DoD's $23.35B Humana Contract: Direct Health Insurance Carrier Services in Kentucky

Contract Overview

Contract Amount: $23,352,182,729 ($23.4B)

Contractor: Humana Government Business Inc

Awarding Agency: Department of Defense

Start Date: 2003-08-27

End Date: 2012-03-31

Contract Duration: 3,139 days

Daily Burn Rate: $7.4M/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 2

Pricing Type: COST PLUS INCENTIVE FEE

Sector: Healthcare

Place of Performance

Location: LOUISVILLE, JEFFERSON County, KENTUCKY, 40202

State: Kentucky Government Spending

Plain-Language Summary

Department of Defense obligated $23.35 billion to HUMANA GOVERNMENT BUSINESS INC for work described as: Key points: 1. Significant contract value of $23.35 billion over its duration. 2. Competition was full and open, suggesting a competitive bidding process. 3. Contract type is Cost Plus Incentive Fee, which can incentivize cost control but also carries risk. 4. The sector is direct health and medical insurance carriers, a critical area for government services.

Value Assessment

Rating: good

The contract value is substantial, and the Cost Plus Incentive Fee structure aims to balance cost and performance. Benchmarking against similar large-scale health insurance contracts would be necessary for a precise value assessment.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

Full and open competition was utilized, which typically leads to better price discovery and potentially lower costs for the government. The existence of multiple bidders would have driven competitive pricing.

Taxpayer Impact: The competitive nature of this contract likely resulted in favorable pricing for taxpayers, although the Cost Plus Incentive Fee structure requires careful monitoring to ensure efficiency.

Public Impact

Ensures healthcare coverage for military personnel and their families. Impacts the healthcare industry and insurance providers in Kentucky. Represents a significant portion of the Defense Health Agency's budget for medical insurance.

Waste & Efficiency Indicators

Waste Risk Score: 75 / 10

Warning Flags

Positive Signals

Sector Analysis

This contract falls within the Healthcare sector, specifically direct health and medical insurance carriers. Spending in this area is substantial government-wide, supporting millions of beneficiaries. Benchmarks would focus on per-member-per-month costs for similar government health plans.

Small Business Impact

The data indicates this contract was not awarded to small businesses, as the 'sb' field is false. Large prime contractors often subcontract to small businesses, but direct award analysis shows no small business participation at the prime level.

Oversight & Accountability

The contract's long duration and Cost Plus Incentive Fee structure necessitate strong oversight from the Defense Health Agency to ensure performance standards are met and costs are managed effectively. Audits and performance reviews would be key accountability mechanisms.

Related Government Programs

Risk Flags

Tags

direct-health-and-medical-insurance-carr, department-of-defense, ky, definitive-contract, billion-dollar

Frequently Asked Questions

What is this federal contract paying for?

Department of Defense awarded $23.35 billion to HUMANA GOVERNMENT BUSINESS INC. See the official description on USAspending.

Who is the contractor on this award?

The obligated recipient is HUMANA GOVERNMENT BUSINESS INC.

Which agency awarded this contract?

Awarding agency: Department of Defense (Defense Health Agency).

What is the total obligated amount?

The obligated amount is $23.35 billion.

What is the period of performance?

Start: 2003-08-27. End: 2012-03-31.

What was the average per-member-per-month cost under this contract compared to other TRICARE regions or private insurance benchmarks?

Determining the exact per-member-per-month cost requires access to detailed financial data and beneficiary enrollment numbers. However, comparing this to other TRICARE contracts and private insurance plans would reveal if the $23.35 billion expenditure provided competitive value for the services rendered. Variations in healthcare needs and regional costs can influence these figures.

How effectively did the Cost Plus Incentive Fee structure incentivize Humana to control costs while maintaining service quality?

The effectiveness of the CPIF structure hinges on the specific incentive targets and the agency's oversight. If targets were well-defined and achievable, it could have driven efficiency. However, without detailed performance reports and cost variance analysis, it's difficult to definitively assess its success in controlling costs versus the potential for scope creep or inflated expenses.

What was the impact of this contract on the availability and quality of healthcare services for beneficiaries in Kentucky?

This contract was crucial for providing direct health and medical insurance services to a significant population in Kentucky. Its long duration suggests a sustained impact. Evaluating the impact would involve analyzing beneficiary satisfaction surveys, network adequacy, access to care metrics, and overall healthcare outcomes within the region covered by Humana.

Industry Classification

NAICS: Finance and InsuranceInsurance CarriersDirect Health and Medical Insurance Carriers

Product/Service Code: MEDICAL SERVICESGENERAL HEALTH CARE SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Offers Received: 2

Pricing Type: COST PLUS INCENTIVE FEE (V)

Evaluated Preference: NONE

Contractor Details

Parent Company: Humana Inc.

Address: 500 W MAIN ST STE 300, LOUISVILLE, KY, 40202

Business Categories: Category Business, Not Designated a Small Business

Financial Breakdown

Contract Ceiling: $19,971,859,454

Exercised Options: $18,804,312,452

Current Obligation: $23,352,182,729

Contract Characteristics

Commercial Item: COMMERCIAL ITEM PROCEDURES NOT USED

Cost or Pricing Data: NO

Timeline

Start Date: 2003-08-27

Current End Date: 2012-03-31

Potential End Date: 2018-11-21 00:00:00

Last Modified: 2022-05-27

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