Michael B. McCallister - President and Chief Executive Officer
Analyst · JP Morgan. You have the floor
Good morning, everyone and thank you for joining us. As we announced in our new release this morning, for the third quarter, Humana, again, posted favorable results $1.78 per diluted share, significantly above our previous guidance for the quarter of $1.45 to a $1.50. EPS includes $0.25 per share associated with certain positive developments specifically related to 2006, which are not expected to return future periods. In additional $0.05 per share, above our expectations was due to better than anticipated ongoing operational results in both our commercial operations and our standalone Medicare Prescription Drug Plans or PDPs. These later developments are forecast to positively reflect fourth quarter 2007 and full year of 2008 results. Excluding the $0.25 per share that is unique to 2006, our third quarter earnings per share are up 61% over the $0.95 per share we earned in the third quarter of the prior year, with much of that increase coming from higher average Medicare membership year-over-year and continued growth in our commercial segment earnings. In addition to these favorable financial results, we achieved the number of milestones since our last earnings call. In late September, we received approval; from centers of Medicare and Medicaid Services, CMS, to resume marketing of our individual private fee-for-service plans in late September. We remain on track to achieve our 2007 membership targets and are well position for 2008. During the quarter, we signed a definitive agreement to acquire KMG America, a group in voluntary insurance benefits and third party administration company, with more than 1 million members. This acquisition broadens and diversifies our commercial portfolio and is forecast to be slightly accretive in 2008. Additionally, we recently closed on our acquisition of CompBenefits, an Atlanta base company with 2.3 million dental and 2.5 million vision members nationwide. It is also expected to be accretive in 2008. In early October, we received pharmacy benefit management accreditation from URAC, the gold standard for independent expert validation to the Company’s pharmacy management organization meets rigorous quality standards for consumer protection and empowerment. Overseas London based Humana Europe was chosen by the United Kingdom’s Department of Health to implement strategies at local level to enhance station experience and proved clinical outcomes and reduced costs. Finally, also in early October, Humana’s new veterans health unit was awarded the Department of Veterans Affairs first ever specialty network demonstration contract known as Project HERO for healthcare effectiveness to resource optimization. Our selection, over six competitors has strategic significance for 2008 and beyond. It positions Humana is the sole contractors that can offer TRICARE network discounts to the VA and these test geographies. 12 year validates the 11 years success of our Military line of business and suggests that as the VA returns increasingly to the private sectors to meet veterans long-term help needs, Humana will be active partner. Let me show you the VA demonstration in more depth. The four circle numbers on this slide represent the areas that makeup the initial Project HERO demonstration areas. Humana was successful in being awarded all four of these regions. As you can see two of them, 8 and 16 have obvious synergies with our existing TRICARE South region. The VA like Medicare represents a growing market in health benefits. To give you some sense of the scale of VA spending, the VA has requested $27 billion for medical services in its proposed budget for the upcoming fiscal year. While, it is difficult to say what portion of the spending might ultimately be contracted to the private sector, Humana’s well positioned to serve our nations veterans. Leveraging our existing government and commercial provider networks to bring Humana's proven techniques for lower cost and superior health plan experience to hundreds of thousands of individuals. Now, let’s look to the future. We are, again, at difficult time for our industry, facing multiple calls to increase wellness, reduce crushing healthcare costs, and find ways to solve the needs of the uninsured. Recent high profile union negotiations highlight just how difficult the issue of funding health benefits is. But our efforts over the past 12 months have brought greater clarity on a variety of important topics, including more future growth in the industry will come from and further validation of the power of the consumer to approve wellness and reduce expenses. Thus, I would like to spend a few moments discussing why we are convinced Humana’s one of the best-positioned companies to succeed in health benefits in 2008 and beyond. In Medicare, we are forecasting net Medicare Advantage membership growth of approximately 20% for 2008. We will continue our evolution from the concentrated membership gains we achieved in 2006 and 2007, to more regular month in, month out growth, through age-ins, group Medicare, and special needs plans. CMS has approved new plans in market expansions in many states, and all of our multiple distribution channels, web, telephonic, company agent, independent agent, and alliance partners are well prepared for the beginning of the 2008 enrollment season on November 15, something I will discuss in more depth in a few moments. In our commercial segment, we foresee continued pricing discipline and further expansion of our pretax margin. Our portfolio migration strategy has been successful and our book of business will approach its desired balance in 2008. ASO, small group, individual, and consumer plans continue to be our areas of strategic focus. Next year, we will also see expanded contributions from KMG and CompBenefits product offerings. The specialty company acquisitions are expected to increase our commercial margins over time as well as enhance our ability to appeal to broad and diverse sector customers. In TRICARE, while we still await the Department of Defense’s release of a request for proposal for the next contract period, we anticipate success in maintaining our South region business. Bidding along undoubtedly be keen, but with our history of excellent service delivery and our knowledge of military families’ health needs, we believe we are very well positioned to win. TRICARE continues to be a good operational performer for the military community in the south region has solid financial performer for our Company. 2008, we will also see the start of the Project HERO demonstration contract on January 1st. We expect that the slowly ramp-up throughout the year with some earnings accretion as the year progresses. We believe each of the components of the operational momentum I have just described will result in continue progress in our 2008 earnings. Earnings per share for 2008 forecast to be in a range of $5.30 to $5.50, up 10% to 16% when compared to 2007 EPS, or 16% to 22% excluding the 25% share… $0.25 per share in the third quarter, items we do not anticipate to recur in future periods. I will now take a closer look on our Medicare and commercial business segments. Turning in more detail, first the Medicare, three points stand out. First, giving the aging in the baby boomers, Medicare continues to show that it is the best near-term opportunity for significant growth in our industry. Through our Medicare leaders in 1980’s and the 1990’s and we are standing our leadership, we only, what I can tell there is 21st century Medicare. Our more sophisticated and organized programs that drives better results and value. Second, we continue to see Medicare’s as solid example of how the insurance industry can work with government to improve consumers’ health outcomes while reducing their expenses. Moreover, surveys continue to shows senior’s satisfaction with Medicare Advantage and PDP offerings in the neighborhood of 90%. And finally, our increased market penetration due to Medicare expansion is open doors and enhancing our commercial provider networks, supplementing the advantages we gained in intensive operational discipline in that segment as well. Medicare was not just a near-term growth opportunity, it will be a growth opportunity for many years to come. That opportunity stems from a number of long-term cost drivers that show no sign of slowing. Coupling these factors with one at the top of the list, an aging population, increases the opportunities for those companies they can present and execute on the solution for the Medicare Trust Fund. We believe and MedPAC is taking similar view and its report to Congress, but the current methodology for funding Medicare today is not sustainable, but over time. Not only our baby boomers aging into a Medicare program, people are living longer as well. There is simply no parallel phenomena and anywhere else in the health benefits universe today. As this chart shows, the pace of aging instructor accelerate dramatically in a few years. As I said earlier, Medicare is an area that as time goes on bodes well for companies like Humana that have a strong head start and a wide variety of product offerings. Seniors are knowledgeable consumers and varying needs from the healthiest and most agile to most vulnerable. Companies with have over time carefully researched and deeply understood Medicare beneficiaries’ needs are the ones emerging as leaders, placing every greater distance between themselves and late entrance competitors. We have always rejected that the one size fits all notion of Medicare market, which is an important element of our long-term Medicare success. Moreover initial outcomes research indicates the tools and techniques that we have successfully developed for our commercial membership base to their positive implications from Medicare. To understand why, it’s important for us to recognize that Medicare is in the state of evolution. From its creation in 1965 to the MMA in 2003, Medicare only paid claims and policed fraud. Over time is the preponderance of episodic diseases gave away through breakthrough surgical and pharmaceutical advances, to today’s prevalence of far more costly long-term chronic conditions, the program has been forced to adjust, 20% through Medicare to their private sectors emphasis on wellbeing and chronic disease management rather than episodic sickness includes a number of tools and techniques that have already shown their effectiveness in lowering costs and advancing wellness for employers and employees. These include care coordination, effective network contracting, catastrophic case management, health improvement and prevention programs and data mining to understand and anticipate Medicare member needs. Our overall strategy for success in the evolution of Medicare is simple, but long-term in its implementation. After the passage of the 2003 Medicare Modernization Act, we set up to rapidly expand our Medicare membership by establishing relationships with Medicare beneficiaries before most of the competitions. Our members are entrusting us with the significant aspect they realize. We want to nurture and sustain those relationships long into the future, through continuing the provide tools and techniques to help lower costs through exemplary service and through member who share their experience with others. We also note that the delivered real customer value, we need to support Medicare members and managing their health and wellbeing, which includes guiding them on using care wisely and pointing out ways they can save money. We continue to build an infrastructure around our guidance proposition, which is distinct… that distinguishes support our members received versus original Medicare. I have already referenced our focus on provider relationships and we continue our successful product development through our network base products. This strategy is designed to follow up our initial enrollment success with a strong focus and commitment to where we believe the future market exists. Let me take you little deeper and how we support our members desired to improve their health status what we will call they are wellbeing. This slide illustrates care coordination as of one example the multiple ways consumer focus techniques work for Medicare members. Humana’s Medicare clinical team deploys an affective combination of high-tech, high-touch report to keep people healthier while producing better outcomes in cost savings for members and for society. When adjusted for severity and demographics, 2006 data shows Humana private fee-for-service members experienced the 6% decrease in hospital visits and a 21% decrease in emergency room visits compared with original Medicare. A highlight private fee-for-service statistics in part, because private fee-for-service sometimes characterizes as a non-managed product. It’s important to know the Humana private fee-for-service members benefit the vast majority of our programs to enhance wellbeing just as PPO and HMO members do. This is an aspect that we make part of the value proposition for all Medicare Advantage offerings. Let’s look at how we are performing with respect of achieving the goal of having Medicare beneficiaries use care more effectively. The recent study summarize on this slide based on the latest available data, indicates our Medicare Advantage plans are shown the shift in healthcare utilization toward more preventive and home care, which reduces cost for the average Humana Medicare Advantage member. It’s clear that people appreciate this help. Members in our medical advantage plans have the right to vote with their feet, yet, they choose to stay. Less than 1% of members who leave our Medicare Advantage plan and go back to original Medicare. As for Medicare Advantages as a whole the survey by America’s health insurance plans earlier this year reported the satisfaction rate of 90% for Medicare Advantage members nationwide. When we look at all this programs impact chronically ill patients the results are even more impressive. Wellness dramatically improves, visits to the doctor or to the hospital decreased, and the cost of the system is significantly reduced. Note in particular the rise in home health visits. Again, our goal is to play closer attention to the member by investing in the appropriate infrastructure needed to allow all of our members to access the clinical guidance tools and technique, ensuring individual get the best results both clinically and financially from the program. As we prepare for the influx of age 65 Medicare beneficiary who are familiar with network based products from their working lines, we began expanding our contractual relationships with hospital, doctors, and other health care service providers. We are well positioned to serve members using these products and we will continue to expand our geographic reach to serve more of them in the future. We have been committed to the broad availability of PPO products and quickly established an expansive regional PPO network when net product was created as the part of the MMA. In fact, 80 % of our private fee-for-service members within areas where they have easy access to our PPO networks. In terms of sales, we expect Medicare Advantage gross sales to rise significantly in 2008, increasingly driven age-ins, employer group retiree sales, members choosing to upgrade and not least our own growing understanding of how best to succeed in this retail environment. We are pleased with the fast start we had in 2006. As other plans began to enter the market fully in 2007, it brought competition around more aggressive plans benefits and premiums. We evaluate our competitive position for 2008 and believe we are now in it environment of greater stability. This together with our attractive 2008 benefit offerings is expected to lead a higher gross sales and lower membership attrition. Turning to the membership growth. Medicare Advantage membership for 2008 is expected to experience net growth of approximately 200,000 to 250,000 almost double the member last year. This will be driven by a mix of market expansion, product expansion, and improve benefit design. For example, in our HMO business, we have opened new markets in Denver Salt Lake City, Tucson, Dallas, and Alexandria, Louisiana. In our, PPO product, additional membership and experience developed over the past year, gave us the data we needed to validate a change in the benefit design to more closely match that offered in our private pay-for-service products. As you can see from the chart, over time, our membership in PPO plans is projected to increase as the number of age-ins continue to grow as our new plan benefits find traction in the market. In our standalone PDP offerings, we anticipate maintaining the leading membership position even with the projected net decline in membership of about 300,000 from the current total of 3.5 million. It’s worth noting that we may benefit greatly this year from reconfiguration of the Medicare.gov website where millions of seniors turns guidance on plan selection. While in the last two years, the plans were ranked according to premium cost, for 2008, the ranking is based on total projected out of pocket expenses where Humana compares quite favorably with the competition. In my frequent visits on the Capital Hill over the past few months, a number of important aspects on Medicare debate have become clear. First, the Medicare Advantage funding cuts past in the house version of the CHAMP Bill are not in sync with the benefits of Medicare beneficiaries. They do not want there benefits cut, they like having options, particularly for rural minority and low income beneficiaries and their voices are getting through the members of Congress. Over the next few months, I am confident that Congress will listen to its constituents' voices. Second, Humana continues to concentrate its effort on operational excellence to ensure we deliver value and improve services to members. Third, mounting evidence indicates that Medicare Advantage with its inherent cost saving attributes, represents part of a long-term solution to Medicare’s projected budgetary dilemma. Without some formal rationalization, the Medicare program is headed for bankruptcy. And finally, coordinated care programs will have an increasingly favorable impact on the Trust Fund's solvency as they reduce unnecessary utilization and produce better health outcomes for seniors as preliminary data shows. I will now turn now to our commercial segment. As our Medicare footprint has grown, we have expanded our commercial operations as well. Today, the commercial segment actively sells in more than 17 states in Puerto Rico. Recent expansion into Utah, Mississippi, Tennessee, Georgia, and Colorado, and other areas have leveraged our nation-wide Medicare footprint to open new and attractive commercial opportunities. In some instances, Medicare has been directly responsible for these opportunities. In others, we have been able to undertake Greenfield commercial expansions. We also began negotiating with hospital systems in major non-Humana cities with a differentiated approach to entering new markets. In the course of these discussions, we have heard many systems say they derive no real benefit from offering different rates to different carriers, and are seeking win-win alternative. As a result, we are moving the discussion from contentious haggling over prices, the traditional commodity bases for negotiations to explore a non-commodity partnerships based on value added administrative services that Humana can now offer. This represents some innovative approach to breaking down historical barriers to entry and ending anti-consumer most favored nation discounting. We will keep you informed of the effort as it goes forward. For 2008, we foresee continued pricing discipline, further expansion of our pretax margin, and more progress in our ongoing effort to migrate our book of business to a balanced and consumer oriented membership portfolio. ASO, small group, individual, and consumer plans continued to be our area of strategic focus. Over the past five years, our ASO block has grown from 22% of our commercial membership to comprise nearly half of our membership today. We believe the ASO business offers greater earnings consistency than large account fully insured business as well as driving important volumes through the provider network. Consumer planned membership has grown from a negligible percentage of our block in 2002 to more than 18% today. Consumer plans remain a differentiator for Humana in the marketplace with proven savings results for our group and individual customers. On October 1, we closed the acquisition of CompBenefits. The addition of CompBenefits creates a combined specialty products business with more than $700 million in annual revenue and more than 6 million covered members. The acquisition expansion had a specialty product continuum by adding dental HMO product options in addition to an established vision product line. Since our specialty offerings are becoming a major strategic direction for us. I will take a few moments to outline the significant of our KMG acquisition. The market trends box shows that voluntary benefits are our growth industry. Both quantitatively in terms of our forecasted 5% to 7% annual growth rate over the next few years, and qualitatively, based on employers increasing willingness to offer these benefits. They are generally paid for by consumers, not employers, and as such did well with our larger consumer strategy. They were an extension of our core health benefits portfolio and create deeper relationships with our members. Finally, KMG brings Humana management team with expertise in product design, pricing, underwriting, and marketing voluntary and supplemental products. I would like to close with some thoughts I would shared with you at our Investor Day in New York last fall. Our success over the last 12 months has already confirmed our commitment to the principles we shared then, which might be described as a roadmap for health benefits leadership in the 21st century. These elements of the successful strategy all revolve around the ideal of thinking differently and embracing the difference. For the sake of time, I won’t read out each of these elements. They will set to win, they was in the slide. And although, we would argue that Humana’s passion for the consumer and our zest for maximizing the power of data are, but two of the many elements that are winning health benefits Company our associates book us on daily. This is something else you have seen before but also worth revisiting. In a way everything I discuss with you today goes back to this diagram. Humana's commitment to consumerism first set forth seven years ago remains unchanged. The only thing that’s changed is that for the four integrated circles above Humana is far more populated with tool, capabilities, and programs and they were at the start. We are thoroughly convinced and growing body of evidence bears it up that given actually more information consumers are just as able to seek and find value in healthcare as they are in the rest of their purchasing lives. By offering guidance at all points of the choose finance and use equation, Humana empowers consumers to maximize their power as drivers of two-thirds of the U.S. economy and make confident successful healthcare decisions for themselves and their families. In summary, as we look at 2008 and beyond, we believe Humana’s poised to continuous industry growth leadership strong execution based on keen understanding of consumers and a long-term strategy to meet the health cost and quality of life challenges our nation faces today are the key to our continued success. We view government has an essential element in a multifaceted solution to the country’s healthcare problems. While political debate often creates ways on Wall Street, our strategic commitment to comprehensive consumerism and the ability that gives us to respond effectively to new circumstances position us well for ongoing success in today's changing environment. With that, I will turn the call over to Jim Bloem.