Humana prepares for ‘frustration’ over Medicare Advantage changes, 13 market exits

https://www.beckerspayer.com/payer/theres-going-to-be-a-lot-of-frustration-humana-prepares-for-medicare-advantage-market-exits-benefit-changes.html

Humana will stop offering Medicare Advantage in 13 counties in 2025, CFO Susan Diamond said Sept. 4.

Speaking at an investor conference, Ms. Diamond said the company will no longer offer several plans in 2025. The exits will affect around 560,000 beneficiaries, 10% of Humana’s MA membership. The company expects to retain around half of the members affected by plan exits.

In most areas where Humana is ending plans, the insurer has another plan available, Ms. Diamond said. She did not specify which counties Humana planned to exit.

“There are very few places, literally 13 counties, where we will have no presence at all — completely insignificant,” she said.

In July, Ms. Diamond said the company expected to lose a few hundred thousand members in 2025. 

Humana ended plans that did not have a path to profitability, Ms. Diamond said.

Rising medical costs and lower reimbursements from CMS led Humana and other insurers to plan market exits in 2025.

CVS Health executives said they expect to lose up to 10% of Aetna’s MA membership next year. Centene is also planning to exit Medicare Advantage markets in six states.

There will be disruption across the MA industry as Humana and its competitors exit markets and adjust benefits to account for rising costs, Ms. Diamond said.

Ms. Diamond said the company acknowledges that there is “going to be a lot of frustration” among beneficiaries about the level of changes being made.

“Even if they’re frustrated by the level of benefit change we made, if that plan is still the best option, they will typically stay in the plan,” Ms. Diamond said. “That’s what we’ve seen historically in cases where we’ve had to make so many types of changes.”

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