Humana Will Exit More Counties In 2027
At a Q2 earnings call, Humana executives said it is planning additional Medicare Advantage (MA) market exits for 2027 to continue its road to financial recovery. Humana has been the biggest enroller in 2026 (expected 25% growth) and that could be part of the contraction plans. The county exits will impact about 600,000 but Humana expects to make up a good deal of that in more profitable counties.
Humana’s medical loss ratio (MLR) was a high 91.1% in the quarter and the membership growth caused that. Humana downgraded its earnings guidance in part due to smaller quality bonuses, another struggle. Humana says it is on track to reach its goal of achieving top quartile Stars in the 2028 Star year.
The company reported $694 million in profit for the quarter, up from $545 million in Q2 2025. Profits through the first half of 2026 were $1.9 billion, compared with $1.8 billion in H1 2025. Revenue was $40.9 billion in the quarter, growing from $32.4 billion in Q1 2025.
Additional articles: https://www.fiercehealthcare.com/payers/humana-still-track-25-medicare-advantage-membership-growth-year and https://www.modernhealthcare.com/insurance/mh-humana-medicare-advantage-markets-2027/ and https://www.beckerspayer.com/financial/humana-turns-694m-q2-profit-amid-medicare-advantage-centerwell-growth/ and https://www.beckershospitalreview.com/finance/humana-to-exit-medicare-advantage-plans-covering-600000-members-in-2027/
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#humana #medicareadvantage #healthplans #margins
https://www.healthcaredive.com/news/humana-2027-medicare-advantage-plan-exits-q2-2026/826441
KFF Says 340B Reform Hurts Large and DSH Hospitals
Healthcare policy group KFF says the Centers for Medicare and Medicaid Services’ recent proposal to reform the 340b drug discount program will hurt many large hospitals and those treating a disproportionate share of low-income patients. It finds the mandatory reallocation of reduction dollars will help for-profit hospitals. The Trump administration is proposing to drop Medicare reimbursement for 340B providers by about 40%.
Additional article: https://www.fiercehealthcare.com/providers/cms-proposed-340b-reimbursement-cuts-who-wins-and-who-loses
#340b #drugpricing
Employers Like ICHRA But Are Slow To Execute
A survey from the Employee Benefit Research Institute and Morgan Health finds that employers are considering funding health insurance through Individual Coverage Health Reimbursement Arrangements (ICHRAs), but they are facing barriers. Over one-third of those surveyed are considering ICHRAs, but just 11% will implement. Employers worry about the individual marketplace, including affordability concerns and that ICHRAs could be too expensive for employees.
But the data seem to show that ICHARA could be increasingly offered over time.
#ichras #healthcare #coverage #exchanges
KFF Says End Of Premium Stabilization Could Lead To Premium Increases
Healthcare policy group KFF opines that the sunset of the special premium stabilization demonstration in the standalone Part D (PDP) program could mean hikes in premiums paid by Part D enrollees.
The stabilization fund was controversial but did stabilize premiums in 2025 and 2026, reduced the average monthly PDP premium by $26 in 2025 and $16 in 2026. But nonetheless, average monthly PDP premiums in 2026 are over four times higher than the average premium for drug coverage in MA plans, which can subsidy Part D from Part C rebates.
#partd #medicare #pdp
— Marc S. Ryan
