Executives at Humana had great news.
The insurance giant’s senior-focused primary care clinics were generating extraordinary medical benefits for older Americans, keeping them out of hospitals and away from emergency rooms, they told investors in the fall of 2022.
At the time, Humana was in the midst of a nearly $2 billion expansion of the clinics across 15 states, and CEO Bruce Broussard was looking to convince Wall Street of the wisdom of serving as both a patient’s doctor and insurer in the Medicare Advantage program. Broussard called it “the flywheel effect.”
“When we integrate effectively in local markets,” he said, “we see better clinical outcomes.”
But his message conflicted sharply with the company’s own internal research. Just six weeks earlier, data presented to managers showed patients cared for by Humana’s clinics actually had much higher rates of hospitalizations and emergency department visits than those who went to similar non-Humana primary care practices.
That more dour assessment didn’t make it into the investor deck. Nor did it — until now — escape the confines of the Kentucky-based company, whose every move and release of information can trigger a cascade of consequences on Wall Street.
This article is exclusive to STAT+ subscribers
Unlock this article — plus in-depth analysis, newsletters, premium events, and news alerts.
Already have an account? Log in
