Humana 2009 Annual Report Download - page 22

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Medical membership under these various arrangements was as follows at December 31, 2009 and 2008:
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, 2009
Capitated HMO
hospital system
based .......... 31,000 — — — — 31,000 22,200 — 22,200 53,200
Capitated HMO
physician group
based .......... 50,200 — — — 117,600 167,800 26,300 — 26,300 194,100
Risk-sharing ...... 285,100 — — — 279,200 564,300 22,400 — 22,400 586,700
Other ............ 1,142,200 1,927,900 1,756,000 1,278,400 4,900 6,109,400 1,768,600 1,571,300 3,339,900 9,449,300
Total ........ 1,508,500 1,927,900 1,756,000 1,278,400 401,700 6,872,500 1,839,500 1,571,300 3,410,800 10,283,300
December 31, 2008
Capitated HMO
hospital system
based .......... 25,600 — — — — 25,600 24,000 — 24,000 49,600
Capitated HMO
physician group
based .......... 48,400 — — — 146,500 194,900 27,500 — 27,500 222,400
Risk-sharing ...... 274,100 — — — 235,600 509,700 25,000 — 25,000 534,700
Other ............ 1,087,800 3,066,600 1,736,400 1,228,300 89,000 7,208,100 1,902,300 1,642,000 3,544,300 10,752,400
Total ........ 1,435,900 3,066,600 1,736,400 1,228,300 471,100 7,938,300 1,978,800 1,642,000 3,620,800 11,559,100
Medical Membership Distribution:
December 31, 2009
Capitated HMO
hospital system
based .......... 2.1% — — — — 0.5% 1.2% — 0.6% 0.5%
Capitated HMO
physician group
based .......... 3.3% — — — 29.3% 2.4% 1.5% — 0.8% 1.9%
Risk-sharing ...... 18.9% — — — 69.5% 8.2% 1.2% — 0.7% 5.7%
All other
membership .... 75.7% 100.0% 100.0% 100.0% 1.2% 88.9% 96.1% 100.0% 97.9% 91.9%
Total ........ 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
December 31, 2008
Capitated HMO
hospital system
based .......... 1.8% — — — — 0.3% 1.2% — 0.7% 0.4%
Capitated HMO
physician group
based .......... 3.4% — — — 31.1% 2.5% 1.4% — 0.8% 1.9%
Risk-sharing ...... 19.1% — — — 50.0% 6.4% 1.3% — 0.7% 4.7%
All other
membership .... 75.7% 100.0% 100.0% 100.0% 18.9% 90.8% 96.1% 100.0% 97.8% 93.0%
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,
2009, 2008, and 2007:
2009 2008 2007
(dollars in thousands)
Benefit Expenses:
Capitated HMO expense ............... $ 560,914 2.3% $ 510,606 2.2% $ 366,075 1.8%
Other benefit expense ................. 24,214,088 97.7% 23,197,627 97.8% 19,904,456 98.2%
Consolidated benefit expense ....... $24,775,002 100.0% $23,708,233 100.0% $20,270,531 100.0%
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