The company reported its third-quarter earnings Oct. 30. On a call with investors, Mr. Rechtin said the company is moving quickly to move its star ratings in the right direction.
“We acknowledge that we have work to do to get back to the results that we expect of ourselves, for our members, our patients and our investors,” Mr. Rechtin said.
Here are five things to know:
- In regulatory filings published Oct. 2, Humana reported a significant decline in its star ratings for 2025. For 2025, around 25% of Humana’s members will be in plans rated 4 stars and above for 2025, down from 94% in 2024. Humana expects the ratings to negatively affect its 2026 earnings.
- Humana has challenged CMS’ star ratings in court. Whether or not the challenge is successful, the company will still invest heavily in improving its ratings, Mr. Rechtin said.
- Mr. Rechtin said he expects CMS’ cut points for star ratings to get tougher.
“I think the entire industry is looking at a movement in metrics, cut points and thresholds that is causing pretty much everybody to reevaluate how far you have to lean in to investment in this program to make sure that you can keep up with that metric movement,” he said.
- The average Medicare Advantage star rating for 2025 is 3.92, down from 4.07 in 2024. CMS said several factors led to tougher cut points in 2025.
- Humana has invested in aligning incentives in its provider in pharmacy networks, and increasing its member outreach, Mr. Rechtin said. The effort has resulted in around 5,000 additional primary care appointments, he said.
