Humana’s Medicare Advantage Squeeze

Hospitalogy October 3, 2024
Blake Madden

Today we’re looking at Humana and the operating challenges ahead for the Medicare Advantage focused enterprise.

You guys seem to be liking the waterfall charts with some narrative explaining the trends so we’re back at it again!

Today, Humana issued an alarming 8-k related to preliminary data released by CMS for its 2025 Star Ratings (which will affect 2026 bonus payouts).

Humana’s single largest plan, fondly named H5216 like a drone from Star Wars, was downgraded to a 3.5 star plan. In 2024, the same plan was rated at 4.5 stars by CMS, exceeding the threshold for quality bonus payouts.

The problem sits in one...

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