Data Driven Leadership in Medicare Advantage with Jennifer L. Kowalski of Elevance Health

Summary

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Podcast Summary: Data Driven Leadership in Medicare Advantage

Podcast: Becker’s Healthcare Podcast
Episode: Data Driven Leadership in Medicare Advantage with Jennifer L. Kowalski of Elevance Health
Host: Scott King (Becker’s Healthcare)
Guest: Jennifer L. Kowalski, Vice President, Public Policy Institute, Elevance Health
Date: March 8, 2026

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Episode Overview

This episode features an in-depth conversation between host Scott King and Jennifer L. Kowalski, focusing on how data-driven leadership is shaping the development, implementation, and success of Medicare Advantage (MA) programs at Elevance Health. Jennifer draws on her extensive background in health policy to dispel common misconceptions about MA, highlight ongoing innovations, and explain how credible data informs both strategy and public health policy. The discussion centers on program flexibility, serving complex populations (especially dual eligibles), and the future direction for Medicare Advantage.

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Key Discussion Points & Insights

Jennifer Kowalski’s Background & Role

[01:05]

• Jennifer has over 11 years as VP at Elevance Health Public Policy Institute (PPI), leading a team of policy experts and researchers.
• PPI’s mission is to create and share policy-relevant, data-driven research to inform health policy.
• Spent a prior dozen years as a healthcare policy consultant to a wide variety of stakeholders (health plans, pharma, etc.).
• Quote:
  “I sometimes refer to us as a bit of an internal think tank in helping to bring evidence credible to health policy conversations and to help shape the future of healthcare policy.” — Jennifer L. Kowalski [01:53]

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Importance of Medicare Advantage at Elevance Health

[02:22]

• Elevance Health considers MA a “critical part” of a broad portfolio that covers all life stages, including Medicaid, individual, and employer-sponsored plans.
• MA is vital for supporting older adults and people with disabilities with coordinated, affordable care.
• Quote:
  “Medicare Advantage plays a central role in how we think about lifelong health and whole person care.” — Jennifer L. Kowalski [02:35]

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Misunderstandings About Medicare Advantage

[03:02 – 05:02]

• Three core themes often misunderstood:
  1. Value:
     • Over half of Medicare beneficiaries choose MA, attracted by features like out-of-pocket maximums and integrated drug coverage, often at $0 premium.
     • Supplemental benefits (vision, dental, groceries, transportation) correlate with better health outcomes, especially for those with chronic illness.
  2. Access:
     • Critics see “networks” in MA as restrictive, but PPI research shows MA members sometimes have shorter wait times for specialists (e.g., neurologists) than traditional Medicare + Medigap members.
  3. Program Efficiency:
     • Growing MA penetration in markets correlates with slower Medicare spending growth, possibly due to broader adoption of high-value care practices.
     • Independent analysis also suggests MA curbs fraud, waste, and abuse more effectively than fee-for-service Medicare.
• Quote:
  “Our research shows that use of these benefits by our members correlates with better health outcomes as well as more appropriate healthcare utilization…particularly true for people with chronic conditions like diabetes.” — Jennifer L. Kowalski [03:52]
  “As Medicare Advantage penetration grows in a market, total Medicare spending growth slows…incentives for high value care appear to influence how providers treat all of their Medicare patients.” — Jennifer L. Kowalski [04:35]

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The Shift in Priorities as Medicare Advantage Grows

[05:24]

• Rapid growth in MA enrollment, especially among “dual eligible” individuals (qualify for both Medicare and Medicaid), who have more complex health needs.
• Complexity arises from navigating two systems with different benefits, providers, and administrative rules.
• Industry focus is shifting to better integration for dual eligibles, using Dual Eligible Special Needs Plans (D-SNPs), which are tailored to the medical and social needs of this group and aim to simplify care navigation.
• Quote:
  “As MA enrollment has grown…one of the most notable trends has been the increasing enrollment among individuals who are dually eligible for Medicare and Medicaid…a key vehicle for that integration is known as Medicare Advantage Dual Eligible Special Needs Plans, or more simply D SNPs.” — Jennifer L. Kowalski [05:24]
• Upcoming PPI research will examine and measure the value of increased benefit integration through D-SNPs for individuals and the overall health system.

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Challenges for Dual Eligible Members

[06:55]

• Dual eligibles must juggle two separate benefit programs, with different rules and networks.
• Without an integrated plan or a care coordinator, navigating these complex programs is overwhelming, especially for those with chronic conditions or high healthcare needs.
• Quote:
  “Absent a plan or a care coordinator to help manage those two separate programs, it can be challenging for an individual to navigate on their own, particularly if that individual also…has a chronic condition.” — Jennifer L. Kowalski [06:55]

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Opportunities for Health Plans

[07:46]

• Two key opportunity areas: Affordability and Ease of Navigation
  • Affordability:
    • Health plans can steer members to lower cost, high-quality care sites (e.g., non-oncology infusions done in offices or at home rather than hospitals), which recent research shows lowers costs and maintains or improves outcomes.
    • This lesson, though derived from commercial members, is relevant for MA populations.
  • Ease of Navigation:
    • Improving system usability: clarify out-of-pocket costs, offer digital provider directories, send preventive care reminders.
    • Robust supplemental benefits (dental, groceries, transportation) help address broader health and access factors.
• Quote:
  “We can do more to make the healthcare system easier to use … provide clearer information … support preventive care with simple reminders … supplemental benefits all help address the full range of factors that influence access to care.” — Jennifer L. Kowalski [08:24]

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Defining Success in Medicare Advantage Leadership

[09:29]

• Success means delivering “credible, data driven evidence” that supports healthier lives for members.
• Leadership includes rigorous research, influencing policy, and using findings to drive internal strategy and care improvements.
• PPI aims to shape thoughtful public policy that nurtures innovation, sustainability, and value in MA—both for members and the broader Medicare program.
• Quote:
  “Success in Medicare Advantage really means leading with that credible, data driven evidence that will ultimately support our members in living healthier lives.” — Jennifer L. Kowalski [09:29]
  “We really want to use PPI’s research to shape thoughtful public policy that supports innovation, that promotes sustainability…and that creates value for the members that we serve.” — Jennifer L. Kowalski [10:13]

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Jennifer’s Personal Evolution as a Leader

[10:28]

• Transitioned from a detail-focused, hands-on policy expert to a strategic leader supporting her team’s growth and expertise.
• Finds satisfaction in seeing her own career trajectory mirror the evolution and expansion of Medicare Advantage.
• Quote:
  “I’ve certainly gone from being in the weeds and really knowing all of the details…to taking a much kind of higher level, strategic look at how it all fits together and how I can support the members of my team in really shining.” — Jennifer L. Kowalski [10:28]
  “I feel like the [MA] program has grown alongside my career and evolved alongside my career, which has been kind of fun.” — Jennifer L. Kowalski [11:09]

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Notable Quotes

• “Our research shows that use of these benefits by our members correlates with better health outcomes as well as more appropriate healthcare utilization…particularly true for people with chronic conditions like diabetes.” — Jennifer L. Kowalski [03:52]
• “As Medicare Advantage penetration grows in a market, total Medicare spending growth slows…incentives for high value care appear to influence how providers treat all of their Medicare patients.” — Jennifer L. Kowalski [04:35]
• “Success in Medicare Advantage really means leading with that credible, data driven evidence that will ultimately support our members in living healthier lives.” — Jennifer L. Kowalski [09:29]

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Key Timestamps

• [01:05] Jennifer’s background and role at Elevance Health PPI
• [02:22] The central role of Medicare Advantage in Elevance Health’s strategy
• [03:02] Common misunderstandings about Medicare Advantage
• [05:24] Shifting priorities with increased MA enrollment, focus on dual eligibles
• [06:55] Specific challenges faced by dual eligible members
• [07:46] Opportunities for improving affordability and navigation in MA
• [09:29] Leadership and the definition of success in Medicare Advantage
• [10:28] Jennifer’s own evolution as a leader

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Tone & Takeaways

The conversation is optimistic, candid, and focused on problem-solving. Jennifer highlights the positive impacts of data-driven policy and research within Elevance Health and the Medicare Advantage space. She stresses the need for continued innovation, integration, and targeted support for vulnerable populations. Throughout, the role of leadership is tied to evidence, openness to change, and fostering both internal talent and system-wide improvement.

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For listeners seeking a comprehensive, data-informed perspective on Medicare Advantage—including innovation, integration, and strategy—this episode serves as an insightful and authoritative resource.

Transcript

[A]

This is where health insurance leadership comes together. Becker's 4th Annual Spring Payer Issues Roundtable brings together over 400 payer and health plan executives and more than 100 speakers to Chicago, April 13th and 14th. This year's event includes keynote conversations with the industry's top leaders and former President George W. Bush. For the full agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right up. We're looking forward to hosting you here in Chicago.

[B]

Hello everyone and welcome to Becker's Healthcare Podcast. I'm Scott King, thrilled today to be joined by a very special guest, Jennifer Kowalski, Vice President, Public Policy Institute, over at Elevance Health. Jennifer, thanks so much for joining us. How are you doing today?

[C]

Good. Thanks for having me, Scott.

[B]

Of course, you know, we have a lot of big topics to get to and we're definitely very excited for you to be speaking with us at our Spring Payer Issues Roundtable in April. But before we get to some of those topics, I wanted to ask you about now, I was wondering if you could please tell us a little about your background, your career in health care.

[C]

Sure. Well, as you mentioned, I'm currently the vice president of the Elevance Health Public Policy Institute, or ppi, where I've led a team of policy experts and researchers for over 11 years. And PPI's role is to conduct and publish policy relevant and data driven research that helps to inform health policy discussions. And prior to my career at Elevance Health, I spent about a dozen years in healthcare policy consulting advising a range of companies, health plans, pharmaceutical manufacturers, and so forth on health care policy and strategy.

[B]

So to follow up your, your background there, Jennifer, you know, we always hear about how much, how important data is to health plans, but with your role with all advanced, it sounds like it's, it's extra important. Is that fair to say?

[C]

Yeah, I think that's exactly fair to say. You know, that that is part of what my team brings to the company. I sometimes refer to us as a bit of an internal think tank in helping to bring evidence credible to health policy conversations and to help shape the future of healthcare policy.

[B]

And the first thing I want to ask you is how do you describe the role within Medicare Advantage that it plays within your overall health plan strategy?

[C]

Yeah, that's a great question, Scott. At Elevance Health, our affiliated health plans really serve people across every stage of life. So that includes Medicare Advantage, but it also includes Medicaid, managed care, individual marketplace coverage, as well as employer sponsored plans. So you can think of Medicare Advantage as a critical part of that portfolio. It allows us to support older adults and people with disabilities with coordinated and affordable care. And so in that sense, Medicare Advantage plays a central role in how we think about lifelong health and whole person care.

[B]

What do people outside the Medicare Advantage space most often misunderstand about the program?

[C]

Yeah, I highlight three core themes here with respect to Medicare Advantage. So one, value, two, access to care, and three, program efficiency. So first, with respect to value, today more than half of Medicare beneficiaries now choose Medicare Advantage as their coverage option. And I don't think that's an accident. So for sure, Medicare Advantage uses provider networks, but members also get an out of pocket maximum. They get integrated prescription drug coverage, often at zero premium. Medicare Advantage has coordinated care and it also includes extra benefits that aren't part of traditional Medicare. So through the Elevance Health Public Policy Institute, we've studied these supplemental benefits. So things like vision, dental transportation assistance, healthy grocery benefits. And our research shows that use of these benefits by our members correlates with better health outcomes as well as more appropriate healthcare utilization. And so this is also particularly true for people with chronic conditions like diabetes. So then second access I think is also often misunderstood. I think critics will point to networks as a limitation of Medicare Advantage. But some of our upcoming research finds that after controlling four key factors, Medicare Advantage members actually experienced shorter wait times to see neurologists compared to traditional Medicare beneficiaries that had Medigap coverage. Lastly, program wide efficiency PPI research found that as Medicare Advantage penetration grows in a market, total Medicare spending growth slows. And this is due in part to spillover effects. So this means that the incentives for delivering high value care in Medicare Advantage appear to influence how providers treat all of their Medicare patients. And likewise, we've also sponsored independent analysis that shows Medicare Advantage is more effective at curbing fraud, waste and abuse than fee for service Medicare.

[B]

So it sounds like the program is a lot more accommodating than some people might think, is that right?

[C]

I think that's right, yeah. And I think it brings more value to members and to the Medicare program writ large than people might realize.

[B]

The next thing I want to ask you, Jennifer, is how are priorities shifting for health plans as the Medicare Advantage population continues to grow?

[C]

Yeah. As MA enrollment has grown, I think one of the most notable trends has been the increasing enrollment among individuals who are dually eligible for Medicare and Medicaid. And if you're not familiar, these individuals often have more complex health care needs, they tend to have higher rates of chronic conditions. And they also have to navigate these two separate benefit programs. And I think that complexity can create some real challenges. And so as a result, both states and cms, the Centers for Medicare and Medicaid Services, as well as health plans themselves, are increasingly focused on better integrating these benefits for dual eligible individuals. One key vehicle for that integration is known as Medicare Advantage Dual Eligible Special Needs plans, or more simply D SNPs. And D SNPs are plans that are designed specifically to meet the medical and social needs of people who are dually eligible. And so these plans emphasize coordinated care, they simplify navigation, and they take a whole person approach to care. And they can vary somewhat in their degree of integration. So the most fully integrated plans will also include long term services and supports. And upcoming research from the PPI focuses on really measuring and demonstrating the value of increasing integration of those benefits. And for the members, of course, but also for the programs writ large.

[B]

I was just curious, what were some of the challenges you referred to in trying to walk that line and keep the balance?

[C]

Oh, yeah, I think, you know, for dual eligible members, I think what some of the challenges are that there's a set of benefits and a set of providers that take Medicare coverage, and then there may be a whole separate set of rules with different benefits, different provider networks in the Medicaid program. And so absent a plan or a care coordinator to help manage those two separate programs, it can be challenging for an individual to navigate on their own, Particularly if that individual also, you know, needs a lot of healthcare services or is, you know, has a chronic condition of some sort.

[B]

Yeah, I could definitely see why that could be difficult for someone to navigate on their own. Where do you see the biggest opportunities for health plans to better serve Medicare Advantage members?

[C]

Yeah, so I'd frame the opportunities in Medicare Advantage around two themes, affordability and ease of navigation. So first, with respect to affordability, one example here is that health plans can help guide members to lower cost sites of care that have comparable quality when it's clear, clinically appropriate for that member. So, for example, recent research that we conducted found that non oncology infusion therapies that are delivered in physician offices, ambulatory infusion centers, or even at home were associated with lower costs, but similar or better outcomes when compared to hospital outpatient departments. And now this study focused on commercial members. But I think the lessons are still relevant for Medicare Advantage. Then second is navigation. We can do more to make the healthcare system easier to use. And there's lots of examples of this. We could provide clearer information on out of pocket costs and quality. With digital tools, we can help members choose providers. We can support preventive care with simple reminders such as about flu shots or cancer screenings, and then to bring it back to supplemental benefits. I think they're an opportunity here as well. So benefits like dental coverage, healthy grocery allowances, and things like transportation assistance all help address the full range of factors that influence access to care along with health and well being.

[B]

And what does success in Medicare Advantage look like from a leadership perspective? Obviously, this, you know, to structure these programs the right way and for them to be as accommodating as they are takes a big amount of the right kind of leadership, Right?

[C]

Absolutely. And from my perspective, and you know, from my role at Elevance Health, success in Medicare Advantage really means leading with that credible, data driven evidence that will ultimately support our members in living healthier lives. And so that can include producing rigorous research that informs our engagement with policymakers and regulators and other stakeholders as they're shaping the future of the MA program. It also means using the evidence that we produce internally. So whether that's to inform strategy or. Or to help identify opportunities to improve care for our members. But ultimately, we really want to use PPI's research to shape thoughtful public policy that supports innovation in Medicare Advantage, that promotes sustainability for the program, and that creates value for the Medicare Advantage members that we serve, and of course, for the Medicare program over the long term.

[B]

And Jennifer, when you look back at your career and, you know, specifically with the things you're working on now, how do you think you've evolved as a leader?

[C]

You know, I think over the last 25 years or so of my career, I've certainly gone from being in the weeds and really knowing all of the details of policies and programs to taking a much kind of higher level, strategic look at how it all fits together and how I can support the members of my team in really shining and being experts in their own right and having the opportunity to grow and learn as well.

[B]

Yeah. So there's a lot of strategy involved in this program, obviously.

[C]

Right? Exactly, exactly. And from an MA perspective, I sort of started my career in consulting around the time that the Medicare Modernization act created Medicare Advantage as we know it today. And so I feel like the program has grown alongside my career and evolved alongside my career, which has been kind of fun.

[B]

Yeah, definitely some big parallels there. And Jennifer, thanks so much for joining the podcast for a great conversation. Like I said, really looking forward to you speaking with us in April and looking forward to working with you again soon.

[C]

Thanks, Scott. I'm looking forward to it as well and appreciate the conversation today.