Humana medicare advantage : Humana reiterated its full-year expectations, but will exit 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond announced at the Wells Fargo Healthcare Conference on Wednesday.
Other members will have fewer plans to pick from in specific regions.
Diamond noted that the changes would affect approximately 560,000 members, or 10% of its individual MA membership base, although Humana expects to absorb almost half of those individuals into other plans.
“Nearly all of those members have other options,” she said, estimating that a few hundred thousand will be lost. “That is not atypical when we do plan exits.”
Humana expects to lose ‘few hundred thousand’ customers in 2025.
Unsurprisingly, Humana is quitting markets where it does not expect to be profitable next year. In July, it informed investors that enrollment will most likely drop, but the specific impact on 2025 financials is unknown.
“The exit itself is positive in the sense that those plans were not contributing,” Diamond pointed out. “And so simply exiting, even if we don’t keep the members, is beneficial. If we eventually retain more of those members, that’s incrementally helpful because the plan options left behind are priced in a way that will benefit them.”
Humana decreased its first-quarter guidance after the Centers for Medicare & Medicaid Services cut the MA benchmark rate by 0.16%. Large payers have since blamed the cuts on reduced benefits and the elimination of covered zones for the next year.
