Humana (HUM) risk factors, FY2025 10-K

Risks Relating to Our Business

1. 01on our ability to appropriately manage health care costs through, among other things, the application of medical management programs such as our chronic care management program
2. 02Failure to adequately price our products or estimate sufficient benefits payable or effectively manage our operating expenses, may result in a material adverse effect on our results of operations, financial position, and cash flows
3. 03solutions, primary care, and home solutions businesses, and the successful implementation of our integrated care delivery model
4. 04If we fail to properly maintain the integrity of our data, to strategically maintain existing or implement new information systems (including systems powered by or incorporating AI/ML), or to protect our proprietary rights to our systems, our business may be materially adversely affected
5. 05We are involved in various legal actions and governmental and internal investigations, any of which, if resolved unfavorably to us, could result in substantial monetary damages or changes in our business practices. Increased litigation and negative publicity could increase our cost of doing business
6. 06In some cases, substantial non-economic or punitive damages as well as treble damages under the federal False Claims Act, Racketeer Influenced and Corrupt Organizations Act and other statutes may be sought
7. 07As a government contractor, we are exposed to risks that may materially adversely affect our business or our willingness or ability to participate in government health care programs74% rewritten
8. 08the requirements of the Social Security Act, which, if not implemented correctly could have a material adverse effect on our results of operations, financial position, or cash flows
9. 09New Laws or Regulations, or Future Legislative, Judicial or Regulatory Changes64% rewritten
10. 10Medicare payment rates and increasing our expenses associated with assessments); our financial position (including our ability to maintain the value of our goodwill); and our cash flowsNew
11. 11Corporate Practice of Medicine and Other Laws
12. 12Anti-Kickback, Physician Self-Referral, and Other Fraud and Abuse Laws
13. 13State Regulation of our Products and Services
14. 14Any failure by us to manage acquisitions, divestitures and other significant transactions successfully may have a material adverse effect on our results of operations, financial position, and cash flows
15. 15If we fail to develop and maintain satisfactory relationships with the providers of care to our members, our business may be adversely affected38% rewritten
16. 16We face significant competition in attracting and retaining talented employees. Further, managing succession for, and retention of, key executives is critical to our success, and our failure to do so could adversely affect our businesses, operating results and/or future performance
17. 17Our in-house dispensing pharmacy business competes with locally owned drugstores, retail drugstore chains, supermarkets, discount retailers, membership clubs, internet companies and other mail-order and long-term care pharmacies
18. 18Changes in the prescription drug industry pricing benchmarks may adversely affect our financial performance
19. 19Our ability to obtain funds from certain of our licensed subsidiaries is restricted by state insurance regulations
20. 20Downgrades in our debt ratings, should they occur, may adversely affect our business, results of operations, and financial condition
21. 21Volatility or disruption in the securities and credit markets, including changes in interest rates, may significantly and adversely affect the value of our investment portfolio and the investment income that we derive from this portfolio