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The Growing Demand for Medicare: Past, Present, and Future

GoHealth reaches a 20-year milestone and looks forward after reflecting on its past

Reflecting on past experiences is an important process for all of us as we plan how we will move forward. We at GoHealth see our 20-year anniversary milestone as a great opportunity to pause and take stock. A look back reveals many incredible transformations and advancements in the American healthcare industry, but there is still much work left to do to improve access to healthcare in America. There will always be a debate about whether some changes were good or bad, and for whom. Still, reform is always necessary to meet the changing health needs of the populations we serve.

Today, we have more knowledge and resources to engage older adults than ever before. The intersection of science and technology allows us to create tools to reach previously unreachable populations. We can take what we’ve learned from older adults to build bridges that meet these populations where they are and close gaps to provide preventive, high-quality care to all.

Choosing to Respond

In 2001, two college graduates got the idea to create GoHealth after deciding that an essential, basic need like health insurance should be more accessible and easier to understand and compare. Today, GoHealth helps older adults live their best lives through enrolling in and fully utilizing Medicare plans, resources, and benefits services.

As an organization, 20 years in the business of health insurance has taught GoHealth how to listen, and as we listened, we’ve learned that older adults are active and enthusiastic about their health, but they need more help to understand the benefits that are available to them. In response to this need, we take the time to ensure our members are confident with their plan and understand every benefit. The sophistication of both our benefits platform and our members continues to grow. We celebrate the opportunity to improve older adults’ health and quality of life for the next 20 years and beyond.

Impending Education Gap

The next decade will be a historic one. The baby boomer generation will fully age into Medicare by 2030, accounting for nearly 80 million people.

The demand for Medicare is growing and will only continue to grow. History has shown that spending per beneficiary will surely increase. However, through our years of listening and learning from our members, we see opportunities to help seniors improve their physical, emotional and financial health by maximizing the value of their health benefits.

Medicare literacy is a critical piece of the puzzle as millions of older adults age into the program. We know how to help people understand Medicare and how to connect them with a plan that best meets their needs. When Medicare-eligible adults know how to tailor their benefits toward the care they need, we see health outcomes improve. And we know that early intervention and quality care lead to lower healthcare costs.

A Bridge to Better Care

GoHealth’s programs and technologies are helping members obtain more value from their health benefits. Meanwhile, Medicare Advantage plans have undertaken progressive expansions to deliver the same value. Educating high-risk and high-need populations will lead to more seniors with high-quality, affordable healthcare insurance through Medicare Advantage and Medicare services.

The GoHealth platform connects with disengaged and underinsured older adults who can benefit from renewed public health resources and benefits through Medicare Advantage. The priorities and tastes of aging populations inform how we engage these populations with benefits solutions that meet their needs where they are, making Medicare seamless, simple and affordable.

One single approach won’t address older adults where they live or cater to the varied types of care they need. By recognizing the diversity of social factors, disease states, and socioeconomic factors among seniors, we build benefits and TeleCare customer service teams that support care management and evolve with health conditions and aging.

Plotting the Course

Anyone in the healthcare industry knows that discussions about payment reforms and innovations to the delivery system date back further than 20 years. Still, as a stakeholder in the healthcare ecosystem, we continue to build services that help our members get more value for every dollar spent on health insurance.

Twenty years has taught us that enhancing access and providing resources lead to a more efficient system. As the demand for Medicare grows, so does the importance of our mission to improve access to healthcare in America. Twenty years ago, that’s what we set out to accomplish. Today, we know GoHealth is living its mission successfully, as we have helped over a million people enroll in a health insurance plan in the last three years alone.

Tomorrow, the next chapter of GoHealth’s history begins. We will continue to advance our mission to improve healthcare access and provide resources for physical, emotional and financial health to the Medicare generations to come.

Meaningful Medicare Markers

Along the way, we have lived through significant reforms and accomplishments in the healthcare industry. We asked some of the folks from GoHealth to share what it meant at the time, how it shaped our business and the potential lasting impact on the next generation of healthcare and Medicare members.

1990 to 1999

Medicare coverage expanded during the nineties through Medicare Advantage. The introduction of Medicare Part C provided Medicare-eligible people a private insurance option(s), and later expanded to include prescription drug coverage (Part D) and extra benefits like vision, dental and hearing coverage.

“Anyone at any age can engage in healthy behavior changes. Having the resources at hand to understand behavior change and take action is critical. One of the great benefits GoHealth provides is helping people find Medicare Advantage benefits that can be life-changing. In the past two years, we have seen Medicare Advantage make meaningful changes toward better delivery of care through initiatives to remove social barriers to healthcare. As advocates of value-based care, we know that Medicare Advantage is the path to better care. Our platform can help seniors live healthier lives by leveraging all the benefits their plan has to offer.”

Co-founder & Chief Executive Officer

2000 to 2009

Before the Ice Bucket Challenge went viral in support of people with Amyotrophic Lateral Sclerosis (ALS), Medicare eligibility shifted to allow Americans younger than 65 to enroll if they receive Social Security Disability Insurance (SSDI) income.

“Expanding the benefits to include younger people with disabilities was a key milestone in the Medicare landscape.”

Co-founder & Chief Strategy Officer

2004

In 2004, GoHealth developed real-time quoting technology so brokers could show customers more plan choices more quickly.

2004

The Medicare Prescription Drug Improvement and Modernization Act added a benefit known as Medicare Part D. Most Medicare Advantage plans offer Part D.

“Access to a comprehensive prescription plan is critical for improved outcomes. Medicare Advantage benefits like Part D have proven to be extremely valuable for our members, connecting them with prescription plans that best meet their healthcare needs while saving them money.”

Co-founder & Chief Strategy Officer

2008

In 2008, GoHealth took its popular quoting technology directly to consumers for the first time.

2010 to 2021

Congress passed the Medicare and Children’s Health Insurance Program Reauthorization Act (MACRA). The legislation propelled the “doc fix” and reform efforts to pay providers for quality care over quantity of care.

“Over the years, we have seen a dramatic shift to align financial incentives from fee-for-service to value-based care. This has been a major transformation in the healthcare industry, as we are no longer focusing on the quantity of services, but rather the overall quality of care being rendered.”

Chief Medical Officer

2013

In 2013, GoHealth technology became a leading provider under the new Affordable Care Act (ACA) plans.

2013

The ACA eliminated the prescription drug donut hole. Medicare members with Part D pay 25% of drug costs until reaching the catastrophic threshold.

“In the past, customers were responsible for a higher percentage of their medication cost. Part D benefits have made it more manageable for customers to access their prescriptions and follow their treatment, which is a huge win for seniors.”

Chief Medical Officer

2016

In 2016, GoHealth entered the Medicare market, using technology to make it simple for customers to get all their benefits.

2020

COVID-19 led to numerous Medicare changes. An increase in telehealth access was most notable as a temporary measure, but the technology’s rapid adoption may lead to permanent changes.

“COVID-19 led to innovative ways to deliver care outside of traditional settings. We quickly learned to adjust to this ‘new normal.’ As a result, we anticipate more seniors embracing telehealth as part of their overall care in the immediate future and beyond. Moving forward, telehealth will represent another effective solution in the delivery of care.”

Chief Medical Officer

2020

In 2020, GoHealth launched its Encompass platform. The proprietary technology platform provides tools and communication resources rooted in value-based care principles.

2020

The CHRONIC Care Act expanded Medicare Advantage benefits for qualified members with at least one chronic condition. Many of the services provided address social risk factors and other barriers to healthcare.

“We continue to narrow healthcare disparities, especially among high-risk populations. We know individuals with chronic conditions often experience challenges with access to their benefits. This expansion advances our mission to improve access to healthcare in America.”

Senior Vice President of Strategic Partnerships

2020

In 2020, GoHealth appointed its first Chief Medical Officer to drive successful care management and innovative clinical solutions in the Medicare Advantage space.

About GoHealth, Inc.

As a leading health insurance marketplace and Medicare-focused digital health company, GoHealth’s mission is to improve access to healthcare in America. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science and deep industry expertise to match customers with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare and individual and family plans. For more information, visit https://www.gohealth.com/.

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