Robert Himmelsbach, President, Florida Medicare, Humana

Invest: spoke with Robert Himmelsbach, president of Florida Medicare at Humana, about how the company is navigating a fast-changing Medicare landscape in its largest state. He discussed Florida’s growth past 1 million Medicare members, the importance of local decision-making, and how preventative care, value-based models, and simplification are shaping Humana’s approach statewide. “Our goal is to make sure that members can live their healthiest life,” Himmelsbach said.

Over the past year, what changes impacted Humana’s Medicare operations in Florida, and in what ways?

Florida is Humana’s largest Medicare state, and we’ve been doing Medicare here for 41 years. Just this past September, we surpassed 1 million Medicare members in Florida. That tells me a lot about what people think of Humana in the state. People trust us. Even in areas where maybe the coverage isn’t the richest, people still choose Humana. We try to be as stable as possible with our benefits and our networks, and we work hard to bring high-quality physicians into those networks.

One thing that’s unique about Humana is that most, if not all, of our operators and decision-makers serving Florida live right here in Florida. A lot of payers make decisions about Florida from far away. That’s not what we do. Our teams live here, work here, and serve their own communities. That makes the work very personal, because these are the people we live alongside every day.

How have member preferences shifted, and how is Humana adapting its approach?

Some of that is driven by CMS and what’s allowed under regulation. A good example is food cards. We were the first payer to launch food cards in the market, and now most plans offer something similar.

But regardless of regulation, our goal never changes. Our goal is to make sure that members can live their healthiest lives. That’s also what members want. Everything we do, whether it’s network design, benefits, or partnerships with providers, points back to that.

One thing I’m especially proud of in Florida is that we have a plan in every county. Many payers focus only on select geographies. We cover the entire state because we have members everywhere who need coverage.

What role does Humana play in shaping the future of healthcare delivery across the state?

We play a significant role. Humana is a trusted name, and that trust matters. I was recently in Tallahassee, and policymakers there share the same goals we do. We are stewards of Medicare dollars that everyone pays into, and we take that responsibility seriously.

Our job is to use those dollars wisely to help members get the care they need and live healthier lives.

Many barriers to better outcomes exist outside the clinical setting. How is Humana addressing non-clinical challenges?

At the end of the day, many of those challenges still impact clinical outcomes. Mental health, food insecurity, transportation, and access to community resources all matter.

Because our teams are based in Florida, we’re able to work directly with local vendors, food banks, veteran organizations, and community partners. We’re not just improving outcomes for members. We’re strengthening the communities we live in.

Value-based care continues to gain momentum. How is Humana advancing value-based and integrated care models?

A large majority of our Medicare members in Florida are already in value-based care arrangements. In fact, we’ve had some form of value-based care here for decades. I’ll meet providers who tell me they’ve been under contract with Humana for 30 years.

Preventive care is the foundation. To help people live their healthiest lives, you need strong primary care relationships upfront. Value-based care allows us to align incentives so providers and Humana are rowing in the same direction.

Sometimes, providers bring ideas to the table. Sometimes we do. Either way, we’re jointly accountable for member outcomes. When you look at the metrics, value-based care delivers healthier results because more people are invested in the member’s success.

What trends are most impactful right now?

The digital space is a big one. Some members are very comfortable navigating online plan selection, while others prefer working with an agent. We support both.

Simplification is another major focus. Medicare can be incredibly complex. I’ve been doing this for 18 years, and I still learn something new all the time. For someone newly eligible, it can be overwhelming. We’re working to simplify plan design and communication so members better understand their options. Technology plays a big role in that.

AI is another area we’re exploring carefully. This isn’t about replacing people or having machines make healthcare decisions. It’s about supporting care teams. A member’s chart can be hundreds of pages long. AI can quickly surface key information so clinicians can focus on managing care.

We constantly gather feedback from members about their experience selecting and using plans, and we apply that insight to future plan years. If something doesn’t work, we adjust. We’re very agile in that space.

Covering every county also requires a strong infrastructure. Florida is a highly mobile state. Members move frequently, so we need provider, transportation, and vendor networks that can support them wherever they go.

How do partnerships with healthcare systems support your strategy?

We’re working with a large hospital system that asked a simple but important question: How do we get doctors back to being doctors? Many physicians spend enormous amounts of time on paperwork related to referrals, authorizations, and admissions. We’re close to finalizing an agreement that would reduce that burden and allow physicians to spend more time with patients.

That focus on simplification and working at the top of one’s license is critical. We want physicians caring for members, not stuck behind a computer. Once this model proves successful, I expect more systems to follow.

What are your key priorities for Medicare Advantage in Florida over the next two to three years?

I want the same thing our members want. I want them to live their healthiest lives. That means preventative care, screenings, and receiving care in the right setting at the right time.

Growth is important, and we’re proud of it, but it’s equally important to take care of the members who have already chosen Humana. They need access to doctors, clear information about their benefits, and confidence that they can reach us when they need help.

I want members to feel comfortable choosing Humana and confident that we’ll do everything we can to support them. That’s the goal now and going forward.

Is there anything else you would like to add?

One pilot I’m excited about involves placing on-site Humana nurses in hospitals. When a member is admitted, our nurse meets with them, helps coordinate post-discharge care, and ensures they understand their benefits.

Many members don’t realize what support is available to them. Having someone guide them before they leave the hospital can make a big difference in outcomes. We’re piloting this in four hospitals and would love to expand it statewide.