29 May

What Does Humana Expect of Its Medicare Business in 2019?

WRITTEN BY Margaret Patrick

Individual MA business

In its first-quarter earnings press release, Humana (HUM) guided for a YoY (year-over-year) increase in enrollments in its individual MA (Medicare Advantage) plans from 375,000–400,000 to 415,000–440,000 in 2019. According to its first-quarter earnings conference call, this revision, which represents a rise of ~14% YoY in memberships, is based on the company’s solid performance in the open enrollment period in March. At the end of the first quarter, Humana had 3.43 million members enrolled in its individual MA plans, a YoY rise of 14% and a sequential rise of 12%.

In the first quarter of 2019, the company enrolled ~30,000 members in its DSNPs (dual-eligible special needs plan), also reported as Medicare members—a significant jump from the 1,400 members it enrolled in DSNPs in the first quarter of 2018. According to its first-quarter earnings conference call, the company is focused on increasing the markets for and the benefits of its DSNP programs. However, despite this performance, the company expects the majority of its Medicare membership growth to come from the traditional Medicare space in 2019.

What Does Humana Expect of Its Medicare Business in 2019?

Group MA and prescription businesses

In its first-quarter earnings press release, Humana reiterated its expected YoY increase of ~30,000 enrollments in its Group MA plans for 2019. According to its first-quarter earnings conference call, the company is expecting an increase in premiums for its Group MA plans in future years due to the return of health insurer fees in 2020 and the potential implementation of point-of-sale drug rebates starting on January 1, 2020.

Unlike individual MA or prescription drug plans, Group MA doesn’t have the protection of the risk corridor program. To learn more about risk corridors, read Humana reacts to a premium stabilization program in 4Q14.

In its first-quarter earnings press release, Humana reiterated its expectation of a YoY decrease in enrollments of 700,000–750,000 in its Medicare stand-alone prescription drug plans for 2019.

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