Centene Corporation Conference Call Summary Company Overview - **Company**: Centene Corporation (NYSE:CNC) - **Date of Conference**: November 11, 2025 - **Speakers**: Sarah London (CEO), Drew Asher (CFO) Key Points Industry Context - Centene operates primarily in the healthcare services sector, focusing on government-sponsored programs such as Medicaid and Medicare. Financial Performance - Q3 results exceeded expectations, leading to an upward revision of the full-year outlook to at least $2 per share [4][7] - The company reported a revenue stream of approximately $5 billion from the Florida Medicaid contract, which is expected to decrease to between $4.5 billion and $9.3 billion next year due to contract changes [8][9] Medicaid Updates - Centene was not awarded the CMS Florida contract after six years, impacting their revenue but allowing for a focus on sustainable margins [5][8] - The company is prioritizing a seamless transition for affected members and is not planning to protest the contract decision [5] - Medicaid margins are expected to remain consistent next year, contrasting with some peers who anticipate declines [15][36] Medicare and Marketplace Insights - Open enrollment for Medicare is ongoing, with a focus on margin improvement rather than membership growth [49][54] - The company is optimistic about its position in the Medicare Advantage market, aiming for break-even by 2027 [49] - There is an uptick in call volume related to Marketplace inquiries, indicating member confusion over premium changes [20][22] Legislative and Subsidy Discussions - Ongoing discussions in Congress regarding enhanced subsidies could significantly impact members and the overall market [24][25] - Centene has prepared for various scenarios regarding subsidy extensions and has built pricing for 2026 accordingly [26][30] Operational Strategies - The company is focused on improving margins through various levers, including rate negotiations and utilization management [15][17] - Centene is actively engaged with state governments to optimize Medicaid programs and address issues like fraud and waste [41][42] Future Outlook - The company sees potential for growth in Medicaid and is exploring disruptive opportunities in employer-sponsored insurance [59] - Centene aims to maintain a flexible capital structure, targeting a debt-to-capital ratio below 40% to seize future opportunities [58] Behavioral Health and Cost Management - Behavioral health accounts for approximately 20% of Medicaid spending, and states are increasingly focused on managing these costs [42][43] - Centene is working with states to implement effective policy changes to control costs while maintaining care quality [41] Conclusion - Centene is navigating a complex healthcare landscape with a focus on sustainable growth, margin improvement, and proactive engagement with legislative changes and state partnerships [59][60]

Financial Data and Key Metrics Changes - The company reaffirmed its full-year guidance, indicating a strong start to 2025 with Q1 results ahead of plan [5][14] - Adjusted EPS guidance for the year is approximately $16.25, with an expected insurance segment benefit ratio of 90.1% to 90.5% [15][14] - G&A costs for the quarter were slightly better than expectations, attributed to the timing of costs expected in the second and third quarters [11][14] Business Line Data and Key Metrics Changes - The Medicare product and experience maintained membership guidance for 2025, with strong performance in the Open Enrollment Period (OEP) [8] - CenterWell and Medicaid businesses showed robust patient and membership growth, with 30 new centers added through acquisition and partnership [12][14] - The company reported a 30% to 50% reduction year over year in members with weight refills due to medication adherence campaigns [11] Market Data and Key Metrics Changes - The company is seeing strong year-to-date performance in markets with high concentrations of members, particularly in Florida, Illinois, and Texas [41] - Medicaid membership growth is on track, with approximately 100,000 growth year-to-date, aligning with the expected annual growth of 175,000 to 250,000 [74] Company Strategy and Development Direction - The company is focused on operational efficiencies, increasing flexibility, and operating leverage while making investments to improve member outcomes [14] - The integration between the insurance segment and CenterWell is aimed at delivering better health outcomes and improving STARS performance [58][60] - The company is committed to returning to a 3% pre-tax margin in Medicare Advantage (MA) by 2027, with ongoing focus on quality and operational excellence [48][90] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the underlying progress of the business despite external challenges, emphasizing control over medical costs and operational efficiencies [50][52] - The company is monitoring changes in consumer behavior due to the Inflation Reduction Act (IRA) and is prepared for potential impacts on future performance [6][14] - Management highlighted the importance of navigating regulatory headwinds while focusing on controllable factors [51][52] Other Important Information - The company is actively working through STARS strategy and bids, with a focus on balancing membership and margins [32][33] - Recent fulfillment agreements with multiple companies are expected to contribute positively to growth [12][63] Q&A Session Summary Question: How much of your investments moved out of Q1? - Management indicated that most of the impact of incremental investments flowed through the MLR in Q1, with expectations for higher levels in the second through fourth quarters [20] Question: Update on the path to the 3% MA margin target? - Management reiterated focus on achieving the 3% margin, with timing tied to STARS outcomes, and no significant changes from previous communications [23] Question: Update on STARS initiatives and bids? - Management expressed confidence in progress made on STARS initiatives and ongoing work on bids, emphasizing a balanced approach to membership and margins [27][32] Question: Experience in Part D relative to expectations? - Trends in the business are consistent with expectations, with mid-single-digit growth on the medical side and low double-digit growth on the pharmacy side [36] Question: Visibility on risk adjustment and Group MA? - Management reported strong membership changes and visibility into risk adjustment, with no significant behavioral changes noted in Group MA [41][43] Question: Comments on Medicaid visibility and utilization? - Medicaid is performing in line with expectations, with strong growth and positive trends in member engagement and outcomes [75][76] Question: Clarification on GAAP EPS and valuation adjustments? - Management clarified that the adjustment in GAAP EPS guidance is unrelated to structural impairment and is part of a complex calculation [93]