Humana is primarily a Medicare Advantage (MA) health insurance company. MA is a privately administered alternative to traditional government Medicare for Americans aged 65 and older; Humana contracts with the Centers for Medicare and Medicaid Services (CMS) to provide Medicare-covered benefits — plus extras like dental, vision, and drug coverage — in exchange for a fixed monthly payment per member. Humana serves roughly 5.2 million individual MA members and also offers group MA for employer retirees, stand-alone Medicare Part D drug plans, Medicaid managed care in about 10 states, and military health services via a TRICARE contract. Humana makes money by collecting fixed CMS payments and managing actual member healthcare costs below that amount. Revenue per member is shaped by risk-adjusted payments (higher for sicker members) and CMS Stars quality bonuses, which meaningfully increase funding for plans rated four stars or above. Beyond insurance, Humana operates CenterWell, a healthcare services arm that includes roughly 350 senior-focused primary care clinics, one of the largest home health businesses in the country, and a mail-order and specialty pharmacy. CenterWell is designed to integrate with Humana's MA business — managing high-cost members more directly and supporting Stars quality metrics. About one-third of Humana's MA members are in fully capitated arrangements where providers take on financial risk, which Humana argues reduces total cost of care. Humana's current earnings recovery plan centers on restoring Stars ratings, stabilizing benefits to reduce member attrition, cutting G&A costs, and scaling Medicaid and CenterWell.
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