MMIT Payer Portrait: Humana Inc.

Humana Inc. is the sixth-largest health insurer in the U.S., serving more than 12.8 million lives across most sectors. Originally founded in the 1960s as a chain of nursing homes, the company has a long history in elder care, with nearly 40% of its members enrolled in Medicare Advantage (MA). Expounding on this legacy, Humana on April 27 revealed plans to acquire Kindred at Home, a large provider of home health and hospice services. Humana currently has a 40% stake in the company, and plans to leverage the acquisition to improve patient outcomes and satisfaction in in-home settings, according to a press release.

This focus on increased integration is not new for the insurer. Humana operates its own pharmacy benefit manager, Humana Pharmacy Solutions, Inc. The company boosted its PBM business with its 2020 acquisition of Enclara Healthcare, a large PBM that served more than 97,000 hospice patients per day at the time the deal was announced, according to a Dec. 26, 2019, article in AIS’s RADAR on Drug Benefits.

As the No. 2 MA insurer in the U.S., Humana has consistently grown its market presence year over year. For the 2021 plan year, the company launched 69 new plan designs in more than 100 new counties, ultimately seeing 9% growth year over year. The insurer is also working on expanding its Medicaid footprint. In 2020, Humana took the reins from CareSource in its formerly co-owned Kentucky Medicaid plan, and upped its ownership stake in Wisconsin-based Medicaid insurer iCare from 50% to 100%. So far in 2021, the insurer has seen Medicaid contract wins in Oklahoma and Ohio. On July 1, Humana will begin serving South Carolina’s Medicaid managed care program.


SOURCE: DHP, AIS’s Directory of Health Plans; MMIT Analytics. Subscribers to AIS’s RADAR on Drug Benefits can read the article about Humana’s acquisition of Enclara Healthcare here: Learn more about subscribing to AIS Health’s publications here: Read more about Humana’s acquisition of Kindred at Home here:

Carina Belles

Carina is a reporter at AIS, specializing in public sector data research, trend analysis and infographics. She holds a Bachelor of Science in Journalism from Ohio University, joining AIS shortly after graduating in 2014.

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