Anyone Know About Humana 2015?

[Seniorgirl411]

Just wondering about Southern Indiana and IL for 2015. Any sneak peeks for 2015? Wonder if I should start writing them. I know I have heard it's a pain to go through their training and certification.

 

[vic120]

I don't

But I just did recertification and seemed like there was more then the usual focus on 5 star plans

So I am def curious

 

[cedwards]

I don't

But I just did recertification and seemed like there was more then the usual focus on 5 star plans

So I am def curious

I think this will be the overwhelming trend this year and each year going forward. Not getting the Star Bonus is going to hurt a lot of carriers this year. UHC spent a lot of time at their roll out talking about how they were going to try to enhance the clients experience. Less complaints/better client experience= better plan rating and more $$$.

 

[yogooglethis]

I think this will be the overwhelming trend this year and each year going forward. Not getting the Star Bonus is going to hurt a lot of carriers this year. UHC spent a lot of time at their roll out talking about how they were going to try to enhance the clients experience. Less complaints/better client experience= better plan rating and more $$$.

I think what Humana is most concerned about when it comes to star ratings is the control they can have on members behavior enrolled in their clinic model HMO plans where they can make sure they see their pcp and have their preventive screenings completed.For example in Florida they have the MCC clinics where they can get much of there medical care done under one roof and they even have free rides on MMC party bus to make sure they get there.I believe the star ratings are heavily weighted in this and also the MA carriers now get additional reimbursement for members who are diagnosed with certain chronic illnesses.Because of the flexibility the PPO's are going to find it harder to raise their ratings and don't have as many touch points as the HMOs with members to uncover un-diagnosed or undocumented chronic illnesses to get the additional funding.

This is just speculation but I have a feeling that Humana's 2014 enhancement of benefits of their PPO plans in Florida was a strategy to be able to convert more people to their HMO plans for 2015 so they may degrade their RPPO for 2015 to make it easier for their captive agents to convert the membership to HMO.

 

[just some f.e.llow]

For example in Florida they have the MCC clinics where they can get much of there medical care done under one roof and they even have free rides on MMC party bus to make sure they get there.

These companies crack me up.
Party bus? Really?

Suzanne is in the back with her canister of oxygen, Mort can't find his denture (because he left the house without it), and Gracie, bless her soul, keeps barking at the driver to show down, because she can feel every bump on her arthritic hip.

PARRRRTY!

 

[yogooglethis]

These companies crack me up.
Party bus? Really?

Suzanne is in the back with her canister of oxygen, Mort can't find his denture (because he left the house without it), and Gracie, bless her soul, keeps barking at the driver to show down, because she can feel every bump on her arthritic hip.

PARRRRTY!

Well I don't think Humana actually calls it a party bus but I saw one the other day next to me at a light and the way it was all painted up in festive colors and graphics make it look more like a bachelor party transport vehicle that might have a stripper pole in it more than a bus taking old farts to have their PSA's and wellness check ups done.Made me feel like I was missing something not being on it until I read the MMC logo

 

[just some f.e.llow]

Well I don't think Humana actually calls it a party bus but I saw one the other day next to me at a light and the way it was all painted up in festive colors and graphics make it look more like a bachelor party transport vehicle that might have a stripper pole in it more than a bus taking old farts to have their PSA's and wellness check ups done.Made me feel like I was missing something not being on it until I read the MMC logo

Hahaha! Nice!........

 

[coachd]

I do their PDP's. Have the APD, but never wrote one. I am in IL and IN. Other companies have a bit better MAPD in my opinion. I write more Med Supps however.