SeekMedicare: Making Medicare Simple
TLDR: SeekMedicare is building a service model in a sales industry. In order to deliver value to consumers, a Medicare distribution agency needs to invest in the people and capabilities necessary to offer a multitude of plan options in every market, and match consumers to coverage best suited to their unique personal attributes.
I am writing to give you an important update on the founding of SeekMedicare and our progress to date, and also to expand a bit into why we started this company and how we are approaching the huge opportunity in front of us.
To date, in our short 7 months of existence, we have delivered on the initial version of our Coverage-as-a-Service platform, including our Agent Console, which guides our agents through the process of obtaining the necessary information from our customers to help them select — and then enroll in — the right coverage based on their unique personal attributes. We have raised a substantial round of venture capital from the outside world, which will allow us to build our service platform the right way, without sacrificing our mission for near-term revenue or sales goals. We have also developed strategic relationships with entities such as Walgreens, and will continue to expand there as we find like-minded enterprises that share our mission and are aligned with consumers and believe in the solution we are bringing to market.
We have also had some operational successes. In our first Annual Enrollment Period, we guided our customers to 10 different insurance carriers across 11 states. In each case, our agents took the time and effort to obtain information about our customers, map that information against the available coverage options, and match them with the plan that best fit their needs. We also stood up our first Seek in-person program, which included delivering a physical presence into almost 100 Walgreens stores and beginning down the path of building a community-based program that intends to help local seniors find and understand their Medicare coverage options, while also providing meaningful, long-term career opportunities in each community that we enter.
We are deeply proud of our team, who truly embraced our mission. I would like to share the story of how Seek came about, and what our role is in the Medicare universe.
The beginning
On July 6, 2020, I became the first employee of a company formally named Seek Insurance Services. In the real world, we call ourselves SeekMedicare, and our mission is to help seniors find and understand the Medicare coverage that best fits their unique needs. We call what we do “Coverage-as-a-Service”. I will come back to that.
Before I go further into the SeekMedicare story, please indulge a short turn into my background: I have spent the entirety of my ~17 year career in healthcare. I have been fortunate, both in terms of having been in the right place at the right time (a few times) and having been able to learn from some of the best and brightest people in the healthcare industry. I’ve spent most of my working years at — or working for — UnitedHealth Group (UNH), which is the largest diversified healthcare company in the U.S. I also spent a few years at Clover Health (CLOV), which is one of the fastest growing Medicare Advantage carriers in the country, as well as a recent entrant to the public markets.
Over the years, I’ve learned a lot about the intricacies of our healthcare system, including the three-sided dynamic among insurers, physicians and consumers. I’ve learned a lot about the business of healthcare (it is a business in our country), and I’ve come to accept as a norm the skepticism — and downright cynicism — people express toward the insurers, hospitals, physician groups and other entities that operate in this industry. I also have a pretty good understanding of why that skepticism exists — and there are plenty of very good reasons for it. At the same time, I have developed a deep conviction that working to change those dynamics for the better is a task worth taking on because healthcare is, all at once, inextricably tied to our personal well-being and the way we experience life itself, and it is also one of the more pressing issues tearing at the economic fabric of our country today.
That is quite a preface, I know. But I am a “perspective person,” in that I want you to have a little bit of perspective on me, as well as share a little of my perspective. That said, I’m really here to talk about our business — SeekMedicare. To start, I didn’t come up with the concept of SeekMedicare (see my note above about being in the right place at the right time — this is one of those times). The concept for this company was developed inside Clover Health by Andrew Toy, Clover’s President and CTO, and Chris Watson, who is now SeekMedicare’s COO. Their insight — and the one that led to the founding of SeekMedicare — was that many distribution agencies operating in the Medicare market today are defined almost exclusively by short-term sales (versus long-term relationships), and they view their main goals as obtaining as much capital as they can to feed their marketing budgets and grow their agent bases. But that model tends to disadvantage one key constituent: the consumer.
The hypothesis posed to me was that, in order to be a true consumer business in the Medicare distribution space, you have to build an agency driven by the principles of neutrality and consumerism — one that defines itself by the value of the services it provides and its relationship to its consumers instead of just sales. Said another way, in order to deliver value to the consumer, a Medicare distribution agency needs to — as a first order of business — invest in the people and capabilities necessary to offer a multitude of plan options to consumers — wherever they are — and match them to coverage based on their unique personal attributes. This is a service model or Coverage-as-a-Service, and not a sales model. This was a good idea. And, as it turns out, there is a lot of data that points to this being the way.
From a business perspective, the tailwinds in the Medicare Advantage space are compelling to say the least. Up to 10,000 seniors age into Medicare eligibility every day in our country. The Medicare Advantage market is growing incredibly fast and continues to take share from Original Medicare as its offerings continue to deliver more value. In 2020, ~39% of all Medicare beneficiaries were enrolled in Medicare Advantage plans (that percentage has doubled in the last 10 years), and all signs point to a 50% share for Medicare Advantage by 2030. That number may be conservative as the trend in Medicare Advantage premiums continues downward, including with respect to plans that include Prescription Drug coverage — where the percentage of zero premium offerings is up to 60% in 2020. All in, many Medicare Advantage carriers are delivering more and more value to consumers, and they are being rewarded with tremendous growth as a result.
But we also know that, in a given year, (i) only ~35% of Medicare Advantage members check their coverage, (ii) only ~9% of Medicare Advantage members change plans and (iii) finally, out of that 9%, around 80% of those consumers use an insurance broker or agency to effect that change. That tells us that, despite the clear trend toward richer benefits and greater Medicare Advantage adoption, consumers still see the path to choosing coverage as complex and confusing — and that’s why, even if they’ve made the switch from Original Medicare to Medicare Advantage, they are not continuously shopping for coverage. Add in that, in 2021 — on average — each Medicare Advantage consumer will have access to 33 plan choices in their given market (that means there are literally thousands of available Medicare Advantage plans nationwide) and you have what we see as a problem that needs to be solved. That is where SeekMedicare comes in.
While I noted our initial successes above, quite naturally, we also learned some lessons as we stood up our business in 3 short months prior to our first Annual Enrollment Period (which occurs October 15 — December 7, every year). Importantly, we learned just how hard it is, and how committed we need to be, to delivering on neutrality and our goals of having at least 80% of plans available in each of our markets (that equates to at least 26 plan options this year) for our consumers. The level of training, and the support our Agent Console needs to provide, is high. We have a long way to go, but we invest in getting better every day.
In all of these things, we see opportunity. SeekMedicare is a new company. We have brought together an incredible group of talented people in a short period of time in order to bring the concept of consumer service into the Medicare distribution industry. We will do that by continuing to build our platform and operations on the principles of neutrality, consumer empowerment and service. Some day, we envision our customers being confident enough, informed enough and supported enough to make their own choices — and we intend to make progress toward that future every day between here and there.
To learn more about what we’re doing, visit www.seekmedicare.com.
