The Villages Health souhlasila se smírem na 541,5 milionu USD kvůli údajnému falešnému kódování diagnóz pro Medicare Advantage v letech 2020 až 2024. Péče v The Villages pokračuje pod CenterWell.
A retirement community's top health provider quietly told the government it had been overbilling Medicare for years, then filed for bankruptcy before the consequences arrived. What happened next reshaped who owns the clinics, who absorbs the loss, and what federal…
The Justice Department’s late August 2026 announcement of a $541.5 million settlement with The Villages Health was framed around the coding period, but the sharpest number in the record came from the company’s own file, according to Healthcare Dive. According to Healthcare Dive, by 2024 about half of the primary care provider’s patient diagnosis codes were unsupported, based on an outside consultant’s review. The provider serves the largest retirement community in the United States. Its coding book, by that measure, had come untethered from its patients’ actual medical conditions.
What the Coding Allegedly Was The U.S. Department of Justice alleges that from 2020 to 2024, the company submitted false diagnosis codes for Medicare Advantage patients to increase its reimbursement in the privatized Medicare program. Per the settlement, the company altered patient medical records and inserted additional diagnosis codes, in some cases years after the visit occurred. Unsupported codes included severe obesity, blood defects and immunodeficiency, submitted to Humana (NYSE:HUM | HUM Price Prediction), UnitedHealthcare and Blue Cross Blue Shield of Florida.
Medicare Advantage plans receive a fixed monthly payment per enrollee, adjusted by that person’s diagnoses. A sicker-looking chart produces a larger check. That is the incentive upcoding exploits. The claims resolved are allegations, and there has been no determination of liability.
Timeline: Self-Report to Sale Per Healthcare Dive, The Villages Health identified and notified the government of its overbilling at the end of 2024, sizing its own bill. It then filed for Chapter 11 bankruptcy in the summer of 2025. Humana’s CenterWell division agreed to acquire the operating business in July 2025, according to Healthcare Dive. That stalking-horse bid set off an auction. A bankruptcy court approved the winning bid in the fall of 2025, with the purchase price rising to $68 million, and the deal closed in late 2025, according to Healthcare Dive. CenterWell added eight primary care centers and two specialty care centers to its network, according to Healthcare Dive. The acquisition price and the settlement figure sit on the same page: $68 million and $541.5 million.
How the Settlement Actually Works The settlement is against the pre-sale legal entity, The Villages Health System LLC, still in bankruptcy. Rather than a direct or immediate payment by CenterWell or Humana, the federal government receives an allowed, nondischargeable claim against the bankruptcy estate, to be resolved in the ongoing Chapter 11 process alongside other creditors. The insurers that received the inflated payments are returning those overpayments to the government, with those amounts credited against the total. The company received cooperation credit for self-disclosing through the federal healthcare fraud reporting portal, which is a substantial reason the figure is not higher.
A National Enforcement Pattern Emerges The same month, the Justice Department resolved two other Medicare Advantage upcoding matters: one with Monogram Health, and one with Complete Health, a value-based primary care operator active in three states. Risk-adjustment integrity has become a live enforcement lane. MedPAC has warned in its January 2026 work that upcoding continues to inflate what Medicare Advantage costs the trust fund relative to traditional Medicare.
What It Means for Patients Care in The Villages was not interrupted. The centers remain open under CenterWell ownership, staffed by the same clinicians patients already knew. The bill lands elsewhere: on the Medicare trust fund, which is to say on taxpayers and on the beneficiaries who fund and draw from it. That is the constituency this settlement was written to make whole.
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Humana ve 2. čtvrtletí 2026 zvýšila členství v Medicare Advantage o 23,8 % meziročně a tržby CenterWell vzrostly o 22,6 %. Zároveň ji tlačí vyšší náklady na péči a zadlužení.
Key Takeaways Humana's Medicare Advantage membership grew 23.8% year over year in the second quarter of 2026.CenterWell revenues rose 22.6% as Humana expanded its senior-focused primary care footprint.Rising medical costs and higher leverage are weighing on Humana's profitability and margins. Humana Inc. (HUM - Free Report) benefits from a strong care delivery model centered on value-based care, increasing premiums, strategic acquisitions, an aging population in the United States and solid cash generation capacity. HUM’s shares have surged 55.7% in the year-to-date period compared with the industry’s growth of 20.9%.
Humana offers health insurance benefits through Health Maintenance Organization, Private Fee-For-Service and Preferred Provider Organization plans. It also provides specialty products such as dental, vision and other supplementary benefits.
Courtesy of solid prospects, HUM currently carries a Zacks Rank #3 (Hold).
Where Do Estimates for HUM Stand?The Zacks Consensus Estimate for Humana’s 2026 earnings is pegged at $9.12 per share, which remained stable over the past seven days. Furthermore, the consensus mark for revenues is pegged at $162.6 billion for 2026, indicating a 25.3% year-over-year rise. It beat earnings estimates in each of the past four quarters, with an average surprise of 9.6%.
HUM’s Growth DriversHumana’s Medicare Advantage business remains a key growth engine, with membership expansion providing a foundation for improving the earnings potential of the portfolio. The company is also benefiting from stronger engagement among members. In the second quarter of 2026, total Medicare Advantage membership grew 23.8% year over year. Meanwhile, total premiums increased 26.4% year over year to $38.8 billion.
CenterWell is adding another growth avenue by expanding its senior-focused primary care footprint while using its pharmacy and home health businesses to build a more integrated care platform. The strategy combines organic patient growth with targeted acquisitions and greater integration across its care delivery businesses. CenterWell’s revenues increased 22.6% year over year in the second quarter of 2026.
The company is expanding its Medicaid footprint through the statewide Illinois contract scheduled to begin in January 2027, giving additional opportunities to diversify growth beyond its core Medicare Advantage business. HUM is using targeted capital allocation to strengthen its healthcare delivery capabilities. The planned divestiture of its minority stake in Gentiva, valued at approximately $900 million, is expected to largely fund the acquisition of MaxHealth. The transaction fits with Humana’s broader focus on expanding CenterWell and building a more integrated care platform.
Humana is also incorporating technology, automation and AI into its efforts to improve operating efficiency and simplify its business model. The company is transforming selected vendor relationships into more strategic technology-enabled partnerships while integrating acquired operations onto common platforms.
HUM’s solid financial position also provides flexibility to support growth and shareholder returns. As of June 30, 2026, the company had cash, cash equivalents and investment securities of $23.9 billion. It has been returning excess capital to its shareholders in the past several years. Humana repurchased common shares worth $108 million in the first half of 2026. It also paid a dividend of $214 million in the first half of 2026.
Key Concerns for HUM StockDespite its strengths, there are challenges to monitor.
Humana is facing rising medical cost intensity, which is weighing on profitability. Total operating expenses have steadily increased as a share of revenues, reaching 96.7% in second-quarter 2026 from 96.6% a year ago, indicating limited operating leverage. Operating expenses rose 26.3% year over year in the second quarter of 2026. The company expects the benefit ratio for the insurance segment to be 92.75%, with a variability margin of plus or minus 25 basis points for 2026, indicating an increase from the 2025 level of 90.4%.
Humana is grappling with a debt-laden balance sheet, which induces an increase in interest expenses. This might put pressure on the company’s margins. As of June 30, 2026, long-term debt was $12 billion. The company’s total debt-to-capital of 43.1% exceeds the industry average of 41.5%, underscoring higher leverage. Also, its forward P/E of 29.91X is higher than the industry average of 15.99X.
Stocks to ConsiderSome better-ranked stocks in the Medical space are BrightSpring Health Services, Inc. (BTSG - Free Report) , Globus Medical, Inc. (GMED - Free Report) and Centene Corporation (CNC - Free Report) , each currently sporting a Zacks Rank #1 (Strong Buy). You can see the complete list of today’s Zacks #1 Rank stocks here.
The Zacks Consensus Estimate for BrightSpring Health Services’ current-year earnings of $1.82 per share has witnessed six upward revisions in the past 30 days against no movement in the opposite direction. BTSG beat earnings estimates in three of the trailing four quarters and missed once, with the average surprise being 16.1%. The consensus estimate for current-year revenues is pegged at $15.3 billion, suggesting 18.2% year-over-year growth.
The Zacks Consensus Estimate for Globus Medical’s current-year earnings of $4.93 per share has witnessed three upward revisions in the past 30 days, against no movement in the opposite direction. GMED beat earnings estimates in each of the trailing four quarters, with the average surprise being 27.9%. The consensus estimate for current-year revenues is pegged at $3.2 billion, suggesting 8.8% year-over-year growth.
The Zacks Consensus Estimate for Centene’s current-year earnings of $4.89 per share has witnessed nine upward revisions in the past 30 days, against no movement in the opposite direction. CNC beat earnings estimates in each of the trailing four quarters, with an average surprise of 151.3%. The consensus estimate for current-year revenues is pegged at $196.3 billion, suggesting 0.8% year-over-year growth.
Humana míří k návratu do top kvartilu Star Ratings do bonusového roku 2028, což by mohlo zlepšit ekonomiku jejích Medicare Advantage plánů. Zlepšení 11 z 12 sledovaných ukazatelů naznačuje, že kvalita roste.
Key Takeaways Humana is targeting a return to top-quartile Star Ratings performance by bonus year 2028.Improvement in 11 of 12 selected measures is outpacing historical trends, signaling quality gains.A rebound could lift MA economics and complement plan selection and operating-efficiency efforts. Humana Inc.’s (HUM - Free Report) Star Ratings recovery is emerging as a key catalyst for its Medicare Advantage (MA) turnaround. After facing a significant Stars-related headwind, the company is targeting a return to top-quartile performance by bonus year 2028. This recovery is important to the broader goal of achieving a sustainable pretax margin of at least 3% by 2028.
Early execution signals are encouraging. The rate of improvement across 11 of 12 selected HEDIS and patient-safety measures outpaced historical trends. This suggests that investments in clinical quality and member engagement are gaining traction. Still, we should view this as positive momentum rather than a completed turnaround.
The potential financial benefit is meaningful. The company defines top-quartile performance as Stars revenue per member per month 10% above the peer median. A successful recovery could improve the economics of its MA plans and complement other margin initiatives, including better plan selection and operating efficiencies.
The October Centers for Medicare & Medicaid Services (“CMS”) Stars release will be the key near-term test. A meaningful rebound would validate its quality improvement efforts and provide greater confidence in its earnings trajectory. More importantly, it could strengthen the case that Humana is on a credible path toward its 2028 margin target, giving investors a stronger reason to remain optimistic about the turnaround.
How Are Peers Positioned?Peers like UnitedHealth Group Incorporated (UNH - Free Report) and Elevance Health, Inc. (ELV - Free Report) are also focused on strengthening Medicare Advantage quality and profitability.
UnitedHealth Group maintains a strong quality profile, with roughly 75-78% of members in 4+ Star plans. This sustained performance secures Quality Bonus Payments and preserves rebate dollars, giving UNH greater flexibility to fund competitive supplemental benefits while protecting underwriting margins.
Elevance Health operates with a broader commercial and Medicaid presence while working to strengthen its Medicare Advantage Stars profile through focused clinical outcomes and member engagement. Improving these quality scores could support ELV with better MA economics over time.
HUM’s Price Performance, Valuation and EstimatesShares of HUM have gained 47.6% year to date, outperforming the broader industry’s 20.2% growth.
Image Source: Zacks Investment Research
From a valuation standpoint, HUM trades at a forward price-to-earnings ratio of 29.24X, up from the industry average of 15.98X. Humana carries a Value Score of B.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for HUM’s 2026 earnings implies a 47% deterioration year over year, followed by a 66.7% improvement next year.
Image Source: Zacks Investment Research
HUM currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Humana v Indianě spolu s HealthStream poskytuje 1 000 stipendií na program Home Health Aide, aby posílila nábor a udržení pečovatelů v domácí péči. Vyškolení pracovníci jsou po třech měsících více než dvakrát častěji zaměstnaní.
Key Takeaways Humana is sponsoring 1,000 Home Health Aide scholarships to strengthen Indiana's home-care workforce.HealthStream tools aim to help providers recruit and retain caregivers in rural and underserved areas.Trained aides are more than twice as likely to remain employed after three months. Humana Inc.’s (HUM - Free Report) Medicaid managed care plan, Humana Healthy Horizons, is teaming up with HealthStream in Indiana to strengthen the state’s home-care workforce. Under the initiative, Humana is sponsoring 1,000 Home Health Aide scholarships, helping remove financial barriers for people entering the caregiving field.
The program uses HealthStream’s Career Network to reach rural and underserved communities, where worker shortages can restrict access to home-based care. Humana is also deploying HealthStream’s CoachUp Care platform, predictive analytics and training tools to help providers recruit and retain caregivers. The initiative builds on a workforce-stability program launched in 2024.
The collaboration targets a persistent challenge in home healthcare: high caregiver turnover. Home-care providers have an average annual turnover rate of 77%, which can disrupt continuity of care. Training appears to make a meaningful difference. HUM says that trained home-care aides are more than twice as likely to remain employed after three months and 64% more likely to stay after six months than workers without comparable training. Early results are also encouraging, with 81% of participating providers achieving above-average caregiver retention. Providers that improved retention reported an average 43% increase.
Better caregiver retention can improve continuity of care and help expand access to home-based services. That could support Humana’s ability to manage care more effectively over time. While the scholarships and technology require upfront spending, stronger workforce stability could help reduce disruptions and improve operational efficiency for participating providers. Overall, this is a long-term care-quality and network-strengthening initiative.
How Are Peers Positioned?Peers like UnitedHealth Group Incorporated (UNH - Free Report) and Elevance Health, Inc. (ELV - Free Report) are also trying to solve the direct-care/home-care workforce problem. UnitedHealthcare's Community Plan includes training for members, families and professional/paraprofessional caregivers, along with employer training for consumer-directed services and skills updates needed to safely maintain members at home. UNH’s approach appears more centered on training and supporting the existing caregiver ecosystem.
Elevance has emphasized employee development, training and retention internally, including instructor-led and virtual training, on-demand learning and technology/AI-related skills development. Last year, ELV averaged about 26 hours of training and development per associate.
Humana’s Price Performance, Valuation and EstimatesHUM shares have gained 51.8% over the year-to-date period, whereas the industry has risen 23%.
Image Source: Zacks Investment Research
From a valuation standpoint, Humana trades at a forward price-to-earnings ratio of 30.34, up from the industry average of 16.40. Yet, HUM carries a Value Score of B.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for Humana’s 2026 earnings is pegged at $9.08 per share, implying a 47% plunge from the year-ago period.
Image Source: Zacks Investment Research
The stock currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Humana uvedla, že výhled na rok 2026 je v souladu s očekáváním a míří k expanzi marže Medicare Advantage v roce 2027. Cílí na udržitelnou marži před zdaněním alespoň 3 % v roce 2028.
UnitedHealth Just Gave Wall Street a Clearer Turnaround SignalHumana NYSE: HUM said its 2026 performance is tracking in line with expectations, with management emphasizing planned Medicare Advantage margin expansion in 2027, progress in its Stars program and continued operating-cost reductions as key components of its path toward a sustainable pretax margin of at least 3% in 2028.
President and Chief Executive Officer Jim Rechtin said the company’s 2026 membership growth trajectory remains on track and that both new and returning members are performing as expected. He said Humana’s priority in preparing its 2027 Medicare Advantage, or MA, bids was to make the margin progress needed to remain on course for its 2028 target.
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3 Stocks Doing the Heavy Lifting in Healthcare’s Rebound“We expect our targeted margin expansion in 2027 to be driven by our ongoing focus on clinical excellence and operating efficiency work, combined with adjustments to our plan mix and benefits,” Rechtin said.
2027 Medicare Advantage Plan Changes Chief Financial Officer Celeste Mellet said Humana expects to make “significant progress” in 2027 compared with 2026, although final results will depend on the size and composition of its membership. The company did not provide a specific margin target for 2027.
3 Healthcare Stocks Set to Benefit From the One Big Beautiful BillHumana expects targeted plan exits for 2027 to affect approximately 600,000 members. Mellet said the company intends to recapture a significant portion of those members, similar to its experience in 2025, when it recaptured just over 40% of affected membership.
The company said it will use plan exits to preserve higher-performing plans, particularly those with greater penetration of value-based care. Mellet described the strategy as removing the lower end of profitability and returns rather than making more uniform benefit reductions across the portfolio. She said most planned exits involve plans with ratings of 3.5 Stars or below for bonus year 2027, though she said the strategy was not principally a Stars-related decision.
Humana said its bids continue to assume cost trends consistent with its 2026 outlook. Mellet reiterated that the company expects all-in medical and pharmacy cost trend of 7% to 8% this year, including lower medical-cost trend and double-digit drug-cost trend. For 2027, she said drug trend is expected to increase modestly due to the health technology pipeline and newly released drugs.
Management also said it incorporates contingency into its bids because they are submitted well ahead of the coverage year.
Cost Trends and Operating Efficiency Mellet said medical costs have been within Humana’s expected range, with slight favorability concentrated in inpatient care. Based on roughly four months of completed claims data, she said the favorable inpatient trend was more concentrated among members served by value-based providers.
The company said it has seen both lower hospital admissions per thousand members and lower unit costs for admissions. Rechtin said Humana is pursuing site-of-service initiatives intended to steer members toward lower-cost and higher-quality settings through local contracting, provider incentives, benefit design and member education.
Humana’s consolidated operating-cost ratio declined 120 basis points year over year in the second quarter, according to Mellet. The company continues to expect an approximately 150-basis-point reduction for the full year. Management said operating-model efforts have generated hundreds of millions of dollars in value during the first half of 2026.
Among the actions cited by Rechtin were centralizing utilization-management operations from 11 markets into one team, expanding outsourcing in finance and human resources, optimizing information-technology vendor relationships and integrating CarePlus operations into Humana’s core platforms.
Mellet said earlier cost efforts were more tactical, while current work is increasingly transformational, including simplification of operations, organizational structures, data management and vendor relationships. She said Humana is not yet reflecting major benefits from technology initiatives but sees a longer-term opportunity.
Stars Progress and December Update Rechtin said Humana’s outlook for bonus year 2028 Stars results remains unchanged and that the company remains confident in its ability to return to top-quartile results. Humana defines that objective as Stars revenue per member per month that is 10% above the median of its peer group, rather than relying solely on the percentage of members enrolled in plans rated 4 Stars or higher.
The company said its rate of improvement in 11 of 12 selected HEDIS and patient-safety measures outpaced the historical compound annual growth rate over the prior four years. Rechtin said the measures were selected because Humana had consistent longitudinal data for comparison and that management believes they are representative of broader performance.
Humana said it does not know the industry thresholds that will ultimately determine Stars outcomes and therefore cannot guarantee a result when the final data are released. The company expects to enter its annual Stars blackout period once it receives plan preview information from the Centers for Medicare & Medicaid Services beginning in August, with final data expected in October.
For bonus year 2029, Humana said it remained 5% ahead of last year’s quality-improvement rate on a per-member basis in key HEDIS measures at the end of the second quarter. New members’ engagement levels were in line with, and on some measures above, those of renewing members, management said.
Humana plans to host a virtual investor update on Dec. 10. Rechtin said the company expects by then to have full visibility into bonus year 2028 Stars results and preliminary insights into 2027 membership trends. He characterized the event as a “mark to market” on existing commitments rather than a change in strategy or financial goals.
Capital Actions, Medicaid and Leadership Humana said it has agreed to divest its minority interest in Gentiva in a transaction valued at approximately $900 million and expected to close in the fourth quarter. Rechtin said proceeds will largely fund the company’s recent acquisition of MaxHealth.
The company also established $1.5 billion in contingent capital facilities using pre-capitalized trust securities, or PCAPS. Mellet said the facilities provide long-duration contingent liquidity without increasing balance-sheet leverage unless drawn, and Humana does not anticipate using them in the near or medium term.
In Medicaid, Humana said it was awarded a statewide Illinois Medicaid managed-care contract scheduled to begin in January 2027. Rechtin said Humana was the only new entrant awarded a contract alongside five incumbents.
Separately, the company announced that Paul Smith, Anthropic’s chief commercial officer, and Fred Crawford, the former president and chief operating officer of Aflac, will join Humana’s board of directors.
About Humana (NYSE:HUM)Humana Inc NYSE: HUM is a health insurance company headquartered in Louisville, Kentucky, that primarily serves individuals and groups across the United States. The company is best known for its Medicare business, offering Medicare Advantage plans and prescription drug (Part D) coverage, alongside a range of commercial and employer-sponsored group health plans. Humana's products are designed to cover medical, behavioral health and pharmacy needs for members, with particular emphasis on seniors and Medicare-eligible populations.
In addition to traditional insurance products, Humana provides care-management and wellness services intended to support chronic-condition management, preventive care and care coordination.
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected].
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Humana ve 2. čtvrtletí překonala odhady zisku, když upravený zisk činil 7,61 USD na akcii. Poměr nákladů na zdravotní péči byl 91,2 % a odpovídal očekáváním.
A screen displays the logo and trading information for Humana on the floor at the New York Stock Exchange (NYSE) in New York City, U.S., December 6, 2023. REUTERS/Brendan McDermid/File Photo Purchase Licensing Rights, opens new tab
CompaniesJuly 29 (Reuters) - Humana (HUM.N), opens new tab on Wednesday beat Wall Street estimates for second-quarter earnings as the health insurer's spend on medical services was in line with expectations, but it left its annual adjusted profit forecast unchanged.
Shares of the company were down about 9% in premarket trading.
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Humana is one of the largest providers of Medicare Advantage plans serving people aged 65 and older as well as people with disabilities.
Investors have been raising their expectations for insurers, after others including larger peer UnitedHealth (UNH.N), opens new tab raised its outlook and have done a better job at controlling costs.
Once a key source of profit growth for insurers, these privately managed Medicare Advantage plans have come under pressure from rising medical costs for three years as well as tighter reimbursement rates, leading some insurers to scale back or exit underperforming markets.
Humana reported a quarterly medical cost ratio, the percentage of premiums spent on medical care, of 91.2%, which the company said was in line with its expectations. Analysts expected a ratio of 91.19%, according to data compiled by LSEG. On an adjusted basis, the company earned a profit of $7.61 per share, compared with analysts' estimates of $7.22 per share.
Reporting by Sriparna Roy and Sneha S K in Bengaluru; Editing by Devika Syamnath
Our Standards: The Thomson Reuters Trust Principles., opens new tab
Soud v USA umožnil pokračování klíčových částí žaloby proti Humana kvůli údajným zavádějícím výrokům o nákladech na zdravotní péči. Po odhalení problémů v říjnu 2024 akcie klesly o 22 %.
Resources Investor Relations Journalists Agencies Client Login Send a Release News Products Contact , /PRNewswire/ -- Schubert Jonckheer & Kolbe LLP reminds Humana Inc. (NYSE: HUM) investors that the firm is investigating potential legal claims arising from alleged false and misleading statements about the company's exposure to increased healthcare utilization costs. Current shareholders are encouraged to contact the firm here: https://www.classactionlawyers.com/humana.
On April 27, 2026, U.S. District Judge Jennifer L. Hall ruled that key claims in a securities fraud lawsuit against Humana and its former CEO and CFO will move forward. The lawsuit alleges that between July 2022 and October 2024, the company misled investors regarding the company's exposure to increased post-pandemic healthcare utilization costs. These statements allegedly caused Humana's stock to trade at artificially inflated prices. Judge Hall found the complaint sufficiently alleged that defendants acted with scienter, or an intent to defraud, in making these false and misleading statements. During this period, company insiders sold over $104 million in stock. When the truth was fully revealed in October 2024 and the company reported sharp declines in many of its plans' Star ratings, Humana's stock price fell 22%.
We are investigating potential wrongdoing by Humana's directors and officers in connection with these allegations.
If you own Humana stock, you may have legal options. Visit https://www.classactionlawyers.com/humana to learn more.
About Schubert Jonckheer & Kolbe LLP
Schubert Jonckheer & Kolbe represents consumers in class actions and shareholders in derivative actions against corporate officers and directors. The firm is based in San Francisco and, with the help of co-counsel, litigates cases nationwide.
Humana čeká za 2. čtvrtletí výnosy 40,65 miliardy USD, tedy meziroční růst o 25,5 %, tažený vyššími prémiemi a expanzí Medicare. Zisk na akcii má být 6,22 USD.
Key Takeaways Humana is expected to post strong Q2 revenue growth driven by higher premiums and Medicare expansion.HUM's rising Insurance and CenterWell operating income support earnings beat hopes.Higher opex, weaker investment income and a rising benefits expense ratio may partially offset positives. Humana Inc. (HUM - Free Report) is set to report second-quarter 2026 results on July 29, before the opening bell. The Zacks Consensus Estimate for the to-be-reported quarter’s earnings is currently pegged at $6.22 per share on revenues of $40.65 billion.
The second-quarter earnings estimate has witnessed three upward revisions and no movement in the opposite direction over the past 60 days. However, the bottom-line projection indicates a year-over-year decrease of 0.8%. Yet, the Zacks Consensus Estimate for quarterly revenues implies year-over-year growth of 25.5%.
Image Source: Zacks Investment Research
For full-year 2026, the Zacks Consensus Estimate for Humana’s revenues is pegged at $162.60 billion, implying a rise of 25.3% year over year. However, the consensus mark for current-year EPS is pegged at $9.25, implying a plunge of around 46% on a year-over-year basis.
HUM’s earnings beat the consensus estimate in three of the trailing four quarters and missed once, with the average surprise being 3.8%.
Q2 Earnings Whispers for HUMOur proven model predicts a likely earnings beat for the company this time around as well. The combination of a positive Earnings ESP and a Zacks Rank #1 (Strong Buy), 2 (Buy) or 3 (Hold) increases the odds of an earnings beat. That is precisely the case here.
Humana has an Earnings ESP of +1.71% and a Zacks Rank #1. You can uncover the best stocks to buy or sell before they’re reported with our Earnings ESP Filter.
You can see the complete list of today’s Zacks #1 Rank stocks here.
What’s Shaping HUM’s Q2 Results?The Zacks Consensus Estimate for HUM’s second-quarter premiums indicates a 25.6% increase from the prior-year quarter’s reported figure, whereas our model predicts 24% growth. We expect total Medicare to witness 26.6% growth in the quarter under review. Similarly, the consensus mark for service revenues signals a 22.3% increase from a year ago, whereas our model predicts a nearly 16% jump.
Also, the Zacks Consensus Estimate for insurance membership predicts a 18.2% year-over-year growth, whereas specialty membership is expected to rise 3.7%.
The Zacks Consensus Estimate for operating income from the Insurance unit indicates 10.2% growth from a year ago. The same for the CenterWell unit predicts a 12.8% growth from the year-ago level. The above-mentioned factors are expected to have positioned the company for an earnings beat in the second quarter.
However, the consensus estimate indicates that Humana’s investment income will see a 13.5% drop from the year-ago level. We expect total operating costs to increase 24.4% in the second quarter, bringing the figure above $38.9 billion. This is likely to have led to a year-over-year decline in the bottom line.
The consensus mark for insurance benefits expense ratio is pegged at 91.3% for the to-be-reported quarter, deteriorating from 89.9% a year ago. These are likely to have partially offset the positives.
How Did Peers Perform?Several healthcare companies, including UnitedHealth Group Incorporated (UNH - Free Report) , Molina Healthcare, Inc. (MOH - Free Report) and Elevance Health, Inc. (ELV - Free Report) , have already reported their financial results for the June quarter of 2026. Here’s how they performed:
UnitedHealth reported second-quarter 2026 adjusted EPS of $6.38, which beat the Zacks Consensus Estimate of $4.94. The bottom line rose 56.4% year over year. Its strong quarterly results were aided by growth in commercial fee-based membership and the strength witnessed in Optum Insight. Medical cost management, pricing discipline and benefit design changes also contributed to the upside. However, weakness in UNH’s Optum Health, Optum Rx and declining risk-based membership partially offset the positives.
Molina reported second-quarter 2026 adjusted EPS of $1.51, which beat the Zacks Consensus Estimate by 10.2%. But the bottom line declined 72.4% from the year-ago period's level. MOH’s earnings benefited from lower operating expenses. However, lower premium revenues, declining membership, and weaker investment income weighed on its performance.
Elevance reported second-quarter 2026 adjusted EPS of $7.45, which surpassed the Zacks Consensus Estimate by 20.6%. However, the bottom line declined 15.7% year over year.The quarterly results were primarily driven by higher premium yields in the Health Benefits segment and increased CarelonRx product revenues. The upside was partly offset by a decline in ELV’s overall medical membership and an elevated expense level.
Humana míří do roku 2028 na 3% marži Medicare Advantage a v roce 2026 očekává asi 25% růst individuálního členství. Zároveň potvrdila upravený EPS alespoň 9,00 USD pro rok 2026.
Key Takeaways Humana aims for a 3% Medicare Advantage margin by 2028 as it rebuilds long-term profitability.HUM expects about 25% individual Medicare Advantage membership growth in 2026 through disciplined execution.Humana reaffirmed at least $9.00 adjusted EPS guidance for 2026 despite Star Ratings headwinds. Humana Inc.’s (HUM - Free Report) turnaround is no longer about growing membership, it's about rebuilding profitability. The company has set a goal of achieving a 3% Medicare Advantage margin by 2028, making it one of the most important milestones for its long-term earnings recovery. The key question is whether Humana can translate that strategy into sustainable profit growth.
Unlike many managed care companies that have scaled back benefits to protect margins, Humana continues to expect approximately 25% growth in individual Medicare Advantage membership in 2026. The focus is on attracting higher-quality members through disciplined pricing, stronger product design and better retention rather than pursuing growth at any cost.
Humana is working to improve medical cost trends through tighter care management and stronger operational execution. It is also investing to rebuild its Medicare Star Ratings, a key driver of future reimbursement and profitability. Higher Star Ratings would increase quality bonus payments, strengthen its competitive position and support long-term profitability.
Despite elevated healthcare utilization and a challenging regulatory environment, Humana reaffirmed its 2026 adjusted EPS guidance of at least $9.00, reflecting confidence in its turnaround plan despite the temporary Star Ratings headwind. The near-term focus is on controlling medical costs, improving Star Ratings and turning membership growth into higher profits. Delivering on these priorities will be key to reaching the 3% Medicare Advantage margin target and supporting a sustained earnings recovery.
How Are Humana's Peers Positioned?Restoring Medicare Advantage profitability has become a key priority across the health insurance industry. UnitedHealth Group Incorporated (UNH - Free Report) and CVS Health Corporation (CVS - Free Report) are also focused on improving margins through disciplined execution.
UnitedHealth Group is emphasizing disciplined pricing, stronger care management and value-based care to improve Medicare Advantage margins. UNH is prioritizing sustainable profitability over aggressive growth, much like Humana.
CVS Health is repricing Medicare Advantage plans, refining benefits and strengthening medical cost management to improve profitability. CVS is taking a disciplined approach to rebuild margins and support long-term earnings growth.
HUM’s Price Performance, Valuation and EstimatesShares of HUM have gained 53.1% year to date, outperforming the broader industry’s 28.5% growth.
Image Source: Zacks Investment Research
From a valuation standpoint, HUM trades at a forward price-to-earnings ratio of 32.21X, up from the industry average of 18.48X. Humana carries a Value Score of B.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for HUM’s 2026 earnings implies a 47.4% deterioration year over year, followed by a 66.1% improvement next year.
Image Source: Zacks Investment Research
The stock currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Key Takeaways Humana's CenterWell posted $6.1B in Q1 2026 revenues, up 19.7%, with growth across all business lines.HUM added patients and centers via MaxHealth and expanded pharmacy services through the Cost Plus partnership.HUM expects CenterWell to generate at least $25B in 2026 revenues as it grows beyond insurance. CenterWell is playing a growing role in Humana Inc.'s (HUM - Free Report) strategy to evolve beyond its traditional health insurance business. By combining primary care, home health and pharmacy services under one platform, CenterWell helps HUM deliver more coordinated care while supporting better health outcomes and improving the overall patient experience.
The segment is also emerging as a meaningful growth driver. In the first quarter of 2026, CenterWell generated $6.1 billion in revenues, up 19.7% year over year, reflecting growth across all three business lines. Higher Medicare enrollment and continued expansion of its payor-agnostic client base contributed to the increase. HUM expects the segment’s total revenues to generate at least $25 billion in 2026.
Humana is further strengthening CenterWell's platform through strategic investments and acquisitions. During the first quarter, CenterWell Senior Primary Care recorded sequential patient growth of 110,500, including approximately 59,000 patients and 54 centers from the recent MaxHealth acquisition. The expansion broadens the company's primary care network while creating additional opportunities to deliver coordinated, value-based care. HUM is also broadening its pharmacy capabilities through its Cost Plus partnership, which aims to develop end-to-end prescription drug solutions for employers.
HUM is also improving operational efficiency by increasing automation and using AI-enabled analytics to identify care gaps, accelerate chronic disease detection and support more proactive care management. These initiatives can improve clinical outcomes while enhancing productivity across the platform. As CenterWell continues to expand its care delivery network and technology capabilities, it is evolving into a key long-term growth engine that diversifies Humana's business beyond health insurance while supporting sustainable earnings growth.
How Are Competitors Faring?Some of HUM’s major competitors in the value-based care space are UnitedHealth Group Incorporated (UNH - Free Report) and Elevance Health, Inc. (ELV - Free Report) .
UnitedHealth, through its Optum segment, is scaling AI-driven care management, pharmacy and provider solutions to improve care coordination and operational efficiency. Its integrated care model supports value-based reimbursement while diversifying revenues beyond its insurance business. UnitedHealth’s total revenues rose 2% year over year in the first quarter of 2026.
Elevance Health is pursuing a similar strategy through Carelon, its healthcare services platform. Carelon combines pharmacy, care delivery and care management capabilities to diversify revenues beyond health insurance. Elevance Health’s total operating revenues rose 1.5% year over year in the first quarter of 2026.
Humana’s Price Performance, Valuation & EstimatesShares of HUM have rallied 49.9% in the year-to-date period compared with the industry’s rise of 8.2%.
Image Source: Zacks Investment Research
From a valuation standpoint, Humana trades at a forward price-to-earnings ratio of 32.09, significantly above the industry average of 16.80. HUM carries a Value Score of B.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for Humana’s 2026 earnings is pegged at $9.01 per share, implying a 47.4% drop from the year-ago period.
Image Source: Zacks Investment Research
HUM stock currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Ambea podala doporučenou veřejnou nabídku na převzetí společnosti Humana, kterou oceňuje přibližně na 2,96 miliardy SEK. Akcionáři mají obdržet 20 SEK v hotovosti, 0,305 akcie Ambea a jedno podmíněné právo na akcii.
CompaniesJune 29 (Reuters) - Swedish care provider Ambea (AMBEA.ST), opens new tab said on Monday it had made a recommended public offer for peer Humana (HUMAN.ST), opens new tab, valuing the company at about 2.96 billion Swedish crowns ($304.13 million).
Ambea is offering Humana shareholders SEK 20 in cash, 0.305 Ambea shares and one contingent value right for each Humana share.
The cash-and-share part of the offer corresponds to SEK 62.30 per Humana share, a 26.8% premium to Humana's closing price on June 26.
The combination would strengthen Ambea's position in the Nordic care market, where ageing populations and increasingly complex care needs are driving structural demand.
Humana's board unanimously recommended shareholders accept the offer, while holders of about 41.9% of Humana's shares have undertaken to accept it.
The contingent value right could pay up to SEK 4.36 per Humana share, depending on Humana's appeal in a damages case against the Swedish state over its revoked personal-assistance licence.
Ambea said it plans to divest Humana's Personal Assistance Sweden business following completion of the offer.
($1 = 9.7326 Swedish crowns)
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Reporting by Jesus Calero; Editing by Jamie Freed
Our Standards: The Thomson Reuters Trust Principles., opens new tab
Humana míří do roku 2028 na pojistné marže nad 3 % a už vidí zlepšení: upravený zisk za 1. čtvrtletí 2026 překonal odhady a tržby CenterWell vzrostly o 19,7 % na 6,1 miliardy USD.
Key Takeaways Humana targets insurance margins above 3% by 2028 through pricing and market exits.CenterWell revenues rose 19.7% year over year to $6.1 billion in Q1 2026 amid tech investments.Humana remains on track to serve 7.3 million Medicare Advantage members in 2026. Humana Inc. (HUM - Free Report) has spent the past two years dealing with higher medical costs as more seniors returned for treatments that were delayed during the pandemic. The pressure weighed heavily on Medicare Advantage margins and profitability. The company is now shifting its focus from membership growth to earnings improvement, with the goal of restoring insurance margins to above 3% by 2028.
We’re already seeing early signs of a turnaround. Humana’s first-quarter 2026 adjusted earnings were $10.31 per share, which topped the Zacks Consensus Estimate by 3.5% as medical cost trends began to moderate. Its vital insurance benefit ratio dropped to 89.4% under management’s 90% ceiling. Despite a turbulent industry landscape, HUM remains on track to achieve approximately 25% growth in individual Medicare Advantage membership this year, showing the resilience of its core business.
The company is pursuing disciplined pricing, exiting less profitable markets, and implementing streamlining initiatives, including the sale of its remaining stake in Gentiva, to free up cash. However, HUM’s real competitive advantage lies in its ability to integrate technology with patient care. A prime example is CenterWell, whose revenues increased 19.7% year over year to $6.1 billion in the first quarter of 2026. By investing in digital tools and automation, Humana is cutting out messy administrative overhead while keeping patient care highly efficient.
Headwinds like Medicare funding pressures aren't vanishing overnight. Humana's early progress suggests its turnaround strategy is genuinely gaining traction. With a sharper focus on profitability, operational efficiency, and integrated care, it finally looks well positioned to navigate the challenges ahead.
How Are Humana's Peers Positioned?Humana is not the only health insurer facing elevated medical costs. Peers like UnitedHealth Group Incorporated (UNH - Free Report) and Elevance Health, Inc. (ELV - Free Report) have also faced pressure from higher healthcare utilization in recent years.
UnitedHealth has been affected by rising Medicare Advantage costs, but its diversified business model provides some protection. UNH's Optum segment, which spans healthcare services, pharmacy benefits and technology solutions, helps offset pressure on its insurance operations and supports earnings stability.
Elevance Health has likewise reported elevated medical costs as members continue to seek healthcare services at higher rates. While insurance remains its core business, Elevance benefits from a diversified mix of commercial, Medicaid and Medicare plans, which helps reduce dependence on any single market.
HUM’s Price Performance, Valuation and EstimatesShares of HUM have gained 40.2% year to date, outperforming the broader industry’s 22.2% increase.
Image Source: Zacks Investment Research
From a valuation standpoint, HUM trades at a forward price-to-earnings ratio of 30.26X, up from the industry average of 17.69X. Humana carries a Value Score of B.
Image Source: Zacks Investment Research
The Zacks Consensus Estimate for HUM’s 2026 earnings implies a 47.4% deterioration year over year, followed by a 66.1% improvement next year.
Image Source: Zacks Investment Research
The stock currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Soud nechal pokračovat klíčové části žaloby proti Humany kvůli údajným zavádějícím výrokům o nákladech na zdravotní péči. Během tohoto období proběhly prodeje akcií zasvěcenými osobami za více než 104 milionů USD.
, /PRNewswire/ -- Schubert Jonckheer & Kolbe LLP advises Humana Inc. (NYSE: HUM) investors that the firm is investigating potential legal claims arising from alleged false and misleading statements about the company's exposure to increased healthcare utilization costs. Current shareholders are encouraged to contact the firm here: https://www.classactionlawyers.com/humana.
On April 27, 2026, U.S. District Judge Jennifer L. Hall ruled that key claims in a securities fraud lawsuit against Humana and its former CEO and CFO will move forward. The lawsuit alleges that between July 2022 and October 2024, the company misled investors regarding the company's exposure to increased post-pandemic healthcare utilization costs. These statements allegedly caused Humana's stock to trade at artificially inflated prices. Judge Hall found the complaint sufficiently alleged that defendants acted with scienter, or an intent to defraud, in making these false and misleading statements. During this period, company insiders sold over $104 million in stock. When the truth was gradually revealed beginning in June 2023 and the company reported disappointing results, the stock price significantly dropped.
We are investigating potential wrongdoing by Humana's directors and officers in connection with these allegations.
If you own Humana stock, you may have legal options. Visit https://www.classactionlawyers.com/humana to learn more.
About Schubert Jonckheer & Kolbe LLP
Schubert Jonckheer & Kolbe represents consumers in class actions and shareholders in derivative actions against corporate officers and directors. The firm is based in San Francisco and, with the help of co-counsel, litigates cases nationwide.
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Dustin L. Schubert
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