Health Tech Nerds Radio The evolution of MA brokerages: from volume to retention—and what’s next | Patrick Keavy & Rebecca Springer (Bailey & Company)
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Apr 30, 2026 
Rebecca Springer, Partner at Bailey & Company and co-author of the Medicare Advantage brokerage market report, specializes in distribution trends and carrier-broker dynamics. She discusses the shift from volume to retention. Conversation covers commission pullbacks, high churn and carrier selectivity. Talks about brokers building tech, lead gen, product diversification, and proving long-term value to carriers and members.
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606 Accounting Created A Valuation Bubble
- The 2019 implementation of ASC 606 forced brokers to recognize lifetime commission value up front, inflating GAAP EBITDA despite weak cash economics.
- That mismatch drove heavy PE and public valuations from 2019–2021 (e.g., GoHealth's multibillion valuation) that later unraveled when cash realities surfaced.
Carrier Pullbacks Created Churn And Commission Risk
- Recent years brought carrier plan pullbacks, churn, and commission cuts, making distribution fragile and unpredictable.
- Examples include Humana terminating about a third of call center contracts and widespread plan decommissioning that left some regions with no commissionable plans.
Generate Leads And Track Long Term Policy Quality
- Invest in technology and generate your own leads so you can measure cost-per-policy and long-term retention, not just placements.
- Top brokers track lead quality, post-enrollment retention, and monetize members year-round to stabilize cash flow.