Humana

Humana. It is a major American for-profit managed health care company headquartered in Louisville, Kentucky. Founded in 1961, it is one of the largest providers of Medicare Advantage plans and a significant operator in the Medicaid and health insurance markets. The company's operations span insurance, clinical care delivery, and wellness services, serving millions of members across the United States.

History

The company was established in 1961 by David A. Jones Sr. and Wendell Cherry as a nursing home operator named Extendicare. It expanded rapidly through acquisitions, including American Medicorp in 1978, transforming into one of the nation's largest hospital companies. In 1974, the corporation was renamed Humana Inc. and began operating Humana Hospitals. A pivotal shift occurred in the 1990s when, under CEO David A. Jones Jr., it divested its hospital division to HCA and Healthtrust to focus exclusively on health insurance. Major growth followed through the acquisition of Employers Health Insurance and, later, significant participation in the Medicare Part D program. The attempted merger with Aetna in 2015 was blocked by the U.S. Department of Justice, but the company solidified its market position by acquiring Kindred at Home and forming a joint venture with Welsh, Carson, Anderson & Stowe.

Business segments

The company operates through two primary business segments: Insurance and CenterWell. The Insurance segment includes its government-funded plans, such as Medicare Advantage, Medicare Supplement, and Medicaid, as well as commercial group health insurance and military health care services through the TRICARE program. The CenterWell segment represents its healthcare services arm, encompassing CenterWell Pharmacy, one of the nation's largest mail-order pharmacies, CenterWell Primary Care, a network of senior-focused clinics, and CenterWell Home Health, which provides home health and hospice services. This integrated model aims to manage both the insurance and care delivery for members, particularly within the senior citizen population.

Financial performance

As a Fortune 500 company and a component of the S&P 500, it reports substantial annual revenue, which exceeded $106 billion in 2023, primarily driven by its Medicare offerings. Its financial results are closely tied to enrollment trends in Medicare Advantage and the medical cost ratios of its plans. The company's stock, traded on the New York Stock Exchange under the ticker HUM, is influenced by federal reimbursement rates set by the Centers for Medicare & Medicaid Services and regulatory changes from the U.S. Congress. Major investments have been directed toward expanding its CenterWell clinical services, which are seen as a long-term growth strategy to control costs and improve margins.

Corporate affairs

The corporate headquarters remains in its founding city of Louisville, Kentucky, where it is a major employer. Key leadership has included CEOs such as Michael B. McCallister and the current CEO, Bruce D. Broussard. The company maintains an active political action committee and engages in extensive lobbying on healthcare policy issues in Washington, D.C.. It is a frequent sponsor of community and sporting events, including the Humana Challenge golf tournament and the Kentucky Derby Festival. The organization also partners with various entities like the YMCA on wellness initiatives and has made commitments to environmental, social, and corporate governance goals.

Controversies

The organization has faced several legal and regulatory challenges, including lawsuits related to Medicare fraud allegations and accusations of improperly denying claims. It has been subject to investigations by the U.S. Department of Health and Human Services and the Securities and Exchange Commission. In 2010, it paid a multi-million dollar settlement to resolve allegations concerning its Medicare Part D practices. The company has also been criticized for its marketing tactics for Medicare Advantage plans and for the high out-of-pocket costs some members encounter. Furthermore, its participation in the TRICARE program for military families has occasionally drawn scrutiny over coverage and service issues.

Category:Health insurance companies of the United States Category:Companies based in Louisville, Kentucky Category:Companies listed on the New York Stock Exchange