Humana added at least 625,000 Medicare Advantage members during open enrollment this year, representing 13.6% year-over-year growth and far outpacing competitors, Chief Financial Officer Susan Diamond said.
“The industry is expected to grow in the high-single-digits,” Diamond said. “We will see some share gains broadly given the strength of our results.”
The growth represents a stark departure from where Humana was this time last year, when it initiated a $1 billion cost-cutting plan after competitors took away market share.
Humana is the nation’s second-largest Medicare Advantage insurer with 5.1 million members as of Sept. 30. UnitedHealthcare is the nation’s largest Medicare Advantage carrier with 7 million members.
Approximately 400,000 of the members Humana gained during open enrollment signed up for Medicare Advantage plans, and 225,000 are dually eligible for Medicare and Medicaid, Diamond said. Half of the company’s new Medicare Advantage members switched from other private insurance carriers, an improvement from the 30% the company reported this time last year. Individuals who were previously enrolled in Medicare Advantage plans are more profitable than individuals aging into the program or those coming from traditional Medicare because their risk scores are cataloged, Diamond said.
Humana credited the growth to its reduced reliance on outside call centers, investment in captive agents and increased bonuses offered to independent agents for marketing its products. The company also focused on developing $0 premium plans.
The company’s primary care centers, operated under the CenterWell and Conviva brands, added approximately 10,000 patients to their rosters during open enrollment, double the amount during the same time last year, Diamond said.
Humana anticipates federal Medicare Advantage rates will rise up to 2% this year, less than half the rate they have increased over the past few years, Diamond said.
The insurer is waiting for the Centers for Medicare and Medicaid Services to release its final rule on how program audits are conducted. Regulators will decide in February whether to eliminate the fee-for-service adjuster and make other changes to risk-adjustment data validation, which insurers oppose.
If regulators remove the fee-for-service adjuster, the “industry is likely to resort to litigation to resolve it, which will tie us all up for a number of years,” Diamond said.