Humana CEO: Healthcare reform isn't working--yet


Although Humana is betting big on the success of health insurance exchanges, its CEO admits that healthcare reform isn't working yet.

Speaking on the insurer's exchange strategy at the Nashville Health Care Council on Tuesday, Humana CEO Bruce Broussard was asked whether he believes the reform law is working, reported The Tennessean. His answer: "I don't think it is. Today, it's not."

Instead, Broussard attributed much of the insurance industry's cost reductions to the economy, providers' increased awareness of utilization of services and consumers' heightened awareness about health prices.

But despite his belief that reform isn't creating any major changes yet, Humana is one of the biggest gamblers among insurers choosing to participate in health insurance exchanges, deciding to sell plans on 14 different online marketplaces.

"It's more offensive than defensive," Broussard said, reported the Nashville Business Journal. "We look at it as an opportunity for us to learn where healthcare is going ... it's like [research and development] ... we will lose some money, but it's no different than [research and development]."

Part of Humana's decision to play big in the exchange markets could be its success with Medicare Advantage plans, The Tennessean noted. "Medicare Advantage has a lot of the elements of the future of healthcare: We get paid a fixed payment, irrelevant of the individual's care. Our payment is increased or decreased based on quality. [We] can't reject anyone; if someone comes to us with stage IV cancer, we have to take them," Broussard said. 

Although Broussard doesn't think reform works yet, he does believe the industry will shift in the next several years. He said reform could lead to more conversations between payers and providers about how to reward quality care rather than services. "I think the reform will help with that, but I think it will be indirect as opposed to direct," Broussard said.

Meanwhile, Humana announced it has partnered with the YMCA to help educate consumers about the reform law. The insurer will sponsor free health and wellness public events, including educational seminars led by Humana representatives, at YMCA locations in states where Humana will be participating in exchanges.

"Given the important need for education on healthcare reform, Humana's partnership with the Y helps provide people with information they can use to make well-informed decisions about their health coverage choices," Roy Beveridge, Humana's chief medical officer, said Tuesday in a statement.

To learn more:
- here's the Humana statement
- read the Nashville Business Journal article
- see The Tennessean article

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