{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:42:46Z","timestamp":1792482166882,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014848","name":"Arnold Ventures","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014848","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the use of brokers in Medicare Advantage plans and standalone Part D plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>We used plan\u2010level broker enrollment data from 2014 to 2023 to compare the rates of broker use in Medicare Advantage and standalone Part D plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>We used broker enrollment data obtained from the Centers for Medicare and Medicaid Services through a Freedom of Information Act request and data from the Medicare Master Beneficiary Summary File. Our sample included 47,862 plan\u2010years from 2014 to 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>In 2023, new enrollees in Medicare Advantage plans were more likely to be enrolled by a broker than those in standalone part D plans (35.6% compared to 27.1%). These results were generally consistent over time, within insurers, and across states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Broker use is more common in Medicare Advantage plans than in standalone Part D plans. Given that brokers are often paid more to enroll beneficiaries in Medicare Advantage plans than in standalone Part D plans, these results suggest that brokers may play a key role in driving Medicare Advantage enrollment growth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70169","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:40:13Z","timestamp":1789522813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Brokers in Medicare Advantage and Standalone Part D Plans"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3733-0244","authenticated-orcid":false,"given":"Jeffrey","family":"Marr","sequence":"first","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Shroff","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Em","family":"Balkan","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal N.","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-1751","authenticated-orcid":false,"given":"David J.","family":"Meyers","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"J.Fugelsten Biniek M.Freed A.Damico andT.Neuman \u201cMedicare Beneficiaries Have 32 Medicare Advantage Prescription Drug Plans Available on Average for 2026 \u201d 2025 KFF https:\/\/www.kff.org\/medicare\/medicare\u2010beneficiaries\u2010have\u201032\u2010medicare\u2010advantage\u2010prescription\u2010drug\u2010plans\u2010available\u2010on\u2010average\u2010for\u20102026\/."},{"key":"e_1_2_10_3_1","unstructured":"Library of Congress \u201cMedicare Part D Prescription Drug Benefit \u201daccessed February 27 2026 https:\/\/www.congress.gov\/crs\u2010product\/R40611."},{"key":"e_1_2_10_4_1","unstructured":"F.LeonardandG.Jacobson \u201cWhat the Decline in Medicare Part D Plan Availability Means \u201d 2025."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2024.89539"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.101.4.1180"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20130778"},{"key":"e_1_2_10_8_1","unstructured":"We use the term broker to refer to insurance agents and brokers throughout for consistency."},{"key":"e_1_2_10_9_1","volume-title":"Challenges of Choice in Medicare: The Role of Agents and Brokers in a Public Program","author":"Skopec L.","year":"2025"},{"key":"e_1_2_10_10_1","unstructured":"F.Leonard G.Jacobson M.Perry S.Dryden andN.Muligan Kolb \u201cThe Challenges of Choosing Medicare Coverage: Views From Insurance Brokers and Agents \u201d 2023."},{"key":"e_1_2_10_11_1","unstructured":"L.Tabor J.Druckman andP.Mejia \u201cBackground: Medicare Insurance Agents \u201dMedicare Payment Advisory Commission https:\/\/www.medpac.gov\/wp\u2010content\/uploads\/2024\/08\/Medicare\u2010agents\u2010MedPAC\u201003.25sec.pdf."},{"key":"e_1_2_10_12_1","unstructured":"Centers for Medicare and Medicaid Services \u201cAgent and Broker Training & Testing Guidelines \u201dCenters for Medicare and Medicaid Services https:\/\/www.cms.gov\/medicare\/health\u2010plans\/managedcaremarketing\/2020\u2010agent\u2010broker\u2010training\u2010testing\u2010guidelines.pdf."},{"key":"e_1_2_10_13_1","unstructured":"F.Leonard G.Jacobson L. A.Haynes andS. R.Collins \u201cTraditional Medicare or Medicare Advantage: How Older Americans Choose and Why \u201d 2022 Commonwealth Fund https:\/\/doi.org\/10.26099\/2rfq\u2010z770."},{"key":"e_1_2_10_14_1","unstructured":"R.Ali A.Cicchiello M.Hanger L.Hollow K.Williams andG.Jacobson \u201cHow Agents Influence Medicare Beneficiaries' Plan Choices \u201d 2021 Commonwealth Fund https:\/\/doi.org\/10.26099\/32d2\u2010pz96."},{"key":"e_1_2_10_15_1","unstructured":"United States ex rel. Shea v. eHealth Inc. et\u00a0al. United States District Court for the District of Massachusetts \u201cComplaint in Partial Intervention of the United States of America \u201dhttps:\/\/www.justice.gov\/d9\/2025\u201005\/usa_v._ehealth_et_al_\u2010_complaint_0.pdf."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2026.0864"},{"key":"e_1_2_10_17_1","unstructured":"A.Cottrill J.Cubanski M.Freed andT.Neuman \u201cThe Role of State Health Insurance Assistance Program (SHIPs) in Helping People With Medicare Navigate Their Coverage \u201d 2025 KFF https:\/\/www.kff.org\/medicare\/the\u2010role\u2010of\u2010ships\u2010in\u2010helping\u2010people\u2010with\u2010medicare\u2010navigate\u2010their\u2010coverage\/."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.2834"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxae072"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2024.89500"},{"key":"e_1_2_10_21_1","unstructured":"Centers for Medicare and Medicaid Services \u201cAI Tools for Medicare Experience Modernization\u2014Request for Information \u201daccessed February 23 2026 https:\/\/www.documentcloud.org\/documents\/27289792\u2010ai\u2010tools\u2010for\u2010medicare\u2010experience\u2010modernization\u2010request\u2010for\u2010information\/."},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1287\/mnsc.2020.02453"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05017"},{"key":"e_1_2_10_24_1","unstructured":"M.Freed J.Fugelsten Biniek A.Damico andT.Neuman \u201cMedicare Advantage 2025 Spotlight: A First Look at Plan Offerings \u201d 2024 KFF https:\/\/www.kff.org\/medicare\/medicare\u2010advantage\u20102025\u2010spotlight\u2010a\u2010first\u2010look\u2010at\u2010plan\u2010offerings\/."}],"container-title":["Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.70169","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1475-6773.70169","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.70169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:34:47Z","timestamp":1792481687000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1475-6773.70169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/1475-6773.70169"],"URL":"https:\/\/doi.org\/10.1111\/1475-6773.70169","archive":["Portico"],"relation":{},"ISSN":["0017-9124","1475-6773"],"issn-type":[{"value":"0017-9124","type":"print"},{"value":"1475-6773","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"2026-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70169"}}