Health System Pulse Survey: Medicare Advantage Is No Longer a Growth Strategy — It’s a Capital Allocation Decision
A&M’s Medicare Advantage (MA) Pulse Survey—capturing insights from 30 health system senior executives—confirms a decisive inflection point. Broad participation with MA plans, once a growth lever to protect volume, maintain market relevance, and participate in value-based care—now erodes stability. Declining reimbursement, rising utilization, escalating denials, and increasing administrative friction have fundamentally altered the economics of participation.
The implication is clear: MA is no longer a growth strategy; it is a capital allocation and operating model decision. The question for health system CEOs and CFOs is not how to manage MA better, but whether, where, and how to participate at all. Discipline—not scale—differentiates winners. Highly selective systems, deeply aligned with one or two payers, or that operate within vertically integrated models, are regaining control and stabilizing margins.
To compete in today’s MA environment, health systems must abandon participation models built on volume, optimism, and misaligned payer relationships. Success now depends on disciplined, evidence‑based partnerships that tightly integrate clinical performance, contracting discipline, and revenue cycle rigor. Systems that fail to redesign their MA strategy and operating model will see continued margin compression; those that commit to selective, data‑driven alignment will restore financial control and create durable growth.
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