Mystery Shopping Study Reveals Flaws in SHIP's Medicare Counseling Services
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Apr 17, 2025
The State Health Insurance Assistance Program (SHIP) was designed to offer free, unbiased information to Medicare beneficiaries about their coverage options, serving as a counter to agents and brokers who get paid to sell Medicare Advantage plans and other coverage. But a recent study published in JAMA Network Open revealed major gaps in the accuracy and completeness of information provided to seniors by SHIP, and the findings were particularly grim for Medicare-Medicaid dual eligibles. Those findings are especially timely as CMS Administrator Mehmet Oz, M.D., at his Senate confirmation hearing signaled an interest in reforming Medicare sales. Also, the Medicare Payment Advisory Commission recently discussed SHIP as a potential alternative to agents and brokers.
The study employed mystery shoppers to evaluate the quality of counseling sessions across 131 SHIP sites in 16 states. Shoppers either visited SHIP sites in person or contacted them via phone or video calls. Of the 306 mystery shopping encounters, nearly 40% were not completed, largely due to a lack of return calls from SHIP counselors, which researchers said could indicate capacity constraints. All of the in-person shops, meanwhile, were completed.
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