Humana 2012 Annual Report Download - page 5

2012 Annual Report 4
First, we saw significant progress
in our Medicare Advantage Star
quality ratings. Sponsored by the
Centers for Medicare and Medicaid
Services (CMS), these ratings are based
on CMS’ analysis of comprehensive
quantitative and qualitative data relative
to plan members’ health outcomes,
their experience with the service
provided by contracting plans, and
their overall satisfaction and sense of
well-being. Highlights of our 2012 Stars
progress were:
1. For bonus year 2014, our average Star
rating increased from 3.28 to 3.82.
2. The contract that includes the
majority of our Florida membership
earned 4.5 Stars.
3. Humana’s Wisconsin plan became
the first and only plan offered by a
publicly traded organization that has
achieved a five-Star rating.
4. Most significant of all, the
percentage of our members in plans
rated four Stars or above increased
to 40 percent. Apart from the high
quality of care and member plan
experience signified by such a rating,
CMS is increasingly linking Star ratings
to payment levels as its emphasis on
pay-for-performance grows.
Our second 2012 milestone was
the major expansion of our HMO
offerings. We believe HMOs allow our
integrated care delivery model to work
more effectively for our members than
any other plan option. The percentage of
individual Medicare Advantage members
who chose to enroll in an HMO reached
48 percent during the 2013 Annual
Election Period for Medicare beneficiaries
in late 2012 and is expected to continue
to rise through the remainder of this
year. We anticipate the full year will
show new HMO enrollment of more
than 50 percent – the highest total
since the implementation of the
Medicare Modernization Act in 2006.
Our third milestone was our
successful bids for Medicaid
business in Ohio, Illinois and
Kentucky. These bids include
individuals dually eligible for Medicare
and Medicaid in both Ohio and
Illinois. Our alliance with CareSource®,
established in 2012, was a key factor in
our Ohio success. As the implementation
of the Affordable Care Act (ACA)
continues, we expect to selectively
pursue Medicaid and dual-eligible
opportunities in geographies that
make strategic sense for us.
2012 Milestones
Through its strategy,
the company achieved
several notable
milestones in 2012.
Average Humana Star Rating
BY 2013
BY 2012 BY 2014
1.0
1.5
2.0
2.5
3.0
3.5
4.0
3.12
3.28
3.82
Average Contract Rating
The highest total since the
implementation of the Medicare
Modernization Act in 2006.
48%
Percentage of
individual Medicare
Advantage Members
in an HMO
BY = Bonus Year