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Key Takeaways
- Shares of health insurance provider Humana plunged after a large share of its Medicare offerings were downgraded by the Centers for Medicare and Medicaid Services.
- Humana said that just a quarter of its members are enrolled in a 4-star or better plan for 2025, down from more than 90% in 2024.
- The company said it is disappointed in its performance and suggested there may be errors in the way the ratings were calculated.
Shares of health insurance provider Humana (HUM) plunged to their lowest level since 2020 after a large share of its Medicare offerings were downgraded by the Centers for Medicare and Medicaid Services (CMS).
Roughly 25% of Humana members, about 1.6 million people, are currently enrolled in plans that have a 4-star or higher Medicare Advantage rating for 2025, according to preliminary data—a massive drop from 94% in 2024.
Why Star Ratings Matter for Humana and Other Insurers
Humana could take a substantial revenue hit if the preliminary data stands when CMS releases its official ratings later this month, as higher star ratings generate bonus payments for the insurers that offer them.
The company said it is “disappointed” with its performance and suggested there may be errors in the way the ratings were calculated. CMS star ratings review plan performance once a year on factors such as the number of annual screenings and preventive services offered, how long it takes to get an appointment, and complaint levels.
“Humana is exploring all available options to mitigate the expected 2026 revenue headwind related to its 2025 Star ratings in the event its challenges to the results are unsuccessful,” the company said in a regulatory filing Wednesday, noting the changes are not expected to affect its outlook in 2024 or 2025.
Those options could include suing CMS, as Elevance Health did successfully last year. The insurer was able to recover money that was at risk due to lower star ratings.
Humana shares tumbled more than 17% in intraday trading Wednesday, and have lost nearly half of their value since the start of the year.