On this episode of The Health System CXO Podcast, Jackie Kimmell, Sr. Director - Member Insights at The Health Management Academy, discusses Medicare Advantage (MA) and its impact on health system executives. 

She also discusses the growth and significance of MA in the healthcare industry, the profitability for payers, the benefits and challenges for beneficiaries, and the struggles health systems face. She also highlights the regulatory changes and headwinds that have affected the profitability of MA plans, leading to decreased margins for payers and lower yields for health systems. 

Lastly - she shares the insights Strategy Executives need to know regarding the variations in MA penetration across different markets and the importance of understanding the MA landscape for healthcare executives.

Key Takeaways
-Medicare Advantage (MA) is a major topic of concern for health system executives due to its significant impact on the healthcare industry.

-Payers have prioritized MA and have seen high profit margins, but regulatory changes and headwinds have affected their profitability.

-MA offers benefits such as low premiums and supplemental benefits, but there may be hidden downsides and challenges for beneficiaries.

-Health systems have contracted with MA plans to benefit from higher reimbursement rates, but they face challenges such as claims denials and lower yields.

-Understanding the MA landscape is crucial for healthcare executives to navigate the changing market and ensure financial sustainability.

Chapters
00:00 Introduction and Podcast Evolution

00:27 The Significance of Medicare Advantage for Health System Executives

03:02 Medicare Advantage: Profitability and Challenges

07:38 Regulatory Changes and Headwinds in Medicare Advantage

09:31 Variations in Medicare Advantage Penetration Across Markets

12:23 Challenges Faced by Health Systems in Medicare Advantage Contracts

17:21 Navigating the Medicare Advantage Landscape as a Healthcare Executive

Welcome to the Health System CXO Podcast, sponsored by The Health Management Academy, featuring content designed for Health System Nurse Executives, Health Equity Officers and Strategy Executives provided by our company SME's - Anne Herleth, Jasmaine McClain, Ph.D. and Jackie Kimmell.

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About The Health Management Academy:
Since 1998, The Health Management Academy has cultivated the premier community of healthcare's most influential changemakers from the top U.S. health systems and innovative industry partners. We power more than 2,000 health system senior executives and 200 industry organizations through exceptional peer groups, original market insights, world-class leadership development programs and novel member alliances. Our industry-leading programs and solutions enable members to facilitate meaningful relationships, navigate strategic transformation and address critical industry issues. To learn more, visit hmacademy.com and follow The Health Management Academy on ...