Recapping Medicarians 2024 & CMS Final Rulings

In this episode, Tim and Cory share their experience at Medicarians Vegas 2024, an event with 3,000+ attendees across the senior health, wealth, and agetech ecosystem. Our hosts also dig into the recent CMS ruling and the effect it may have across the entire insurance industry.

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Transcript

Tim Robinson: [00:00:00] Hello everybody, welcome to another edition of Insurtech Building Blocs. This is Tim Robinson and I'm accompanied with my co host Cory Schmidt, Hey Cory, how you doing?  

Cory Schmidt: Doing well. How are you Tim?  

Tim Robinson: I am doing excellent. We are. Oh, less than 24 hours returning from the Medicarians event in Las Vegas. 

Tim Robinson: So I guess if you can't see our bleary eyes or any of those type things, but hopefully our voices sound okay. So , we're excited to cover off on. Some highlights from the Medicarians event from our perspective as well as talk a bit about the latest CMS rulings and that's the Center for Medicare and Medicaid Services, otherwise known as CMS. 

Tim Robinson: One before we dive in here, one, one [00:01:00] thing to to note Cory, are your ears still ringing from the, from the event?  

Cory Schmidt: Yes. I think the one, the one thing I will say the, the Medicarians event was at the Fontainebleau, I think is how you say it, which was a fantastic property. I believe it just opened in December. 

Cory Schmidt: You know, and one thing I dislike about Vegas is there's always, it's always loud. There's always, you know, too much noise in the background, whether it's. Slot machines, you know, music, but yeah, I think we had a specific experience with loud music where I didn't expect it, Tim, in terms of what I thought we were going to get. 

Tim Robinson: Normally when you think of a steakhouse, you think of white tablecloths, quiet mahogany booths. That is not the case at one of the places that you can eat at that restaurant. So if anyone didn't experience it, you know, And you like actually great steaks and really loud music, just bring your earplugs, but we, we had fun, but certainly I [00:02:00] think all of us were, were happy when we, when we left. 

Tim Robinson: So pretty amazing. And if you are looking for a thousand dollar Tomahawk steak. Such a thing does exist at a Papi Steak at the, at the hotel.  

Cory Schmidt: So not only does it exist, the level of pomp and circumstance by which it's brought out is pretty phenomenal. So I will say like, it's a bit of an experience. 

Cory Schmidt: I'm not sure I would do it again. And for the record, obviously we weren't eating any thousand dollar steaks, but you get to observe the people around you, you know, since spending all kinds of dollars. And fortunately we live here in the Midwest, so I think we can, get probably equally good stakes for a tiny fraction of that cost. 

Tim Robinson: That's a, that's a good call. So if you have any if you have any comments, if you experienced Papi Steak and do you think differently, please please let Cory and I know. Well, look, let's let's dive in. Medicarians. Vegas roughly 3000 attendees. We were also, we also had representation down at the, the LeadsCon [00:03:00] show over at Paris. 

Tim Robinson: But really Cory and I spent the bulk of our time at at Medicarians. Wow. There was there was a lot of discussion around obviously the, the latest CMS rulings. But before we dive into that, you know, I. This is my first Medicarians. I think I'm almost at my year anniversary here or at my year anniversary with AgencyBloc. 

Tim Robinson: And what I thought was, was amazing. It's just the amount of, of energy and activity for our team at the booth, but also the great conversations, great opportunity to meet with other industry leaders, both from a technology perspective carrier perspective. Marketing organization producers, both, you know, large shops, small shops. 

Tim Robinson: What a, what a great way to get together with a really broad spectrum of thought leaders in the space. What are your, what are your thoughts, Cory?  

Cory Schmidt: Yeah, I totally agree with that. I was really impressed by the diversity [00:04:00] of the attendees this year, as well as what Medicarians You know, included in terms of the panels and the speakers, like there was just a lot of different perspectives that they were highlighting throughout the show. 

Cory Schmidt: And I thought it was really compelling. I fully expected it to continue to be more of an upmarket, like IMO, FMO and carrier representation, but I think we're definitely seeing a lot of, you know, retail agents that are attending this particular conference. I think it's, it's got a lot of momentum. It's got a lot of attention and I think it's well deserved. 

Cory Schmidt: They, they did a fantastic. Fantastic job putting on the conference.  

Tim Robinson: Yeah, I agree that the panel discussions I really enjoyed you know, candidly in, in other industries that I've been in and when you go to these conferences, there's not a lot of opportunity to go see a panel discussion of let's call it high quality or caliber where the discussions are really meaningful [00:05:00] and I, and I. 

Tim Robinson: I thought that really was a highlight for me and really resonated. So it was, it was great to see. And then, all right, let's let's, let's talk about the, the, the CMS ruling. And I know there is a lot of content that's been put out there. There's articles, podcasts, YouTube videos. There's a lot, and there's also a lot of differing views on what the latest ruling means. 

Tim Robinson: And so, you know, we're happy to share some of our, our thoughts, perspectives on it again, just from having conversations with with a lot of folks that are spending a lot of time and energy on it. In case you've not taken a look, it is 1000. 327 pages of goodness. And you know, what, what is interesting is that there. 

Tim Robinson: Some of the conflicting views are because the, the language in the, in the document does [00:06:00] conflict itself in a couple of areas. And I, I think there's a, the final publication will come out in late April, I believe April 23rd. So we'll see if there's some additional refinement that occurs there. But, but I also think. 

Tim Robinson: You know, Cory, from you, you've been in the industry for a little while. Have you seen this kind of energy around a CMS ruling? Just in the time, the 15 plus years that you've been in the, in the space.  

Cory Schmidt: I'm not sure we've seen it to this level. I think that you know, in the past, there've been some pretty significant changes that have come via CMS. 

Cory Schmidt: Even just in the last couple of years, the, the call recording requirements created a lot of buzz and stir in the industry. And there've been other changes, you know, prior to that, that were certainly significant. I think this one in particular seems like they have a motivation to try to shift some of the funding for [00:07:00] the Medicare Advantage enrollment specifically to the retailers as opposed to the distributors which, you know, it, it's an interesting approach. 

Cory Schmidt: And I think that that's what I was most interested to hear about when, you know, when we were at Medicarians is, You know, we, we had a lot of conversations with IMOs FMOs. Many of those were customers of ours. And you know, I was really interested to kind of hear what their take is. And I think that by and large, I will say there's more optimism than not about how they are viewing this. 

Cory Schmidt: I think they feel like the. The final rule or the draft commentary that came out the 1300 and some odd pages provides for some ability for you know, the marketing middlemen, the field marketing organizations to continue to be part of the To be continue to be part of the hierarchy here in terms of how the the structure, you know, works. 

Cory Schmidt: But I think to your point, Tim, like there's a, there's a lot to be taken in terms of the [00:08:00] interpretation. I certainly didn't read 1327 pages. I don't think anybody on our team did, but I certainly went at some specific areas and First thing I did was control F when I opened the PDF and I'm looking for things like override and bonuses and you know, IMO, FMO to see kind of what the, what the CMS guidance was in terms of those kinds of changes, because those are really important entities and, you know, to our organization as our retailers, obviously we serve both markets, but I think by and large, optimism is, is still The key term that I'm, that I'm getting from the IMO FMO market, I think there's a lot to be clarified in terms of what CMS truly means by the transfer of funds. 

Cory Schmidt: They use that, that terminology repeatedly throughout. They, they also, I think the interesting piece is they specifically kind of carve out the marketing organizations, but they also say that The compensation can't be related to the [00:09:00] undertaking of enrolling someone into a Medicare Advantage plan. 

Cory Schmidt: So I think what they're trying to, to disconnect is this this carrier approach of paying based on like volume and, or, you know, bonusing based on volume of enrollments into Medicare Advantage. But I have it be. You know, not connected to that so that it's not driving, you know, agents and brokers to put beneficiaries in particular plans where they know they're going to get more compensation than not. 

Cory Schmidt: So they're absolutely trying to level the playing field. They're trying to not tie it directly to the volume of enrollments onto particular products or carriers, which I think ultimately is probably. Better for the beneficiaries so that they get, they get placed into the proper plan. And I know that that's what, you know, when we talk to retail agents, that's what they want. 

Cory Schmidt: They want the beneficiaries to end up in the best possible plan that's available to them that, you know, optimizes their benefits and provides for the lowest out of pocket cost. And undoubtedly that's what the, you know, insurance agent market really wants as [00:10:00] well. So I think Yeah, to your original question, absolutely. 

Cory Schmidt: It's a big deal. I think a lot of people are paying attention to this. I'm not sure we know fully what it means, but I think there's optimism that there are ways to make this work with the industry as it sits today.  

Tim Robinson: Yeah, love, love the perspectives. And, and it's also, if I understand there's, there's a piece of this, which is trying to protect the, the consumer, the beneficiary from the, the leads or rights from, from basically getting a lead capture selling it 50 times. 

Tim Robinson: And then the, the. The poor beneficiary is, you know, getting hammered through email, phone calls. There's some examples of that, that we've all heard about. We probably even have family members or friends that have experienced it. So I think that's, I think we can all agree that that's a very good thing. 

Tim Robinson: So I think that'll disrupt the leads and lead distribution markets. That was certainly something we talked about quite a bit as well. Some [00:11:00] organizations are probably positioned really well where they already Kind of the marketing framework and capture and being able to, you know, distribute amongst their team and in a more direct capacity. 

Tim Robinson: And I, and I think that's, that's good. That's good in a lot of ways.  

Cory Schmidt: Absolutely. I think you know, we, in speaking with again, some of those same IMOs, FMOs, they obviously understand there are some bad actors, you know, in the industry and, and they want nothing more than to eliminate that. But they also don't want to have sweeping changes that affect the good parts of the industry and the parts of the industry that are enabling the carriers to get these products distributed, to build agent, you know, distribution channels. 

Cory Schmidt: Because I think it is clear that the carriers don't want to have to work with every single. Downline retail agency. So these marketing organizations obviously serve a really important a really important part of the industry. And I think that's, that's something that we continue to see as, as, you know, as the final ruling comes out on the [00:12:00] 23rd and then we get interpretations, it'll be interesting to see how that, how that plays out. 

Tim Robinson: And I guess, you know, one, one thing that may be missed here, because the, like I, the, the commission compensation piece is incredibly important. It's how business owners make determinations and where they can invest and continue to provide. Like if you're investing in the business, you can do more things for your customers, right? Whoever you're in customer, in this case, beneficiaries or your downline agents. And so. Roughly so it is of a real concern. What are the changes in the flow of dollars that can be received. But I think what's, what's probably taken a pretty significant backseat is some of the other changes that are highlighted here as well. 

Tim Robinson: Do you want to talk a little bit about some of those that you, that you saw?  

Cory Schmidt: Yeah, I think the one that we maybe heard about the most is the is the changes that are, I think it's related to the inflation reduction act as it relates to capping [00:13:00] prescription drug costs on the PDP plans, at least that's the, that's the topic that seemed to be most prevalent at Medicarians. 

Cory Schmidt: It sounds like to me that You know, previously there was no cap on out of pocket costs on the PDP plans. And so they're implementing an out of pocket cap. I believe it's 2, 000. I don't know if that varies based on the kind of plan, but at a high level, my understanding is, you know, previously, you know, using a Medicare supplement along with a PDP opened up more potential, you know, out of pocket costs. 

Cory Schmidt: If your prescription drug costs were high, my understanding is with these changes, there may be more benefit now to. You know, enrolling beneficiaries in a Medicare sup with a, with a PDP. And so we could see a shift over to that side of the market. In fact, I think there's some folks that believe that like, this is what the government or CMS and others are trying to actually do is, is sort of like. 

Cory Schmidt: Tilt the balance back to medicare supplement and or at least put them on a level playing field with the medicare [00:14:00] advantage Products and again, I am by no means an expert. I don't claim to be it's just we're you know This is something we're hearing a lot about at medicare ians and it seems to be that a lot of our customers I know are already considering like how they could diversify and And make sure they're, they're selling multiple product lines so that one change, you know, to a particular line of products, whether it be Medicare Advantage or something else in the future, isn't entirely disruptive and they don't have revenue concentration specifically on a, on a particular product line, I think I'm, I think you maybe even experienced him, even discussions around like supplementary and ancillary types, types of benefits. 

Tim Robinson: Yeah, that's right. I think. And anyone that's gone through this, I mean, they're the, the reality is there are a lot of ancillary supplement supplementary benefits that most people, most consumers, beneficiaries don't even know about. And this is, this is kind of the, the tricky part, [00:15:00] because the more you know about them, the more you use them, right? The idea is then you can lower the ongoing costs of healthcare. I think it's a real opportunity. It gets it gets overlooked. And I certainly you can see some of the language in the ruling that's trying to address that where it's requiring additional notification and education of the beneficiaries. And so I think that's a, I think it's a really good thing. 

Tim Robinson: And I hope that starts to get some. Some additional traction there. I know that's again, it's, it's not just, we're in the, we're in the space, whether as a enabler through technologies and solutions or as the agent or as the FMO IMO or as the carrier, so ultimately we can help. You know, help people and so I, I think it's just really important that we embrace and understand there's, there's a lot of education that has to happen for the beneficiary. 

Tim Robinson: And when that happens, we end up in a better place from being able to [00:16:00] provide greater care.  

Cory Schmidt: I think that's a really key point for us as an organization. Obviously we have always leaned in very heavily to the retail side of the market and ensuring that they can efficiently and effectively, you know, manage their book of business, engage with leads, convert sales. 

Cory Schmidt: You know, it's really that core to our, our belief of how do we make our customers more profitable and more successful. And so I think to your point, like anytime there's disruption, everybody, you know, starts to look around and wonder how it's going to affect them. I will say, I think to the extent that, that we continue to lean into making re the retail channels more successful I think that that's a. 

Cory Schmidt: That's a theme and a strategy I think that will continue to be successful because there's a significant market here that needs to be served. There's a really important retail broker channel that's incredibly important to distributing those products. And so I think we'll need to, you know, continue to lean in heavily on that strategy and also support other things like the supplemental and [00:17:00] ancillary benefits, you know, supporting distribution of those. 

Cory Schmidt: And I think we might even see a shift into some other markets as well. We've already seen the ACA under 65 market. Continue to grow. And I think that these kinds of changes always force people to kind of look around, even whether, whether the change ends up being disruptive or not. I think just the fact that it's there and it's being discussed causes people to reevaluate their business, reevaluate, reevaluate revenue concentration, reevaluate their business strategy. 

Cory Schmidt: And I think that's ultimately usually a good thing.  

Tim Robinson: Yeah, absolutely agree. These, these points of disruption in industries generally create a lot of opportunity. It's just a matter of, of how in tune you are with the changes and, and where you can go next. So we'll, we'll see we'll see what the next. 

Tim Robinson: I don't know, 12 months or so has in store, maybe even broader, but yeah, these changes will impact the enrollment season coming up for coverage. Effective January [00:18:00] 1 2025. hard to believe we're talking about 2025, but that is the reality here. And Cory, you know, maybe maybe as we wrap up here I'm going to guess you have to turn the suitcase over to repack in much the same way that I am as we head off this weekend to Atlanta for our BlocBuilder conference. 

Tim Robinson: So Excited to go down there with the team. We're going to have customers, partners down there, joining us. I think we're, we're going to be well over 300 people in attendance. So really excited to continue these conversations as well as continue to talk about our, our products and services and the future of AgencyBloc and how to your, to your points, how we can better serve the market and all that, and we really are focusing on helping all aspects of the market. 

Tim Robinson: So  

Cory Schmidt: I'm trying to regroup on all the things I volunteered to moderate or participate in and remember exactly what I'm supposed to be [00:19:00] doing. But yeah, to your point, suitcase emptied. Currently need to reload it and then head out on a, on an early flight Sunday to, to get ready. So, but I'm super excited. 

Cory Schmidt: It's, it's one of my favorite times of the year, getting to engage with our customers and hear directly from them and not just the good, but also the bad and how we, not the bad, but you know, the The criticisms, how we can improve and the feedback. And so I think it's, it's really a, an incredible time for us. 

Cory Schmidt: And I always come off of a BlocBuilder, really energized. And I, I expect nothing less this year.  

Tim Robinson: Well, that's great. And I'll, I'll see if I can find a techno blend steakhouse down there for us as well, but I may not be lucky. That's, that's a pretty unique thing. So  

Cory Schmidt: yeah, maybe maybe we'll have that. 

Cory Schmidt: The, the conference of silence, no background music, no, no extra noise. It'll just, well, yeah, we'll, we'll try to keep it we'll try to re recuperate our eardrums.  

Tim Robinson: But that sounds great. And as always awesome to chat with you, Cory, and look forward to seeing you here in [00:20:00] just a couple of days and Neal, our producer was kind enough to step in and help us pull us together quickly. 

Tim Robinson: So thanks Neal. I think we'll do another quick one next week as well, just as a recap of the, the BlocBuilder event with that have have an amazing, I guess this would be weekend that we're heading into, so I'm really just saying it to you, Cory, have an amazing weekend, Cory everybody else, please keep the comments coming and look forward to give me a recap of a BlocBuilder. 

Tim Robinson: Take care, everybody. Thanks all.