Humana: Wellness Visits & Medicare Advantage Profits
- Humana is banking on increased member engagement through annual wellness visits to drive profitability in its Medicare Advantage plans.
- George renaudin, president of Humana’s insurance business, defended the value of these visits at a recent investor day in Louisville, Ky.
- However, the practice of using annual wellness visits to maximize government payments through diagnosis coding has drawn criticism.
Humana is prioritizing annual wellness visits to boost Medicare advantage profitability, a strategy mirroring tactics used by competitors. News Directory 3 reports on how Humana aims to boost its financial performance, focusing on member engagement to combat financial scrutiny. Concerns exist about potential overpayments stemming from diagnosis coding during these visits. Learn about Humana’s plans for a new primary care partnership,aiming to integrate clinical insights into provider workflows and improve Medicare margins through accurate diagnoses and better outcomes. CEO Jim Rechtin highlights the importance of member retention for long-term success, viewing the company as a senior services provider encompassing insurance and primary care through its CenterWell brand. Explore how Humana is refining this approach, balancing accurate coding with cost-effective care. Discover what’s next in Humana’s wellness visit strategy.
Humana Focuses on Wellness Visits to Boost Medicare Advantage Profit
Humana is banking on increased member engagement through annual wellness visits to drive profitability in its Medicare Advantage plans. This approach, common among its competitors, aims to improve the company’s financial performance amid scrutiny of Medicare Advantage’s impact on the federal budget.
George renaudin, president of Humana’s insurance business, defended the value of these visits at a recent investor day in Louisville, Ky. He emphasized thier popularity among seniors, citing the convenience and personalized attention they offer.
However, the practice of using annual wellness visits to maximize government payments through diagnosis coding has drawn criticism. A federal watchdog report indicated that insurers, including Humana and UnitedHealth, collected billions in 2023 from diagnoses added during these assessments without documented treatment.
Lisa stephens, chief operating officer of Humana’s insurance division, outlined plans for a “new, innovative” partnership wiht its primary care subsidiary to integrate clinical insights into provider workflows. Call center staff will also be instructed to promote annual wellness visits when members inquire about benefits.
jim Rechtin, Humana’s CEO, stressed the importance of viewing the company as a senior services provider, encompassing both insurance and primary care through its CenterWell brand. The company aims to improve its Medicare margin by focusing on accurate diagnoses, follow-up care, and better clinical outcomes.
“Benefits tend to attract new members, service tends to keep them,” Rechtin said, highlighting the importance of member retention for long-term financial success.
What’s next
Humana will continue to refine its approach to annual wellness visits, balancing the need for accurate diagnosis coding with the goal of providing comprehensive and cost-effective care to its Medicare Advantage members.