Core Viewpoint - A lawsuit has been filed against Centene Corporation and its senior executives for potential violations of federal securities laws, with claims under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 [1][2]. Company Overview - Centene Corporation is a healthcare company that provides services to consumers enrolled in government-sponsored healthcare programs such as Medicaid and Medicare, as well as those purchasing insurance under the Affordable Care Act [3]. Financial Guidance and Performance - On December 12, 2024, Centene announced financial guidance for fiscal year 2025, claiming stability in earnings despite challenges [4]. - The company increased its 2025 guidance on February 4, 2025, citing enrollment overperformance, and again on April 25, 2025, due to strong growth in enrollment and retention [4]. - However, the actual market conditions showed lower than expected enrollment growth and increased morbidity rates in the majority of the states Centene serves [4]. Stock Performance and Market Reaction - On July 1, 2025, Centene withdrew its previous guidance after an independent actuarial report revealed lower than expected market growth and higher morbidity rates [5]. - Following this news, Centene's stock price plummeted by $22.87 per share, a decline of over 40%, from $56.65 on July 1, 2025, to $33.78 on July 2, 2025 [5].

Medicare Advantage Program Challenges - UnitedHealth is facing significant challenges due to collapsing profits in its Medicare Advantage program [1] - Tighter V28 billing codes are reducing extra margins for insurers and doctors, impacting UnitedHealth's Optimum Health and its 90,000 doctors [2] - The company's doctor unit, Optim Health, which was previously a strength, is now a significant drag on performance in Medicare Advantage [5] - UnitedHealth inherited many patients by offering more generous benefits while competitors cut back, leading to current problems [6] Financial Outlook and Guidance - Analyst estimates for 2025 earnings per share range from $18 to $26, with a consensus of nearly $21; anything less than $18 would be a significant concern [3] - Investors are focused on how UnitedHealth plans to stem losses and improve its financial situation [2] Regulatory and Legal Issues - The Department of Justice (DOJ) is investigating UnitedHealth's billing practices [3] Market Impact - UnitedHealth's struggles are weighing on the Dow Jones Industrial Average, dragging it down by 1400 points this year [7]

Core Insights - FTI Consulting has appointed Elizabeth (Liz) Goodman as a Senior Managing Director in the Healthcare and Life Sciences practice within its Strategic Communications segment [1][4] Company Overview - FTI Consulting, Inc. is a leading global expert firm specializing in crisis and transformation, with over 7,900 employees across 32 countries and territories as of June 30, 2025 [6] - The company generated $3.70 billion in revenues during the fiscal year 2024 [6] Appointment Details - Dr. Goodman brings over 30 years of experience in healthcare, health insurance, and health law and policy, focusing on Medicare, Medicaid, and long-term services [2] - In her new role, Dr. Goodman will assist healthcare and life sciences payers and providers in navigating complex business environments, advising C-suite executives on brand equity, stakeholder management, and risk mitigation [3][5] - Her previous roles include Chief Legal and Public Affairs Officer at Commonwealth Care Alliance and Executive Vice President of Government Affairs and Innovation at America's Health Insurance Plans [4] Strategic Goals - Dr. Goodman aims to address regulatory shifts, evolving care models, and changing expectations in the healthcare sector, collaborating with FTI Consulting's experts to develop strategies for business-critical challenges [5] - The hiring of Dr. Goodman is part of the ongoing expansion of the Healthcare and Life Sciences practice at FTI Consulting, following several recent appointments in public affairs and corporate reputation [5]

WASHINGTON, July 28, 2025 (GLOBE NEWSWIRE) -- FTI Consulting, Inc. (NYSE: FCN) today announced the appointment of Elizabeth (Liz) Goodman as a Senior Managing Director in the Healthcare and Life Sciences practice within the firm’s Strategic Communications segment. Dr. Goodman, who is based in Washington, D.C., joins FTI Consulting with more than 30 years of experience in healthcare, health insurance and health law and policy at the state and federal levels, including a focus on Medicare, Medicaid and long-t ...

Cost Estimation - US health insurers significantly underestimated health costs for 2025 due to changes in government programs [1] Market Outlook - Expect health insurance price hikes next year [1]

Core Insights - UnitedHealth (NYSE: UNH) is scheduled to release its earnings on July 29, 2025, with analysts expecting earnings of $4.94 per share on revenue of $111.6 billion, compared to last year's earnings of $6.80 per share on revenues of $98.86 billion, indicating a contraction in profit margins due to rising medical costs [2][3] Group 1: Earnings Performance - Over the past five years, UNH stock has shown positive one-day returns after earnings announcements in 53% of cases, with a median one-day gain of 4.0% and a maximum increase of 7.2% [2][7] - In the last three years, the percentage of positive one-day returns drops to 45%, with a median of 4.0% for positive returns and -2.9% for negative returns [7] Group 2: Financial Metrics - UnitedHealth has a current market capitalization of approximately $267 billion, generating $410 billion in revenue over the past twelve months, with operating profits of $33 billion and a net income of $22 billion, reflecting strong operational profitability [3] Group 3: Trading Strategies - Traders can utilize historical data to position themselves ahead of earnings releases or analyze post-earnings returns to guide their trading strategies [5][9] - Understanding the correlation between short-term (1D) and medium-term (5D, 21D) returns can help traders make informed decisions based on historical performance [9]

UnitedHealth Group Incorporated ( UNH ) faced several adverse catalysts during 2025, which resulted in a massive stock sell-off. The stock is currently down by around 45% year-to-date, and it is a massive dip for a mega-cap ($200+ billion) company.With a decade at a Big 4 audit firm specializing in the banking, mining, and energy sectors, I bring a strong foundation in finance and strategy. Currently, I serve as the Head of Finance for a leading owner and operator of retail real estate, where I oversee comp ...

Core Viewpoint - A lawsuit has been filed against Centene Corporation and its senior executives for potential violations of federal securities laws, with claims under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 [1][2]. Group 1: Company Overview - Centene Corporation is a healthcare company that provides services to consumers enrolled in government-sponsored healthcare programs such as Medicaid and Medicare, as well as those purchasing insurance under the Affordable Care Act [3]. Group 2: Financial Guidance and Performance - On December 12, 2024, Centene announced financial guidance for fiscal year 2025, claiming stability in earnings despite challenges [4]. - The company increased its 2025 guidance on February 4, 2025, citing enrollment overperformance, and again on April 25, 2025, due to strong growth in enrollment and retention [4]. - Contrary to these claims, the majority of the market served by Centene was experiencing lower than expected enrollment growth and increased morbidity rates [4]. Group 3: Stock Performance and Market Reaction - On July 1, 2025, Centene withdrew its previous guidance after an independent actuarial report revealed lower than expected market growth and higher morbidity rates in 22 of the 29 states it serves [5]. - Following this news, Centene's stock price fell by $22.87 per share, a decline of over 40%, from $56.65 on July 1, 2025, to $33.78 on July 2, 2025 [5].

Core Insights - Centene Corporation (CNC) reported a second-quarter 2025 adjusted loss per share of 16 cents, missing the Zacks Consensus Estimate of earnings of 68 cents, and a significant decline from the year-ago profit of $2.42 per share [1][11] Financial Performance - The company's revenues increased by 22.4% year over year to $48.7 billion, surpassing the consensus mark by 10.9% [2][11] - Medicaid revenues grew 7% year over year to $21.7 billion, while Medicare revenues surged 58% year over year to $9.5 billion [3] - Commercial revenues improved 18% year over year to $10.1 billion [3] - Total premiums reached $41.7 billion, an 18.8% year-over-year increase, driven by higher premiums and an expanding membership base [4] Membership and Operational Metrics - Total membership (excluding TRICARE) was 28 million as of June 30, 2025, reflecting an 8.9% year-over-year growth, although there were declines in Medicaid and Medicare memberships [6] - The health benefits ratio deteriorated to 93%, a 540 basis point decline year over year, exceeding the consensus mark of 90.82% [7] Expenses and Losses - Operating expenses totaled $49.2 billion, a 27.4% year-over-year increase, attributed to rising medical costs, premium tax expenses, and administrative costs [7] - Adjusted net loss was recorded at $79 million, contrasting with year-ago earnings of $1.3 billion [8] Cash and Equity Position - As of June 30, 2025, Centene had cash and cash equivalents of $14.5 billion, up from $14.1 billion at the end of 2024 [9] - Total assets increased to $86.4 billion from $82.4 billion at the end of 2024, while long-term debt decreased to $17.6 billion from $18.4 billion [9] Share Repurchase Activity - Centene repurchased common shares worth approximately $432 million in the second quarter of 2025 [12] Peer Comparison - Elevance Health, Inc. reported second-quarter 2025 adjusted EPS of $8.84, missing estimates and showing a 12.6% year-over-year decline [13] - UnitedHealth Group is expected to report a significant year-over-year decline in profits despite a projected 12.8% revenue increase [14]

Financial Data and Key Metrics Changes - The company reported an adjusted per share loss of $0.16 for Q2 2025, which was below the financial goals set at the beginning of the year [7][33] - Premium and service revenue for Q2 2025 was $42.5 billion, reflecting challenges in the Marketplace and Medicaid segments [33][41] - The adjusted diluted EPS guidance for the full year 2025 has been revised down to approximately $1.75, significantly lower than the previous guidance of $7.25 [24][40] Business Line Data and Key Metrics Changes - Marketplace membership reached 5.9 million, generating over $10 billion in commercial premium and service revenue, but faced a $1.2 billion pretax drag due to risk adjustment transfer revenue shortfalls [8][10] - The Medicaid portfolio reported a health benefits ratio (HBR) of 94.9%, driven by increased medical costs in behavioral health, home health, and high-cost drugs [15][19] - Medicare Advantage is on track for breakeven in 2027, with PDP membership stable at 7.8 million and showing improved performance [21][23] Market Data and Key Metrics Changes - The company anticipates a $2.4 billion headwind to Marketplace earnings in 2025 due to a significant morbidity shift, with some states experiencing a 16% to 17% year-over-year change [10][11] - Medicaid rate adjustments are expected to be around 5% for 2025, an increase from the previous expectation of 4% [19][24] - The overall market is expected to contract further, with the company projecting a decrease in Marketplace membership to 5.4 million by year-end 2025 [69][70] Company Strategy and Development Direction - The company is focused on restoring profitability in the Marketplace by repricing 100% of the book for 2026, addressing the morbidity shifts observed in 2025 [12][29] - In Medicaid, the strategy includes advocating for rate adjustments and managing costs through clinical interventions and fraud prevention [18][19] - The company aims to leverage its size and scale to create transparency in market dynamics and improve pricing strategies [76][78] Management's Comments on Operating Environment and Future Outlook - Management expressed disappointment with Q2 performance but emphasized a unified focus on restoring earnings trajectory and improving performance across the portfolio [7][24] - The company is actively engaging with state partners to address Medicaid cost trends and secure necessary rate adjustments [19][60] - Future earnings potential is seen in the ability to manage costs effectively and secure favorable rates, with confidence in the long-term viability of its business segments [41][42] Other Important Information - The company has filed 2026 pricing in 17 states and expects to submit additional filings soon, aiming for state certification of rates [12][36] - Cash flow from operations was $1.8 billion for Q2, with unregulated cash on hand at $234 million [39] - The company does not anticipate further share buybacks in 2025 but remains open to opportunistic actions based on market conditions [39][40] Q&A Session Summary Question: Capital position and potential needs for additional capital - The company plans to inject a net $300 million into subsidiaries in the second half of the year, with a renewed $4 billion credit facility available [44][46] Question: Risk adjustment true-up and market impacts - Management acknowledged that program integrity measures led to a significant morbidity shift, affecting expectations for 2026 pricing [48][51] Question: Medicaid guidance and HBR expectations - The company expects a 140 basis point improvement in HBR for the second half of the year, focusing on specific states that contributed to Q2 underperformance [56][59] Question: Weekly data membership trends and market size - The overall market is expected to contract, with the company projecting further membership attrition due to program integrity measures [67][70] Question: Strategy for risk adjustment payables - The company is considering adjustments to product and benefit structures to optimize for lower payables while maintaining profitability [74][76]