Humana Reports No Progress On Dismal Star Ratings
A shocker announcement today. Humana, the second largest Medicare Advantage (MA) health plan, told regulators and investors that its Star ratings remained largely steady and did not recover from a catastrophic low. What’s more, based on how enrollment looks to pan out in 2026, its percentage of members in 4 Star or greater plans will drop from 25% in 2025 to 20% in 2026. Historically, Humana has been a high performer. In 2024, it had 94% of members in 4 Star or greater plans.
The collapse of Star ratings for Humana in 2025 and now 2026 has cost billions in annual revenue. A good share of the drop in 2025 resulted from a lower Star rating in a nationwide contract with millions of enrollees. Humana was said to be addressing the concentration of enrollees in that one contract but apparently the time was too short to meaningfully impact ratings.
Humana said that the poor performance was in line with expectations and that its financial outlook has not changed.
The nation’s largest MA plan, UnitedHealthcare, saw a rebound in ratings for 2026, but Humana in the number 2 spot did not. I had predicted a modest recovery in Star overall for the industry from 2025. But with Humana’s performance, a recovery, if any, will be small.
Additional article: https://www.fiercehealthcare.com/payers/humana-says-20-members-ma-plans-four-plus-stars-2026 and https://www.healthcaredive.com/news/humana-2026-medicare-advantage-star-ratings-slip/801839/ and https://www.beckerspayer.com/payer/medicare-advantage/1-in-5-members-in-4-star-ma-plans-humana/
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#medicareadvantage #stars #quality #cms #humana
https://www.modernhealthcare.com/insurance/mh-humana-medicare-advantage-plans-members-cms/
SCAN’s MA Expansion
SCAN Health Plan is bucking the Medicare Advantage (MA) trends. Blessed by a well-run plan and good Star scores, SCAN is actually one of a small number of health plans in MA expanding in 2026. SCAN announced earlier it would enter a new state. Now the Medicare Plan Finder shows that SCAN will offer coverage in 33 counties across six states, with Washington a new addition to its geographic footprint.
#scan #medicareadvantage #cms
Health Plan Lobby Pushes Exchange Credit Extensions
Faced with its plans losing billions in revenue if the enhanced premium subsidies in the Exchanges expire, the health plan lobby is sponsoring a full-court-press in terms of marketing to get the credits extended. “Healthcare costs will skyrocket,” advertisements warn, urging Americans to “Tell Congress” to act to continue the tax credits as the video shifts to a view of the Capitol building.
The healthcare lobby is hoping moderate and swing district Republicans will band together with Democrats to extend the subsidies either as part of a deal to reopen the government or in the next few weeks before Exchange open enrollment hits. Conservatives and the GOP leadership in Congress are likely opposed.
(Article may require a subscription.)
#exchanges #aca #obamacare #congress #governmentshutdown
https://www.modernhealthcare.com/insurance/mh-aca-subsidies-government-shutdown/e-funding-bill-shutdown-vote
— Marc S. Ryan
