On Heels of GAO Report, Council for Affordable Health Coverage Sends Letter Urging Medicare Plan Finder Reforms

WASHINGTON, Aug. 8 -- The Council for Affordable Health Coverage issued the following news, dated Aug. 5:

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- Coalition writes "It is absolutely critical that CMS end its unfair and taxpayer-financed competition with the private sector"

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Days after the nonpartisan Government Accountability Office (GAO) released a startling report on shortcomings in the Centers for Medicare and Medicaid Services' (CMS) online shopping tool, Medicare Plan Finder (MPF), the Council for Affordable Health Coverage (CAHC) sent new correspondence to the agency warning against the latest efforts to tinker around the edges with the beleaguered website.

CMS plans to replace MPF - which received a grade of "D" or "F" in seven of 13 scoring categories in a 2018 CAHC-led study - with "Medicare Coverage Tools" (MCT) ahead of the next enrollment season. The agency has done little to explain how the rebranded site will improve upon the failed status quo in which 73 percent of State Health Insurance Assistance Program (SHIP) directors say that it is "difficult" or "very difficult" for beneficiaries to compare plan information. CAHC has championed turning over the site's enrollment functions to the private sector.

"No amount of tinkering with MPF - not even a slick name change - will change the incentives at play," explains CAHC in its letter. "Government bureaucracies simply do not keep up with market demand. If this site's grip on Medicare enrollment and comparison shopping is allowed to fester, we believe many private efforts will fail or will simply move on to other challenges."

CAHC's correspondence further advises that "CMS should fill the legitimate public role of providing information on all plans and options available under Medicare, but it should end permanently its foray into e-commerce by ceasing MCT's enrollment functions. It is absolutely critical that CMS end its unfair and taxpayer-financed competition with the private sector."

Read CAHC's full letter to CMS here (https://horizondc.us2.list-manage.com/track/click?u=aa74e81b676f6a390631dd0c2&id=37cbeb3e32&e=ab80be3c2e).

Timeline of CAHC's Recent Work to Reform Medicare Plan Finder:

* April 25, 2018: CAHC's Clear Choices Campaign and the National Council on Aging release their joint report, "Modernizing Medicare Plan Finder: Evaluating and Improving Medicare's Online Comparison Shopping Experience." The report gave Medicare Plan Finder grades of "D" or "F" in seven out of 13 criteria and issued 11 key recommendations for improvement, while also positing that "faced with limited budgets and considering the vast experience and expertise in the private sector, MPF could be partially or fully privatized."

* October 1, 2018: CMS's eMedicare initiative announces changes to the Medicare Plan Finder tool mirroring some CAHC recommendations.

* February 8, 2019: At a meeting of CMS's National Medicare Education Program (NMEP), the agency announces that it will replace Medicare Plan Finder with "Medicare Coverage Tools," which it bills as "a suite of digital services that will help Medicare Beneficiaries and those who help them easily find and enroll in coverage that meets their needs." To date, the public lacks clear information about the new site's features or costs.

* July 30, 2019: The Government Accountability Office (GAO) issues a new report on Medicare Plan Finder, which cited CAHC's own research and found that the site "is difficult for beneficiaries to use and provides incomplete information."

* August 2, 2019: CAHC writes to CMS about the pitfalls of Medicare Plan Finder and the looming "Medicare Coverage Tools," saying "No amount of tinkering with MPF - not even a slick name change - will change the incentives at play. Government bureaucracies simply do not keep up with market demand ...[CMS] should end permanently its foray into e-commerce by ceasing MCT's enrollment functions."

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August 2, 2019

To: Seema Verma, Administrator, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244

Dear Administrator Verma,

The Council for Affordable Health Coverage (CAHC) writes to express our concerns with CMS' recent announcement that it intends to launch Medicare Coverage Tools (MCT), a new and improved Medicare Plan Finder (MPF), for Medicare beneficiaries at the beginning of this fall's Medicare Annual Enrollment Period. CAHC is a broad-based alliance with a singular focus: bringing down the cost of health care for all Americans. Our membership represents a broad range of interests, including small and large employers, manufacturers, retailers, insurers, patient groups, and physician organizations.

While CMS has not publicly provided many details about the new tool's features or costs, it has touted the expected launch as a major improvement in the Medicare.gov consumer experience./1 We are concerned CMS views what should be a one-time upgrade to MPF as an ongoing process that will pit a government website in direct competition with private sector tools. This is especially important in light of this week's release of the GAO report on MPF and its conclusions that the site is woefully behind private sector innovations/2. The GAO report opens by acknowledging that MPF "is difficult for beneficiaries to use and provides incomplete information according to stakeholders and research studies."/3

Medicare enrollment continues to grow at a rapid clip. In fact, 10,000 Baby Boomers retire every day, and an estimated 80 million people will be on Medicare by 2030, with more than 60 million as of 2019/4, according to the GAO. Program enrollees are increasingly tech savvy and spend time online shopping for goods and services. As a result, online shopping and decision support tools must convey accurate and usable information to serve a vastly larger and increasingly digitally connected population. State-of-the-art private websites save beneficiaries and taxpayers money as the right person is best matched to the right plan.

Consumers deserve better information on their Medicare health plan choices, but the MPF tool is outdated and does not meet the most basic needs. The poor organization and display of information on the website make it difficult for consumers to delineate vital cost and coverage information or to select the best value health plan. According to our research, many beneficiaries find the website confusing, making it difficult to discern the value of Medicare Advantage versus traditional Medicare/5.

We believe competition is better for the beneficiary. Only in health care does government run and fund e-commerce tools to directly compete with private sector innovators. Such heavy-handed federal intervention tips the scales against the market, hampers innovation, and relies on Congressional appropriations and government contracts - rather than consumer satisfaction - to stay afloat. It is not surprising, then, that only a small fraction of Medicare's 56 million enrollees use MPF to sign up or to change health plans.

No amount of tinkering with MPF - not even a slick name change - will change the incentives at play. Government bureaucracies simply do not keep up with market demand. If this site's grip on Medicare enrollment and comparison shopping is allowed to fester, we believe many private efforts will fail or will simply move on to other challenges. It is time to end the competition between government-run health care exchange websites and private sector tools.

CMS should fill the legitimate public role of providing information on all plans and options available under Medicare, but it should end permanently its foray into e-commerce by ceasing MCT's enrollment functions. CMS should continue to provide plan information on MA, Part D and FFS options on Medicare.gov, but include information about, and provide hyperlinks to, private sector sites that can meet all beneficiary enrollment needs.

It is absolutely critical that CMS end its unfair and taxpayer financed competition with the private sector. Instead, we encourage CMS to focus its dollars and efforts on resources that educate Medicare beneficiaries about their program options.

Thank you for examining this issue and for your work on improving consumer choices in Medicare.

Sincerely,

Joel C. White, President

Footnotes:

1/ See "Medicare Coverage Tools - Reponses Due by February 18, 2019," HPMS Memo (February 11, 2019).

2/ Usability Problems and Incomplete Information Create Challenges for Beneficiaries Comparing Coverage Options

GAO-19-627: Published: Jul 26, 2019. Publicly Released: Jul 30, 2019. Accessed at https://www.gao.gov/products/GAO-19-627

3/ https://www.gao.gov/products/GAO-19-627

4/ https://www.gao.gov/products/GAO-19-627

5/ CAHC, "Modernizing Medicare Plan Finder: Evaluating and Improving Medicare's Online Comparison Shopping Experience", April 2018 available at https://static1.squarespace.com/static/58bf2243d482e99321a69178/t/5aeb252f03ce64bd5357a07b/1525359929196/CC+2018+MedicarePF+Report+5.3.18+FINAL.pdf