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1月前
CENTENE CORPORATION REPORTS FIRST QUARTER 2026 RESULTSApril 28, 2026 6:00 AM
PR Newswire (US)
-- First Quarter GAAP Diluted Earnings Per Share of $3.11; Adjusted Diluted Earnings Per Share of $3.37 ---- Increases 2026 GAAP Diluted EPS Guidance to Greater than $2.37 & Adjusted Diluted EPS to Greater than $3.40 --Strong first quarter 2026 adjusted diluted EPS of $3.37, approximately $0.50 better than our expectations.Medicaid HBR of 93.1%, reflecting continued tangible progress managing medical costs coupled with moderate flu.Medicare segment HBR of 84.9%, from outperformance in both Medicare Advantage and PDP.Commercial HBR of 75.3%, slightly above expectations, primarily reflecting higher acuity among Marketplace Silver Tier members prior to anticipated future 2026 net risk adjustment benefit. Marketplace pre-tax earnings for Q1 were in-line with expectations inclusive of favorable SG&A.$1.0 billion of debt reduction during the first quarter 2026. ST. LOUIS, April 28, 2026 /PRNewswire/ -- Centene Corporation (NYSE: CNC) (the Company) announced today its financial results for the first quarter ended March 31, 2026. In summary, the 2026 first quarter results were as follows:
Total revenues (in millions)$ 49,944
Premium and service revenues (in millions)$ 44,655
Health benefits ratio87.3 %
SG&A expense ratio7.6 %
Adjusted SG&A expense ratio (1)7.6 %
GAAP diluted earnings per share$ 3.11
Adjusted diluted earnings per share (1)$ 3.37
Total cash flow provided by operations (in millions)$ 4,366
(1)Represents a non-GAAP financial measure. A full reconciliation of the adjusted diluted earnings per share (EPS) and adjusted selling, general and administrative (SG&A) expenses is shown in the Non-GAAP Financial Presentation section of this release."We continue to make tangible progress in our margin recovery efforts while strengthening the fundamental operations of each of our businesses," said Chief Executive Officer of Centene, Sarah M. London. "Our strong first quarter results position us to increase our full year 2026 adjusted diluted EPS guidance to greater than $3.40. We remain confident in the long-term earnings power of the enterprise and motivated by the positive and lasting impact we can deliver for the families and communities we serve."Awards & Community EngagementIn March, the Centene Foundation and Carolina Complete Health, a Centene subsidiary, announced their investment in and groundbreaking of the Northeast Winston-Salem Choice Neighborhood Initiative. In partnership with McCormack Baron Salazar, the investment will help rebuild 244 affordable housing units and connect residents to essential healthcare and address community needs.In March, the Centene Foundation and WellCare of Kentucky, a Centene subsidiary, launched the WellCare Food is Medicine Program to address diabetes-related needs in rural Kentucky. The program will provide eligible Medicaid enrollees with diabetes access to weekly home-delivered, medically tailored meals, recipes, and educational materials for up to three years.In February, Buckeye Health Plan, a Centene subsidiary, announced awards to six Ohio healthcare providers under the Provider Accessibility Initiative, a program supported by the National Council on Independent Living's Barrier Removal Fund. The funding will be used to purchase equipment to support patients with disabilities and make ADA-compliant improvements to provider facilities, such as handrails, wheelchair ramps, and sliding doors.In January, Centene was named one of the World's Most Admired Companies™ by Fortune® for the eighth consecutive year. The distinction was determined based on Centene's quality of management and products, social responsibility, ability to attract talent, and more.MembershipThe following table sets forth membership by line of business:
March 31,
2026
2025Traditional Medicaid (1)10,923,100
11,369,400High Acuity Medicaid (2)1,503,800
1,589,400Total Medicaid12,426,900
12,958,800Marketplace3,582,200
5,626,000Individual and Commercial Group (3)481,000
448,200Total Commercial4,063,200
6,074,200Medicare (4)1,002,200
1,043,200Medicare Prescription Drug Plan (PDP)8,780,600
7,867,800Total at-risk membership26,272,900
27,944,000
(1)Membership includes Temporary Assistance for Needy Families (TANF), Medicaid Expansion, Children's Health Insurance Program (CHIP), Foster Care, and Behavioral Health.(2)Membership includes Aged, Blind, or Disabled (ABD), Intellectual and Developmental Disabilities (IDD), Long-Term Services and Supports (LTSS), and Medicare-Medicaid Plans (MMP) Duals. The Company operated MMPs through December 31, 2025. In 2026 these members are included in Medicare as a result of the Centers for Medicare and Medicaid Services (CMS) transition to Dual Eligible Special Needs Plans (D-SNP) based integration.(3)Membership includes Commercial Group, Individual Coverage Health Reimbursement Arrangement (ICHRA) and Other Off-Exchange Individual.(4)Membership includes Medicare Advantage, Medicare Supplement, and Applicable Integrated Plans (AIPs) as a result of the CMS transition to D-SNP based integration in 2026.Premium and Service RevenuesThe following table sets forth supplemental revenue information ($ in millions):
Three Months Ended March 31,
2026
2025
% ChangeMedicaid$ 23,596
$ 22,299
6 %Commercial9,556
10,149
(6) %Medicare (1)10,326
8,759
18 %Other1,177
1,282
(8) %Total premium and service revenues$ 44,655
$ 42,489
5 %
(1)Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.Statement of Operations: Three Months Ended March 31, 2026For the first quarter of 2026, premium and service revenues increased 5% to $44.7 billion from $42.5 billion in the comparable period of 2025. The increase was primarily driven by premium yield and membership growth in the PDP business, state-directed payments, and rate increases to address medical trend in the Medicaid business, partially offset by lower Marketplace and Medicaid membership.Health benefits ratio (HBR) of 87.3% for the first quarter of 2026 represents a decrease from 87.5% in the comparable period in 2025. The Medicaid HBR decreased by 50 basis points primarily driven by rate and revenue increases, continued tangible progress in managing medical costs and moderate flu costs. The consolidated HBR decrease was also driven by an increase to the premium deficiency reserve (PDR) in 2025 versus no PDR in 2026 for our Medicare Advantage business as a result of our progression towards profitability. The decreases were partially offset by the decline in Marketplace membership and the corresponding impact on consolidated member mix.The SG&A expense ratio was 7.6% for the first quarter of 2026, compared to 7.9% in the first quarter of 2025. The adjusted SG&A expense ratio was 7.6% for the first quarter of 2026, compared to 7.9% in the first quarter of 2025. The decreases were primarily driven by strong cost management, leveraging of expenses over higher revenues and reduced Marketplace membership, which operates at a meaningfully higher SG&A expense ratio, as well as overall discipline in Marketplace SG&A. The decreases were also driven by growth in the PDP business, which operates at a meaningfully lower SG&A expense ratio as compared to the overall company.The effective tax rate was 26.7% for the first quarter of 2026, compared to 24.7% in the first quarter of 2025. For the first quarter of 2026, our effective tax rate on adjusted earnings was 26.5%, compared to 24.7% in the first quarter of 2025.GAAP diluted EPS of $3.11 for the first quarter of 2026.Adjusted diluted EPS of $3.37 for the first quarter of 2026.Cash flow provided by operations for the first quarter of 2026 was $4.4 billion, primarily driven by net earnings, the partial sale of the 2025 CMS PDP receivables, and the temporary benefit of the timing of payments, partially offset by the establishment of 2026 CMS PDP receivables and a delay in premium payments from one of our state partners subsequently received in April 2026.Balance SheetAt March 31, 2026, the Company had cash, investments and restricted deposits of $41.8 billion and maintained $437 million of cash available for general corporate use. Medical claims liabilities totaled $20.6 billion. The Company's days in claims payable (DCP) was 48 days, an increase of two days as compared to the fourth quarter of 2025.During the first quarter of 2026, the Company sold a participating interest of $1.0 billion of 2025 plan year stand-alone Part D risk-sharing programs receivables and received net cash proceeds of $970 million, resulting in a loss on sale of receivables of $30 million recorded in SG&A in the first quarter of 2026. The proceeds from the sale were used to repurchase $1.0 billion of the Company's par value senior notes due 2027 in March 2026. Following the senior note repurchase, total debt was $16.4 billion, which included no borrowings on the $4.0 billion Revolving Credit Facility at quarter end.OutlookPlease refer to the Forward-Looking Statements, which should be reviewed in conjunction with the Company's 2026 outlook.The Company is increasing its 2026 premium and service revenues guidance range by $1.0 billion to a range of $171.0 billion to $175.0 billion driven by Medicaid. The Company is also increasing its investment and other income expectation by $50 million to $1.45 billion.The Company is updating its 2026 GAAP diluted EPS guidance floor to greater than $2.37 and its 2026 adjusted diluted EPS guidance floor to greater than $3.40.The Company's annual guidance for 2026 is as follows and will be discussed further on our conference call:
Full Year 2026
GAAP diluted EPS
> $2.37
Adjusted diluted EPS (1)
> $3.40
(1) A full reconciliation of adjusted diluted EPS is shown in the Non-GAAP Financial Presentation section of this release.
Full Year 2026
Low
High
Total revenues (in billions)
$ 187.5
$ 191.5
Premium and service revenues (in billions)
$ 171.0
$ 175.0
HBR
90.9 %
91.7 %
SG&A expense ratio
7.0 %
7.6 %
Adjusted SG&A expense ratio (2)
7.0 %
7.6 %
Effective tax rate
27.0 %
28.0 %
Adjusted effective tax rate (3)
26.0 %
27.0 %
Diluted shares outstanding (in millions)
495.6
498.6
(2)Adjusted SG&A expense ratio excludes severance costs of approximately $20 million to $24 million and acquisition
and divestiture related expenses of approximately $575 thousand.(3)Adjusted effective tax rate excludes income tax effects of adjustments of approximately $165 million to $169 million.Conference CallAs previously announced, the Company will host a conference call Tuesday, April 28, 2026, at 8:30 a.m. ET to review the financial results for the first quarter ended March 31, 2026.Investors and other interested parties are invited to listen to the conference call by dialing 1-877-883-0383 (toll free) in the U.S. and Canada; +1-412-902-6506 (toll) from abroad, including the following Elite Entry Number: 0526805 to expedite caller registration; or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section.A webcast replay will be available for on-demand listening shortly following the completion of the call for the next 12 months or until 11:59 p.m. ET on Tuesday, April 27, 2027, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Tuesday, May 5, 2026, by dialing 1-855-669-9658 (toll free) in North America, or +1-412-317-0088 (toll) from abroad, and entering access code 2041356.Non-GAAP Financial PresentationThe Company is providing certain non-GAAP financial measures in this release as the Company believes that these figures are helpful in allowing investors to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently across periods. The Company uses the presented non-GAAP financial measures internally in evaluating the Company's performance and for planning purposes, by allowing management to focus on period-to-period changes in the Company's core business operations, and in determining employee incentive compensation. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The Company strongly encourages investors to review its consolidated financial statements and publicly filed reports in their entirety and cautions investors that the non-GAAP financial measures used by the Company may differ from similar measures used by other companies, even when similar terms are used to identify such measures. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.Specifically, the Company believes the presentation of non-GAAP financial measures that excludes amortization of acquired intangible assets, acquisition and divestiture related expenses, as well as other items, allows investors to develop a more meaningful understanding of the Company's core performance over time.The tables below provide reconciliations of non-GAAP items ($ in millions, except per share data):
Three Months Ended March 31,
2026
2025GAAP net earnings attributable to Centene$ 1,541
$ 1,311Amortization of acquired intangible assets166
173Other adjustments (1)7
3Income tax effects of adjustments (2)(42)
(42)Adjusted net earnings$ 1,672
$ 1,445
(1)Other adjustments include the following pre-tax items:
2026:
(a)enterprise optimization costs of $13 million, gain on sale of a provider network in the Other segment of $10 million, net loss on debt extinguishment of $5 million, a net gain on real estate transactions of $4 million, and severance costs due to enterprise optimization and contract exits of $3 million.
2025:
(a)a reduction to the previously reported gain on the sale of Magellan Rx of $10 million and a net gain on real estate transactions of $7 million.
(2)The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment.
Three Months Ended March 31,
Annual Guidance
December 31, 2026
2026
2025
GAAP diluted EPS attributable to Centene$ 3.11
$ 2.63
greater than $2.37Amortization of acquired intangible assets0.33
0.35
~$1.31Other adjustments (3)0.01
0.01
~$0.06Income tax effects of adjustments (4)(0.08)
(0.09)
~$(0.34)Adjusted diluted EPS$ 3.37
$ 2.90
greater than $3.40
(3)Other adjustments include the following pre-tax items:
2026:
(a)for the three months ended March 31, 2026: enterprise optimization costs of $0.03 per share ($0.02 after-tax), gain on sale of a provider network in the Other segment of $0.02 per share ($0.01 after-tax), net loss on debt extinguishment of $0.01 per share ($0.01 after-tax), and a net gain on real estate transactions of $0.01 per share ($0.01 after-tax).
(b)for the year ended December 31, 2026, an estimated: $0.04 per share ($0.03 after-tax) of severance costs, $0.03 per share ($0.02 after-tax) of enterprise optimization costs, $0.02 per share ($0.01 after-tax) gain on sale of a provider network in the Other segment, $0.02 per share ($0.02 after-tax) net loss on debt extinguishment, and a $0.01 per share ($0.01 after-tax) net gain on real estate transactions.
2025:
(a)for the three months ended March 31, 2025: a reduction to the previously reported gain on the sale of Magellan Rx of $0.02 per share ($0.02 after-tax) and a net gain on real estate transactions of $0.01 per share ($0.01 after-tax).
(4)The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment.
Three Months Ended March 31,
2026
2025GAAP selling, general and administrative expenses$ 3,397
$ 3,353Less:
Severance3
—Enterprise optimization costs13
—Adjusted selling, general and administrative expenses$ 3,381
$ 3,353To provide clarity on the way management defines certain key metrics and ratios, the Company is providing a description of how the metric or ratio is calculated as follows:Health Benefits Ratio (HBR) (GAAP) = Medical costs divided by premium revenues.SG&A Expense Ratio (GAAP) = Selling, general and administrative expenses divided by premium and service revenues.Adjusted SG&A Expense Ratio (non-GAAP) = Adjusted selling, general and administrative expenses divided by premium and service revenues.Adjusted Effective Tax Rate (non-GAAP) = GAAP income tax expense (benefit) excluding the income tax effects of adjustments to net earnings divided by adjusted earnings (loss) before income tax expense.Adjusted Net Earnings (non-GAAP) = Net earnings less amortization of acquired intangible assets, less acquisition and divestiture related expenses, as well as adjustments for other items, net of the income tax effect of the adjustments.Adjusted Diluted EPS (non-GAAP) = Adjusted net earnings divided by weighted average common shares outstanding on a fully diluted basis.Debt to Capitalization Ratio (GAAP) = Total debt, divided by total debt plus total stockholder's equity.Average Medical Claims Expense (GAAP) = Medical costs for the period divided by number of days in such period. Average medical claims expense is most often calculated for the quarterly reporting period.Days in Claims Payable (GAAP) = Medical claims liabilities divided by average medical claims expense. Days in claims payable is most often calculated for the quarterly reporting period.In addition, the following terms are defined as follows:State-directed Payments: Payments directed by a state that have minimal risk but are administered as a premium adjustment. These payments are recorded as premium revenue and medical costs at close to a 100% HBR. In many instances, the Company has little visibility to the timing of these payments until they are paid by a state.Pass-through Payments: Non-risk supplemental payments from a state that the Company is required to pass through to designated contracted providers. These payments are recorded as premium tax revenue and premium tax expense.About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading healthcare enterprise that is committed to helping people live healthier lives. The Company takes a local approach with local teams to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured individuals. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene's investor relations website, https://investors.centene.com.Forward-Looking StatementsAll statements, other than statements of current or historical fact, contained in this press release are forward-looking statements. Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "predict," "intend," "seek," "target," "goal," "potential," "may," "will," "would," "could," "should," "can," "continue," and other similar words or expressions (and the negative thereof). Our 2026 full year guidance outlined in the section titled "Outlook" is a forward-looking statement. Centene Corporation and its subsidiaries (Centene, the Company, our or we) intends such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, and we are including this statement for purposes of complying with these safe-harbor provisions. In particular, these statements include, without limitation, statements about our expected future operating or financial performance, changes in laws and regulations, market opportunity, expectations concerning pricing actions, competition, expected contract start dates and terms, expected activities in connection with completed and future acquisitions and dispositions, our investments, and the adequacy of our available cash resources. These forward-looking statements reflect our current views with respect to future events and are based on numerous assumptions and assessments made by us in light of our experience and perception of historical trends, current conditions, business strategies, operating environments, future developments, and other factors we believe appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future, including economic, regulatory, competitive, and other factors that may cause our or our industry's actual results, performance, or achievements to be materially different from any future results, performance, or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties, and assumptions. All forward-looking statements included in this press release are based on information available to us on the date hereof. Except as may be otherwise required by law, we undertake no obligation to update or revise the forward-looking statements included in this press release, whether as a result of new information, future events, or otherwise, after the date hereof. You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables, and events including, but not limited to: our ability to design and price products that are competitive and/or actuarially sound; our ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical costs; rate cuts, insufficient rate changes or other payment reductions or delays by government payors affecting our government businesses; the effect of social, economic, and political conditions, geopolitical events and state and federal policies, including the amount and terms of state and federal funding for government-sponsored healthcare programs, including as a result of changes in U.S. presidential administrations or Congress; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively referred to as the ACA) and any regulations enacted thereunder, including the timing and terms of renewal or modification of the Enhanced Advance Premium Tax Credits (eAPTCs) or program integrity initiatives that could have the effect of reducing membership or profitability of our products; unanticipated increased healthcare costs, including due to changes in consumer and provider behaviors, inflation and tariffs; our ability to maintain or achieve improvement in the Centers for Medicare and Medicaid Services (CMS) Star ratings and maintain or achieve improvement in other quality scores in each case that could impact revenue and future growth; competition, including for providers, broker distribution networks, contract reprocurements and organic growth; our ability to adequately anticipate demand and timely provide for operational resources to maintain service level requirements in compliance with the terms of our contracts and state and federal regulations; our ability to comply with the terms of our contracts and state and federal regulations and our ability to effectively oversee our third-party vendors to comply with the terms of their contracts with us and state and federal regulations; our ability to manage our information systems effectively; disruption, unexpected costs, or similar risks from business transactions, including acquisitions, divestitures, and changes in our relationships with third-party vendors; impairments to real estate, investments, goodwill and intangible assets; changes in senior management, loss of one or more key personnel or an inability to attract, hire, integrate and retain skilled personnel; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies, and advances in medicine; our ability to effectively and ethically use artificial intelligence and machine learning in compliance with applicable laws; changes in macroeconomic conditions, including inflation, interest rates and volatility in the financial markets; negative public perception of the Company and the managed care industry; uncertainty concerning government shutdowns, debt ceilings or funding; tax matters; disasters, climate-related incidents, acts of war or aggression or major epidemics; changes in expected contract start dates and terms; changes in provider, broker, vendor, state, federal and other contracts and delays in the timing of regulatory approval of contracts, including due to protests and our ability to timely comply with any such changes to our contractual requirements or manage any unexpected delays in regulatory approval of contracts; the expiration, suspension, or termination of our contracts with federal or state governments (including, but not limited to, Medicaid, Medicare or other customers); the difficulty of predicting the timing or outcome of legal or regulatory audits, investigations, proceedings or matters including, but not limited to, our ability to resolve claims and/or allegations on acceptable terms, or at all, or whether additional claims, reviews or investigations will be brought; challenges to our contract awards; cyber-attacks or other data security incidents or our failure to comply with applicable privacy, data or security laws and regulations; the exertion of management's time and our resources, and other expenses incurred and business changes required in connection with complying with the terms of our contracts and the undertakings in connection with any regulatory, governmental, or third party consents or approvals for acquisitions or dispositions; any changes in expected closing dates, estimated purchase price, or accretion for acquisitions or dispositions; losses in our investment portfolio; restrictions and limitations in connection with our indebtedness; a downgrade of our corporate family rating, issuer rating or credit rating of our indebtedness; the availability of debt and equity financing on terms that are favorable to us and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission (SEC). This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other factors that may affect our business operations, financial condition, and results of operations, in our filings with the SEC, including our annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Due to these important factors and risks, we cannot give assurances with respect to our future performance, including without limitation our ability to maintain adequate premium levels or our ability to control our future medical and selling, general and administrative (SG&A) costs.CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED BALANCE SHEETS(In millions, except shares in thousands and per share data in dollars)
March 31,
2026
December 31,
2025
(Unaudited)
ASSETS
Current assets:
Cash and cash equivalents$ 21,264
$ 17,888Premium and trade receivables19,426
18,105Short-term investments2,477
2,432Other current assets1,822
1,945Total current assets44,989
40,370Long-term investments16,599
17,035Restricted deposits1,432
1,412Property, software and equipment, net2,090
2,037Goodwill10,835
10,835Intangible assets, net4,364
4,530Other long-term assets866
528Total assets$ 81,175
$ 76,747LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND
STOCKHOLDERS' EQUITY
Current liabilities:
Medical claims liability$ 20,627
$ 20,544Accounts payable and accrued expenses16,832
13,796Return of premium payable1,570
1,592Unearned revenue953
736Current portion of long-term debt63
50Total current liabilities40,045
36,718Long-term debt16,308
17,351Deferred tax liability744
833Other long-term liabilities2,551
1,789Total liabilities59,648
56,691Commitments and contingencies
Redeemable noncontrolling interests25
23Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or
outstanding at March 31, 2026 and December 31, 2025—
—Common stock, $0.001 par value; authorized 800,000 shares; 625,477 issued and
493,771 outstanding at March 31, 2026, and 623,463 issued and 491,757
outstanding at December 31, 20251
1Additional paid-in capital20,823
20,777Accumulated other comprehensive (loss)(171)
(58)Retained earnings10,215
8,674Treasury stock, at cost (131,706 and 131,706 shares, respectively)(9,441)
(9,441)Total Centene stockholders' equity21,427
19,953Nonredeemable noncontrolling interest75
80Total stockholders' equity21,502
20,033Total liabilities, redeemable noncontrolling interests and stockholders' equity$ 81,175
$ 76,747 CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF OPERATIONS(In millions, except shares in thousands and per share data in dollars)(Unaudited)
Three Months Ended March 31,
2026
2025Revenues:
Premium$ 43,887
$ 41,712Service768
777Premium and service revenues44,655
42,489Premium tax5,289
4,131Total revenues49,944
46,620Expenses:
Medical costs38,303
36,503Cost of services702
698Selling, general and administrative expenses3,397
3,353Depreciation expense134
142Amortization of acquired intangible assets166
173Premium tax expense5,381
4,217Total operating expenses48,083
45,086Earnings from operations1,861
1,534Other income (expense):
Investment and other income407
382Debt extinguishment(5)
—Interest expense(164)
(170)Earnings before income tax2,099
1,746Income tax expense560
432Net earnings1,539
1,314(Earnings) loss attributable to noncontrolling interests2
(3)Net earnings attributable to Centene Corporation$ 1,541
$ 1,311
Net earnings per common share attributable to Centene Corporation:Basic earnings per common share$ 3.13
$ 2.64Diluted earnings per common share$ 3.11
$ 2.63
Weighted average number of common shares outstanding:
Basic492,069
496,214Diluted495,591
498,180 CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF CASH FLOWS(In millions, unaudited)
Three Months Ended March 31,
2026
2025Cash flows from operating activities:
Net earnings$ 1,539
$ 1,314Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization300
314Stock compensation expense67
59Loss on debt extinguishment5
—Deferred income taxes(53)
(27)Loss on divestitures—
10Changes in assets and liabilities
Premium and trade receivables(1,353)
(2,684)Other assets(188)
(669)Medical claims liabilities95
1,603Unearned revenue217
208Accounts payable and accrued expenses2,905
563Other long-term liabilities849
814Other operating activities, net(17)
5Net cash provided by operating activities4,366
1,510Cash flows from investing activities:
Capital expenditures(200)
(135)Purchases of investments(987)
(1,630)Sales and maturities of investments1,276
1,236Net cash provided by (used in) investing activities89
(529)Cash flows from financing activities:
Proceeds from long-term debt—
750Payments and repurchases of long-term debt(1,046)
(958)Common stock repurchases(29)
(41)Proceeds from common stock issuances10
10Other financing activities, net2
(11)Net cash (used in) financing activities(1,063)
(250)Net increase in cash, cash equivalents and restricted cash and cash equivalents3,392
731Cash and cash equivalents reclassified from held for sale4
—Cash, cash equivalents and restricted cash and cash equivalents, beginning of period17,957
14,156Cash, cash equivalents and restricted cash and cash equivalents, end of period$ 21,353
$ 14,887Supplemental disclosures of cash flow information:
Interest paid$ 146
$ 129Income tax net payments (refunds)$ (19)
$ 7
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated
Balance Sheets to the totals above:
March 31,
2026
2025Cash and cash equivalents$ 21,264
$ 14,815Restricted cash and cash equivalents, included in restricted deposits89
72Total cash, cash equivalents and restricted cash and cash equivalents$ 21,353
$ 14,887 CENTENE CORPORATIONSUPPLEMENTAL FINANCIAL DATA
Q1
Q4
Q3
Q2
Q1
2026
2025
2025
2025
2025MEMBERSHIP
Traditional Medicaid (1)10,923,100
10,932,600
11,115,400
11,227,400
11,369,400High Acuity Medicaid (2)1,503,800
1,585,800
1,591,000
1,592,300
1,589,400Total Medicaid12,426,900
12,518,400
12,706,400
12,819,700
12,958,800Marketplace3,582,200
5,541,400
5,828,100
5,862,800
5,626,000Individual and Commercial Group (3)481,000
452,500
447,900
449,700
448,200Total Commercial4,063,200
5,993,900
6,276,000
6,312,500
6,074,200Medicare (4)1,002,200
1,002,600
1,013,200
1,026,900
1,043,200Medicare PDP8,780,600
8,118,600
7,972,500
7,845,800
7,867,800Total at-risk membership26,272,900
27,633,500
27,968,100
28,004,900
27,944,000
(1)Membership includes TANF, Medicaid Expansion, CHIP, Foster Care and Behavioral Health.(2)Membership includes ABD, IDD, LTSS and MMPs. The Company operated MMPs through December 31, 2025. In 2026 these members are included in Medicare as a result of the CMS transition to D-SNP based integration.(3)Membership includes Commercial Group, ICHRA and Other Off-Exchange Individual.(4)Membership includes Medicare Advantage, Medicare Supplement and AIPs as a result of the CMS transition to D-SNP based integration in 2026.
NUMBER OF EMPLOYEES61,000
61,100
60,900
60,300
60,400
DAYS IN CLAIMS PAYABLE48
46
48
47
49
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)Regulated$ 40,239
$ 37,289
$ 37,574
$ 36,403
$ 35,922Unregulated1,533
1,478
1,259
1,086
1,042Total$ 41,772
$ 38,767
$ 38,833
$ 37,489
$ 36,964
DEBT TO CAPITALIZATION43.2 %
46.5 %
45.5 %
39.0 %
39.5 % OPERATING RATIOSThree Months Ended March 31,
2026
2025HBR87.3 %
87.5 %SG&A expense ratio7.6 %
7.9 %Adjusted SG&A expense ratio 7.6 %
7.9 % HBR BY PRODUCTThree Months Ended March 31,
2026
2025Medicaid93.1 %
93.6 %Commercial75.3 %
75.0 %Medicare (5)84.9 %
86.3 %(5)Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.MEDICAL CLAIMS LIABILITY The changes in medical claims liability are summarized as follows (in millions):Balance, March 31, 2025
$ 19,911Less: Reinsurance recoverables
64Balance, March 31, 2025, net
19,847Incurred related to:
Current period
161,744Prior periods
(1,972)Total incurred
159,772Paid related to:
Current period
142,498Prior periods
16,197Total paid
158,695Plus: Premium deficiency reserve
(270)Plus: Divestitures
(109)Balance, March 31, 2026, net
20,545Plus: Reinsurance recoverables
82Balance, March 31, 2026
$ 20,627Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the "Incurred related to: Prior periods" amount may be offset as Centene actuarially determines the "Incurred related to: Current period." Additionally, approximately $34 million was recorded as a reduction to premium revenues resulting from development within "Incurred related to: Prior periods" due to minimum HBR and other return of premium programs.The amount of the "Incurred related to: Prior periods" above represents favorable development and includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, receipts from other third-party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service March 31, 2025, and prior.
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Original: CENTENE CORPORATION REPORTS FIRST QUARTER 2026 RESULTS
US Market News
2月前
Centene Announces New Executive Leadership StructureApril 6, 2026 7:00 AM
PR Newswire (US)
Appoints Daniel Finke to Group President, Markets and Commercial and Wellcare CEO Michael Carson to Group President, Medicare and Specialty ST. LOUIS, April 6, 2026 /PRNewswire/ -- Centene Corporation (NYSE: CNC), a leading healthcare enterprise committed to helping people live healthier lives, today announced the creation of two new executive leadership positions, which will report to Chief Executive Officer Sarah London. Centene has hired Daniel Finke as Group President, Markets and Commercial, and appointed Michael Carson to Group President, Medicare and Specialty.
"We are pleased to recognize Michael's continued leadership and excited to leverage Dan's deep industry expertise and track record of strategic execution," said Sarah London, Chief Executive Officer of Centene. "Their collective experience will be instrumental as we continue to strengthen performance across the portfolio and deliver sustainable, profitable growth." Finke, a seasoned healthcare executive with more than two decades of experience leading and scaling complex health plan organizations across government and commercial markets, will oversee the Medicaid and Commercial segments. He joins Centene from Convey Health Solutions, where he served as Chief Executive Officer. Prior to joining Convey, he was Executive Vice President of CVS Health and President of Aetna, leading strategy and operations spanning Medicare, Medicaid, and Commercial insurance businesses. "I am excited to join Centene at a time of meaningful opportunity across government-sponsored healthcare and the individual market," said Finke. "Centene's mission-driven focus and strong market presence position the company to deliver innovative, high-quality solutions for members, providers and government partners. I look forward to working with the leadership team to drive long-term value for our stakeholders, including by positively impacting the health of the communities we serve." As Group President, Medicare and Specialty, Michael Carson will have expanded oversight of Centene's Medicare Advantage, Medicare Part D, Duals, and Specialty businesses. Carson's experience spans nearly three decades of healthcare leadership. Prior to joining Centene in January 2024 as CEO of its Medicare business, Wellcare, Carson served as Chief Executive Officer for Bright Healthcare and Harvard Pilgrim Health Care, as well as CareAbout, a multi-specialty, value-based care delivery organization. "In this expanded role, I will continue to build on the strong foundation we have established across our Medicare and specialty businesses," said Group President, Medicare and Specialty, Michael Carson. "As the healthcare landscape evolves, our focus remains on improving affordability, access, and outcomes for the members we serve. In particular, we look forward to deepening our ability to provide a better, more integrated experience to those who need it most, including those who are dually eligible for Medicaid and Medicare." About Centene Corporation?
Centene Corporation, a Fortune 500 company, is a leading healthcare enterprise that is committed to?helping people live healthier lives. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured individuals. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene's investor relations website,?http://investors.centene.com/.Forward-Looking Statements
All statements, other than statements of current or historical fact, contained in this press release are forward-looking statements.?Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "predict," "intend," "seek," "target," "goal," "potential," "may," "will," "would," "could," "should," "can," "continue" and other similar words or expressions (and the negative thereof). Centene Corporation and its subsidiaries (Centene, the Company, our or we) intends such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, and we are including this statement for purposes of complying with these safe-harbor provisions. In particular, these statements include, without limitation, statements about our expected future operating or financial performance, changes in laws and regulations, market opportunity, quality, member experience, expectations concerning pricing actions, competition and our investments. These forward-looking statements reflect our current views with respect to future events and are based on numerous assumptions and assessments made by us in light of our experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors we believe appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future, including economic, regulatory, competitive and other factors that may cause our or our industry's actual results, performance or achievements to be materially different from any future results, performance, or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions. All forward-looking statements included in this press release are based on information available to us on the date hereof. Except as may be otherwise required by law, we undertake no obligation to update or revise the forward-looking statements included in this press release, whether as a result of new information, future events, or otherwise, after?the date hereof. You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables and events including, but not limited to: our ability to design and price products that are competitive and/or actuarially sound; our ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical costs; rate cuts, insufficient rate changes or other payment reductions or delays by government payors affecting our government businesses; the effect of social, economic, and political conditions, geopolitical events and state and federal policies, including the amount and terms of state and federal funding for government-sponsored healthcare programs, including as a result of changes in U.S. presidential administrations or Congress; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively referred to as the ACA) and any regulations enacted thereunder, including the timing and terms of renewal or modification of the enhanced advance premium tax credits or program integrity initiatives that could have the effect of reducing membership or profitability of our products; unanticipated increased healthcare costs, including due to changes in consumer and provider behaviors, inflation and tariffs; our ability to maintain or achieve improvement in the Centers for Medicare and Medicaid Services (CMS) Star ratings and maintain or achieve improvement in other quality scores in each case that could impact revenue and future growth; competition, including for providers, broker distribution networks, contract reprocurements and organic growth; our ability to adequately anticipate demand and timely provide for operational resources to maintain service level requirements in compliance with the terms of our contracts and state and federal regulations; our ability to comply with the terms of our contracts and state and federal regulations and our ability to effectively oversee our third-party vendors to comply with the terms of their contracts with us and state and federal regulations; our ability to manage our information systems effectively; disruption, unexpected costs, or similar risks from business transactions, including acquisitions, divestitures, and changes in our relationships with third-party vendors; impairments to real estate, investments, goodwill and intangible assets; changes in senior management, loss of one or more key personnel or an inability to attract, hire, integrate and retain skilled personnel; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies, and advances in medicine; our ability to effectively and ethically use artificial intelligence and machine learning in compliance with applicable laws; changes in macroeconomic conditions, including inflation, interest rates and volatility in the financial markets; negative public perception of the Company and the managed care industry; uncertainty concerning government shutdowns, debt ceilings or funding; tax matters; disasters, climate-related incidents, acts of war or aggression or major epidemics; changes in expected contract start dates and terms; changes in provider, broker, vendor, state federal and other contracts and delays in the timing of regulatory approval of contracts, including due to protests and our ability to timely comply with any such changes to our contractual requirements or manage any unexpected delays in regulatory approval of contracts; the expiration, suspension, or termination of our contracts with federal or state governments (including, but not limited to, Medicaid, Medicare or other customers); the difficulty of predicting the timing or outcome of legal or regulatory audits, investigations, proceedings or matters including, but not limited to, our ability to resolve claims and/or allegations on acceptable terms, or at all, or whether additional claims, reviews or investigations will be brought; challenges to our contract awards; cyber-attacks or other data security incidents or our failure to comply with applicable privacy, data or security laws and regulations; the exertion of management's time and our resources, and other expenses incurred and business changes required in connection with complying with the terms of our contracts and the undertakings in connection with any regulatory, governmental, or third-party consents or approvals for acquisitions or dispositions; any changes in expected closing dates, estimated purchase price, or accretion for acquisitions or dispositions; losses in our investment portfolio; restrictions and limitations in connection with our indebtedness; a downgrade of our corporate family rating, issuer rating or credit rating of our indebtedness; the availability of debt and equity financing on terms that are favorable to us and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission (SEC). This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other factors that may affect our business operations, financial condition, and results of operations, in our filings with the SEC, including our annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.
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Original: Centene Announces New Executive Leadership Structure
US Market News
4月前
CENTENE CORPORATION REPORTS 2025 RESULTS AND ANNOUNCES 2026 GUIDANCEFebruary 6, 2026 6:00 AM
PR Newswire (US)
-- 2025 Full Year GAAP Diluted Loss Per Share of $(13.53); Adjusted Diluted Earnings Per Share of $2.08 ---- 2026 Adjusted Diluted Earnings Per Share Guidance of Greater than $3.00 --Consolidated HBR of 94.3% in the fourth quarter of 2025, which includes a Commercial HBR of 95.4% that was 100 basis points higher than expectations driven by net out of period items.Medicaid HBR of 93.0% in the fourth quarter of 2025, reflecting continued progress and representing 40 basis points of sequential improvement compared to the third quarter.Fundamental fourth quarter 2025 trend was consistent with expectations in Medicaid and Medicare Advantage, and slightly favorable in Marketplace and Medicare PDP.Strong SG&A management throughout 2025 with an adjusted SG&A expense ratio of 7.4% for the full year.ST. LOUIS, Feb. 6, 2026 /PRNewswire/ -- Centene Corporation (NYSE: CNC) (the Company) announced today its financial results for the fourth quarter and year ended December 31, 2025. In summary, the 2025 fourth quarter and full year results were as follows:
2025 Results
Q4
Full YearTotal revenues (in millions)$ 49,725
$ 194,777Premium and service revenues (in millions)$ 44,727
$ 174,581Health benefits ratio94.3 %
91.9 %SG&A expense ratio7.5 %
7.4 %Adjusted SG&A expense ratio (1)7.5 %
7.4 %GAAP diluted loss per share$ (2.24)
$ (13.53)Adjusted diluted earnings (loss) per share (1)$ (1.19)
$ 2.08Total cash flow provided by operations (in millions) $ 437
$ 5,088
(1) Represents a non-GAAP financial measure. A full reconciliation of the adjusted diluted earnings (loss) per share and adjusted selling, general and administrative (SG&A) expenses is shown in the Non-GAAP Financial Presentation section of this release."We are pleased to end a challenging year carrying positive momentum from the extensive and decisive actions taken in the back half of 2025 with the goal of restoring Marketplace profitability and stabilizing the trajectory of our Medicaid business," said Chief Executive Officer of Centene, Sarah M. London. "As we look to 2026, we are positioned to deliver meaningful margin improvement and renewed adjusted diluted EPS growth. We expect full year 2026 adjusted diluted EPS to be greater than $3.00, marking important progress toward restoring the enterprise's embedded earnings power all while continuing to work to provide access to affordable, high-quality care for our members."Other EventsIn December 2025, Centene signed a definitive agreement to divest the remaining Magellan Health businesses. As a result, the Company recorded non-cash impairment charges associated with the pending divestiture totaling $513 million, or $389 million after-tax.Awards & Community EngagementIn November, the Centene Foundation and five Centene subsidiaries – Buckeye Health Plan, Sunshine Health, Carolina Complete Health, Meridian Health Plan of Illinois, and Superior HealthPlan – announced a number of contributions to support food banks and community-based organizations addressing food insecurity following disruptions to the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).In November, Health Net, a Centene subsidiary, announced the renewal of its partnership with LA Family Housing to support initiatives aimed at increasing access to stable, affordable housing and to build infrastructure for whole-person health for individuals experiencing homelessness in parts of Los Angeles County.In October, Iowa Total Care, a Centene subsidiary, in partnership with Central Iowa Shelter & Services, announced the opening of a new Empowerment Command Center and Affordable Housing Project, aimed at providing essential services, including job training, health and wellness services, housing support, and more, to residents of Wapello County, Iowa.In October, Home State Health, a Centene subsidiary, launched a Foster Care Center of Excellence (FCCOE) in partnership with Jordan Valley Community Health Center in Missouri. The pediatric clinic provides comprehensive care – including behavioral and physical health, vision, and dental services – for children and youth. Centene's FCCOEs are also operational in Texas, Washington, and Oklahoma.MembershipThe following table sets forth membership by line of business:
December 31,
2025
2024Traditional Medicaid (1)10,932,600
11,408,100High Acuity Medicaid (2)1,585,800
1,595,400Total Medicaid12,518,400
13,003,500Marketplace5,541,400
4,382,100Individual and Commercial Group (3)452,500
431,400Total Commercial5,993,900
4,813,500Medicare (4)1,002,600
1,110,900Medicare Prescription Drug Plan (PDP) 8,118,600
6,925,700Total at-risk membership27,633,500
25,853,600TRICARE eligibles—
2,747,000Total27,633,500
28,600,600
(1)Membership includes Temporary Assistance for Needy Families (TANF), Medicaid Expansion, Children's Health Insurance Program (CHIP), Foster Care and Behavioral Health.(2)Membership includes Aged, Blind, or Disabled (ABD), Intellectual and Developmental Disabilities (IDD), Long-Term Services and Supports (LTSS) and Medicare-Medicaid Plans (MMP) Duals.(3)Membership includes Commercial Group, Individual Coverage Health Reimbursement Arrangement (ICHRA) and Other Off-Exchange Individual.(4)Membership includes Medicare Advantage and Medicare Supplement.Premium and Service RevenuesThe following table sets forth supplemental revenue information ($ in millions):
Three Months Ended December 31,
Year Ended December 31,
2025
2024
% Change
2025
2024
% Change Medicaid$ 23,045
$ 20,825
11 %
$ 90,238
$ 83,851
8 %Commercial10,792
8,723
24 %
42,003
33,702
25 %Medicare (1)9,610
5,476
75 %
37,210
23,032
62 %Other1,280
1,272
1 %
5,130
4,920
4 %Total premium and service revenues $ 44,727
$ 36,296
23 %
$ 174,581
$ 145,505
20 %
(1)Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.Statement of Operations: Three Months Ended December 31, 2025For the fourth quarter of 2025, premium and service revenues increased 23% to $44.7 billion from $36.3 billion in the comparable period of 2024. The increase was primarily driven by premium yield and membership growth in the PDP business, overall market growth in the Marketplace business, as well as rate increases and state-directed payments in the Medicaid business, partially offset by lower Medicaid membership.Health benefits ratio (HBR) of 94.3% for the fourth quarter of 2025 represents an increase from 89.6% in the comparable period in 2024. The increase was primarily driven by the impact of higher Marketplace morbidity in 2025 on medical costs and program changes in the PDP business as a result of the Inflation Reduction Act (IRA) compared to the fourth quarter of 2024. The Medicaid HBR decreased by 40 basis points, primarily driven by rate and revenue increases, partially offset by higher medical costs largely related to behavioral health and home health.The SG&A expense ratio was 7.5% for the fourth quarter of 2025, compared to 8.9% in the fourth quarter of 2024. The adjusted SG&A expense ratio was 7.5% for the fourth quarter of 2025, compared to 8.9% in the fourth quarter of 2024. The decreases were primarily driven by continued discipline, leveraging of expenses over higher revenues and growth in the PDP business, which operates at a meaningfully lower SG&A expense ratio as compared to the overall company. The decreases were partially offset by growth in the Marketplace business, which operates at a meaningfully higher SG&A expense ratio.The effective tax rate was 28.7% for the fourth quarter of 2025, compared to 19.2% in the fourth quarter of 2024. The effective tax rate for the fourth quarter of 2025 reflects the impact of the Magellan Health impairment and the release of state uncertain tax position liabilities resulting from statute of limitations expirations. For the fourth quarter of 2025, our effective tax rate on adjusted earnings was 32.1%, compared to 20.7% in the fourth quarter of 2024. The adjusted effective tax rate for the fourth quarter of 2025 reflects the release of state uncertain tax position liabilities resulting from statute of limitations expirations.In December 2025, Centene signed a definitive agreement to divest the remaining Magellan Health businesses. As a result, the Company recorded impairment charges associated with the pending divestiture totaling $513 million, or $389 million after-tax.GAAP diluted loss per share of $(2.24) for the fourth quarter of 2025.Adjusted diluted loss per share of $(1.19) for the fourth quarter of 2025.Cash flow provided by operations for the fourth quarter of 2025 was $437 million, primarily driven by the timing of pharmacy rebates, CMS and state remittances, as well as claims and other payments.Statement of Operations: Year Ended December 31, 2025For the full year 2025, premium and service revenues increased 20% to $174.6 billion from $145.5 billion in the comparable period of 2024 primarily driven by premium yield and membership growth in the PDP business, overall market growth in the Marketplace business, and rate increases in the Medicaid business, partially offset by lower Medicaid membership and lower Marketplace estimated risk adjustment revenue. The full year 2024 benefited from outperformance in Marketplace risk adjustment for the 2023 benefit year.HBR of 91.9% for the full year 2025 represents an increase compared to 88.3% in 2024. The increase was primarily driven by lower Marketplace estimated risk adjustment revenue, increased Marketplace medical costs, program changes in the PDP business as a result of the IRA and higher medical costs in Medicaid driven primarily by behavioral health, home health and high-cost drugs, partially offset by Medicaid rate increases.The SG&A expense ratio was 7.4% for the full year 2025, compared to 8.5% for the full year 2024. The adjusted SG&A expense ratio was 7.4% for the full year 2025, compared to 8.5% for the full year 2024. The decreases were primarily driven by continued discipline, leveraging of expenses over higher revenues and growth in the PDP business, which operates at a meaningfully lower SG&A expense ratio as compared to the overall company. The decreases were partially offset by growth in the Marketplace business, which operates at a meaningfully higher SG&A expense ratio.As a result of market conditions in July 2025, including the One Big Beautiful Bill Act and the decline in the Company's stock price, we performed a quantitative impairment analysis during the third quarter to determine whether goodwill was impaired. In October 2025, we completed our quantitative goodwill impairment analysis and recorded a non-cash goodwill impairment of $6.7 billion in the third quarter of 2025.The effective tax rate was 0.8% for 2025, compared to 22.6% for 2024. The effective tax rate for 2025 reflects the non-deductible nature of the goodwill impairment and the release of state uncertain tax position liabilities resulting from statute of limitations expirations. The effective tax rate for 2024 reflects tax effects of the Circle Health Group (Circle Health) divestiture, settlements with tax authorities and valuation allowance releases. For the full year 2025, our effective tax rate on adjusted earnings was 20.4%, compared to 23.8% in 2024. The adjusted effective tax rate for 2025 reflects the release of state uncertain tax position liabilities resulting from statute of limitations expirations.GAAP diluted loss per share was $(13.53) for the full year 2025, driven by the goodwill impairment.Adjusted diluted earnings per share (EPS) of $2.08 for the full year 2025.Cash flow provided by operations for the full year 2025 was $5.1 billion, which was primarily driven by net earnings, improved pharmacy rebate timing and higher medical claims liabilities primarily driven by higher membership.Balance SheetAt December 31, 2025, the Company had cash, investments and restricted deposits of $38.8 billion and maintained $400 million of cash available for general corporate use. Medical claims liabilities totaled $20.5 billion. The Company's days in claims payable (DCP) was 46 days, a decrease of two days as compared to the third quarter of 2025, driven by the impact of state-directed payments and the elimination of the Medicare Advantage premium deficiency reserve. Total debt was $17.4 billion, which included no borrowings on the $4.0 billion Revolving Credit Facility at year end.OutlookPlease refer to the Forward-Looking Statements, which should be reviewed in conjunction with the Company's 2026 outlook.For its 2026 fiscal year, the Company's guidance is as follows.
Full Year 2026GAAP diluted EPS
> $1.98Adjusted diluted EPS (1)
> $3.00
(1) A full reconciliation of adjusted diluted EPS is shown in the Non-GAAP Financial Presentation section of this release.
Full Year 2026
Low
High Total revenues (in billions)
$ 186.5
$ 190.5Premium and service revenues (in billions)
$ 170.0
$ 174.0HBR
90.9 %
91.7 %SG&A expense ratio
7.1 %
7.7 %Adjusted SG&A expense ratio (2)
7.1 %
7.7 %Effective tax rate
27.0 %
28.0 %Adjusted effective tax rate (3)
26.0 %
27.0 %Diluted shares outstanding (in millions)
495.6
498.6
(2) Adjusted SG&A expense ratio excludes acquisition and divestiture related expenses of approximately $300 thousand.(3) Adjusted effective tax rate excludes income tax effects of adjustments of approximately $161 million to $164 million.For additional guidance details, please see the 2026 Guidance Presentation, which can be accessed on the Company's website at www.centene.com, under the Investors section.Conference CallAs previously announced, the Company will host a conference call Friday, February 6, 2026, at 9:00 a.m. ET to review the financial results for the fourth quarter and year ended December 31, 2025.Investors and other interested parties are invited to listen to the conference call by dialing 1-877-883-0383 in the U.S. and Canada; +1-412-902-6506 from abroad, including the following Elite Entry Number: 2815529 to expedite caller registration; or via a live, audio webcast on the Company's website at www.centene.com, under the Investors section.A webcast replay will be available for on-demand listening shortly following the completion of the call for the next 12 months or until 11:59 p.m. ET on Tuesday, February 9, 2027, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Friday, February 13, 2026, by dialing 1-877-344-7529 in the U.S., 1-855-669-9658 in Canada, or +1-412-317-0088 from abroad, and entering access code 3210284.Non-GAAP Financial PresentationThe Company is providing certain non-GAAP financial measures in this release as the Company believes that these figures are helpful in allowing investors to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently across periods. The Company uses the presented non-GAAP financial measures internally in evaluating the Company's performance and for planning purposes, by allowing management to focus on period-to-period changes in the Company's core business operations, and in determining employee incentive compensation. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The Company strongly encourages investors to review its consolidated financial statements and publicly filed reports in their entirety and cautions investors that the non-GAAP financial measures used by the Company may differ from similar measures used by other companies, even when similar terms are used to identify such measures. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.Specifically, the Company believes the presentation of non-GAAP financial measures that excludes amortization of acquired intangible assets, acquisition and divestiture related expenses, as well as other items, allows investors to develop a more meaningful understanding of the Company's core performance over time.The tables below provide reconciliations of non-GAAP items ($ in millions, except per share data):
Three Months Ended
December 31,
Year Ended December 31,
2025
2024
2025
2024GAAP net earnings (loss) attributable to Centene $ (1,101)
$ 283
$ (6,674)
$ 3,305Amortization of acquired intangible assets169
173
685
692Acquisition and divestiture related expenses3
7
4
82Other adjustments (1)513
(20)
7,328
(117)Income tax effects of adjustments (2)(167)
(39)
(315)
(209)Adjusted net earnings (loss)$ (583)
$ 404
$ 1,028
$ 3,753
(1) Other adjustments include the following pre-tax items:
2025:
(a)for the three months ended December 31, 2025: Magellan Health impairment of $513 million, exit costs related
to the wind-down of certain contracts in the Other segment of $13 million, a favorable adjustment to the gain on
sale of Magellan Rx of $12 million, and net gain on debt extinguishment of $1 million;
(b)for the twelve months ended December 31, 2025: goodwill impairment of $6,723 million, Magellan Health
impairment of $513 million, intangible asset impairment related to the wind-down of certain contracts in the Other
segment of $55 million, exit costs related to the wind-down of certain contracts in the Other segment of
$22 million, a net loss on real estate transactions of $18 million, a favorable adjustment to the gain on sale of
Magellan Rx of $2 million and net gain on debt extinguishment of $1 million.
2024:
(a) for the three months ended December 31, 2024: gain on the sale of Collaborative Health Systems (CHS) of
$17 million and net gain on the sale of property of $3 million;
(b) for the twelve months ended December 31, 2024: net gain on the previously reported divestiture of Magellan
Specialty Health due to the achievement of contingent consideration and finalization of working capital
adjustments of $83 million, net gain on the sale of property of $24 million, gain on the previously reported
divestiture of Circle Health of $20 million, gain on the sale of CHS of $17 million, Health Net Federal Services
asset impairment due to the 2024 final ruling on the TRICARE Managed Care Support Contract of $14 million,
severance costs due to a restructuring of $13 million, an additional loss on the divestiture of our Spanish and
Central European businesses of $7 million and gain on the previously reported divestiture of HealthSmart due to
the finalization of working capital adjustments of $7 million.
(2)The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The three and
twelve months ended December 31, 2025, include a tax benefit of $4 million related to tax adjustments on previously reported
divestitures and impacts of the One Big Beautiful Bill Act (OBBBA). The twelve months ended December 31, 2024 include
a tax benefit of $1 million related to tax adjustments on previously reported divestitures.
Three Months
Ended December 31,
Year Ended December 31,
Annual Guidance
December 31, 2026
2025
2024
2025
2024
GAAP diluted earnings (loss) per share attributable to
Centene$ (2.24)
$ 0.56
$ (13.53)
$ 6.31
greater than $1.98Amortization of acquired intangible assets0.34
0.34
1.39
1.32
~$1.34Acquisition and divestiture related expenses0.01
0.01
0.01
0.16
~$—Other adjustments (3)1.04
(0.04)
14.86
(0.22)
~$0.01Income tax effects of adjustments (4)(0.34)
(0.07)
(0.64)
(0.40)
~$(0.33)Effect of basic to diluted shares (5)—
—
(0.01)
—
~$—Adjusted diluted earnings (loss) per share$ (1.19)
$ 0.80
$ 2.08
$ 7.17
greater than $3.00
(3)Other adjustments include the following pre-tax items:
2026:
(a)for the twelve months ended December 31, 2026, an estimated: $0.01 per share ($0.01 after-tax) net loss on debt
extinguishment.
2025:
(a)for the three months ended December 31, 2025: Magellan Health impairment of $1.04 per share ($0.79 after-tax),
exit costs related to the wind-down of certain contracts in the Other segment of $0.03 per share ($0.02 after-tax),
and a favorable adjustment to the gain on sale of Magellan Rx of $0.03 per share ($0.02 after-tax);
(b)for the twelve months ended December 31, 2025: goodwill impairment of $13.63 per share ($13.62 after-tax),
Magellan Health impairment of $1.04 per share ($0.79 after-tax), intangible asset impairment related to the wind-
down of certain contracts in the Other segment of $0.11 per share ($0.08 after-tax), exit costs related to the wind-
down of certain contracts in the Other segment of $0.04 per share ($0.03 after-tax), a net loss on real estate
transactions of $0.04 per share ($0.03 after-tax).
2024:
(a)for the three months ended December 31, 2024: gain on the sale of CHS of $0.03 per share ($0.02 after-tax) and
net gain on the sale of property of $0.01 per share ($0.01 after-tax);
(b)for the twelve months ended December 31, 2024: net gain on the previously reported divestiture of Magellan
Specialty Health due to the achievement of contingent consideration and finalization of working capital
adjustments of $0.16 per share ($0.12 after-tax), net gain on the sale of property of $0.04 per share ($0.03 after-
tax), gain on the previously reported divestiture of Circle Health of $0.04 per share ($0.12 after-tax), gain on the
sale of CHS of $0.03 per share ($0.02 after-tax), Health Net Federal Services asset impairment due to the 2024
final ruling on the TRICARE Managed Care Support Contract of $0.03 per share ($0.02 after-tax), severance
costs due to a restructuring of $0.02 per share ($0.01 after-tax), an additional loss on the divestiture of our Spanish
and Central European businesses of $0.01 per share ($0.01 after-tax) and gain on the previously reported
divestiture of HealthSmart due to the finalization of working capital adjustments of $0.01 per share ($0.01 after-
tax).
(4) The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The three and
twelve months ended December 31, 2025, include a tax benefit of $0.01 related to tax adjustments on previously reported
divestitures and impacts of the OBBBA.
(5) Reflects the $0.00 and $0.01 impact of using 493,042 thousand and 494,502 thousand shares in the calculation of adjusted
diluted EPS for the three and twelve months ended December 31, 2025, respectively. The additional 1,509 thousand and
1,386 thousand shares for the three and twelve months ended December 31, 2025, respectively, were excluded from the
calculation of the GAAP net loss per share and related adjustments due to their anti-dilutive effect.
Three Months Ended
December 31,
Year Ended December 31,
2025
2024
2025
2024GAAP selling, general and administrative expenses$ 3,370
$ 3,231
$ 12,904
$ 12,400Less:
Acquisition and divestiture related expenses3
7
4
82Restructuring costs13
—
22
13Real estate transaction costs—
—
2
—Adjusted selling, general and administrative
expenses$ 3,354
$ 3,224
$ 12,876
$ 12,305To provide clarity on the way management defines certain key metrics and ratios, the Company is providing a description of how the metric or ratio is calculated as follows:Health Benefits Ratio (HBR) (GAAP) = Medical costs divided by premium revenues.SG&A Expense Ratio (GAAP) = Selling, general and administrative expenses divided by premium and service revenues.Adjusted SG&A Expense Ratio (non-GAAP) = Adjusted selling, general and administrative expenses divided by premium and service revenues.Adjusted Effective Tax Rate (non-GAAP) = GAAP income tax expense (benefit) excluding the income tax effects of adjustments to net earnings divided by adjusted earnings (loss) before income tax expense.Adjusted Net Earnings (non-GAAP) = Net earnings less amortization of acquired intangible assets, less acquisition and divestiture related expenses, as well as adjustments for other items, net of the income tax effect of the adjustments.Adjusted Diluted EPS (non-GAAP) = Adjusted net earnings divided by weighted average common shares outstanding on a fully diluted basis.Debt to Capitalization Ratio (GAAP) = Total debt, divided by total debt plus total stockholder's equity.Average Medical Claims Expense (GAAP) = Medical costs for the period divided by number of days in such period. Average medical claims expense is most often calculated for the quarterly reporting period.Days in Claims Payable (GAAP) = Medical claims liabilities divided by average medical claims expense. Days in claims payable is most often calculated for the quarterly reporting period.In addition, the following terms are defined as follows:State-directed Payments: Payments directed by a state that have minimal risk but are administered as a premium adjustment. These payments are recorded as premium revenue and medical costs at close to a 100% HBR. In many instances, the Company has little visibility to the timing of these payments until they are paid by a state.Pass-through Payments: Non-risk supplemental payments from a state that the Company is required to pass through to designated contracted providers. These payments are recorded as premium tax revenue and premium tax expense.About Centene Corporation Centene Corporation, a Fortune 500 company, is a leading healthcare enterprise that is committed to helping people live healthier lives. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured individuals. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace.Centene uses its investor relations website to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Centene is routinely posted and is accessible on Centene's investor relations website, https://investors.centene.com.Forward-Looking StatementsAll statements, other than statements of current or historical fact, contained in this press release are forward-looking statements. Without limiting the foregoing, forward-looking statements often use words such as "believe," "anticipate," "plan," "expect," "estimate," "predict," "intend," "seek," "target," "goal," "potential," "may," "will," "would," "could," "should," "can," "continue" and other similar words or expressions (and the negative thereof). Our 2026 full year guidance outlined in the section titled "Outlook" is a forward-looking statement. Centene Corporation and its subsidiaries (Centene, the Company, our or we) intends such forward-looking statements to be covered by the safe-harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995, and we are including this statement for purposes of complying with these safe-harbor provisions. In particular, these statements include, without limitation, statements about our expected future operating or financial performance, changes in laws and regulations, market opportunity, expectations concerning pricing actions, competition, expected contract start dates and terms, expected activities in connection with completed and future acquisitions and dispositions, our investments and the adequacy of our available cash resources. These forward-looking statements reflect our current views with respect to future events and are based on numerous assumptions and assessments made by us in light of our experience and perception of historical trends, current conditions, business strategies, operating environments, future developments and other factors we believe appropriate. By their nature, forward-looking statements involve known and unknown risks and uncertainties and are subject to change because they relate to events and depend on circumstances that will occur in the future, including economic, regulatory, competitive and other factors that may cause our or our industry's actual results, performance or achievements to be materially different from any future results, performance, or achievements expressed or implied by these forward-looking statements. These statements are not guarantees of future performance and are subject to risks, uncertainties and assumptions. All forward-looking statements included in this press release are based on information available to us on the date hereof. Except as may be otherwise required by law, we undertake no obligation to update or revise the forward-looking statements included in this press release, whether as a result of new information, future events, or otherwise, after the date hereof. You should not place undue reliance on any forward-looking statements, as actual results may differ materially from projections, estimates, or other forward-looking statements due to a variety of important factors, variables and events including, but not limited to: our ability to design and price products that are competitive and/or actuarially sound; our ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical costs; rate cuts, insufficient rate changes or other payment reductions or delays by government payors affecting our government businesses; the effect of social, economic, and political conditions, geopolitical events and state and federal policies, including the amount and terms of state and federal funding for government-sponsored healthcare programs, including as a result of changes in U.S. presidential administrations or Congress; changes in federal or state laws or regulations, including changes with respect to income tax reform or government healthcare programs as well as changes with respect to the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively referred to as the ACA) and any regulations enacted thereunder, including the timing and terms of renewal or modification of the enhanced advance premium tax credits or program integrity initiatives that could have the effect of reducing membership or profitability of our products; unanticipated increased healthcare costs, including due to changes in consumer and provider behaviors, inflation and tariffs; our ability to maintain or achieve improvement in the Centers for Medicare and Medicaid Services (CMS) Star ratings and maintain or achieve improvement in other quality scores in each case that could impact revenue and future growth; competition, including for providers, broker distribution networks, contract reprocurements and organic growth; our ability to adequately anticipate demand and timely provide for operational resources to maintain service level requirements in compliance with the terms of our contracts and state and federal regulations; our ability to comply with the terms of our contracts and state and federal regulations and our ability to effectively oversee our third-party vendors to comply with the terms of their contracts with us and state and federal regulations; our ability to manage our information systems effectively; disruption, unexpected costs, or similar risks from business transactions, including acquisitions, divestitures, and changes in our relationships with third-party vendors; impairments to real estate, investments, goodwill and intangible assets; changes in senior management, loss of one or more key personnel or an inability to attract, hire, integrate and retain skilled personnel; membership and revenue declines or unexpected trends; changes in healthcare practices, new technologies, and advances in medicine; our ability to effectively and ethically use artificial intelligence and machine learning in compliance with applicable laws; changes in macroeconomic conditions, including inflation, interest rates and volatility in the financial markets; negative public perception of the Company and the managed care industry; uncertainty concerning government shutdowns, debt ceilings or funding; tax matters; disasters, climate-related incidents, acts of war or aggression or major epidemics; changes in expected contract start dates and terms; changes in provider, broker, vendor, state federal and other contracts and delays in the timing of regulatory approval of contracts, including due to protests and our ability to timely comply with any such changes to our contractual requirements or manage any unexpected delays in regulatory approval of contracts; the expiration, suspension, or termination of our contracts with federal or state governments (including, but not limited to, Medicaid, Medicare or other customers); the difficulty of predicting the timing or outcome of legal or regulatory audits, investigations, proceedings or matters including, but not limited to, our ability to resolve claims and/or allegations on acceptable terms, or at all, or whether additional claims, reviews or investigations will be brought; challenges to our contract awards; cyber-attacks or other data security incidents or our failure to comply with applicable privacy, data or security laws and regulations; the exertion of management's time and our resources, and other expenses incurred and business changes required in connection with complying with the terms of our contracts and the undertakings in connection with any regulatory, governmental, or third-party consents or approvals for acquisitions or dispositions; any changes in expected closing dates, estimated purchase price, or accretion for acquisitions or dispositions; losses in our investment portfolio; restrictions and limitations in connection with our indebtedness; a downgrade of our corporate family rating, issuer rating or credit rating of our indebtedness; the availability of debt and equity financing on terms that are favorable to us and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission (SEC). This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain other factors that may affect our business operations, financial condition, and results of operations, in our filings with the SEC, including our annual report on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Due to these important factors and risks, we cannot give assurances with respect to our future performance, including without limitation our ability to maintain adequate premium levels or our ability to control our future medical and selling, general and administrative costs.CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED BALANCE SHEETS(In millions, except shares in thousands and per share data in dollars)
December 31, 2025
December 31, 2024
(Unaudited)
ASSETS
Current assets:
Cash and cash equivalents$ 17,888
$ 14,063Premium and trade receivables18,105
19,713Short-term investments2,432
2,622Other current assets1,945
1,601Total current assets40,370
37,999Long-term investments17,035
17,429Restricted deposits1,412
1,390Property, software and equipment, net2,037
2,067Goodwill10,835
17,558Intangible assets, net4,530
5,409Other long-term assets528
593Total assets$ 76,747
$ 82,445LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND
STOCKHOLDERS' EQUITY
Current liabilities:
Medical claims liability$ 20,544
$ 18,308Accounts payable and accrued expenses13,774
13,174Return of premium payable1,592
2,008Unearned revenue736
661Current portion of long-term debt50
110Total current liabilities36,696
34,261Long-term debt17,351
18,423Deferred tax liability833
684Other long-term liabilities1,811
2,567Total liabilities56,691
55,935Commitments and contingencies
Redeemable noncontrolling interests23
10Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or
outstanding at December 31, 2025 and December 31, 2024—
—Common stock, $0.001 par value; authorized 800,000 shares; 623,463 issued and
491,757 outstanding at December 31, 2025, and 620,195 issued and 495,907
outstanding at December 31, 20241
1Additional paid-in capital20,777
20,562Accumulated other comprehensive (loss)(58)
(504)Retained earnings8,674
15,348Treasury stock, at cost (131,706 and 124,288 shares, respectively)(9,441)
(8,997)Total Centene stockholders' equity19,953
26,410Nonredeemable noncontrolling interest80
90Total stockholders' equity20,033
26,500Total liabilities, redeemable noncontrolling interests and stockholders' equity$ 76,747
$ 82,445 CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF OPERATIONS(In millions, except shares in thousands and per share data in dollars)(Unaudited)
Three Months Ended
December 31,
Year Ended December 31,
2025
2024
2025
2024Revenues:
Premium$ 43,978
$ 35,519
$ 171,556
$ 142,303Service749
777
3,025
3,202Premium and service revenues44,727
36,296
174,581
145,505Premium tax4,998
4,509
20,196
17,566Total revenues49,725
40,805
194,777
163,071Expenses:
Medical costs41,489
31,809
157,702
125,707Cost of services680
688
2,670
2,729Selling, general and administrative expenses3,370
3,231
12,904
12,400Depreciation expense160
141
590
549Amortization of acquired intangible assets169
173
685
692Premium tax expense5,089
4,588
20,538
17,806Impairment513
—
7,311
13Total operating expenses51,470
40,630
202,400
159,896Earnings (loss) from operations(1,745)
175
(7,623)
3,175Other income (expense):
Investment and other income369
344
1,572
1,784Debt extinguishment1
—
1
—Interest expense(168)
(172)
(678)
(702)Earnings (loss) before income tax(1,543)
347
(6,728)
4,257Income tax (benefit) expense(443)
67
(51)
963Net earnings (loss)(1,100)
280
(6,677)
3,294(Earnings) loss attributable to noncontrolling interests(1)
3
3
11Net earnings (loss) attributable to Centene Corporation $ (1,101)
$ 283
$ (6,674)
$ 3,305
Net earnings (loss) per common share attributable to Centene Corporation:
Basic earnings (loss) per common share$ (2.24)
$ 0.57
$ (13.53)
$ 6.33Diluted earnings (loss) per common share$ (2.24)
$ 0.56
$ (13.53)
$ 6.31
Weighted average number of common shares outstanding:
Basic491,533
500,424
493,116
521,790Diluted491,533
501,978
493,116
523,744 CENTENE CORPORATION AND SUBSIDIARIESCONSOLIDATED STATEMENTS OF CASH FLOWS(In millions, unaudited)
Year Ended December 31,
2025
2024Cash flows from operating activities:
Net earnings (loss)$ (6,677)
$ 3,294Adjustments to reconcile net earnings (loss) to net cash provided by operating activities
Depreciation and amortization1,275
1,241Stock compensation expense204
212Impairment7,311
13(Gain) on debt extinguishment(1)
—Deferred income taxes(60)
13(Gain) loss on divestitures, net(2)
(120)Changes in assets and liabilities
Premium and trade receivables1,480
(4,333)Other assets(230)
46Medical claims liabilities2,336
368Unearned revenue80
(54)Accounts payable and accrued expenses(657)
(528)Other long-term liabilities(46)
(70)Other operating activities, net75
72Net cash provided by operating activities5,088
154Cash flows from investing activities:
Capital expenditures(767)
(644)Purchases of investments(4,541)
(7,183)Sales and maturities of investments5,780
5,785Divestiture proceeds, net of divested cash—
990Net cash provided by (used in) investing activities472
(1,052)Cash flows from financing activities:
Proceeds from long-term debt750
1,300Payments and repurchases of long-term debt(1,895)
(622)Common stock repurchases(475)
(3,124)Proceeds from common stock issuances37
46Purchase of noncontrolling interest(19)
—Other financing activities, net(19)
(6)Net cash (used in) financing activities(1,621)
(2,406)Effect of exchange rate changes on cash, cash equivalents and restricted cash—
8Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents3,939
(3,296)Cash and cash equivalents reclassified (to) from held for sale(138)
—Cash, cash equivalents and restricted cash and cash equivalents, beginning of period14,156
17,452Cash, cash equivalents and restricted cash and cash equivalents, end of period$ 17,957
$ 14,156Supplemental disclosures of cash flow information:
Interest paid$ 647
$ 688Income taxes paid, net$ 448
$ 1,002
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated
Balance Sheets to the totals above:
December 31,
2025
2024Cash and cash equivalents$ 17,888
$ 14,063Restricted cash and cash equivalents, included in restricted deposits69
93Total cash, cash equivalents and restricted cash and cash equivalents$ 17,957
$ 14,156 CENTENE CORPORATIONSUPPLEMENTAL FINANCIAL DATA
Q4
Q3
Q2
Q1
Q4
2025
2025
2025
2025
2024MEMBERSHIP
Traditional Medicaid (1)10,932,600
11,115,400
11,227,400
11,369,400
11,408,100High Acuity Medicaid (2)1,585,800
1,591,000
1,592,300
1,589,400
1,595,400Total Medicaid12,518,400
12,706,400
12,819,700
12,958,800
13,003,500Marketplace5,541,400
5,828,100
5,862,800
5,626,000
4,382,100Individual and Commercial Group (3)452,500
447,900
449,700
448,200
431,400Total Commercial5,993,900
6,276,000
6,312,500
6,074,200
4,813,500Medicare (4)1,002,600
1,013,200
1,026,900
1,043,200
1,110,900Medicare PDP8,118,600
7,972,500
7,845,800
7,867,800
6,925,700Total at-risk membership27,633,500
27,968,100
28,004,900
27,944,000
25,853,600TRICARE eligibles—
—
—
—
2,747,000Total27,633,500
27,968,100
28,004,900
27,944,000
28,600,600
(1)Membership includes TANF, Medicaid Expansion, CHIP, Foster Care and Behavioral Health.(2)Membership includes ABD, IDD, LTSS and MMP Duals.(3)Membership includes Commercial Group, ICHRA and Other Off-Exchange Individual.(4)Membership includes Medicare Advantage and Medicare Supplement.
NUMBER OF EMPLOYEES61,100
60,900
60,300
60,400
60,500
DAYS IN CLAIMS PAYABLE46
48
47
49
53
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)Regulated$ 37,289
$ 37,574
$ 36,403
$ 35,922
$ 34,433Unregulated1,478
1,259
1,086
1,042
1,071Total$ 38,767
$ 38,833
$ 37,489
$ 36,964
$ 35,504
DEBT TO CAPITALIZATION46.5 %
45.5 %
39.0 %
39.5 %
41.2 %
OPERATING RATIOS Three Months Ended December 31,
Year Ended December 31,
2025
2024
2025
2024HBR94.3 %
89.6 %
91.9 %
88.3 %SG&A expense ratio7.5 %
8.9 %
7.4 %
8.5 %Adjusted SG&A expense ratio 7.5 %
8.9 %
7.4 %
8.5 %
HBR BY PRODUCT Three Months Ended December 31,
Year Ended December 31,
2025
2024
2025
2024Medicaid93.0 %
93.4 %
93.7 %
92.5 %Commercial95.4 %
81.8 %
87.9 %
77.3 %Medicare (5)96.1 %
86.7 %
92.0 %
88.7 %
(5)Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement.MEDICAL CLAIMS LIABILITY The changes in medical claims liability are summarized as follows (in millions):Balance, December 31, 2024
$ 18,308Less: Reinsurance recoverables
65Balance, December 31, 2024, net
18,243Incurred related to:
Current period
160,109Prior periods
(2,315)Total incurred
157,794Paid related to:
Current period
140,691Prior periods
14,677Total paid
155,368Plus: Premium deficiency reserve
(92)Plus: Divestitures
(109)Balance, December 31, 2025, net
20,468Plus: Reinsurance recoverables
76Balance, December 31, 2025
$ 20,544Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the "Incurred related to: Prior periods" amount may be offset as Centene actuarially determines the "Incurred related to: Current period." Additionally, approximately $93 million was recorded as a reduction to premium revenues resulting from development within "Incurred related to: Prior periods" due to minimum HBR and other return of premium programs.The amount of the "Incurred related to: Prior periods" above represents favorable development and includes the effects of reserving under moderately adverse conditions, new markets where we use a conservative approach in setting reserves during the initial periods of operations, receipts from other third-party payors related to coordination of benefits and lower medical utilization and cost trends for dates of service December 31, 2024, and prior.
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Original: CENTENE CORPORATION REPORTS 2025 RESULTS AND ANNOUNCES 2026 GUIDANCE