Humana, Inc.
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Humana Inc. is a for-profit American
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
company based in
Louisville Louisville ( , , ) is the largest city in the Commonwealth of Kentucky and the 28th most-populous city in the United States. Louisville is the historical seat and, since 2003, the nominal seat of Jefferson County, on the Indiana border. ...
,
Kentucky Kentucky ( , ), officially the Commonwealth of Kentucky, is a state in the Southeastern region of the United States and one of the states of the Upper South. It borders Illinois, Indiana, and Ohio to the north; West Virginia and Virginia to ...
. In 2021, the company ranked 41 on the
Fortune 500 The ''Fortune'' 500 is an annual list compiled and published by ''Fortune'' magazine that ranks 500 of the largest United States corporations by total revenue for their respective fiscal years. The list includes publicly held companies, along ...
list, which made it the highest ranked (by revenues) company based in
Kentucky Kentucky ( , ), officially the Commonwealth of Kentucky, is a state in the Southeastern region of the United States and one of the states of the Upper South. It borders Illinois, Indiana, and Ohio to the north; West Virginia and Virginia to ...
. It has been the third largest health insurance provider in the nation. The health insurer
Aetna Aetna Inc. () is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, ...
said on July 3, 2015, that it had agreed to acquire its smaller rival Humana for $37 billion in cash and stock but walked away from the deal after a court ruling that the merger would be anti-competitive.


History


1961–1983: Nursing homes and hospitals

Lawyers David A. Jones Sr. and
Wendell Cherry Wendell Cherry (September 25, 1935 – July 16, 1991) was an American lawyer, entrepreneur, art collector and patron. The company he co-founded, Humana, grew under his leadership to become the largest hospital operator in the United States. In the ...
founded a
nursing home A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to in ...
company in 1961. The company, known in 1968 as Extendicare Inc., became the largest nursing home company in the United States. In 1972, Jones and Cherry sold the nursing home chain to purchase
hospitals A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
. In 1974, the partners changed the corporate name to Humana Inc. The name was meant to change public perception from 'warehousing' or indifferently treating people to providing a higher-level of human care and, by extension, more humane care. It grew in the following years, both by business and in 1978 through the takeover of American Medicorp Inc., which doubled the company's size, and growing into the world's largest hospital company in the 1980s. During this period, Humana developed the double corridor model for hospital construction. This design minimized the distance between patients and nurses by placing nursing support services in the interior of the building with patient rooms surrounding the perimeter.


1984–present

As the American health care system changed in the 1980s, "one of its hospitals in Arizona lost a contract with the largest health-maintenance organization in the area ndHumana created its own
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
plan." In 1993, Humana had become the largest hospital operator in the country, owning 77 hospitals. Humana executives spun off hospital operations from health insurance operations to create Galen Health Care. The following year they sold the 73 hospitals of Galen Health Care Inc. to Nashville-based Columbia
Hospital Corporation of America HCA Healthcare is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owns and operates 186 hospitals and approximately 2,000 sites of care, including sur ...
for $3.4 billion. In 1998, one year after Jones had stepped aside as CEO,
United Healthcare UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. It offers health care products and insurance services. UnitedHealth Group is the world's seventh largest c ...
made an unsuccessful attempt to acquire Humana. Humana pulled out of the acquisition after United stock dropped $2.9 billion in value. In 2001, Humana was a cofounder of Avality. In 2005, Humana entered into a
business partnership A partnership is an arrangement where parties, known as business partners, agree to cooperate to advance their mutual interests. The partners in a partnership may be individuals, businesses, interest-based organizations, schools, governments o ...
with
Virgin Group Virgin Group Ltd. is a British multinational venture capital conglomerate founded by Richard Branson and Nik Powell in February 1970. Virgin Group's date of incorporation is listed as 1989 by the Companies House, who class it as a holding c ...
, offering financial incentives to members for healthy behavior, such as regular exercise. On November 16, 2006, the Centers for Disease Control and Prevention (CDC) and Humana Inc. partnered to expand on traditional private-sector approaches to population health management. In 2006, Humana launched an education campaign to market
Medicare Advantage Medicare Advantage (Medicare Part C, MA) is a capitated program for providing Medicare benefits in the United States. Under Part C, Medicare pays a private-sector health insurer a fixed payment. The insurer then pays for the health care expenses ...
(MA) and Prescription Drug Plans (PDP) nationwide to Medicare-eligible consumers, following the passage of the
Medicare modernization act The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare (United States), Medicare i ...
. The same year, Humana launched RightSource, a national
mail-order Mail order is the buying of goods or services by mail delivery. The buyer places an order for the desired products with the merchant through some remote methods such as: * Sending an order form in the mail * Placing a telephone call * Placing a ...
retail
pharmacy Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links heal ...
business. In March 2008, ''
Fortune Magazine ''Fortune'' is an American multinational business magazine headquartered in New York City. It is published by Fortune Media Group Holdings, owned by Thai businessman Chatchaval Jiaravanon. The publication was founded by Henry Luce in 1929. The ...
'' named Humana one of the Top 5 Most Admired Healthcare Companies in the United States. In 2010, Humana bought Texas-based
Concentra Concentra Inc., is a national health care establishment founded in 1979 in Amarillo, Texas. The headquarters of the corporation is in Addison, Texas and runs approximately 520 urgent care locations across 44 states. The company is linked with ove ...
Inc., which owns urgent-care and physical therapy centers, for $790 million, effectively returning to healthcare services. In May 2011, Humana announced it would be using mobileStorm to transmit protected health information to patients. In March 2015, Humana announced the sale of Concentra to private equity firm
Welsh, Carson, Anderson & Stowe Welsh, Carson, Anderson & Stowe (WCAS), also referred to as Welsh Carson, is a private equity firm. WCAS was formed in 1979 and focuses on investing in two growth industries, technology and healthcare, primarily in the United States. WCAS has a ...
and Select Medical Holdings Corporation for about $1 billion, with proceeds to fund a "$2 billion share buyback program and other corporate spending." In July 2015,
Aetna Aetna Inc. () is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, ...
announced that it would acquire Humana for $37 billion in cash and stock (approximately $230 a share at that time). Aetna and Humana shareholders would own 74% and 26% of the new combined company, however the merger was blocked by a federal judge in January 2017. In February 2017,
Aetna Inc. Aetna Inc. () is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans ...
and Humana Inc. quashed a $34 billion merger agreement after judges ruled against the merger for a second time. In July 2018, Humana joined two
private equity firm A private equity firm is an investment management company that provides financial backing and makes investments in the private equity of startup or operating companies through a variety of loosely affiliated investment strategies including leve ...
s in the acquisition of
Kindred Healthcare Kindred Healthcare was a post-acute healthcare services company that operated long-term acute-care hospitals and provides rehabilitation services across the United States. Kindred's headquarters and support center were located in Louisville, Ke ...
. The deal provided Humana with a 40% stake in the company's home health, hospice and community care businesses, called "Kindred at Home," for approximately $800 million. In August 2018, Humana announced the creation of a digital health and analytics division called Humana Studio H. In December 2019, the company announced it would acquire Enclara Healthcare from Consonance Capital Partners and Enclara management. In 2021, Susan Diamond, formerly occupying an interim position, was announced to be the new permanent CFO. Her appointment to the position comes with the company's focus being turned towards the home healthcare business, acquiring in April of the same year a 60% stake in Kindred at Home, an in-home care and hospice business. In April 2022, it was announced Humana would sell a 60% interest of its Kindred at Home division to the private investment company,
Clayton, Dubilier & Rice Clayton, Dubilier & Rice is an American private equity company. It is one of the oldest private equity investment firms in the world. Founded in 1978, CD&R has managed the investment of more than $30 billion in approximately 90 businesses, repre ...
, for $2.8 billion USD.


Corporate affairs


Sponsorship

Humana is the presenting sponsor of the ''
Grand Ole Opry The ''Grand Ole Opry'' is a weekly American country music stage concert in Nashville, Tennessee, founded on November 28, 1925, by George D. Hay as a one-hour radio "barn dance" on WSM. Currently owned and operated by Opry Entertainment (a divis ...
'' and the
National Senior Games The National Senior Games (Senior Olympics) are a sports competition for senior citizens in the United States. It is conducted by the National Senior Games Association (NSGA) once every two years. Akin to the Summer Olympics, it is a multi-sport ...
. Since 1979, Humana has been a principal sponsor of the annual
Humana Festival of New American Plays Humana Festival of New American Plays is an internationally renowned festival that celebrates the contemporary American playwright. Produced annually in Louisville, Kentucky by Actors Theatre of Louisville, this festival showcases new theatrica ...
in Louisville, Kentucky.
LPGA The Ladies Professional Golf Association (LPGA) is an American organization for female golfers. The organization is headquartered at the LPGA International in Daytona Beach, Florida, and is best known for running the LPGA Tour, a series of weekl ...
player
Nancy Scranton Nancy Scranton (born April 26, 1961) is an American professional golfer. Scranton was born in Centralia, Illinois. She attended Florida State University and the University of Kentucky. Her rookie season on the LPGA Tour was 1985. She has three to ...
was a spokesperson for Humana. In the past, PGA Tour player
David Toms David Wayne Toms (born January 4, 1967) is an American professional golfer who currently plays on the PGA Tour Champions. From 1992 to 2017, Toms was a member of the PGA Tour, where he won 13 events, including one major, the 2001 PGA Championshi ...
' David Toms Foundation has partnered with the Humana Foundation to provide grants to several children's charities in New Orleans. Humana is the official health benefits provider of the
PGA Tour The PGA Tour (stylized in all capital letters as PGA TOUR by its officials) is the organizer of professional golf tours in the United States and North America. It organizes most of the events on the flagship annual series of tournaments also k ...
and
Champions Tour PGA Tour Champions (formerly the Senior PGA Tour and the Champions Tour) is a men's professional senior golf tour, administered as a branch of the PGA Tour. History and format The Senior PGA Championship, founded in 1937, was for many years ...
. The
Humana Distaff Handicap The Derby City Distaff Stakes is a Grade I American thoroughbred horse race for fillies and mares aged three and older over a distance of seven furlongs on the dirt held annually in early May on the Kentucky Derby day meeting at Churchill Down ...
is a
Grade 1 First grade (also called Grade One, called ''Year 2'' in England or Primary 2 in Scotland) is the first grade in elementary school and the first school year after kindergarten. Children are usually 6–7 years old in this grade. Examples by re ...
race for
thoroughbred The Thoroughbred is a horse breed best known for its use in horse racing. Although the word ''thoroughbred'' is sometimes used to refer to any breed of purebred horse, it technically refers only to the Thoroughbred breed. Thoroughbreds are c ...
fillies A filly is a female horse that is too young to be called a mare. There are two specific definitions in use: *In most cases, a ''filly'' is a female horse under four years old. *In some nations, such as the United Kingdom and the United States, t ...
and
mares A mare is an adult female horse or other equine. In most cases, a mare is a female horse over the age of three, and a filly is a female horse three and younger. In Thoroughbred horse racing, a mare is defined as a female horse more than four y ...
, four-years-old and up. The race is run each spring on
Kentucky Derby The Kentucky Derby is a horse race held annually in Louisville, Kentucky, United States, almost always on the first Saturday in May, capping the two-week-long Kentucky Derby Festival. The competition is a Grade I stakes race for three-year ...
day at
Churchill Downs Churchill Downs is a horse racing complex located on Central Avenue in south Louisville, Kentucky, United States, famed for hosting the annual Kentucky Derby. It officially opened in 1875 and was named for Samuel Churchill, whose family was ...
and set at a distance of 7 furlongs for a purse of $250,000.


Humana Military Healthcare Services

In 1993, Humana founded Humana Military Healthcare Services (HMHS) as a wholly owned subsidiary. They were awarded their first
TRICARE Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, in ...
contract in 1995, and began serving military beneficiaries in 1996. From 2004 to 2009, HMHS was the managed care contractor for the Department of Defense
Military Health System The Military Health System (MHS) is a form of nationalized health care operated within the United States Department of Defense that provides health care to active duty, Reserve component and retired U.S. Military personnel and their dependents. ...
TRICARE Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, in ...
South Region. In 2009, HMHS' Managed Care Support Contract was awarded to United Military and Veterans Services, a subsidiary of
UnitedHealth Group UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. It offers health care products and insurance services. UnitedHealth Group is the world's seventh largest c ...
. HMHS protested that decision and the
Government Accountability Office The U.S. Government Accountability Office (GAO) is a legislative branch government agency that provides auditing, evaluative, and investigative services for the United States Congress. It is the supreme audit institution of the federal govern ...
upheld the protest in late 2009. In 2011, HMHS regained the five-year contract to administer medical benefits to military members and families in the South region, a contract worth $23.5 billion. In 2018, this was moved to the new TRICARE East region during the TRICARE regional realignment.


Legal campaign against drug price fixing

Humana filed a lawsuit in August 2019, alleging that 37 defendants engaged in a “far-reaching conspiracy” to “blatantly fix the price” of generic drugs. This follows a similar smaller lawsuit from October 2018.


Controversy

In 1987, Humana sued
NBC The National Broadcasting Company (NBC) is an Television in the United States, American English-language Commercial broadcasting, commercial television network, broadcast television and radio network. The flagship property of the NBC Enterta ...
over a story line in the television
medical drama A medical drama is a television show or film in which events center upon a hospital, an ambulance staff, or any medical environment. Most recent medical drama (film and television), dramatic programming go beyond the events pertaining to the chara ...
''
St. Elsewhere ''St. Elsewhere'' was an American medical drama television series created by Joshua Brand and John Falsey, that originally ran on NBC from October 26, 1982, to May 25, 1988. The series stars Ed Flanders, Norman Lloyd, and William Daniels as ...
'' in which the hospital was to be sold to a for-profit medical corporation and renamed "Ecumena", with subsequent changes to the hospital, both positive and negative, emanating from that change. Humana was successful at forcing NBC into showing a disclaimer at the beginning of the September 30 episode saying that the drama had no connection whatsoever with Humana. On May 30, 1996,
Linda Peeno Linda Peeno is an American physician, ethicist, and lecturer known for being a whistleblower against the American managed healthcare industry. Whistleblowing Following employment as a medical reviewer for Humana and medical director at Blue Cros ...
, a physician who was contracted to work for Humana for nine months, testified before
Congress A congress is a formal meeting of the representatives of different countries, constituent states, organizations, trade unions, political parties, or other groups. The term originated in Late Middle English to denote an encounter (meeting of a ...
as to the downside of
managed care The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("man ...
. Peeno said she was effectively rewarded by her employer for causing the death of a patient, because it saved the company a half-million dollars. Peeno stated that she felt the "managed care" model was inherently unethical. In 1999, season one of Michael Moore's TV series ''
The Awful Truth ''The Awful Truth'' is a 1937 American screwball comedy film directed by Leo McCarey and starring Irene Dunne and Cary Grant. Based on the 1923 play ''The Awful Truth'' by Arthur Richman, the film recounts how a distrustful rich couple begins d ...
'' reported on Humana refusing to pay for a diabetic patient with pancreatic failure needing a transplant. The man's policy stated it covered all of his
diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...
-related expenses, but another section of the policy stated that it did not cover organ transplants. Moore conducted a fake funeral on the front steps of the Humana building, and three days later Humana changed its policy and authorized the man's treatment..
Michael Moore Michael Francis Moore (born April 23, 1954) is an American filmmaker, author and left-wing activist. His works frequently address the topics of globalization and capitalism. Moore won the 2002 Academy Award for Best Documentary Feature for ' ...
's 2007 documentary ''
Sicko ''Sicko'' is a 2007 American political documentary film by filmmaker Michael Moore. Investigating health care in the United States, it focuses on the country's health insurance and the pharmaceutical industry. The film compares the for-profit ...
'' used the video of Linda Peeno's testimony. On June 28, 2007, Humana declared that Peeno was never a Humana "associate" (permanent, full-time employee), but rather a "part-time contractor." Humana disputed portions of her Congressional testimony by saying that because the patient's healthcare plan did not cover heart transplants, denial of coverage was valid. The
U.S. Dept. of Health and Human Services The United States Department of Health and Human Services (HHS) is a Cabinet of the United States, cabinet-level United States federal executive departments, executive branch department of the U.S. federal government of the United States, fede ...
investigated Humana in 2009 for sending flyers to Medicare recipients that the
AARP AARP (formerly called the American Association of Retired Persons) is an interest group in the United States focusing on issues affecting those over the age of fifty. The organization said it had more than 38 million members in 2018. The magazin ...
characterized as deceptive. In more detail - on September 21, 2009 the
U.S. Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is " ...
opened an investigation into Humana mass mailings to elderly Medicare recipients. The mail was made to appear to contain official information about
Medicare Advantage Medicare Advantage (Medicare Part C, MA) is a capitated program for providing Medicare benefits in the United States. Under Part C, Medicare pays a private-sector health insurer a fixed payment. The insurer then pays for the health care expenses ...
and prescription drug benefit information, but instead alleged that core Medicare benefits could be cut by the
Obama administration Barack Obama's tenure as the 44th president of the United States began with his first inauguration on January 20, 2009, and ended on January 20, 2017. A Democrat from Illinois, Obama took office following a decisive victory over Republican ...
's healthcare reform,Dawn Te
Humana Mailer Targets Elderly, Claims Medicare Benefits To Be Cut
''
Huffington Post ''HuffPost'' (formerly ''The Huffington Post'' until 2017 and sometimes abbreviated ''HuffPo'') is an American progressive news website, with localized and international editions. The site offers news, satire, blogs, and original content, and ...
''. September 16, 2009.
a claim refuted by John Rother,
AARP AARP (formerly called the American Association of Retired Persons) is an interest group in the United States focusing on issues affecting those over the age of fifty. The organization said it had more than 38 million members in 2018. The magazin ...
's executive vice president. Douglas Elmendorf, the head of the
Congressional Budget Office The Congressional Budget Office (CBO) is a federal agency within the legislative branch of the United States government that provides budget and economic information to Congress. Inspired by California's Legislative Analyst's Office that manages ...
(CBO), supported the claim that Medicare benefits could be cut, but his comments were in reference to just one of several congressional bills. CBO estimates of another healthcare reform bill found that changes to premiums would vary.The Effect of H.R. 3200 on Medicare Part D Premiums
Congressional Budget Office, Director's Blog. August 28, 2009
The
Centers for Medicare and Medicaid Services The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer M ...
instructed Humana to cease all such mailings to Medicare plan members pending an investigation. HHS Secretary Kathleen Sebelius, in a letter to the insurance industry, threatened that bad actors may be excluded from new health insurance markets that were to open in 2014. Senate Republicans pointed out in a letter to Sebelius that a 1997 directive from the Centers for Medicare and Medicaid Services explicitly allowed HMOs to tell members about legislation and urge them to express opinions.


See also

*
Top 100 Contractors of the U.S. federal government The Top 100 Contractors Report is a list developed annually by the U.S. General Services Administration as part of its tracking of U.S. federal government procurement, of the "Top 100" contractors in the United States. In fiscal year 2005, the f ...
*
List of major employers in Louisville, Kentucky Louisville's major employers include United Parcel Service, Ford Motor Company and GE Appliances. Major employers * United Parcel Service **UPS Airlines * Ford Motor Company ** Kentucky Truck Plant ** Louisville Assembly Plant * GE Appliances * ...


References


External links

* {{authority control Financial services companies established in 1961 Companies listed on the New York Stock Exchange American companies established in 1961 Health care companies established in 1961 Companies based in Louisville, Kentucky Hospital networks in the United States Pharmacy benefit management companies based in the United States 1961 establishments in Kentucky Health care companies based in Kentucky Health insurance companies of the United States