KFF HEALTH NEWS – Humana’s stock took a tumble after the provider admitted to the SEC that only about 1 in 4 of its members were signed up to Medicare Advantage plans rated four stars or more. Meanwhile, CMS is making it harder in 2025 for insurers to get top marks, due to changes in the way stars are calculated.
The Washington Post: Medicare Advantage Giant Humana Reels After Ratings Cut
One of the country’s largest providers of private Medicare plans saw its stock sink to its lowest level in 15 years after the federal government cut the rating for one of its most popular offerings.
Shares of Humana plunged Wednesday after the company revealed in a filing to the Securities and Exchange Commission that only 1.6 million people — about a quarter of its members — are signed up for Medicare Advantage plans rated four stars or higher for 2025. This year, 94 percent of its members are enrolled in them. (Telford, 10/2)
Modern Healthcare: How 2025 Medicare Advantage Ratings Will Be Affected By Cut Points
Getting top quality scores will continue to be a challenge for Medicare Advantage insurers that had grown accustomed to high star ratings and lucrative bonus payments.
That’s because the Centers for Medicare and Medicaid Services is elevating most of the “cut points” used to calculate 2025 Medicare Advantage star ratings, according to financial analysts and consultants who previewed the agency’s guidelines before the highly anticipated release of the latest ratings later this month. (Berryman, 10/2)
In other news —
The New York Times: Another Woman Dies In Childbirth At Woodhull Hospital In Brooklyn
The woman, Bevorlin Garcia Barrios, is the third woman to die during childbirth at Woodhull Medical Center since 2020, deepening concern about the beleaguered hospital’s ability to safely provide maternity care and deliver babies. (Goldstein and Parnell, 10/3)
San Francisco Chronicle: California AG Lawsuit Seeks To Reopen AHMC Hospital In Moss Beach
In a move that could restore critical medical services to a coastal Bay Area community, California Attorney General Rob Bonta on Wednesday sued the owner of Seton Coastside hospital, alleging the recent closure of its emergency department violates the terms of a state-mandated agreement that requires the hospital to maintain emergency and other medical services.
The lawsuit, filed in San Mateo County Superior Court, accuses AHMC Healthcare … of failing to meet conditions it agreed to in 2020, when it acquired the hospital from its previous owner. (Ho, 10/2)
Axios: Steward’s Hospital Solutions Spark New Concerns
The Steward Health debacle may be nearing an end, but critics worry some of the arrangements in place to keep the chain’s hospitals and 5,000-person doctors group up and running could trigger another fiasco.
Why it matters: Almost everyone agrees that Steward’s management had a big hand driving the system into bankruptcy. But some argue there were also systemic problems related to private equity ownership and risky sale-leasebacks of properties that still loom over the surviving entities. (Owens, 10/2)
Modern Healthcare: Why Labcorp, Quest Diagnostics Are Buying Up Hospital Labs
Independent lab companies have continued their transaction spree in 2024, either by forming partnerships with hospitals and health systems or by outright acquiring some of their lab assets.
Quest Diagnostics has announced seven acquisitions this year, including its recent purchase of select lab assets from Minneapolis-based Allina Health. Slated to close later this year are deals with OhioHealth in Columbus and University Hospitals in Cleveland. (DeSilva, 10/2)
