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HUM

Humana

$177.73

0.2 (0.11%)

10:18
10/12/16
10/12
10:18
10/12/16
10:18

Humana comments on Medicare Star quality ratings

Humana commented on updated Star quality ratings for the 2018 plan year published by the Centers for Medicare and Medicaid Services, or CMS, showing that the percentage of the company's July 31, 2016 membership in 4-Star plans or higher declined to approximately 37%, or 1.17M members, from approximately 78%, or 2.15M members, in the prior year. The company noted that the decline in membership in 4-Star rated plans does not take into account certain operational actions the company intends to take over the coming quarters to mitigate any potential negative impact of these published ratings on Star bonus revenues for 2018. The company believes that the decline is primarily attributable to the impact of lower scores for certain Stars measures as a result of the company's recently-closed comprehensive program audit by CMS. The Civil Monetary Penalty imposed by CMS on December 29, 2015 resulted in an automatic downgrade to the Beneficiary Access and Plan Performance Star measure, and certain other issues associated with the timeliness of member service and appeal measurements noted in the audit resulted in downgrades to two additional Star measures. In addition, higher threshold levels for certain individual Star measures as compared to the previous year reduced the company's ratings on these measures. Thresholds for Star measures are calculated across the sector, without regard to weighted average membership of each plan. Together, these factors more than offset the company's improved Star rating performance in certain quality measures such as Healthcare Effectiveness Data and Information Set. Humana believes that its Star ratings for the 2018 bonus year do not accurately reflect the company's actual performance under the applicable Star measures. Consequently, the company intends to file for reconsideration of certain of those ratings under the appropriate administrative process. Humana expects the impact of CMS' comprehensive program audit on the company's Star ratings to be limited to the 2018 bonus year. On September 8, 2016, CMS notified Humana that, based upon the results of an independent validation audit demonstrating that the company had substantially remediated the issues identified in the audit, CMS had formally closed that audit. Humana expects to evaluate its contract structures for rationalization to mitigate the negative impact on Star bonus revenues for 2018.

HUM Humana
$177.73

0.2 (0.11%)

07/22/16
COWN
07/22/16
NO CHANGE
Target $160
COWN
Outperform
Cigna has greatest upside should DOJ block mergers, says Cowen
Cowen noted the DOJ tone toward the pending managed care deals is decidedly negative and raised the burden of proof on the companies to demonstrate the deals are not anti-competitive. Cowen believes Cigna has the most upside of the four companies involved whether the deals go through or not. Cowen has an Outperform rating and $160 price target on Cigna shares.
08/22/16
LEER
08/22/16
NO CHANGE
LEER
Leerink less positive that Anthem challenge to DOJ lawsuit will be successful
Following a conference call with an anti-trust specialist, Leerink analyst Ana Gupte is less positive that the Anthem (ANTM) challenge to the lawsuit by the DOJ will be successful. The analyst says that the specialist views the obstacles to a defense by Anthem-Cigna (CI) to the anti-trust concerns as too numerous to result in a successful close. Further, the analyst believes that any favorable decision, however unlikely, on the merger close, will likely be appealed by the DOJ. Nonetheless, the lower likelihood of this defense being successful may improve the odds of a successful Aetna (AET)-Humana (HUM) defense, the analyst notes.
08/25/16
COWN
08/25/16
NO CHANGE
COWN
Managed Care mergers unlikely to close, says Cowen
Cowen analyst Christine Arnold believes the current managed care mergers including Aetna (AET) and Humana (HUM) and Anthem (ANTM) and Cigna (CI) are unlikely to close. The analyst said the government's ability to appeal could extend the litigation process beyond the termination dates stipulated in the merger agreements. Arnold believes the Aetna/Humana merger has a better chance of closing relative to the Anthem/Cigna deal, but believes neither are likely to close.
09/22/16
EVER
09/22/16
INITIATION
EVER
Buy
Humana initiated with a Buy at Evercore ISI

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SRNE

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RRC

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$103.74

-1.01 (-0.96%)

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UMBF

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$77.00

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GMED

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AIXG

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DB

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STOR

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