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SEGMENT INFORMATION | 12 Months Ended
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Dec. 31, 2023
Segment Reporting [Abstract] |
SEGMENT INFORMATION | SEGMENT INFORMATION During December 2022, we realigned our businesses into two distinct segments: Insurance and CenterWell. The Insurance segment includes the businesses that were previously included in the Retail and Group and Specialty segments, as well as the Pharmacy Benefit Manager, or PBM, business which was previously included in the Healthcare Services segment. The CenterWell segment (formerly Healthcare Services) represents our payor-agnostic healthcare services offerings, including pharmacy solutions, primary care, and home solutions. In addition to the new segment classifications being utilized to assess performance and allocate resources, we believe this simpler structure will create greater collaboration across the Insurance and CenterWell businesses and will accelerate work that is underway to centralize and integrate operations within the organization. 2021 segment financial information was recast to conform to the 2022 presentation. Our two reportable segments, Insurance and CenterWell, are based on a combination of the type of health plan customer and adjacent businesses centered on well-being solutions for our health plans and other customers, as described below. These segment groupings are consistent with information used by our Chief Executive Officer, the Chief Operating Decision Maker, to assess performance and allocate resources. The Insurance segment consists of Medicare benefits, marketed to individuals or directly via group Medicare accounts, as well as our contract with CMS to administer the Limited Income Newly Eligible Transition, or LI-NET, prescription drug plan program and contracts with various states to provide Medicaid, dual eligible demonstration, and Long-Term Support Services benefits, which we refer to collectively as our state-based contracts. This segment also includes products consisting of employer group commercial fully-insured medical and specialty health insurance benefits marketed to individuals and employer groups, including dental, vision, and other supplemental health benefits, as well as administrative services only, or ASO. In addition, our Insurance segment includes our military services business, primarily our T-2017 East Region contract, as well as the operations of our PBM business. The CenterWell segment includes our pharmacy solutions, primary care, and home solutions operations. The segment also includes our strategic partnerships with WCAS to develop and operate senior-focused, payor-agnostic, primary care centers, as well as our minority ownership interest in Gentiva Hospice operations. Services offered by this segment are designed to enhance the overall healthcare experience. These services may lead to lower utilization associated with improved member health and/or lower drug costs. Our CenterWell intersegment revenues primarily relate to the operations of CenterWell Pharmacy (our mail-order pharmacy business), CenterWell Specialty Pharmacy, and retail pharmacies jointly located within CenterWell Senior Primary Care clinics. In addition, our CenterWell intersegment revenues includes revenues earned by certain owned providers (CenterWell Senior Primary Care) derived from certain value-based arrangements with our health plans. Under these value-based arrangements, our owned providers enter into agreements with our health plans to stand ready to deliver, integrate, direct and control the administration and management of certain health care services for our members. In exchange, the owned provider receives a premium that is typically paid on a per-member per-month basis. These value-based arrangements represent a single performance obligation where revenues are recognized in the period in which we are obligated to provide integrated health care services to our members. Fee-for-service revenue is recognized at agreed upon rates, net of contractual allowances, as the performance obligation is completed on the date of service. We present our consolidated results of operations from the perspective of the health plans. As a result, the cost of providing benefits to our members, whether provided via a third party provider or internally through a stand-alone subsidiary, is classified as benefits expense and excludes the portion of the cost for which the health plans do not bear responsibility, including member co-share amounts and government subsidies of $20.7 billion in 2023, $19.7 billion in 2022, and $18.1 billion in 2021. In addition, depreciation and amortization expense associated with certain businesses delivering benefits to our members, primarily associated with our primary care and pharmacy operations, are included with benefits expense. The amount of this expense was $138 million in 2023, $122 million in 2022, and $108 million in 2021. Other than those described previously, the accounting policies of each segment are the same and are described in Note 2. Transactions between reportable segments primarily consist of sales of services rendered by our CenterWell segment, primarily pharmacy solutions, primary care, and home solutions, to our Insurance segment customers. Intersegment sales and expenses are recorded at fair value and eliminated in consolidation. Members served by our segments often use the same provider networks, enabling us in some instances to obtain more favorable contract terms with providers. Our segments also share indirect costs and assets. As a result, the profitability of each segment is interdependent. We allocate most operating expenses to our segments. Assets and certain corporate income and expenses are not allocated to the segments, including the portion of investment income not supporting segment operations, interest expense on corporate debt, and certain other corporate expenses. These items are managed at a corporate level. These corporate amounts are reported separately from our reportable segments and are included with intersegment eliminations in the tables presenting segment results below. Premium and services revenues derived from our contracts with the federal government, as a percentage of our total premium and services revenues, were approximately 84% for 2023, 82% for 2022 and 83% for 2021.
| Insurance |  | CenterWell |  | Eliminations/ Corporate |  | Consolidated
| (in millions)
2023 |  |  |  |  |  |  |
External revenues |  |  |  |  |  |  |
Premiums: |  |  |  |  |  |  |
Individual Medicare Advantage | $ | 78,837 |  |  | $ | — |  |  | $ | — |  |  | $ | 78,837 |
Group Medicare Advantage | 6,869 |  |  | — |  |  | — |  |  | 6,869 |
Medicare stand-alone PDP | 2,189 |  |  | — |  |  | — |  |  | 2,189 |
Total Medicare | 87,895 |  |  | — |  |  | — |  |  | 87,895 |
Commercial fully-insured | 3,527 |  |  | — |  |  | — |  |  | 3,527 |
Specialty benefits | 1,007 |  |  | — |  |  | — |  |  | 1,007 |
Medicare Supplement | 735 |  |  | — |  |  | — |  |  | 735 |
State-based contracts and other | 8,108 |  |  | — |  |  | — |  |  | 8,108 |
Total premiums | 101,272 |  |  | — |  |  | — |  |  | 101,272 |
Services revenue: |  |  |  |  |  |  |
Home solutions | — |  |  | 1,342 |  |  | — |  |  | 1,342 |
Primary care | — |  |  | 842 |  |  | — |  |  | 842 |
Commercial ASO | 237 |  |  | — |  |  | — |  |  | 237 |
Military services and other | 763 |  |  | — |  |  | — |  |  | 763 |
Pharmacy solutions | — |  |  | 849 |  |  | — |  |  | 849 |
Total services revenue | 1,000 |  |  | 3,033 |  |  | — |  |  | 4,033 |
Total external revenues | 102,272 |  |  | 3,033 |  |  | — |  |  | 105,305 |
Intersegment revenues |  |  |  |  |  |  |
Services | 31 |  |  | 4,921 |  |  | (4,952) |  |  | — |
Products | — |  |  | 10,451 |  |  | (10,451) |  |  | — |
Intersegment revenues | 31 |  |  | 15,372 |  |  | (15,403) |  |  | — |
Investment income | 551 |  |  | — |  |  | 518 |  |  | 1,069 |
Total revenues | 102,854 |  |  | 18,405 |  |  | (14,885) |  |  | 106,374 |
Operating expenses: |  |  |  |  |  |  |
Benefits | 89,100 |  |  | — |  |  | (706) |  |  | 88,394 |
Operating costs | 10,408 |  |  | 16,791 |  |  | (14,011) |  |  | 13,188 |
Depreciation and amortization | 692 |  |  | 210 |  |  | (123) |  |  | 779 |
Total operating expenses | 100,200 |  |  | 17,001 |  |  | (14,840) |  |  | 102,361 |
Income (loss) from operations | 2,654 |  |  | 1,404 |  |  | (45) |  |  | 4,013 |
Interest expense | — |  |  | 3 |  |  | 490 |  |  | 493 |
Other expense, net | — |  |  | — |  |  | 137 |  |  | 137 |
Income (loss) before income taxes and equity in net losses | 2,654 |  |  | 1,401 |  |  | (672) |  |  | 3,383 |
Equity in net losses | (6) |  |  | (57) |  |  | — |  |  | (63) |
Segment earnings (loss) | $ | 2,648 |  |  | $ | 1,344 |  |  | $ | (672) |  |  | $ | 3,320 |
Net loss (income) attributable to noncontrolling interests | 6 |  |  | (1) |  |  | — |  |  | 5 |
Segment earnings (loss) attributable to Humana | $ | 2,654 |  |  | $ | 1,343 |  |  | $ | (672) |  |  | $ | 3,325 |
| Insurance |  | CenterWell |  | Eliminations/ Corporate |  | Consolidated
| (in millions)
2022 |  |  |  |  |  |  |
External revenues |  |  |  |  |  |  |
Premiums: |  |  |  |  |  |  |
Individual Medicare Advantage | $ | 65,591 |  |  | $ | — |  |  | $ | — |  |  | $ | 65,591 |
Group Medicare Advantage | 7,297 |  |  | — |  |  | — |  |  | 7,297 |
Medicare stand-alone PDP | 2,269 |  |  | — |  |  | — |  |  | 2,269 |
Total Medicare | 75,157 |  |  | — |  |  | — |  |  | 75,157 |
Commercial fully-insured | 4,389 |  |  | — |  |  | — |  |  | 4,389 |
Specialty benefits | 1,047 |  |  | — |  |  | — |  |  | 1,047 |
Medicare Supplement | 743 |  |  | — |  |  | — |  |  | 743 |
State-based contracts and other | 6,376 |  |  | — |  |  | — |  |  | 6,376 |
Total premiums | 87,712 |  |  | — |  |  | — |  |  | 87,712 |
Services revenue: |  |  |  |  |  |  |
Home solutions | — |  |  | 2,333 |  |  | — |  |  | 2,333 |
Primary care | — |  |  | 568 |  |  | — |  |  | 568 |
Commercial ASO | 300 |  |  | — |  |  | — |  |  | 300 |
Military services and other | 550 |  |  | — |  |  | — |  |  | 550 |
Pharmacy solutions | — |  |  | 1,025 |  |  | — |  |  | 1,025 |
Total services revenue | 850 |  |  | 3,926 |  |  | — |  |  | 4,776 |
Total external revenues | 88,562 |  |  | 3,926 |  |  | — |  |  | 92,488 |
Intersegment revenues |  |  |  |  |  |  |
Services | 56 |  |  | 3,532 |  |  | (3,588) |  |  | — |
Products | — |  |  | 9,841 |  |  | (9,841) |  |  | — |
Intersegment revenues | 56 |  |  | 13,373 |  |  | (13,429) |  |  | — |
Investment income | 223 |  |  | 8 |  |  | 151 |  |  | 382 |
Total revenues | 88,841 |  |  | 17,307 |  |  | (13,278) |  |  | 92,870 |
Operating expenses: |  |  |  |  |  |  |
Benefits | 75,934 |  |  | — |  |  | (244) |  |  | 75,690 |
Operating costs | 9,251 |  |  | 15,835 |  |  | (12,415) |  |  | 12,671 |
Depreciation and amortization | 634 |  |  | 181 |  |  | (106) |  |  | 709 |
Total operating expenses | 85,819 |  |  | 16,016 |  |  | (12,765) |  |  | 89,070 |
Income (loss) from operations | 3,022 |  |  | 1,291 |  |  | (513) |  |  | 3,800 |
Gain on sale of Gentiva Hospice | — |  |  | (237) |  |  | — |  |  | (237) |
Interest expense | — |  |  | — |  |  | 401 |  |  | 401 |
Other expense, net | — |  |  | — |  |  | 68 |  |  | 68 |
Income (loss) before income taxes and equity in net earnings (losses) | 3,022 |  |  | 1,528 |  |  | (982) |  |  | 3,568 |
Equity in net earnings (losses) | 18 |  |  | (22) |  |  | — |  |  | (4) |
Segment earnings (loss) | $ | 3,040 |  |  | $ | 1,506 |  |  | $ | (982) |  |  | $ | 3,564 |
Net loss (income) attributable to noncontrolling interests | 5 |  |  | (1) |  |  | — |  |  | 4 |
Segment earnings (loss) attributable to Humana | $ | 3,045 |  |  | $ | 1,505 |  |  | $ | (982) |  |  | $ | 3,568 |
| Insurance |  | CenterWell |  | Eliminations/ Corporate |  | Consolidated
| (in millions)
2021 |  |  |  |  |  |  |
External revenues |  |  |  |  |  |  |
Premiums: |  |  |  |  |  |  |
Individual Medicare Advantage | $ | 58,654 |  |  | $ | — |  |  | $ | — |  |  | $ | 58,654 |
Group Medicare Advantage | 6,955 |  |  | — |  |  | — |  |  | 6,955 |
Medicare stand-alone PDP | 2,371 |  |  | — |  |  | — |  |  | 2,371 |
Total Medicare | 67,980 |  |  | — |  |  | — |  |  | 67,980 |
Commercial fully-insured | 4,950 |  |  | — |  |  | — |  |  | 4,950 |
Specialty benefits | 1,052 |  |  | — |  |  | — |  |  | 1,052 |
Medicare Supplement | 731 |  |  | — |  |  | — |  |  | 731 |
State-based contracts and other | 5,109 |  |  | — |  |  | — |  |  | 5,109 |
Total premiums | 79,822 |  |  | — |  |  | — |  |  | 79,822 |
Services revenue: |  |  |  |  |  |  |
Home solutions | — |  |  | 1,166 |  |  | — |  |  | 1,166 |
Primary care | — |  |  | 413 |  |  | — |  |  | 413 |
Commercial ASO | 306 |  |  | — |  |  | — |  |  | 306 |
Military services and other | 547 |  |  | — |  |  | — |  |  | 547 |
Pharmacy solutions | — |  |  | 623 |  |  | — |  |  | 623 |
Total services revenue | 853 |  |  | 2,202 |  |  | — |  |  | 3,055 |
Total external revenues | 80,675 |  |  | 2,202 |  |  | — |  |  | 82,877 |
Intersegment revenues |  |  |  |  |  |  |
Services | 41 |  |  | 2,828 |  |  | (2,869) |  |  | — |
Products | — |  |  | 9,024 |  |  | (9,024) |  |  | — |
Intersegment revenues | 41 |  |  | 11,852 |  |  | (11,893) |  |  | — |
Investment income (loss) | 214 |  |  | 4 |  |  | (31) |  |  | 187 |
Total revenues | 80,930 |  |  | 14,058 |  |  | (11,924) |  |  | 83,064 |
Operating expenses: |  |  |  |  |  |  |
Benefits | 69,639 |  |  | — |  |  | (440) |  |  | 69,199 |
Operating costs | 8,340 |  |  | 12,968 |  |  | (11,187) |  |  | 10,121 |
Depreciation and amortization | 539 |  |  | 152 |  |  | (95) |  |  | 596 |
Total operating expenses | 78,518 |  |  | 13,120 |  |  | (11,722) |  |  | 79,916 |
Income (loss) from operations | 2,412 |  |  | 938 |  |  | (202) |  |  | 3,148 |
Interest expense | — |  |  | — |  |  | 326 |  |  | 326 |
Other income, net | — |  |  | — |  |  | (532) |  |  | (532) |
Income before income taxes and equity in net earnings | 2,412 |  |  | 938 |  |  | 4 |  |  | 3,354 |
Equity in net earnings | — |  |  | 65 |  |  | — |  |  | 65 |
Segment earnings | $ | 2,412 |  |  | $ | 1,003 |  |  | $ | 4 |  |  | $ | 3,419 |
Net income attributable to noncontrolling interest | — |  |  | (1) |  |  | — |  |  | (1) |
Segment earnings attributable to Humana | $ | 2,412 |  |  | $ | 1,002 |  |  | $ | 4 |  |  | $ | 3,418 |

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