HUM (US)


November 26, 2025

Medicare Advantage Tech Changes Proposal: RFI Eases Risk Adjustment Concerns, Star Rating Changes Afoot [HUM, ALHC, UNH, CVS, ELV, PRVA, ASTH]

By Beth Steindecker

Our read of the proposed Contract Year 2027 Policy and Technical Changes regulation for Medicare Advantage (MA) and Part D (fact sheet here), confirms our expectations for a positive regulatory backdrop for 2027 for MA [HUM, ALHC,…

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November 7, 2025

Obesity Drug Pricing Deal: Devil in the Details

By John Leppard

As outlined by the Trump administration, we view yesterday’s obesity drug pricing deal with NVO and LLY as a modest near-term positive (potentially better for LLY), with the $245 / mo. price point for Medicare…

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November 5, 2025

Medicare Advantage: Still Expecting Light Regulatory Touch for CY27 [HUM, ALHC, AGL, UNH, CVS, ELV, CNC, PRVA]

By Beth Steindecker

Listening to recent earnings calls held by various Medicare Advantage (MA) insurers and value-based care providers [HUM, ALHC, AGL, UNH, CVS, ELV] leaves us with the following thoughts on the MA regulatory policy environment for…

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October 14, 2025

[HUM] Stars Rating Litigation Likely Brings Chapter to Close

By Beth Steindecker

We think this morning’s court ruling against Humana (HUM) in its Medicare Advantage (MA) Stars litigation is likely the end of the road in its efforts to secure a higher score for its 2026 payment…

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September 29, 2025

Medicare Advantage: CMS’ Stable Message Eclipsed by Falling Enrollment Forecast, But A Wait and See Attitude Is Appropriate

By Beth Steindecker

While reports over the weekend about CMS’s Friday release of the Medicare Advantage (MA) and Part D Plan (PDP) premium, deductible and other information for the 2026 plan year focused on the 2.6% projected cut…

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September 26, 2025

Medicare Advantage RADV Audits in Legal Limbo, But Don’t Discount Its Resurrection [HUM, UNH, CVS, CNC, ELV, ALHC]

By Beth Steindecker

Medicare Advantage (MA) insurers [HUM, UNH, CVS, CNC, ELV, ALHC] received some positive legal news that for now neutralizes the concern of widespread Medicare audits and potential concomitant recoupments. However, yesterday’s federal district court ruling…

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July 30, 2025

HUM: MA Stars Lawsuit May Provide Another Boost to HUM, Timing Unknown

By Beth Steindecker

Against the backdrop of positive Q2 earnings, upward full-year guidance, and voiced confidence in the ability to manage the medical cost and utilization trends throughout 2H and into next year, we think the recently refiled…

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July 28, 2025

CY26 Medicare Part D: Additional Spending but CMS Starting to Put on the Brakes

By Beth Steindecker

Today’s CMS release regarding its CY26 Medicare Part D program gives  the impression the agency is focusing on stability in its drug benefit program with the goal to ensure 1) enrollees – especially those in…

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July 2, 2025

Medicare Advantage RADV Update: Tons More PY19 Audits, UNH Has the Most For Now

By Beth Steindecker

CMS’s addition last week of 300+ Medicare Advantage (MA) [UNH, HUM, CNC, ELV, CVS, ALHC] contracts to be audited for risk adjustment data verification (RADV) during plan year (PY) 2019 raises the risk of larger…

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June 16, 2025

Medicare Advantage: Filling in RADV Blanks; HUM Has Most Contracts Targeted [HUM, UNH, CVS, ELV, CNC, ALHC]

By Beth Steindecker

Late Friday, CMS announced the latest list of Medicare Advantage (MA) contracts to be targeted for risk adjustment data verification (RADV) audits – this time for payment year (PY) 2019 – and its associated processes…

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