Medicare Advantage Training
Medicare Advantage: What Every Physician Executive Needs to Know
MA now covers more than half of all Medicare enrollees. Every major payer, health system, and MSO is built around MA economics. If you want to lead in healthcare, you need to understand this model deeply — not just clinically, but financially and operationally.
Why This Matters
MA is the dominant business model in American healthcare — and most physicians can't explain how it works.
54%
of Medicare enrollees now in MA plans
$400B+
in annual MA premiums paid by CMS
#1
topic in physician executive job interviews
What You'll Learn
The Core MA Concepts Taught in ClinX Academy
How MA Plans Make Money
Medicare Advantage plans receive a risk-adjusted premium from CMS for each enrollee. The higher the risk score (RAF), the higher the payment. Understanding this model is foundational to every executive conversation in MA.
Risk Adjustment & HCC Coding
Hierarchical Condition Categories (HCCs) determine how much CMS pays a plan per member. Accurate documentation drives revenue. Physician executives need to understand RAF scores, HCC mapping, and the relationship between documentation and payment.
Stars Ratings & Quality Metrics
CMS awards quality bonuses to MA plans based on Stars ratings. HEDIS measures, member satisfaction, and chronic disease management all feed into Stars. Leaders need to know how Stars affects the plan's financial performance.
Capitation & PMPM Economics
Most MA provider contracts involve capitation — a fixed per-member-per-month payment. Understanding how to manage clinical cost under a capitated model is the core competency of value-based care leadership.
Shared Savings & Full-Risk Contracts
From partial risk to global capitation — physician executives need to understand the risk spectrum, how shared savings arrangements are structured, and how to negotiate a contract that aligns incentives.
Prior Authorization & Utilization Management
MA plans manage cost through utilization management. Clinical leadership in MA means understanding PA criteria, UM protocols, appeals, and how to balance member care with plan economics.
The Instructor
Taught by Alex Mohseni, MD — and 25+ Physician Executives
ClinX Academy was built by Alex Mohseni, MD, to give clinicians the business education he wished he had. The MA curriculum is taught by physicians who have negotiated risk contracts, run MA-focused organizations, and sat at the table with payers.
This is not an academic course. It is operational knowledge from people who use it every day.
Free Resources
Start Here Before You Enroll
Medicare Cheat Sheet
Plain-language overview of Medicare program types, MA economics, and the payment structures every physician leader should know.
Download free →
Non-Clinical Jobs Guide
Comprehensive guide to the executive roles where MA expertise is most valuable — Medical Director, CMO, VP of Medical Affairs, and beyond.
Download free →
Enroll Today
Learn Medicare Advantage from the Inside Out
35+ hours of curriculum. 25+ expert faculty. The MA knowledge that opens executive doors.