizes the importance of transparency in broker compensation and the need for comprehensive education initiatives aimed at beneficiaries to empower informed decision-making.

The findings indicate that while brokers serve as a valuable resource for beneficiaries navigating the complexities of Medicare, their financial incentives can create biases in plan selection, potentially steering beneficiaries toward plans that may not optimally meet their healthcare needs. The study highlights the critical balance that must be maintained between facilitating broker engagement and safeguarding beneficiaries' interests in the competitive Medicare marketplace.

Ultimately, this research contributes to the ongoing discourse on Medicare reform by providing empirical evidence on the role of brokers in plan selection processes. It advocates for enhanced regulatory frameworks that ensure broker practices align with the overarching goal of improving access to quality care for Medicare beneficiaries. The insights derived from this analysis will inform future policy initiatives aimed at optimizing the Medicare selection process, ensuring that beneficiaries receive unbiased information and access to plans that best meet their health needs.

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Published

19-08-2022

How to Cite

[1]
M. Mahesh, “Broker Incentives and Their Influence on Medicare Plan Selection: A Comparative Analysis of Medicare Advantage and Part D”, J. of Artificial Int. Research and App., vol. 2, no. 2, pp. 493–512, Aug. 2022, Accessed: Nov. 07, 2024. [Online]. Available: https://aimlstudies.co.uk/index.php/jaira/article/view/264

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