Humana 2007 Annual Report Download - page 22

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Medical membership under these various arrangements was as follows at December 31, 2007 and 2006:
Government Segment Commercial Segment
Medicare
Advantage
Medicare
stand-alone
PDP
Military
services
Military
Services
ASO Medicaid
Total
Segment
Fully-
Insured ASO
Total
Segment
Total
Medical
Medical Membership:
December 31, 2007
Capitated HMO
hospital system
based .......... 27,000 — — — — 27,000 24,500 — 24,500 51,500
Capitated HMO
physician group
based .......... 23,000 — — — 150,500 173,500 25,800 — 25,800 199,300
Risk-sharing ...... 275,200 — — — 230,800 506,000 26,000 — 26,000 532,000
Other ............ 817,800 3,442,000 1,719,100 1,146,800 183,700 7,309,400 1,732,300 1,643,000 3,375,300 10,684,700
Total ........ 1,143,000 3,442,000 1,719,100 1,146,800 565,000 8,015,900 1,808,600 1,643,000 3,451,600 11,467,500
December 31, 2006
Capitated HMO
hospital system
based .......... 29,800 — — — — 29,800 33,600 — 33,600 63,400
Capitated HMO
physician group
based .......... 23,900 — — — 148,300 172,200 29,900 — 29,900 202,100
Risk-sharing ...... 279,300 — — — 239,700 519,000 25,900 — 25,900 544,900
Other ............ 669,600 3,536,600 1,716,400 1,163,600 181,100 7,267,300 1,664,800 1,529,600 3,194,400 10,461,700
Total ........ 1,002,600 3,536,600 1,716,400 1,163,600 569,100 7,988,300 1,754,200 1,529,600 3,283,800 11,272,100
Medical Membership Distribution:
December 31, 2007
Capitated HMO
hospital system
based .......... 2.4% — — — — 0.3% 1.4% — 0.7% 0.5%
Capitated HMO
physician group
based .......... 2.0% — — — 26.6% 2.2% 1.4% — 0.8% 1.8%
Risk-sharing ...... 24.1% — — — 40.9% 6.3% 1.4% — 0.8% 4.7%
All other
membership ..... 71.5% 100.0% 100.0% 100.0% 32.5% 91.2% 95.8% 100.0% 97.7% 93.0%
Total ........ 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
December 31, 2006
Capitated HMO
hospital system
based .......... 3.0% — — — — 0.4% 1.9% — 1.0% 0.6%
Capitated HMO
physician group
based .......... 2.4% — — — 26.1% 2.2% 1.7% — 0.9% 1.8%
Risk-sharing ...... 27.9% — — — 42.1% 6.4% 1.5% — 0.8% 4.8%
All other
membership ..... 66.7% 100.0% 100.0% 100.0% 31.8% 91.0% 94.9% 100.0% 97.3% 92.8%
Total ........ 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Capitation expense as a percentage of total benefit expense was as follows for the years ended December 31,
2007, 2006, and 2005:
2007 2006 2005
(dollars in thousands)
Benefit Expenses:
Capitated HMO expense ............. $ 366,075 1.8% $ 382,584 2.2% $ 456,123 3.9%
Other benefit expense ................ 19,904,456 98.2% 17,038,620 97.8% 11,195,347 96.1%
Consolidated benefit expense ...... $20,270,531 100.0% $17,421,204 100.0% $11,651,470 100.0%
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