Here's something to put on your TV watchlist for Thanksgiving break.

John Oliver recently covered Medicare Advantage on Last Week Tonight — potentially misleading viewers, but also pointing out valid flaws in the system. As someone deep in the MA market, it’s worthwhile to unpack a few things he points out:

1. “MA is overly expensive for the government due to upcoding.” → Members with multiple chronic conditions cost more and carriers should be appropriately compensated. We still need to fight improper upcoding, and the best way to do this is to encourage healthy market competition to incentivize carriers and providers to curb misconduct and improve the member experience.

2. “MA offers limited networks and requires prior authorizations.” → Carrier requirements are necessary to manage costs and get beneficiaries appropriate care. But they can be misused and cause consequential delays. That’s when beneficiaries need advocates. At Spark, our brokers can use our Client Services to find new providers, research policy coverage, help with prescription drugs, and more.

3. “MA marketing is aggressive.” → While non-clinical services can contribute to positive health outcomes, we don’t support spammy marketing focused on supplemental benefits. There’s an opportunity here for the industry to build technology to identify and prevent low enrollment quality. Think things like proactive plan fit analysis, telephonic improvements, and broker quality scoring.

Is MA a perfect option? As John Oliver showed us, no, there are valid criticisms. The average consumer can’t fix these issues on their own, but as agents and industry leaders, we can work together to fight for beneficiaries and push the industry in the right direction.

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