Many Providers, Specialists, and Hospitals are exiting being part of Humana’s network and in some cases are outright refusing to accept Medicare Advantage Plans.
This is because they see how difficult Humana, and MA in general, are to work with. Especially in regards to delaying and denying claims and the slowness for which Humana and other MA private companies pay their bills.
The crumbling of the MA infrastructure has already begun. Maybe the mighty companies are not too big to fail…
@c3 lol yeh sure, maybe a handful of skeezes but not the majority and ultimately won't be for Humana or the poor members.
What middle managers? The ones working their second jobs when they are supposed to be working for Humana? Or the ones that are inaccessible because they are always in meetings thinking of new things to do so they have a job? Or the ones managing teams from their cell phones instead of their home office where they are supposed to be? The middle managers and C-Suites are part of the problem and instead of solutions, they just create more work because they are so far removed from the front they have no idea what is really going on.
@c3 Let's get granular. How many AEP apps are in lower star rating plans? Lots of apps does not equate to lots of $$. Context, context, context
@c3 AEP may be doing well but I feel very sorry for those members once they file a claim and find out that Humana will not approve and pay a claim much beyond having a hang nail. And they really will be upset when they find out that their provider for years as out of the blue decided (or forced to) end their contract with Humana’s network.
@c3 it might look good. But all we are doing is picking up the castoffs from the other payors that has cost them money. The first year of new members are the most costly. If you were here 3-4 years ago when this happened stocks plummeted and we lost a lot of money. So this is really not a good thing.
@OP yet somehow we are having a successful AEP...
@aw Yea, totally agree. It is really a shame this systemic issue has led to this metastatic spiraling downfall, due to the poor decisions of Humana’s C-Suite Executives as well as the poor leadership of middle management.
But now I think the recent decisions of going with Outsourcing AND Artificial Intelligence to replace US citizen’s jobs, they will soon find out things will go from bad to worse.
2026 is bound to be a bumpy ride with lots of headwinds.
@OP - I'll add to the list of people leaving, to include members and employees.