Humana, the second-largest Medicare Advantage insurer in the country, is turning to a familiar strategy to boost profitability: encouraging members to attend their annual wellness visits. At the company’s recent investor day in Louisville, Kentucky, executives argued that there is still money to be made in the private form of Medicare for older adults, despite recent scrutiny of the program’s impact on the federal budget. George Renaudin, president of Humana’s insurance business, defended the annual wellness visits, stating that seniors love the convenience and personalized attention they receive during these at-home visits.
However, critics argue that insurers often use these visits to add lucrative diagnosis codes, as patients who appear sicker on paper draw higher government payments. Humana plans to increase annual wellness visits through a new partnership with its primary care subsidiary and by embedding clinical insights into providers’ workflow systems.
Medicare Advantage profitability strategy
The company will also instruct call center workers to ask members if they have had their annual wellness visit and offer to schedule it for them. A recent analysis found that insurers collected an estimated $7.5 billion in 2023 from diagnoses added during health risk assessments and chart reviews that had no record of treatment, with Humana receiving the second-highest amount after UnitedHealth. CEO Jim Rechtin urged investors to view Humana as a senior services business, not just a health insurer.
The company’s focus is on returning its Medicare margin to a sustainable level by ensuring members receive accurate diagnoses, follow-up care, and improved clinical outcomes. Rechtin emphasized that retaining customers over multiple years, during which the company can have a greater impact on their care, is what drives the business. Benefits may attract new members, but service is what keeps them coming back.