Humana 2009 Annual Report Download - page 20

Membership
The following table summarizes our total medical membership at December 31, 2009, by market and product:
Government Commercial
Medicare
Advantage
Medicare
stand-alone
PDP Medicaid
Military
services PPO HMO ASO Total
Percent of
Total
(in thousands)
Florida .................... 377.9 82.0 51.8 — 104.4 160.0 81.3 857.4 8.3%
Kentucky .................. 59.3 41.1 — — 116.3 41.7 525.8 784.2 7.6%
Texas ..................... 96.2 172.5 — — 165.6 152.0 125.9 712.2 6.9%
Puerto Rico ................ 14.8 0.3 349.9 — 39.0 15.6 36.1 455.7 4.4%
Illinois .................... 72.1 54.0 — — 137.1 70.0 94.8 428.0 4.2%
Ohio ..................... 51.2 64.0 — — 12.7 89.0 170.4 387.3 3.8%
Wisconsin ................. 50.5 40.4 — — 63.6 52.9 170.8 378.2 3.7%
Louisiana ................. 79.6 28.3 — — 39.6 30.4 133.8 311.7 3.0%
Tennessee ................. 68.7 54.3 — — 62.8 18.7 65.5 270.0 2.6%
Missouri/Kansas ............ 63.3 105.6 — — 63.1 13.1 7.0 252.1 2.5%
Georgia ................... 41.9 51.6 — — 8.3 91.2 36.2 229.2 2.2%
Indiana ................... 31.8 61.0 — — 32.0 2.9 50.5 178.2 1.7%
Michigan .................. 34.8 62.5 — — 40.0 — 5.9 143.2 1.4%
North Carolina ............. 63.5 69.6 — — 8.0 — — 141.1 1.4%
Arizona ................... 31.4 25.6 — — 30.5 25.1 12.2 124.8 1.2%
Virginia ................... 51.5 63.5 — — 3.3 — — 118.3 1.2%
Colorado .................. 19.5 22.6 — — 40.2 23.7 — 106.0 1.0%
California ................. 7.3 95.8 — — 1.2 — — 104.3 1.0%
Military services ............ — — — 1,756.0 — — — 1,756.0 17.1%
Military services ASO ....... — — — 1,278.4 — — — 1,278.4 12.5%
Others .................... 293.2 833.2 — — 85.5 — 55.1 1,267.0 12.3%
Totals .................... 1,508.5 1,927.9 401.7 3,034.4 1,053.2 786.3 1,571.3 10,283.3 100.0%
Provider Arrangements
We provide our members with access to health care services through our networks of health care providers
with whom we have contracted, including hospitals and other independent facilities such as outpatient surgery
centers, primary care physicians, specialist physicians, dentists and providers of ancillary health care services and
facilities. These ancillary services and facilities include ambulance services, medical equipment services, home
health agencies, mental health providers, rehabilitation facilities, nursing homes, optical services, and
pharmacies. Our membership base and the ability to influence where our members seek care generally enable us
to obtain contractual discounts with providers.
We use a variety of techniques to provide access to effective and efficient use of health care services for our
members. These techniques include the coordination of care for our members, product and benefit designs,
hospital inpatient management systems and enrolling members into various disease management programs. The
focal point for health care services in many of our HMO networks is the primary care physician who, under
contract with us, provides services to our members, and may control utilization of appropriate services by
directing or approving hospitalization and referrals to specialists and other providers. Some physicians may have
arrangements under which they can earn bonuses when certain target goals relating to the provision of quality
patient care are met. Our hospitalist programs use specially-trained physicians to effectively manage the entire
range of an HMO member’s medical care during a hospital admission and to effectively coordinate the member’s
discharge and post-discharge care. We have available a variety of disease management programs related to
specific medical conditions such as congestive heart failure, coronary artery disease, prenatal and premature
infant care, asthma related illness, end stage renal disease, diabetes, cancer, and certain other conditions.
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