The evolution of MA brokerages: from volume to retention—and what’s next | Patrick Keavy & Rebecca Springer (Bailey & Company)

Patrick Keavy and Rebecca Springer from Bailey & Company join following the Medicarians conference and the release of their MA brokerage market report.Patrick walks through how the 606 accounting change in 2019 reshaped the MA brokerage market by requiring brokers to recognize lifetime commission value upfront. Combined with rapid MA enrollment growth, this inflated EBITDA in ways that didn't reflect actual cash economics — drawing significant PE investment and driving a valuation bubble that eventually collapsed as carriers pulled back commissions and decommissioned plans.Rebecca covers what the market looks like today: a tough AEP, significant churn, and carriers becoming increasingly selective about their broker relationships. The brokers that navigated this period successfully did so by focusing on long-term member retention over volume, generating their own leads, and engaging members throughout the policy lifecycle rather than at enrollment alone.Looking ahead, Patrick and Rebecca describe a market moving toward product diversification, technology investment, and a fundamentally different value proposition — brokers as trusted, long-term partners for both carriers and members rather than high-volume enrollment engines. Rebecca flags one important gap: brokers are doing this value-add work, but nobody has figured out how to quantify it systematically for carriers yet.Access the report here: https://bnco.com/insights/medicare-advantage-brokerage/For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe