Humana Inc. (HUM)

Sector: Healthcare|Industry: Healthcare Plans|Market Cap: $28.88B|Employees: 67.6K


Humana Inc. is a health and well-being company committed to putting health first for its teammates, customers, and company. They operate through two segments: Insurance, which offers medical and supplemental benefit plans, and CenterWell, which provides payor-agnostic healthcare services. Humana's primary revenue streams are derived from Medicare and state-based contracts, with a significant portion from Medicare Advantage plans. The company has a national presence and a geographically diverse membership base.

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Business Summary

Humana Inc. is committed to putting health first for its teammates, customers, and company. Through its Humana insurance services and CenterWell health care services, the company aims to make it easier for the millions of people it serves to achieve their best health, delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. As of December 31, 2023, the company had approximately 17 million members in its medical benefit plans, as well as approximately 5 million members in its specialty products. 84% of the company's total premiums and services revenue were derived from contracts with the federal government.

Key Statistics

  • Employees: 67,600 (as of December 31, 2023)
  • Headquarters: Louisville, Kentucky
  • Founded: 1964
  • Revenue: $106.4 billion (FY2023)
  • Market Cap: $55.1 Billion (as of June 30, 2023, for non-affiliate shares)

Leadership

  • CEO: Bruce D. Broussard
  • CFO: Susan M. Diamond
  • Chief Information Officer: Samir M. Deshpande
  • President and Chief Operating Officer: James A. Rechtin
  • Board Chair: Kurt J. Hilzinger

Mr. Broussard has served as CEO since January 1, 2013. Ms. Diamond was elected CFO in June 2021. Mr. Deshpande was elected Chief Information Officer in July 2021. Mr. Rechtin was elected President and Chief Operating Officer in January 2024.

Key Financial Metrics

  • Annual Revenue: $106.4 billion (FY2023)
  • Net Income: $2.5 billion (FY2023)
  • Total Assets: $47.1 billion (as of December 31, 2023)
  • Key Financial Highlights: The company's net income was $2.5 billion, or $20.00 per diluted common share for FY2023. The company's revenues were $106.4 billion for FY2023.

Products and Services

Humana's products and services include:

  • Medical and Specialty Insurance: These products allow members to access health care services through networks of health care providers. These include HMOs, PPOs, and POS plans.
  • Medicare Advantage: Health insurance benefits, including wellness programs, chronic care management, and care coordination, to Medicare eligible persons under HMO, PPO, PFFS, and Special Needs Plans.
  • Medicare Stand-Alone Prescription Drug Plans (PDPs): Stand-alone prescription drug plans under Medicare Part D, including a PDP offering co-branded with Walmart Inc.
  • Group Medicare Advantage and Medicare Stand-Alone PDP: Products that enable employers that provide post-retirement health care benefits to replace Medicare wrap or Medicare supplement products with Medicare Advantage or stand-alone PDPs from Humana.
  • Medicare Supplement: Products that help pay the medical expenses that Medicare FFS does not cover, such as copayments, coinsurance and deductibles.
  • State-based Contracts: Programs to serve members enrolled in Medicaid.
  • Group Commercial Coverage: Products including fully insured, self-funded and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs.
  • Specialty and Ancillary Insurance: Benefits consisting of dental, vision, life and disability to employer groups and individuals.
  • Military Services: Administrative services to arrange health care services for active-duty and retired military personnel and their dependents.
  • CenterWell Segment: Includes pharmacy solutions, primary care, and home solutions operations.

Key Business Segments

Humana operates through two reportable segments:

  • Insurance: Includes Medicare and state-based contract beneficiaries, employer group commercial fully-insured medical and specialty health insurance benefits, and the PBM business.
  • CenterWell: Represents payor-agnostic healthcare services offerings, including pharmacy solutions, primary care, and home solutions.

Business Strategy

Humana's strategy is centered on an integrated care delivery model, which unites quality care, high member engagement, and sophisticated data analytics. Key strategic initiatives include improving the consumer experience, engaging members in clinical programs, and offering assistance to providers in transitioning from fee-for-service to value-based arrangements. The company aims to improve health outcomes and affordability for individuals and the health system as a whole.

Industry Context

The health benefits industry is highly competitive. Humana's competitors vary by local market and include other managed care companies, national insurance companies, and other HMOs and PPOs. Many of the competitors have a larger membership base and/or greater financial resources than Humana. The company competes on the basis of many factors, including service and the quality and depth of provider networks, but expects that price will continue to be a significant basis of competition.

Risk Factors

  • Pricing and Product Risks: The company's profitability may be materially adversely affected if it does not design and price its products properly, if the premiums it charges are insufficient to cover the cost of health care services, or if its estimates of benefits expense are inadequate.
  • Competitive Risks: The health benefits industry is highly competitive, and the company's ability to sell its products and retain customers may be influenced by the competitive landscape.
  • Government Regulation Risks: The policies and decisions of the federal and state governments regarding the Medicare Advantage and Prescription Drug Plans, military services and Medicaid programs in which the company participates have a substantial impact on its profitability.
  • Data Integrity and System Risks: The company's business depends significantly on effective information systems and the integrity and timeliness of the data it uses. Failure to maintain the integrity of its data, to strategically maintain existing or implement new information systems, or to protect its proprietary rights to its systems, may materially adversely affect the business.
  • Cybersecurity Risks: The company, and the third-party service providers on whom it relies, may be unable to defend its information technology systems against cybersecurity attacks, contain such attacks when they occur, or prevent other privacy or data security incidents that result in security breaches that disrupt its operations.

Last Updated

2024-02-15

(Generated from latest 10-K filing)