Medicare Releases App to Help Seniors Navigate Health Care Marketplace

Evie Fordham | Politics and Health Care Reporter


The Centers for Medicare & Medicaid Services (CMS) released a smartphone app called “What’s Covered” Monday to give people with Original Medicare and others a “modernized Medicare experience,” but the app’s developers still have a “learning curve,” health care expert Michael Abrams told The Daily Caller News Foundation.

“What’s Covered” is simple. Enter the name of an item or service, and the app should inform users of coverage.

“However, anyone who has attempted to coax information from Siri or another personal electronic assistant knows, if you don’t ask the question in terms that the app is programmed to recognize, all you get is frustration,” Abrams told TheDCNF Monday. “If early reviews are an indication, the developers may need to expand on the vocabulary of the app before it is able to respond meaningfully to the queries of many potential users. For example, queries about ‘cataracts,’ ‘knee replacement’ and ‘knee’ returned nothing – not even a request for further clarification. To be fair, finding a way to make the 68,000 categories of healthcare services currently used by our healthcare system comprehensible is a herculean task. But the ‘What’s Covered’ app will need further development if it’s to be useful.”

CMS said the app is for both specified beneficiaries and their caregivers — which makes sense, given that only 46 percent of U.S. adults age 65 and older owned smartphones as of January 2018, according to Pew. But CMS developing an app may represent a forward-thinking attitude. (RELATED: Sanders And Trump Could Become Strange Bedfellows In Fight Against High Drug Prices)

The Medicare population is projected to increase almost 50 percent by 2030 — from 54 million beneficiaries in 2015 to more than 80 million beneficiaries in 2030, according to CMS.

“President Trump is delivering on his commitment to Medicare by modernizing tools that deliver health information in the most convenient way possible,” CMS Administrator Seema Verma said according to a CMS press release. “This new app is the next in a suite of products designed to give consumers more access and control over their Medicare information.”

While the app may take some modification, Abrams said Medicare beneficiaries’ behavior will also require some modification.

“[C]onsumers also need to get into the habit of looking at transparency in the cost and quality in health services is something they should be entitled to,” he told TheDCNF. “After 30 or more years of treating cost and quality data as something that wasn’t a legitimate concern for patients, most consumers were probably not expecting this app, and it may take some time to make is useful and integrate it into consumer behavior.”

And as more Americans turn 65, the percent of Medicare beneficiaries who are tech-savvy is likely to grow as well. Sixty-five percent of Medicare beneficiaries “indicate they use the Internet daily or almost daily,” according to CMS. The questions they ask tend to focus on what Medicare covers, hence the app.

Making health care costs more transparent and easier to find has been a common goal for the Trump administration. For example, CMS required hospitals to update their online price list annually starting Jan. 1. Health and Human Services Secretary Alex Azar proposed a rule designed to lower drug prices by requiring drug companies to disclose medicine prices in advertisements in October.

Abrams is the co-author with Rita Numerof of the 2016 book “Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model.” Numerof and Abrams co-founded the health care consulting firm Numerof and Associates.

Follow Evie on Twitter @eviefordham.

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