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    HUM
    Earnings call· Jun 2026(Q2 FY26)

    HUMANA Q2 FY26 earnings call HUM

    Jul 29, 2026 Source

    Executive summary

    Humana Q2 FY26 — On Track for 2028 Margin Goal and Stars Improvement

    Humana reported Q2 FY26 results in line with expectations, reaffirming its commitment to achieving a sustainable 3% pretax margin by 2028. The company highlighted significant operational improvements, particularly in Stars performance and cost efficiency, while strategically adjusting its 2027 MA bid approach to prioritize margin expansion. Management remains confident in its long-term strategy and will provide a comprehensive update at a December investor event.

    Highlights

    5
    • Q2 consolidated operating cost ratio decreased by 120 basis points year-over-year, with a full-year reduction of approximately 150 basis points expected.

    • Operating model efforts have yielded hundreds of millions of dollars in value so far in 2026.

    • Rate of improvement for Bonus Year '28 Stars outpaced historical CAGR across 11 of 12 HEDIS and patient safety metrics.

    • Secured a statewide Illinois Medicaid managed care contract, set to go live in January 2027.

    • Established $1.5 billion in contingent capital facilities (PCAPs) to enhance liquidity and balance sheet efficiency.

    Concerns

    3
    • Planned MA exits for 2027 are anticipated to impact approximately 600,000 members.

    • IBNR remained flat from last quarter, despite expectations for it to decrease as the year progresses.

    • The sunsetting of the Part D premium stabilization program will unfortunately have a greater impact on members than on the company.

    Guidance & targets

    9
    CategoryTargetConfidence
    Individual MA Pretax Margin
    at least 3%
    high materiality
    High
    Operating Cost Ratio Reduction
    approximately 150 basis points
    medium materiality
    High
    MA Margin Expansion
    meaningful progress
    high materiality
    High
    Gentiva Divestiture Closing
    fourth quarter
    medium materiality
    High
    Illinois Medicaid Managed Care Contract Go-Live
    January of '27
    medium materiality
    High
    2026 Cost Trend Assumption
    high single-digit range or 7% to 8%
    high materiality
    High
    Next Year Drug Trend
    tick modestly higher
    medium materiality
    Medium
    MA Plan Exit Member Recapture Rate
    similar portion as we did in 2025 (just over 40%)
    medium materiality
    Medium
    Stars Revenue PMPM Target
    10% above our peer group median
    high materiality
    High

    Operational metrics

    7
    Operating Cost Ratio
    120down YoY
    Q2 FY26

    Consolidated operating cost ratio decreased year-over-year.

    Operating Model Efforts Value
    hundreds of millions of dollars
    YTD 2026

    Value generated from operating model transformation initiatives.

    Quality Improvement Rate (HEDIS)
    5%ahead of last year
    Q2 FY26

    Maintained momentum for Bonus Year '29 Stars.

    Individual MA Pretax Margin
    double
    FY26

    Expected performance for the current fiscal year.

    Contingent Capital Facilities
    $1.5B
    Current

    Established to enhance access to low-cost, long-term liquidity.

    MA Plan Exits Impacted Members
    600,000
    FY27

    Anticipated number of members impacted by planned exits in 2027.

    IBNR Trend
    flatvs last quarter
    Q2 FY26

    IBNR remained flat from Q1, despite expectations for it to decrease as the year progresses due to faster processing of pharmacy claims. It is up significantly year-over-year and versus the beginning of the year, more so than membership.

    Industry KPIs

    7
    MetricValueDetails
    Utilization trendslower
    Stars rate environment10%%
    Client retention new winssignificant portion
    Pharmacy scripts specialtyhigh single-digit range or 7% to 8%%
    Membership covered lives by line600,000members
    Adjusted EPS EBITDA leverage guidance120bps
    Medical cost trend vs pricing assumptionhigh single-digit range or 7% to 8%%

    Deals & partnerships

    3
    GentivaDivestiture of minority interest$900 million

    Agreement to divest minority interest in Gentiva, valued at approximately $900 million.

    MaxHealthAcquisition

    Recent acquisition of MaxHealth, largely funded by the Gentiva divestiture.

    State of IllinoisStatewide Medicaid managed care contract

    Awarded a statewide Illinois Medicaid managed care contract, set to go live in January 2027. Humana was the only new entrant awarded.

    Risks & headwinds

    5
    Stars Outcome UncertaintyOctober (BY '28 results)

    cannot guarantee an outcome

    Mitigation: Strong operational progress and multiple paths to achieve PMPM Stars revenue target.

    MA Plan Exits Impact2027

    impact approximately 600,000 members

    Mitigation: Working to recapture a significant portion of impacted members (similar to 40% in 2025).

    Part D Premium Stabilization Program Sunsetend of 2026

    greater impact for members

    Mitigation: Planned for this possibility in the bid process; will protect members as best as possible.

    Drug Trend Accelerationnext year (2027)

    tick modestly higher

    Mitigation: Very focused on pricing for this risk in 2027 Part D bids.

    IBNR TrendQ2 FY26

    remained basically flat from last quarter

    Mitigation: Continuing to build prudent reserves; monitoring data closely.

    What to watch in Q3 FY26

    5

    BY '28 Stars Results

    October
    CurrentMeasurement period complete, strong operational progress noted
    TargetFinal data released by CMS

    Why it matters

    Stars ratings significantly impact MA revenue and competitive positioning, crucial for the 2028 margin goal.

    And while we do not intend to share this detail every year, we wanted to share today as it demonstrates that the operational changes and the investments we have made in our Stars program over the last 1.5 years are driving the intended results.

    Q&A highlights

    7

    Clarification on the expected margin improvement from 2027 bids towards the 2028 goal, and details on trend assumptions, including any conservatism.

    Management expects significant progress in 2027 towards the 2028 margin goal, but specific figures depend on final membership. Trend assumptions for 2027 are in line with 2026 (high single-digits), with drug trend expected to tick modestly higher. Bids include contingency for future movements.

    we do expect to make significant progress in '27 versus '26 and well on our path to 2028.

    asked by Justin Lake · answered by Celeste Mellet

    3 min read6 chapters

    Detailed Narrative

    01

    Stars Performance and Strategy

    Humana remains confident in achieving top quartile Stars results for Bonus Year '28, defining this as Stars revenue PMPM 10% above the peer group median. The company demonstrated significant operational progress, with the rate of improvement for 11 out of 12 de-identified HEDIS and patient safety metrics outpacing historical CAGRs. For BY '29, member engagement efforts have maintained momentum, with a 5% lead in quality improvement rate on a per-member basis in key HEDIS metrics at the end of Q2. New members are performing in line with or better than renewing members in terms of engagement.

    02

    Operating Model Transformation

    The company is actively transforming its operating model to be simpler, leaner, and faster, focusing on efficiency, innovation, and talent. Initiatives include centralizing operations like utilization management (11 markets into 1 team), expanding outsourcing in finance and HR, and optimizing vendor relationships in IT. These efforts have already yielded hundreds of millions of dollars in value in 2026, with further progress expected through continued simplification of infrastructure and processes.

    03

    2027 MA Bid Approach

    Humana's primary goal for 2027 MA bids is to make necessary margin progression to stay on track for its 2028 sustainable 3% pretax margin commitment. This will be driven by clinical excellence, operating efficiency, benefit adjustments, and targeted plan exits. Approximately 600,000 members are expected to be impacted by plan exits, primarily in lower-performing plans, with a goal to recapture a significant portion of this volume, similar to the 40% recapture rate in 2025. The strategy prioritizes retaining members in higher-value plans, particularly those with greater value-based care penetration.

    04

    Cost Trend Observations

    The company's 2026 cost trend assumption of high single-digits (7-8%) for medical and pharmacy remains in line with expectations. There has been slight favorability in the inpatient space, driven by both lower admits per 1,000 and lower unit costs. This favorability is more pronounced among members engaged with value-based providers, which management views as further evidence of stabilization in the MA trend environment. Drug trend is expected to tick modestly higher in 2027 due to the health technology pipeline.

    05

    Capital Allocation and Balance Sheet Efficiency

    Humana continues to enhance its balance sheet efficiency, including the establishment of $1.5 billion in contingent capital facilities using pre-capitalized trust securities (PCAPs), a first in the healthcare space. This provides low-cost, long-term liquidity without immediate balance sheet impact. The company also announced an agreement to divest its minority interest in Gentiva for approximately $900 million, which will largely fund the recent acquisition of MaxHealth. These actions reflect a prudent capital deployment approach focused on strengthening the balance sheet.

    06

    Medicaid Expansion and Board Appointments

    Humana is expanding its Medicaid platform, having been awarded a statewide Illinois Medicaid managed care contract set to go live in January 2027. This marks Humana as the only new entrant among five incumbents. Additionally, Paul Smith (Chief Commercial Officer at Anthropic) and Fred Crawford (former President and COO at Aflac) have been appointed to Humana's Board of Directors, bringing expertise in technology transitions, finance, and operations to support the company's journey as a consumer healthcare company.

    AI-generated summary of the company’s earnings call. Not investment advice.