Humana

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. As of 2014 Humana had over 13 million members in the U.S.,[2] reported a 2013 revenue of US$41.3 billion,[3] and had 41,600 employees.[4] In 2018, the company ranked 56 on the Fortune 500 list,[5] which made it the highest ranked (by revenues) company based in Kentucky. It has been the third largest health insurance in the nation.[6]

This article is about the health insurance company. For other uses, see Humana (disambiguation).

Humana Inc.
Public
Traded as
ISINUS4448591028 
IndustryManaged health care
FoundedAugust 18, 1961 (1961-08-18) (as Extendicare Inc.)
Louisville, Kentucky, U.S.
Headquarters500 West Main Street, Louisville, Kentucky, U.S.
Key people
Kurt J. Hilzinger
(Chairman)
Bruce D. Broussard
(Chief Executive Office [CEO])
Revenue US$64.888 billion (2019)[1]
US$3.192 billion (2019)[1]
US$2.707 billion (2019)[1]
Total assets US$29.074 billion (2019)[1]
Total equity US$12.037 billion (2019)[1]
Number of employees
~46,000 (December 2019)[1]
Websitewww.humana.com

The U.S. Dept. of Health and Human Services investigated Humana in 2009 for sending flyers to Medicare recipients that the AARP characterized as deceptive. The company's managed care model has also been criticized for ethical lapses and limitations.

The health insurer Aetna said on July 3, 2015, that it had agreed to acquire its smaller rival Humana for $37 billion in cash and stock[7] but walked away from the deal after a court ruling that the merger would be anti-competitive.[8]

History

1961–1983: Nursing homes and hospitals

Lawyers David A. Jones Sr. and Wendell Cherry founded a nursing home company in 1961.[9] The company, known in 1968 as Extendicare Inc., became the largest nursing home company in the United States. In 1972, Jones and Cherry sold the nursing home chain, to purchase hospitals.[10]

In 1974, the partners changed the corporate name to Humana Inc.[10] The name was meant to change public perception from 'warehousing' or indifferently treating people to providing a higher-level of human care and, by extension, more humane care.[11] It grew in the following years, both by business and in 1978 through the takeover of American Medicorp Inc.,[12] which doubled the company's size, and growing into the world's largest hospital company in the 1980s.[13] During this period, Humana developed the double corridor model for hospital construction. This design minimized the distance between patients and nurses by placing nursing support services in the interior of the building with patient rooms surrounding the perimeter.

1984–present

As the American health care system changed in the 1980s, "one of its hospitals in Arizona lost a contract with the largest health-maintenance organization in the area [and] Humana created its own health insurance plan."[10]

In 1993, Humana had become the largest hospital operator in the country, owning 77 hospitals. Humana executives spun off hospital operations from health insurance operations to create Galen Health Care. The following year they sold the 73 hospitals of Galen Health Care Inc. to Nashville-based Columbia Hospital Corporation of America for $3.4 billion.[10]

In 1998, one year after Jones had stepped aside as CEO, United Healthcare made an unsuccessful attempt to acquire Humana.[10] Humana pulled out of the acquisition after United stock dropped $2.9 billion in value.[14] In 2001, Humana was a cofounder of Availity.[15]

In 2005, Humana entered into a business partnership with Virgin Group, offering financial incentives to members for healthy behavior, such as regular exercise.[16]

On November 16, 2006, the Centers for Disease Control and Prevention (CDC) and Humana Inc. partnered to expand on traditional private-sector approaches to population health management.[17]

In 2006, Humana launched an education campaign to market Medicare Advantage (MA) and Prescription Drug Plans (PDP) nationwide to Medicare-eligible consumers, following the passage of the Medicare modernization act. The same year, Humana launched RightSource, a national mail-order retail pharmacy business.[10] In March 2008, Fortune Magazine named Humana one of the Top 5 Most Admired Healthcare Companies in the United States.[18]

In 2010, Humana bought Texas-based Concentra Inc., which owns urgent-care and physical therapy centers, for $790 million, effectively returning to healthcare services.[10] In May 2011, Humana announced it would be using mobileStorm to transmit protected health information to patients.[19]

In March 2015, Humana announced the sale of Concentra to private equity firm Welsh, Carson, Anderson & Stowe and Select Medical Holdings Corporation for about $1 billion, with proceeds to fund a "$2 billion share buyback program and other corporate spending."[20]

In July 2015, Aetna announced that it would acquire Humana for $37 billion in cash and stock (approximately $230 a share at that time). Aetna and Humana shareholders would own 74% and 26% of the new combined company, however the merger was blocked by a federal judge in January 2017.[21][22] In February 2017, Aetna Inc. and Humana Inc. quashed a $34 billion merger agreement after judges ruled against the merger for a second time.[23]

In July 2018, Humana joined two private equity firms in the acquisition of Kindred Healthcare. The deal provided Humana with a 40% stake in the company's home health, hospice and community care businesses, called "Kindred at Home," for approximately $800 million.[24][25] In August 2018, Humana announced the creation of a digital health and analytics division called Humana Studio H.[26]

In December 2019, the company announced it would acquire Enclara Healthcare from Consonance Capital Partners and Enclara management.[27]

Corporate affairs

Sponsorship

LPGA player Nancy Scranton is a spokesperson for Humana.[28] In the past, PGA Tour player David Toms' David Toms Foundation has partnered with the Humana Foundation to provide grants to several children's charities in New Orleans.[29] Humana is the official health benefits provider of the PGA Tour and Champions Tour.

The Humana Distaff Handicap is a Grade 1 race for thoroughbred fillies and mares, four-years-old and up. The race is run each spring on Kentucky Derby day at Churchill Downs and set at a distance of 7 furlongs for a purse of $250,000.

Humana is the presenting sponsor of the Grand Ole Opry.[30]

Since 1979, Humana has been a principal sponsor of the annual Humana Festival of New American Plays in Louisville, Kentucky.[31]

Humana Military Healthcare Services

In 1993, Humana founded Humana Military Healthcare Services (HMHS) as a wholly owned subsidiary.[10] They were awarded their first TRICARE contract in 1995, and began their military beneficiaries in 1996.[32]

From 2004 to 2009, HMHS was the managed care contractor for the Department of Defense Military Health System TRICARE South Region.

In 2009, HMHS' Managed Care Support Contract was awarded to United Military and Veterans Services, a subsidiary of UnitedHealth Group. HMHS protested that decision and the Government Accountability Office upheld the protest in late 2009.[33]

In 2011, HMHS regained the five-year contract to administer medical benefits to military members and families in the South region, a contract worth $23.5 billion.[10]

Controversy

In 1987, Humana sued NBC over a story line in the television medical drama St. Elsewhere in which the hospital was to be sold to a for-profit medical corporation and renamed "Ecumena", with subsequent changes to the hospital, both positive and negative, emanating from that change. Humana was successful at forcing NBC into showing a disclaimer at the beginning of the September 30 episode saying that the drama had no connection whatsoever with Humana.[34]

On May 30, 1996, Linda Peeno, a physician who was contracted to work for Humana for nine months, testified before Congress as to the downside of managed care. Peeno said she was effectively rewarded by her employer for causing the death of a patient, because it saved the company a half-million dollars. Peeno stated that she felt the "managed care" model was inherently unethical.[35]

In 1999, season one of Michael Moore's TV series The Awful Truth reported on Humana refusing to pay for a diabetic patient with pancreatic failure needing a transplant.[36] The man's policy stated it covered all of his diabetes-related expenses, but another section of the policy stated that it did not cover organ transplants. Moore conducted a fake funeral on the front steps of the Humana building, and three days later Humana changed its policy and authorized the man's treatment..

Michael Moore's 2007 documentary Sicko used the video of Linda Peeno's testimony. On June 28, 2007, Humana declared that Peeno was never a Humana "associate" (permanent, full-time employee), but rather a "part-time contractor." Humana disputed portions of her Congressional testimony by saying that because the patient's healthcare plan did not cover heart transplants, denial of coverage was valid.[37]

On September 21, 2009 the U.S. Department of Health and Human Services opened an investigation into Humana mass mailings to elderly Medicare recipients.[38] The mail was made to appear to contain official information about Medicare Advantage and prescription drug benefit information, but instead alleged that core Medicare benefits could be cut by the Obama administration's healthcare reform,[39] a claim refuted by John Rother, AARP's executive vice president.[40] Douglas Elmendorf, the head of the Congressional Budget Office (CBO), supported the claim that Medicare benefits could be cut,[41] but his comments were in reference to just one of several congressional bills. CBO estimates of another healthcare reform bill found that changes to premiums would vary.[42] The Centers for Medicare and Medicaid Services instructed Humana to cease all such mailings to Medicare plan members pending an investigation.[39] HHS Secretary Kathleen Sebelius, in a letter to the insurance industry, threatened that bad actors may be excluded from new health insurance markets that were to open in 2014. Senate Republicans pointed out in a letter to Sebelius that a 1997 directive from the Centers for Medicare and Medicaid Services explicitly allowed HMOs to tell members about legislation and urge them to express opinions.

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See also

References
  1. "Humana Inc. 2019 Annual Report (Form 10-K)". last10k.com. U.S. Securities and Exchange Commission. February 2020.
  2. Patrick, Margaret (February 16, 2015). "Humana: Unraveling the history of a health insurance giant". Market Realist. Retrieved December 25, 2016.
  3. "Financial Statements for Humana Inc". December 31, 2013. Retrieved May 6, 2012.
  4. "Annual Report 2016 on SEC Filing Form 10-K". Humana Inc. February 17, 2017. Retrieved June 21, 2017.
  5. "Fortune 500 Companies 2018: Who Made the List". Fortune. Retrieved November 10, 2018.
  6. "Fortune 500 2013". Money.cnn.com. Retrieved May 28, 2014.
  7. Bray, Chad; Abelson, Reed (July 3, 2015). "Aetna Agrees to Acquire Humana for $37 Billion in Cash and Stock". The New York Times. Retrieved December 27, 2015.
  8. "Cigna demands Anthem pay $14.8 billion in lawsuit to terminate merger agreement". The Washington Post.
  9. Larson, Chris (February 20, 2020). "Major Humana investor sheds half of its holdings in the company". Louisville Business First.
  10. Steve Ivey and Ed Green (November 11, 2011). "Humana's history has been one of recognizing opportunities". American City Business Journals. Retrieved March 23, 2015.
  11. Sawyer, Robert (August 16, 2006). Kiss & Sell: Writing for Advertising: (Redesigned & Rekissed). AVA Publishing. ISBN 9782940373468 – via Google Books.
  12. Cole, Robert J. (December 22, 1977). "T. W. A. Plans Offer For Medicorp Shares". The New York Times. ISSN 0362-4331. Retrieved January 24, 2017.
  13. Politics, Peter Dreier E. P. Clapp Distinguished Professor of; College, Occidental (March 18, 2010). "Humana: Profits Over People". The Huffington Post. Retrieved January 24, 2017.
  14. Burton, Thomas M. (August 10, 1998). "Humana Walks Away From Merger After United HealthCare Stock Falls". The Wall Street Journal. ISSN 0099-9660. Retrieved January 23, 2017.
  15. Mathis, Karen Brune (July 30, 2010). "Availity: from scratch to 300 employees and 700 million transactions". Financial News & Daily Record. Retrieved August 17, 2016.
  16. Green, Ed (March 23, 2006). "Humana, Virgin launch health rewards program in Louisville". Business First. Retrieved January 23, 2017.
  17. "CDC and Humana Partner to Create Next Generation of Public Health; Alliance to Leverage Private-Sector Resources to Address Chronic Diseases". Humana. November 16, 2006.
  18. "America's Most Admired Companies 2008: Industry: Health Care: Insurance, Managed Care | FORTUNE". Money.cnn.com. March 17, 2008. Retrieved August 5, 2009.
  19. mobileStorm Launches First HIPAA-Compliant, Cloud-based mHealth Communication Platform; Announces Humana as a Beta Client. Smart Phone Health Care. May 27, 2011.
  20. "Humana to sell Concentra medical center unit for $1 billion". Reuters. March 23, 2015. Retrieved March 23, 2015.
  21. "Aetna Acquiring Humana for $37 Billion". BusinessWire. July 3, 2015.
  22. Cancryn, Adam (January 23, 2017). "Judge blocks major health insurance merger". Politico. Retrieved January 23, 2017.
  23. Wilde Mathews, Anna; Kendall, Brent (February 15, 2017). "Antitrust Rulings Put Chill on Health-Insurance Mergers". The Wall Street Journal. Retrieved February 15, 2017.
  24. Japsen, Bruce (April 5, 2018). "Kindred Shareholders Approve Humana Deal". Forbes. Retrieved September 28, 2018.
  25. Larson, Chris (September 20, 2018). "Humana CFO: 'What we're trying to do with health care is fundamental transformation'". Louisiana Business First. Retrieved September 28, 2018.
  26. Greer, Carolyn (August 27, 2018). "Humana plans new analytics division - here's where it's going". Louisville Business First.
  27. "Humana to Acquire Enclara Healthcare". BioSpace. Retrieved July 1, 2020.
  28. "LPGA's Nancy Scranton Becomes Humana Ambassador; Veteran Golfer Will Offer Golfing and Lifestyle Tips Targeted to Humana's Female Audience".
  29. Center, Foundation. "David Toms, Humana Foundations Partner to Assist New Orleans Charities". Philanthropy News Digest (PND). Retrieved January 24, 2017.
  30. "About the Opry". Grand Ole Opry. Archived from the original on June 16, 2013. Retrieved August 17, 2016.
  31. "Humana Festival of New American Plays". Humana Foundation. Archived from the original on July 15, 2014. Retrieved August 17, 2016.
  32. Project Healthcare Effectiveness Through Resource Optimization: Hearing. DIANE Publishing. p. 83. ISBN 9781422323243.
  33. "U.S. TRICARE Contract Protest By Humana Upheld". CBS News. Retrieved May 11, 2020.
  34. "Humana lawsuit over 'St. Elsewhere' prompts TV disclaimer by NBC". Chicago Sun-Times. October 1, 1987. Archived from the original on May 16, 2011. Retrieved August 5, 2009.
  35. "Testimony of Linda Peeno, MD about Managed Care in the Healthcare Industry - May 30, 1996". nomanagedcare.org. Archived from the original on June 1, 2008. Retrieved October 22, 2010.
  36. Chris Kaltenbach (April 7, 1999). "Moore to tell 'Awful Truth'". Baltimore Sun. Retrieved March 23, 2015.
  37. "Humana issues statement on Moore's 'Sicko'". Business First. June 28, 2007. Retrieved July 7, 2007.
  38. Medicare Probes Humana's Letter To Patients About Effects Of Health Reform Medical News Today, September 23, 2009 Archived September 27, 2009, at the Wayback Machine
  39. Dawn Teo Humana Mailer Targets Elderly, Claims Medicare Benefits To Be Cut Huffington Post. September 16, 2009.
  40. King, Neil (August 25, 2009). "GOP Tees Up Medicare Manifesto". WSJ. Retrieved October 22, 2010.
  41. Budget chief says Medicare benefits could be cut Erica Werner, Associated Press. September 23, 2009
  42. The Effect of H.R. 3200 on Medicare Part D Premiums Congressional Budget Office, Director's Blog. August 28, 2009
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