Humana Invests In Medicare Choice Tool Healthpilot

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Dive Brief:

• Humana has made a minority investment in Healthpilot, a company that aims to help beneficiaries choose Medicare plans, the insurer said Wednesday. Financial terms of the deal weren’t disclosed.
• Healthpilot uses an artificial intelligence model to recommend Medicare Advantage, Medicare supplement and prescription drug plans based on enrollee information.
• Healthpilot will continue to recommend plans options from other payers following the investment, Humana said in the release. 

Dive Insight:

Picking and enrolling in a Medicare plan can be challenging for some beneficiaries, particularly for those under age 65 with disabilities, according to a survey published last fall by health policy research firm KFF. 

Twenty-three percent of respondents under 65 reported difficulties finding insurance to meet their needs, compared with 14% of beneficiaries surveyed over age 65.

That could be due to the number of coverage choices beneficiaries have to make, such as picking drug plans or deciding between traditional Medicare and Medicare Advantage, according to KFF.

Healthpilot, which was founded in 2020, aims to help beneficiaries pick plans based on their healthcare preferences and needs. It uses enrollee information, like their health profile, physician choices, cost preferences and medication utilization, to make plan recommendations to beneficiaries, according to a press release. 

“By leveraging Healthpilot’s advanced analytics and AI, beneficiaries can be paired with plans that best meet their needs, thereby enhancing their overall healthcare experience,” David Dintenfass, president of enterprise growth at Humana, said in a statement.

The investment comes as beneficiaries are increasingly choosing MA plans in lieu of traditional Medicare. MA, where the government pays private insurers to manage the care of Medicare beneficiaries, has also steadily grown in popularity over the past 16 years, enrolling more than half the eligible Medicare population last year. 

The program can be lucrative for insurers too. Humana, one of the largest MA payers in the country, said it would exit the employer-sponsored insurance market to focus on government plans early last year. 

Still, Humana and other insurers have recently faced turbulence in MA, including slowing growth and heightened medical costs, that hit their bottom lines

The insurer pulled its profit outlook for 2025 after reporting first-quarter results in late April, citing declining MA payment rates and other factors that created more uncertainty than usual. It reported increased revenue of $29.6 billion during the quarter, but net income fell to $741 million from $1.2 billion during the same period last year.

Humana will release second-quarter earnings on July 31.