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Employees say:"I have a People Leader that does not micromanage but is available to provide assistance when I need it. I love the guidance and training that People Leaders receive from Corporate. I enjoy the people I work most closely with, who are from all over the country. I also love working remotely and, as an introvert, think that I work best that way. I also love Centene's focus on work/life balance. "

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Employees say:"I love our mission and each day I see how our team and all the employees from within the organizations strives to achieve the upmost of our mission. I love what I do, what we do for our community and our members. Always going above and beyond, the recognition of each staff member speaks volumes to myself and others."

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The 300 companies on this list are transforming industries from the inside out.

GPTW Health Care Large 2023-Centene Corporation

Employees say: 
 
"At Centene Corporation, new, innovative ideas are encouraged. We constantly strive to work with community partners and invest in the communities we serve. We are constantly evolving and are flexible to handle change."

GPTW Women 2023-Centene Corporation

Employees say: 
 
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F500-2023-Centene

The health care company, led by CEO Sarah London, focuses on insurance plans offered through Medicaid and the Affordable Care Act. Revenue was up 15% in 2022 from the previous year. 
<ul> 
 	<li>Centene’s $2.2 billion acquisition of behavioral-health specialist Magellan Health, completed in January 2022, was cited by the company as a major factor in its revenue growth for the year.</li> 
 	<li>Elsewhere, Centene has been divesting itself of “noncore” subsidiaries in an ongoing review of its portfolio. Divisions that it has sold off include Magellan’s pharmacy and specialty-health units. In May 2023, Centene announced it would divest its A.I.-powered health care analytics company Apixio.</li> 
</ul>

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Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

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Employees say: 
 
“Yes, we operate as family. Everyone has the same goals and that is to take care of our members and each other. Executive leadership is very personable and accommodating. This company does its very best to reward their employees and accommodate them the best way that they can. I love my company. Everyone is very friendly, family oriented and considerate of one another. I would recommend Centene/Superior Health Plan to anyone that I feel would be a good fit for the company.”

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A global health crisis continued to drive revenue growth at Centene, a health insurer with considerable exposure to the Medicaid and Affordable Care Act marketplaces. Revenue increased 13.4% in 2021, to $126 billion, and as of early 2022, Centene’s managed care membership had increased by 1.9 million over the previous year. In January 2022, Centene acquired Magellan Health for $2.2 billion, expanding its behavioral-health offerings. The company is also coping with a loss in the corner office: In April 2022, CEO Michael F. Neidorff, who headed Centene for more than 25 years, passed away after a long illness. Sarah London, formerly vice chairwoman, is now chief executive.

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A couple of strategic bets paid off for Centene over the past year. The health insurer dug in to the Affordable Care Act’s marketplaces even when the Obama-era health law’s future was far from certain, and through April 2021 it had added 320,000 new members under the Biden administration’s expanded special enrollment period for those individual insurance exchanges. Centene’s 2020 revenues exceeded $111 billion, after executives accurately predicted that the COVID pandemic would bring about a windfall, with growing demand for coronavirus-related services across the nation. The question is how long that win streak can last. “This a year with unique drivers,” said CEO Michael Neidorff in late April 2021, “which we cannot be certain can continue throughout all of 2022.”

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F500-2021-24-Centene

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Centene has at times been an oddity among its health insurance peers. In the past few years, the company has remained steadfast in serving the Affordable Care Act’s individual insurance markets, despite what would seem like never-ending legal and political uncertainty surrounding the government program. Well, it seems the skeptics lost that bet. Centene's strategy, coupled with acquisitions that focus on government-affiliated health plans like Medicare and Medicaid, propelled the insurer to 24% revenue growth in 2019, compared with the previous year. And it may benefit from another financial tailwind to come: The firm reportedly expects billions of dollars in revenue growth this year, due to the coronavirus crisis.

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Centene has at times been an oddity among its health insurance peers. In the past few years, the company has remained steadfast in serving the Affordable Care Act’s individual insurance markets, despite what would seem like never-ending legal and political uncertainty surrounding the government program. That strategy, coupled with acquisitions that focus on government-affiliated health plans like Medicare and Medicaid, propelled Centene to 24% year-over-year revenue growth in 2019—not to menition a steady, decade-long rise on the Fortune 500. And the insurer may benefit from another financial tailwind to come: The firm reportedly expects billions of dollars in revenue growth this year, due to the coronavirus crisis.

As we face unprecedented collective challenges, cooperation has become a business superpower.

50.CTW20.Centene

This insurer’s 24 million members, the vast majority of whom belong to Medicaid, Medicare, and Health Insurance Marketplace plans, are disproportionately vulnerable to harm from the pandemic. Centene has leaned into the challenge of keeping them healthy by plowing money into infrastructure that helps Medicaid members access telehealth, and by removing barriers (like prior authorizations) to COVID-19 testing and care.

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Centene is the largest Medicaid managed-care organization in the U.S. as of 2026. The company works with programs in the public and private sector to provide health care services to the underinsured and uninsured, military veterans, and commercial organizations. Programs it serves include Medicaid and Medicare plans, Medicare prescription drug plans, the Health Insurance Marketplace, and Tricare plans. It also operates its own health care and dental clinics and pharmacies.

Q2 2026

Q1 2026

Q4 2025

Q3 2025

Q2 2025

Q1 2025

Q4 2024

Centene (CNC): Company Profile, Stock Price, News, Rankings

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Centene

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day and welcome to the Centene Corporation Fourth Quarter and Full Year 2025 Earnings Conference Call. All participants will be in listen-only mode. Did you need assistance? Please signal a conference specialist by pressing the star key followed by zero. After today's presentation, there will be an opportunity to ask questions.

To ask a question, you may press star then one on your telephone keypad, and to withdraw your question, please press star then two. Please note today's event is being recorded. I would now like to turn the conference over to Jennifer Gilligan, Senior Vice President, Investor Relations. Please go ahead.

Thank you, Rocco, and good morning, everyone. Thank you for joining us on our fourth quarter and year-end 2025 earnings results conference call. Sarah London, Chief Executive Officer, and Drew Asher, Executive Vice President and Chief Financial Officer of Centene, will host this morning's call, which also can be accessed through our website at centene.com.

Also, guidance slides can be found on our website alongside the webcast. Any remarks that Centene may make about future expectations, plans, and prospects constitute forward-looking statements for the purpose of the safe harbor provision under the Private Securities Litigation Reform Act of 1995. Specifically, our commentary on 2026, including drivers of Adjusted Diluted Earnings Per Share for 2026, are forward-looking statements.

Actual results may differ materially from those indicated by those forward-looking statements as a result of various important factors, including those discussed in our Fourth Quarter and Year-End 2025 Press Release and 2026 Guidance Presentation filed this morning, and other public SEC filings which are available on the company's website under the Investor section. Centene anticipates that subsequent events and developments may cause its estimates to change.

While the company may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so. I will also refer to certain non-GAAP measures. A reconciliation of these measures with the most directly comparable GAAP measures can be found in our Fourth Quarter and Year-End 2025 Press Release and 2026 Guidance Presentation. With that, I would like to turn the call over to our CEO, Sarah London. Sarah?

Thank you, Jen, and thanks everyone for joining us. This morning, we reported a fourth quarter adjusted diluted loss per share of $1.19, contributing to our full year 2025 adjusted diluted EPS of $2.08. While 2025 was undeniably challenging, disciplined execution enabled us to close the year slightly ahead of the expectations we outlined on our third quarter call. Medicaid profitability improved, strengthening the trajectory of our largest business.

Underlying medical cost trend within Marketplace and across the Medicare segment was in line to slightly favorable as we closed out Q4, and both segments delivered 2026 enrollment results consistent with our expectations, creating a solid foundation for next year's earnings power. As we look to 2026, we are positioned to deliver meaningful margin improvement and renewed adjusted EPS growth.

We expect full year 2026 adjusted EPS to be greater than $3, representing more than 40% year-over-year growth and marking important progress toward restoring the enterprise's embedded earnings power. This outlook incorporates Medicaid margin stability, significant margin recovery within our marketplace business, and continued progress towards our goal of break-even in Medicare Advantage. Now let's take a look at our business lines, beginning with Medicaid.

As an organization, we have been laser-focused on restoring our Medicaid business to sustainable profitability while maintaining our focus on quality outcomes for our members and the communities we serve. As a result of strong cross-enterprise execution, we demonstrated significant progress on this mission in the back half of 2025, with continued momentum through Q4.

Our fourth quarter health benefits ratio of 93.0 was consistent with expectations we set for investors in October, representing 40 basis points of sequential improvement and 190 basis points of improvement from Q2 levels. While flu drove significant national media coverage, flu and influenza-related illness costs within Medicaid were consistent with the elevated expectations we had incorporated into our financial outlook. Trend patterns remained largely consistent in Q4 compared to Q3, with behavioral health still driving roughly half of excess trend and both home health and high-cost drugs as secondary pressure points.

As we head into 2026, we continue to organize around the key levers that will drive improvement in the Medicaid business, including optimizing our networks for cost and quality performance, thoughtful implementation of new and enhanced clinical programs, rate advocacy and collaboration with our state partners on program reform, increasing vigilance in our detection and reduction of unnecessary utilization, and a more aggressive approach to fraud within the provider ecosystem in service of our mandate to protect Medicaid program integrity.

Our Applied Behavior Analysis, or ABA, task force established in Q2 of 2025 is a perfect example of how we have pulled critical levers to manage costs on behalf of our state partners while improving the quality of member care at the same time. Leveraging Centene's scale and reach, the team analyzed our ABA data across our 29-state footprint.

What we found were consistent patterns of outlier providers with volume versus outcomes-driven care patterns, where the maximum number of hours are prescribed for every patient instead of an individualized care plan. We found children who had been in therapy for five to 10 years, where clinical evidence suggests the optimal duration is two to three years, as well as those enrolled in 40 hours per week of therapy instead of balanced school-integrated care.

And we saw a lack of appropriate board-certified oversight of registered behavior technicians. These dynamics drive cost in the system, but far more importantly, they are red flags relative to the quality of patient care for a very vulnerable population. Centene's approach has been data-driven and multi-pronged. We engage directly with providers on gaps we see and focus our networks on providers who follow evidence-based best practices.

We meet directly with our state partners to share data, inform program design, and reduce outlier payments. We launched an ABA-specific engagement program to support members, their parents, and their providers. These programs are developed and led by PhD-level board-certified behavioral analysts who are still practicing, so this is not algorithmic or theoretical for us.

It is about being responsible stewards of taxpayer dollars and transforming the health of the communities we serve, one kiddo at a time in this case. Rates continue to be another powerful and important tool to ensure program sustainability. On this front, we closed 2025 with a composite rate adjustment of approximately 5.5% above 2024 levels, consistent with our prior commentary. 1/1 final rates were in line with our expectation.

And as the underlying data naturally rolls forward, we believe rate decisions will increasingly be made on data that reflects the acuity and trend dynamics we have experienced in Medicaid over the last two years. We will continue to be proactive in our engagement and data sharing as we move through 2026 and prepare for 2027 program changes.

Standing here today, we have greater visibility into the drivers of our core business and command of the levers needed to drive earnings recovery in Medicaid over the next few years while maintaining and improving the quality of our care our members receive. Turning to Marketplace, fundamental medical cost trend for our Marketplace business came in slightly better than expectations in Q4. In December, we also received an updated view of the 2025 Wakely data, which showed favorable development relative to our reserve.

We experienced two out-of-period items in the quarter, including a 2023 CMS reconciliation and costs related to No Surprises Act disputes. This prompted us to add an accrual for further NSA development related to 2025 dates of service, which ultimately pushed the segment HBR up by roughly 100 basis points versus our original expectations. We have accounted for estimated 2026 NSA costs in our guidance.

While the No Surprises Act was designed to protect consumers, it has increasingly become weaponized by market participants looking to extract profits from the system through the Independent Dispute Resolution, or IDR, process. We are vocal in advocating for NSA reform, and in the meantime, will be taking a more proactive litigious posture as necessary. As an example, earlier this week, we filed a multimillion-dollar lawsuit against a New York provider alleging fraudulent manipulation of in-network and out-of-network claims.

We will continue to take aggressive action to protect the system from fraudulent and abusive exploitation of NSA loopholes. Turning to 2026, the Marketplace team executed incredibly well over the last few months in a dynamic open enrollment period, investing in additional operational support to care for a customer base navigating significant change and uncertainty. In the absence of congressional intervention, Enhanced Advance Premium Tax Credits expired at the end of 2025.

As a reminder, we accounted for this assumption and the impact it would have on the market risk pool and cost in our 2026 pricing. Ambetter membership developed in line with expectations, and we are on track for first quarter ending membership of roughly 3.5 million members as compared to our December membership of 5.5 million. While market signups are being reported publicly, this isn't the most helpful indicator of true market dynamics.

Now that we are into February, paid membership is the most important metric for planning and forecasting. Through the end of January, Ambetter paid rates, while below historical levels, are right in line with our expectations in a post-EAPTC environment. Relative to member demographics, our membership is more notably enrolled in Bronze plans for 2026 compared to prior years, with many of those members still able to access $0 premium products.

Bronze membership will represent a little over 30% of our marketplace enrollment this year compared to a range of 19%-24% over the past four years. Age and gender demographics remain consistent with recent years. Risk adjustment was obviously a source of significant deviation from our financial plans last year. As you think about the expectations incorporated into our 2026 plan, we anticipate being in a meaningful payable position for the 2026 plan year at this time.

Consistent with other years, we will reassess our risk adjustment position and assumptions as we move through the year and receive additional data. To that end, in an effort to drive additional visibility at an industry level, we are pleased to have worked closely with Wakely, the independent actuarial firm, to support publication of a new report reflecting marketwide paid membership, metallic tier distribution, and statewide average premium set to be released toward the end of Q1 in order to help market participants better inform risk adjustment assumptions going forward.

While 2025 was a difficult year for the marketplace business, we believe the actions we took in the back half of 2025 set us up to navigate 2026 with increased visibility and confidence. We continue to advocate for program reform that will drive affordability and further stabilize the individual marketplace overall as an alternative to employer-sponsored insurance and a solution for small business owners and other hardworking Americans and their families. Finally, Medicare. Our Medicare segment delivered strong results throughout 2025.

Fourth quarter fundamental Medicare Advantage performance was in line with our expectations, setting us up with a solid jump-off point for 2026. We completed a review of our provider contract portfolio in the quarter and adjusted certain receivables accordingly, which drove the slightly elevated HBR compared to expectations. Overall, we continue to look for opportunities to position the business for improved profitability in 2026 on the way to our goal of break-even Medicare Advantage results in 2027, an important enterprise milestone.

Our Medicare Advantage product positioning yielded the intended results for 2026 membership, and we expect to end the first quarter with a decline in MA membership consistent with our strategy to refine our footprint and fine-tune our value proposition for Medicaid beneficiaries. PDP ended Q4 with some additional favorability thanks to slightly moderating trend, and that team deserves a well-earned shout-out for having managed the business expertly through significant program changes.

As we look ahead to 2026, Part D enrollment is tracking to high single-digit % growth at the end of the first quarter compared to year-end 2025, with member mix across the products aligning well with program and formulary design. This year provides an important opportunity to build on the meaningful progress we've made in Medicare Advantage and further strengthen the platform that will most effectively serve Medicare beneficiaries as well as dual-eligible membership.

We continue to focus on stars improvement, clinical engagement, and overall SG&A efficiencies. At the same time, we launched a redesigned duals operating model, leveraging insights from our deep experience managing complex populations to enhance our service and member experience for a duals member base that now accounts for roughly 40% of our Medicare Advantage business.

Last week's 2027 Advance Notice, at least initially, suggests a more pressured view of rates than industry expectations, but it does not change our focus on returning our Medicare book to profitability, aligning closely with our key Medicaid markets and continuing to invest in quality programs and benefits that support our core member base. We expect rates to be finalized in early April, consistent with prior years. Taking a step back, our long-term goal across our businesses is to deliver industry-leading outcomes at an industry-leading cost structure.

As we create the roadmap to harvest Centene's full potential earnings power, there is no question that data, technology, and artificial intelligence will be a critical lever and accelerant to this work. Over the last few years, we have been building the necessary data foundation and systematically integrating AI into our operations, resulting in proof points around accelerated prior authorization approvals, improved call center operations, enhanced member navigation and engagement experiences, and advanced analytics capabilities that support our medical economics work and our payment integrity operations.

As an example of the latter, we currently score our claims data against 75 different algorithms designed to triangulate potential fraud. Alerts are triggered and sent to a group of cross-functional experts for immediate review and intervention.

As we step into 2026, we are closely tracking the inflection of GenAI and accelerating our integration of agentic capabilities into our core operations to drive automation and efficiency, and using it as a catalyst to reimagine and elevate the experience we deliver to our members, partners, and other stakeholders. You should expect to hear more on this in the quarters ahead. 2025 challenged us, but it also made us stronger.

Amid continued landscape volatility and with the benefit of enhanced visibility across lines of business as we move through the back half of the year, we took the opportunity as an organization to reassess and refresh our views of both existing and emergent headwinds and tailwinds. We have prudently positioned our 2026 outlook, incorporating an expectation the policy-related variability will continue to influence our core business lines.

We are confident in our ability to execute against the outlook we have provided today, building on the positive momentum we have generated in recent months. We see continued opportunity for margin expansion in the months and years ahead while keeping our members at the center of everything we do. As I have said before and feel only more strongly after the year we have navigated, Centene is an incredibly powerful engine.

They are fired up and focused on the opportunity ahead and committed to the hard work necessary to deliver margin that will power our mission. With that, I will turn it over to Drew to provide more details about the quarter and our view of 2026.

Thank you, Sarah. Today we reported fourth quarter and full year 2025 results, including $174.6 billion in premium and service revenue, an adjusted diluted earnings per share of $2.08. The fourth quarter GAAP diluted loss per share of $2.24 includes a $389 million net loss prompted by a Q4 definitive agreement to divest the remaining Magellan business.

Recall, we previously divested the Magellan pharmacy and specialty businesses at gains over the past few years. From an adjusted earnings standpoint, we are pleased that the underlying fundamentals in Q4 are tracking our prior forecasted full year adjusted diluted EPS of greater than $2.00.

This sets us up well for our 2026 guidance that we'll cover in a minute. Starting with Medicaid, we saw continued progress and improvement in the HBR, with Q4 improving to 93.0%. While we have a lot further to go in Medicaid to achieve a reasonable HBR and margin, the back half of 2025 was a good start with two consecutive quarters of HBR improvement.

Our 1/1 net rates are supportive of our 2026 guidance of a stable Medicaid HBR, with an assumed full year 2026 net rate impact of mid-4s and a corresponding mid-4s 2026 net trend expectation. As expected, we continue to see slight attrition in membership, closing out 2025 at 12.5 million members. We continue to drive quality and affordability healthcare initiatives and work with our state partners on the optimal program structures and associated rates.

While certain areas are still elevated, behavioral, home health, and high-cost drugs, we can see tangible progress in the business. Overall, this is another quarter of good progress in Medicaid. Our commercial segment HBR in Q4 was about a point higher than our forecast, with a few items moving in both directions, but the elements that matter most for 2026 were positive.

Importantly, the current period medical cost and trend were slightly better than our expectations in the fourth quarter. So we feel good about Q4 fundamentals as we turn the calendar into 2026. Another positive sign in the quarter was a favorable change in our view of 2025 relative morbidity or risk adjustment based upon the third round of Wakely data.

Centene (CNC) Q4 2025 Earnings Call Transcript

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