Centene is like Humana, but for Medicaid and Affordable Care Act (ACA) marketplace plans.

Centene is like a UnitedHealth Group focused predominantly on government-sponsored healthcare programs.

Centene is like the public sector arm of a major health insurer (e.g., Cigna or Elevance Health).

• Medicaid Managed Care: Centene administers comprehensive health plans for individuals and families eligible for state Medicaid programs.
• Medicare Advantage Plans: Centene offers privately administered health plans for Medicare-eligible individuals, providing integrated medical and pharmacy benefits.
• Affordable Care Act (ACA) Marketplace Plans: Centene provides health insurance plans to individuals and families through government-regulated exchanges established by the Affordable Care Act.
• Pharmacy Benefits Management (PBM): Centene manages prescription drug programs, including formulary development, drug utilization review, and claims processing for its health plans and other clients.
• Correctional Healthcare Services: Centene delivers comprehensive physical and behavioral healthcare services to incarcerated populations in state and and county correctional facilities.

Centene (Symbol: CNC) - Major Customers

• State Governments: Centene contracts with numerous state governments across the United States to provide managed care services for Medicaid beneficiaries. These contracts represent a significant portion of Centene's revenue.
• Federal Government (Centers for Medicare & Medicaid Services - CMS): Centene contracts with CMS to offer Medicare Advantage plans and Medicare Prescription Drug Plans (Part D) to eligible individuals. CMS also provides oversight for the Health Insurance Marketplace (ACA) plans where Centene is a major participant.
• U.S. Department of Defense (DoD) / Military Health System (TRICARE): Through its subsidiary, Health Net Federal Services, LLC, Centene has served as a managed care contractor for the TRICARE program, providing healthcare services to military service members, retirees, and their families in specific regions.

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Sarah M. London, Chief Executive Officer

Sarah M. London became the Chief Executive Officer of Centene in March 2022. Before this, she served as Centene's Vice Chairman, where her responsibilities included strategy, technology, ancillary services, enterprise compliance and quality, and Centene's portfolio of independent, non-health plan companies. She also held the role of Senior Vice President of Technology Innovation and Modernization. Ms. London joined Centene in 2020. Prior to her tenure at Centene, she was an Operating Partner at Optum Ventures, the venture capital arm of UnitedHealth Group, where she led investments in early-stage healthcare startups. She also served as Chief Product Officer for Optum Analytics, and joined Optum after its acquisition of Humedica, a clinical analytics start-up where she led client services and operations. Her early career included positions at Accretive Health (now R1 RCM) and Health Leads.

Drew Asher, Chief Financial Officer

Drew Asher was appointed Executive Vice President and Chief Financial Officer of Centene in May 2021. He joined Centene in January 2020 in conjunction with the acquisition of WellCare, where he had been Executive Vice President, Specialty. Before joining Centene, Mr. Asher served as Chief Financial Officer of WellCare Health Plans for six years, starting in October 2014. Prior to WellCare, he held senior finance positions at Aetna. He spent nearly 15 years at Coventry Health Care, most recently as Senior Vice President of Corporate Finance, and was promoted to CFO after Coventry was acquired by Aetna in 2013. Mr. Asher began his career as an auditor at Deloitte & Touche LLP.

Brent Layton, President and Chief Operating Officer

Brent Layton serves as President and Chief Operating Officer of Centene. He joined Centene in 2006. Before becoming President and COO, he was the Executive Vice President of Markets, Products, International, and Chief Business Development Officer for over 15 years. Mr. Layton previously ran a managed care consulting firm and established a diverse group of healthcare companies.

Shannon Bagley, Executive Vice President and Chief Administrative Officer

Shannon Bagley is the Executive Vice President and Chief Administrative Officer at Centene Corporation. She joined Centene in 2003. Ms. Bagley spent nearly ten years leading the Internal Audit and Enterprise Risk Management teams and held various executive positions in Home State Health, Integration Management, and Human Resources prior to her current role.

Colin Toney, Executive Vice President of Mergers & Acquisitions

Colin Toney joined Centene's executive team as the Executive Vice President of Mergers & Acquisitions in July 2021. In this role, he is responsible for acquisitions, divestitures, investments, joint ventures, and other partnerships for Centene. Mr. Toney has been involved in significant acquisitions for the company, including Wellcare, Magellan, and HealthSmart.

Centene (CNC) faces several key risks to its business, primarily driven by legal and regulatory challenges, uncertainties in government healthcare programs, and persistent issues with rising medical costs.

1. Legal and Regulatory Headwinds & Significant Financial Underperformance: Centene is currently grappling with ongoing securities class action lawsuits and investigations by the U.S. Securities and Exchange Commission (SEC). These legal challenges stem from allegations of misleading statements regarding enrollment growth, morbidity rates, and accounting irregularities within its Medicaid and pharmacy benefit management (PBM) operations. The company has experienced lower-than-expected enrollment and higher medical costs in its Marketplace states, leading to substantial revenue shortfalls, a reported loss in Q2 2025, the withdrawal of its 2025 financial guidance, and a significant drop in its stock price.
2. Policy and Subsidy Uncertainty in Government Healthcare Programs: A substantial portion of Centene's business relies on government-sponsored healthcare programs, including Medicaid, Medicare, and the Affordable Care Act (ACA) Marketplace. This dependence exposes the company to significant risks from potential shifts in healthcare laws and regulations. Key concerns include the possible expiration or reduction of ACA exchange subsidies, ongoing Medicaid redeterminations that can affect enrollment numbers, and the impact of the Inflation Reduction Act (IRA) on Medicare Part D, which introduces increased underwriting risks and market volatility for 2025 bids. Such policy changes can materially affect Centene's membership, revenue, and overall profitability.
3. Increasing Medical Costs and Challenges in Profitability: Centene continues to face challenges in controlling escalating medical costs, particularly within its ACA Exchange market and Medicaid segments, with notable increases in behavioral health, home health, and high-cost drugs. This trend, coupled with declining margins and significant goodwill and intangible asset impairment charges, indicates ongoing struggles to translate revenue growth into consistent and sustainable profitability, posing a substantial threat to the company's financial health.

The clear emerging threat to Centene is the increasing shift by state governments towards **alternative value-based care models and direct contracting with provider networks for their Medicaid populations, potentially diminishing the traditional role and profitability of large private managed care organizations.**

This trend is emerging due to:

1. **Intensified Focus on Cost Control and Accountability:** Post-pandemic and following the large-scale Medicaid redeterminations, states are under heightened pressure to demonstrate cost-effectiveness, improve health outcomes, and ensure transparency in their Medicaid programs. This leads to a re-evaluation of current managed care models.
2. **Growth of Provider-Led Risk Models:** Integrated health systems and large Accountable Care Organizations (ACOs) are increasingly capable and willing to take on financial risk directly from state governments to manage patient populations, potentially bypassing the need for a traditional MCO as the primary intermediary. This allows states to potentially cut administrative costs associated with MCOs and exert more direct control over care delivery.
3. **State-Specific Innovations:** A growing number of states are exploring or implementing hybrid models or direct contracting strategies for parts of their Medicaid programs, moving away from a sole reliance on broad MCO contracts. These initiatives aim to foster more direct partnerships between the state and care providers, with a focus on specific outcomes and value.

This represents a structural shift in how government healthcare programs could be administered, analogous to how new delivery models disrupted Blockbuster or how new service models impacted traditional taxis, by offering a potentially more direct, efficient, or value-driven alternative to the established system.

Centene Corporation (NYSE: CNC) primarily operates in the U.S. managed healthcare market, offering a spectrum of products and services. The addressable markets for its main offerings are sized as follows:

• Medicaid Managed Care: As of July 2022, approximately 72 million Medicaid enrollees in the United States received their care through risk-based Managed Care Organizations (MCOs). The total Medicaid enrollment in the U.S. peaked at 94.5 million in April 2023.
• Medicare Advantage: In 2025, the Medicare Advantage market in the United States saw a record 34.5 million individuals enrolled. This represents over half, or 54%, of the eligible Medicare population as of 2024, with 32.8 million people enrolled.
• Affordable Care Act (ACA) Health Insurance Marketplace: The U.S. Affordable Care Act Marketplace recorded a high of 24.3 million people enrolled in health plans for 2025. The Centers for Medicare & Medicaid Services (CMS) reported 24.2 million consumers selected plan year 2025 coverage through the Marketplaces.
• TRICARE: The U.S. Department of Defense's healthcare delivery system, TRICARE, served approximately 9.4 million beneficiaries in 2018. In 2023, TRICARE continued to cover around 9.4 million beneficiaries across its various plans, including TRICARE Prime, TRICARE Select, and Medicare-eligible beneficiaries (TRICARE For Life), serving individuals in the U.S. and globally.

Centene Corporation (CNC) is expected to drive future revenue growth over the next 2-3 years through several key initiatives across its core business segments:

1. Growth and Margin Recovery in the Medicaid Business: Centene, a significant provider in the Medicaid sector, is actively pursuing strategies to stabilize and improve profitability. This includes focusing on rate advocacy, implementing cost containment measures, and enhancing operational efficiencies within its Medicaid programs. The company expects Medicaid profitability to remain consistent with 2025 levels, driven by these ongoing efforts.
2. Expansion and Enhanced Profitability in the Marketplace (ACA) Business: The Marketplace segment has demonstrated robust revenue growth. Centene is strategically repricing its Marketplace offerings for 2026 to achieve increased profitability. This aligns with a broader market expectation of significant expansion in the ACA Marketplace.
3. Targeted Growth in Medicare Advantage and Prescription Drug Plan (PDP) Segments: Centene is strategically expanding its presence in the Medicare Advantage and PDP markets, particularly by focusing on dual-eligible beneficiaries who qualify for both Medicare and Medicaid. The company is working towards achieving breakeven in its Medicare segment by 2027, with anticipated margin improvements in 2026.
4. Focus on Dual-Eligible Population and Integrated Care: Leveraging its extensive Medicaid footprint, Centene sees substantial growth opportunities in better serving and aligning care for individuals eligible for both Medicare and Medicaid. Regulatory changes, such as the mandate for integrated care by 2030, further enhance Centene's advantage in this complex population.

Share Repurchases

• Centene's Board of Directors authorized a stock repurchase program with a total authorization of up to $10,000 million, which included a $4,000 million increase in 2023.
• As of December 31, 2024, Centene had $2,230 million remaining available under its stock repurchase program.
• The company repurchased shares worth $3,113 million in 2024, $1,633 million in 2023, and $3,096 million in 2022, primarily funded by divestiture proceeds and free cash flow.

Share Issuance

• Centene reported proceeds from common stock issuances of $29 million in the third quarter of 2025, and $37 million for the first nine months of 2025.

Inbound Investments

• Politan Capital Management acquired a $900 million stake in Centene in December 2021.

Outbound Investments

• Centene acquired Magellan Health for a total enterprise value of $2.2 billion in January 2021.
• The company acquired PANTHERx Rare in December 2020 and Apixio in November 2020.
• Centene divested two pharmacy organizations, Magellan Rx and PANTHERx Rare, for a total of $2.8 billion in 2022.

Capital Expenditures

• Centene spent $644 million on capital expenditures in 2024 and $799 million in 2023.
• These capital expenditures were primarily focused on system enhancements and computer hardware.
• For 2025, Centene plans to spend approximately $700 million on capital expenditures, mainly for system enhancements.