Our Amplify offering remains an essential component of eHealth’s diversification strategy, as it allows us to scale revenue without a corresponding investment in variable marketing. Building scale is critical to achieving sustainable profitability for our business. Additionally, our largest Amplify customers will be moving to a non-broker of record fee-based PPO compensation model starting in Q2 of this year, which has the benefit of favorable cash flow timing compared to the traditional commission-based compensation model. Given our emphasis on profitability and cash flow generation, we continue to allocate capital thoughtfully and intentionally to support our core product, programs, and diversification initiatives. While spanning our presence outside of our core MA broker of record business is an important objective for this team, we will be doing so in a measured way that allows us to diversify, while at the same time continuing to expand margins.
In our employer and individual business, this means focusing on rebuilding the foundation and certain key processes before returning to enrollment growth. Recall, we took a similar approach last year within our core Medicare Advantage business, pausing growth as we enhanced our Medicare sales, marketing, and technology organizations before returning to strong growth at the end of 2023. On the technology side, following the close of Q1, we successfully piloted our new enrollment feature, Live Advice. This video chat capability provides an even greater level of transparency within the shopping, education, and enrollment process and builds instant connection between the benefit advisor and beneficiary. We believe this new capability has the potential to drive higher conversion rates and elevate retention as members feel more confident in the enrollment process and their plan selection.
Over time, it could also empower beneficiaries to return to our platform to enroll through online transactions with minimal or no agent assistance. We continue to fine tune our online platform, reducing friction points and streamlining the customer experience. In Q1, these efforts, combined with greater lead quality, helped drive a 20% year-over-year increase in online unassisted conversion rate, an important operational lever. Within our marketing organization, we launched the ePerks program. ePerks offers participants a suite of tools and rewards meant to increase engagement and create a lasting member relationship. This includes [Seamless Start] (ph), a service that helps beneficiaries set up their initial PCP appointment, mail order drugs, and annual wellness visits as needed.
ePerks users also gain access to dedicated advisors who can answer questions and conduct periodic checkups to make sure that the beneficiaries are still in the optimal plan for them. Finally, ePerks includes special offers from our partners. The first of these partner offerings comes from Retirable, an organization that provides access to holistic retirement and financial planning services. We are excited about the potential of this new program and the favorable impact that we anticipate on our retention and customer affinity. Since its launch last month, we have already enrolled more than 200,000 existing eHealth Medicare customers in ePerks. Additionally, eHealth continues to place a strong emphasis on our existing retention initiatives. These include our rebuilt approach to the customer journey that we discussed on last quarter’s call, tracking all channels and interactions with our platform, including lead nurturing, service, support, and value added programs.
The goal is to provide an increasingly personalized experience to each of our members, depending on their unique situations and needs. Trailing 12 month turnover in our Medicare Advantage Book of Business improved both sequentially and on a year-over-year basis. In conclusion, we had a strong start to the year and are well positioned to deliver on our growth and profitability goals. We are reiterating our 2024 annual guidance and are looking forward to updating you on our execution milestones in the coming quarters. Additionally, having achieved positive operating cash flow for the trailing 12 month ended March 31st, we are focused on achieving the important goal of free cash flow generation. eHealth ended the quarter with a significant cash balance in $845.3 million in contract asset receivable value, which continues to be validated through positive adjustments, including another $2.5 million in net adjustment or tail revenue, booked in Q1.
Our Blue Torch credit facility matures in February 2025. We have begun exploring multiple avenues to improve our capital structure, including monetizing a portion of our contract receivable asset, with the goal of lowering interest costs and providing additional liquidity for growth initiatives. Finally, our latest investor presentation will be posted on our website next week. It reflects important enhancements as well as feedback from many of you on our previous presentations. We look forward to discussing it further in New York City. John will now provide additional details of our financial performance and key metrics for the quarter. John?
John Stelben: Thank you, Fran. Our first quarter results were driven by strong revenue growth in our Medicare business coupled with fixed cost savings across our organization, resulting in significantly improved adjusted EBITDA and operating cash flow compared to a year ago. Revenue of $93 million grew 26% year-over-year, driven primarily by our Medicare segment. First quarter Medicare segment revenue was $82.4 million, up 33% year-over-year with growth in approved members, increased MA LTVs and higher non-commission revenue as compared to Q1 of 2023. First quarter Medicare Advantage Broker of Record, or BOR, approved members grew 9%, Medicare Supplement BOR approved members grew 35%, and total Medicare BOR approved members grew 10% compared to Q1 a year ago.
These results include enrollments from our core agency choice model as well as our carrier dedicated Amplify enrollment model that we launched in 2023 and are scaling this year. Since the Amplify launch last year and through the end of Q1 of 2024, virtually all our sales on that platform have been BOR enrollments, where eHealth collects ongoing commissions in the same manner as our core agency business. Starting with Q2, we are transitioning our largest Amplify deals to BPO arrangements where eHealth has paid a onetime enrollment fee, as well as payments to cover certain call center costs as opposed to receiving recurring commission payments. New enrollments generated under these BPO payment models will not flow through our reported approved member or estimated membership metrics.
