Humana filed a challenge to CMS' Medicare Advantage clawback rule and said it plans to expand into in-home primary care.
Here are nine stories about Humana Becker's has covered since Aug. 2.
- Humana is among the eight payers named to Fortune's top places to work in healthcare.
- Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans. The insurer filed the lawsuit in the U.S District Court in the Northern District of Texas, asking the judge to require CMS to vacate the final rule, as it will have "unpredictable consequences for Medicare Advantage organizations and the millions of seniors who rely on the Medicare Advantage program for their healthcare."
- CenterWell, Humana's older-adult focused primary care business, is expanding to in-home primary care.
- Pittsburgh-based Highmark Health named Carl Daley, who was most recently senior vice president of Medicare strategy and operations at Humana, as chief financial officer. Mr. Daley spent nearly 12 years at Humana, holding various leadership positions, including insurance CFO from 2017 to 2020.
- Humana has some of the top-rated Medicare Advantage plans in the country's largest markets, according to J.D. Power.
- Humana and kidney care provider Interwell Health reached a value-based care agreement in 13 states for most Humana Medicare Advantage HMO and PPO members living with chronic kidney disease as well as members across the country living with end-stage kidney disease.
- Humana ended a cataract surgery prior authorization policy for Medicare Advantage beneficiaries in Georgia that had been criticized by ophthalmology groups.
- Higher utilization is putting pressure on Medicare Advantage medical cost ratios and will likely continue through the end of 2023, Humana executives told investors. Humana is planning to offset some of the additional costs in its Medicare Advantage business by finding ways to cut administrative costs, CFO Susan Diamond said.
- Humana posted a 38 percent increase in profits year over year and expects to exceed the industry's average Medicare Advantage growth rate this year, according to the company's second-quarter earnings. Total revenues in the second quarter were $26.7 billion, up 13 percent year over year.