Humana is appointing new executives and expanding CenterWell, its primary care business.
Here are seven updates about the Louisville, Ky.-based payer Becker's has reported since Jan. 13.
- CMS' new Medicare Advantage auditing standards did not include enough information about auditing methods to understand its full impacts, Humana executives said on an investor call. CEO Bruce Broussard told investors Humana is "considering all our options to address or challenge" the elimination of the fee-for-service adjuster.
- Humana posted revenues of nearly $93 billion in 2022 and a net loss of $15 million in the most recent quarter, according to its year-end earnings report.
- Humana appointed Steward Health Care President Sanjay Shetty, MD, to lead its healthcare services business, CenterWell. Dr. Shetty will start April 1. In addition, the company promoted its Medicare president, George Renaudin, to president of Medicare and Medicaid, effective immediately.
- Humana plans to open 10 CenterWell clinics in the Dallas-Fort Worth, Texas, area in 2023, part of a major expansion of the older-adult-focused primary care clinics. Two clinics were set to open Feb. 1 and 2, with the rest slated to open throughout the year.
- As part of CenterWell's rapid expansion, Humana will also open three new clinics in Charlotte, N.C.
- Vanderbilt University Medical Center will drop Humana Medicare Advantage plans April 1 over a dispute in reimbursement rates. Humana said Vanderbilt indicated it would agree to a new contract only if the company will start paying 20 percent more for all services the health system provides, starting April 1. Humana said that it has attempted to negotiate, but the message it has received is that the system is "unwilling to discuss a new rate that is anything less than a 20 percent increase." Nashville-based Vanderbilt also plans to drop Wellcare of Tennessee Medicare Advantage plans.
- Nashville, Tenn., Mayor John Cooper sent letters to Vanderbilt University Medical Center and Humana officials urging the sides to prevent "what could otherwise unfold into catastrophic scenarios" if the health system splits with the insurer's Medicare Advantage plan.