Humana Medicare Star notes slide for 2026

Diving brief:

• Humana will hold 20% of its members of Medicare Advantage in the plans classified 4 or more in 2026, slightly down compared to 2025, but in accordance with internal expectations, the insurer revealed Thursday.
• HUMANA – The second largest MA carrier in the country – has seen an improvement in members in the plans evaluated 4.5 stars or more. Next year, 14% of the members of MA of Humana will be very well rated in these plans, compared to 3% in 2025.
• Humana’s average star note of 3.61 is almost stable from year to year. The insurer, who worked to improve his notes, said that she was not satisfied with the results. However, Humana’s actions increased by around 3% in the trade on Thursday after its disclosure.

Diving insight:

It is a busy season for observers of the insurance market, the CMS publishing more information on the Medicare Landscape Advantage for the coming year – including by mistake.

On Wednesday, the regulators published more detailed information on MA plan offers for 2026 and inadvertently published certain data on stars, leading Humana to deposit his own disclosure to investors, said the insurer.

Although Humana’s average stars’ average note has been essentially unchanged, the results are generally disappointing for the insurer. Indeed

To put this further in context, Humana had 94% of the members of the plans evaluated at least 4 stars in 2024.

To reach this threshold is the key to insurers of the Privatized Medicare program. Plans that receive an overall note of 4 or more receive higher premium payments. Higher scores also lead to higher discounts if the plans submit offers lower than the CMS reference for the coming year.

Humana expects to lose billions of dollars in income due to the fall in stars’ ratings from 2024 to 2025, so a new drop for 2026 will not help.

“Although the company is not satisfied with its 2026 Star notes, it is satisfied with the tactical operational improvements made during the last months of the 2026 measurement period, creating a solid base for the expected return of the company to the best quartile results for the Star 2027 notes”

In addition to continuing the government in order to improve its scores, Humana has shaken up to improve its notes in filling the shortcomings in care, by increasing the awareness of members and investing in technology, according to executive comments.

The insurer also continued a strategy called “Diversification of contracts”.

The CMS measures quality through stars notes at the contract rather than in the level of an individual plan. A contract may include many different plans. Consequently, by juggling with the registration of members in certain plans and the allocation of the plan to certain contracts, Humana can move more members in more highly rated contracts and guarantee payments by higher member.

In addition to the diversification of contracts, Humana has ceased to pay commissions to brokers for a third of its products, according to a research note from the TD Cowen investment bank. The reduction of commissions to third parties who help the elderly to register for coverage is another strategy of insurers to orient members in more profitable or very well rated plans.

Following her efforts, Humana expects the percentage of its members in the plans evaluated at least 4 stars to be “significantly” that 20% in 2027, according to the insurer’s file.

The main insurers listed on the stock market currently prioritizes the profits on the growth of MA after two years of margins reduction in the former lucrative program. The elderly consumed more medical care than expected insurers, which increased the expenses, while the regulatory changes have repressed the reimbursement.

The three largest MA carriers, including Humana, have all reduced the number of states and counties they serve for 2026, according to an analysis of the CMS data published on Wednesday. However, Humana has kept her relatively stable plan performances, a decision that feared that certain investors would attract him could attract many new members in Humana’s plans, including some who could saddle the payer with higher medical expenses.

Overall, the payer based in Louisville, in Kentucky, plans to double his margin before tax in the plans of my individual next year, excluding the impact of stars’ notes, according to disclosure.

Unitedhealthcare, the largest MA carrier in the United States, also revealed that certain stars’ results at the start of this year. In September, the insurer Unitedhealth said that it would hold about 78% of its registrants MA in plans evaluated 4 or more, largely from one year to the next.