Financial Data and Key Metrics Changes - The company reported adjusted EPS of $17.14 for 2025, exceeding initial guidance of approximately $16.25 [17] - The full-year insurance segment benefit ratio was 90.4%, slightly better than guidance [18] - For 2026, the company expects full-year adjusted EPS of at least $9, with a year-over-year decline anticipated due to a stars headwind [19] Business Line Data and Key Metrics Changes - The company experienced approximately 1 million member growth, or 20%, during the Annual Enrollment Period (AEP) [8] - Retention rate improved by over 500 basis points year-over-year, with over 70% of new sales coming from switches from competitor plans [9] - The company expects individual Medicare Advantage (MA) membership growth of approximately 25% for full year 2026 [10] Market Data and Key Metrics Changes - The company absorbed approximately 12% of members impacted by competitor plan exits, which is less than its market share [9] - Nearly 30% of new sales were bounce-back members, indicating a positive mix of new sales [9] Company Strategy and Development Direction - The company remains committed to a consumer-centric strategy, focusing on maximizing customer lifetime value and member retention [6] - Plans are designed to be priced for sustainable margins, moving away from loss leader strategies [8] - The company is expanding its Medicaid and CenterWell footprint, with Medicaid now spanning 13 states [14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the operational capacity to absorb growth and maintain quality care for members [10] - The company is adapting to the funding environment and expects to unlock earnings potential by 2028 [15] - Management acknowledged the challenges posed by the Advance Rate Notice but emphasized a commitment to protect consumers [15] Other Important Information - The company is focused on capital efficiency and plans to fund membership growth and strategic acquisitions while maintaining credit ratings [24] - A new President of Medicare Advantage, Aaron Martin, joined the company, bringing extensive healthcare experience [16] Q&A Session Summary Question: Can you expand on the level of earnings outside of MA underwriting? - Management indicated that earnings associated with CenterWell will contribute positively, with significant tailwinds expected from new membership [30] Question: How is the typical progress of margins for new members over time? - Management noted that margins typically improve significantly from year one to year two, with ongoing improvements expected in subsequent years [35] Question: What are the expectations for 2026 compared to Investor Day? - Management highlighted that the biggest difference is the embedded conservatism in their numbers, leading to a broader haircut in guidance [45] Question: How did the D-SNP membership growth compare to expectations? - The absolute number of new D-SNP members exceeded expectations, although the percentage growth was slightly lower [48] Question: What is the impact of the stars headwind on margins? - Management explained that the stars headwind affects both new and existing members, with similar margins expected for both cohorts [32] Question: How will the company adjust to the rate notice? - Management stated that they will adapt to the final rate notice and advocate for appropriate funding levels [59]

Core Insights - The first year of retirement is a critical financial transition that requires careful management of income, taxes, budgeting, and long-term planning [1][2] Group 1: Essential Money Moves - Tracking expenses is crucial in the first months of retirement to understand spending patterns and adjust budgets accordingly [3] - Securing healthcare coverage is essential, especially for those not yet eligible for Medicare, to avoid depleting savings due to unexpected medical costs [4][5] - Proper allocation of retirement funds is necessary to align with risk tolerance and time frame, balancing between less risky assets and stocks for long-term growth [6][7][8]

Looking ahead, management guided to 2026 adjusted EPS greater than $3 , which London said implies more than 40% year-over-year growth . She attributed the outlook to three central assumptions: Medicaid margin stability , “significant margin recovery” in Marketplace , and continued improvement toward Medicare Advantage break-even .On a GAAP basis, Centene posted a fourth-quarter diluted loss per share of $2.24 . Asher said the quarter included a $389 million net loss tied to a definitive agreement in the fou ...

Core Insights - Centene Corporation (CNC) reported a fourth-quarter 2025 adjusted loss per share of $1.19, which was better than the Zacks Consensus Estimate of a loss of $1.25 per share, compared to adjusted earnings of 80 cents per share in the same quarter last year [1][9] - Total revenues reached $49.7 billion, reflecting a year-over-year increase of 21.9% and surpassing the consensus estimate by 3.1% [1][4] Revenue Breakdown - Medicaid revenues increased by 11% year over year to $23 billion, while Medicare revenues surged 75% year over year to $9.6 billion. Commercial revenues rose 24% year over year to $10.8 billion [3] - Premium revenues grew by 23.8% year over year to $44 billion, driven by higher premiums and membership in the PDP and Marketplace businesses, as well as Medicaid rate hikes, exceeding the Zacks Consensus Estimate of $43.5 billion [4] Membership and Costs - Total membership declined by 3.4% year over year to 27.6 million, missing the consensus mark of 27.9 million, primarily due to decreases in Medicaid and Medicare memberships [5] - The health benefits ratio worsened by 470 basis points year over year to 94.3%, with operating expenses rising 26.7% year over year to $51.5 billion, largely due to increased medical costs, which escalated by 30.4% year over year [6][9] Financial Position - As of December 31, 2025, Centene had cash and cash equivalents of $17.9 billion, a 27.2% increase from the end of 2024. Total assets decreased by 6.9% to $76.7 billion, while long-term debt fell by 5.8% to $17.4 billion [7] - The company generated $5.1 billion in net cash from operations in 2025, a significant increase from the previous year [8] Full-Year Performance - For the full year 2025, total revenues amounted to $194.8 billion, a 19.4% increase from 2024, while adjusted EPS dropped 71% year over year to $2.08. Premium and service revenues reached $174.6 billion, up 20% year over year [11] 2026 Guidance - Management projects premium and service revenues for 2026 to be between $170 billion and $174 billion, indicating a potential decline of 1.5% from 2025. Total revenues are expected to range from $186.5 billion to $190.5 billion, suggesting a 3.2% decrease from 2025 [12] - Adjusted EPS is anticipated to exceed $3.00, representing a 44.2% increase from 2025, while GAAP EPS is expected to remain above $1.98 [12]

Financial Data and Key Metrics Changes - The company reported a fourth quarter adjusted diluted loss per share of $1.19, contributing to a full year 2025 adjusted diluted EPS of $2.08, which was slightly ahead of expectations outlined in the previous quarter [7][8] - The fourth quarter GAAP diluted loss per share was $2.24, including a $389 million net loss from the divestiture of the remaining Magellan business [40][41] - The company anticipates full year 2026 adjusted EPS to exceed $3, representing over 40% year-over-year growth [10] Business Line Data and Key Metrics Changes - Medicaid's health benefits ratio (HBR) improved to 93.0% in Q4, showing a 40 basis points sequential improvement and a 190 basis points improvement from Q2 levels [12][42] - The Marketplace segment's HBR was about a point higher than forecasted, with slight improvements in medical cost trends [44] - The Medicare segment delivered strong results, with expectations for membership growth in the PDP business and a focus on achieving break-even in Medicare Advantage by 2027 [28][29] Market Data and Key Metrics Changes - The company closed 2025 with approximately 12.5 million Medicaid members, with expectations for a 5%-6% decline in member months in 2026 [43][52] - Marketplace membership is projected to be around 3.5 million by the end of Q1 2026, down from 5.5 million in December [24][53] - Medicare segment revenue is expected to grow by approximately $7.5 billion, driven by premium yield increases and membership growth [54] Company Strategy and Development Direction - The company is focused on restoring Medicaid business to sustainable profitability while enhancing quality outcomes for members [11] - Key strategies include optimizing networks, implementing new clinical programs, and increasing vigilance against fraud [13][16] - The company is leveraging data and technology, including AI, to improve operational efficiency and member engagement [34][36] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in executing the 2026 outlook, citing positive momentum and opportunities for margin expansion [38] - The company acknowledged the challenges faced in 2025 but emphasized the strength gained from navigating those challenges [36] - Management highlighted the importance of proactive engagement with state partners to address rate adjustments and program reforms [100][102] Other Important Information - The company ended 2025 with approximately $400 million in cash available for corporate use and reduced debt by $189 million, resulting in a debt-to-cap ratio of 46.5% [50] - The adjusted SG&A expense ratio for Q4 was 7.5%, bringing the full year to 7.4%, reflecting continued discipline and scale [50] Q&A Session Summary Question: Medicaid rate expectation for 4.5% - Management explained that the 4.5% rate assumption is prudent, considering the favorable maturation of 2025 rates and ongoing efforts to bend trend [63][64] Question: Trend comparison for 2025 and 2026 - Management indicated that the 2025 trend was in the mid-6s, while the 2026 assumption is a net trend of mid-4s, reflecting aggressive actions taken in the latter half of 2025 [67][69] Question: Confidence in exchange member dynamics - Management expressed confidence in margin improvement for the Marketplace segment, citing improved visibility and historical data to support pricing strategies [75][84] Question: Incremental decline in Medicaid membership - Management acknowledged slight attrition in membership and discussed the impact of state eligibility tightening and program changes on future membership [86][89] Question: Actuarial soundness lookback process - Management emphasized the importance of shortening the lookback period and maximizing the inclusion of recent data in the actuarial process to inform rate adjustments [95][100] Question: Segment margins in 2026 guidance - Management provided insights into expected margins, indicating opportunities for improvement across all business lines, with specific targets for Medicaid, Marketplace, and Medicare segments [104][105]

Financial Data and Key Metrics Changes - The company reported an adjusted loss per share of $2.75 on premium revenue of $10.7 billion for Q4 2025, which was below expectations due to strong trend pressure in Medicare and Marketplace, along with retroactive items in Medicaid totaling $2 per share [6][19] - For the full year 2025, premium revenue was $43 billion, reflecting an 11% year-over-year growth, while adjusted earnings per share were $11.03, with a pretax margin of 1.6% [7][8] - The Medicaid Medical Care Ratio (MCR) for Q4 was 93.5%, and for the full year, it was 91.8% with a pretax margin of 2.8% [9][21] Business Line Data and Key Metrics Changes - In Medicaid, the MCR for Q4 was 93.5%, impacted by retroactive premium rate actions, while the adjusted MCR was 92.3% with a pretax margin of 2% [7][20] - The Medicare MCR for Q4 was 97.5%, with elevated utilization affecting margins, while the full year MCR was 92.4% [21] - The Marketplace MCR was 99% for Q4, influenced by high utilization and prior period claim settlements, with a full year MCR of 90.6% [22] Market Data and Key Metrics Changes - The company secured a historic RFP win in Florida, expected to yield $6 billion in annual run rate premium, complementing previous contract wins in Wisconsin, Georgia, and Texas, contributing over $9 billion in Medicaid premium [11] - The company anticipates 2026 premium revenue of approximately $42 billion, slightly lower than 2025, with growth from the Florida CMS contract offset by a planned reduction in the Marketplace segment [12][29] Company Strategy and Development Direction - The company aims to focus on dual-eligible members in Medicare, planning to exit the traditional MAPD product for 2027 [14] - The acquisition pipeline remains active, with the company looking to capitalize on opportunities in a challenging operating environment [12] - The company projects a low single-digit margin in Medicaid for 2026, indicating confidence in future rate restoration and earnings potential [17] Management's Comments on Operating Environment and Future Outlook - Management expressed disappointment in the 2025 results but remains confident in the long-term outlook, expecting Medicaid rates and medical cost trends to reach equilibrium [10][17] - The company believes the 2026 forecast for Medicaid represents a trough for managed Medicaid margins, with potential for recovery in subsequent years [17] - Management highlighted that every 100 basis points on the Medicaid MCR is worth nearly $5 per share, indicating significant upside potential [17] Other Important Information - The company reported a capital foundation that remains strong, with a parent company cash balance of approximately $223 million at year-end [23] - The adjusted G&A ratio for Q4 was 6.9%, reflecting disciplined cost management [22] Q&A Session Summary Question: Variance in Medicaid margins across states and potential exit considerations - Management indicated that rates are generally underfunded across the portfolio, with no current plans for exits from any states [36] Question: Adjustments to benefit design in Medicaid - Management noted some sporadic adjustments but no wholesale shifts in benefit design across states [42][48] Question: Membership attrition assumptions for 2026 - Management expects a 2% membership attrition, attributing the decline to program integrity and tightening enrollment processes [50][52] Question: Size of Medicaid expansion enrollment and attrition sources - The Medicaid expansion population is approximately 1.3 million members, with expected attrition of 15%-20% due to new work requirements [59][60] Question: Positive and negative dynamics affecting 2026 guidance - Management believes there are no significant negative dynamics, with a focus on potential upside from rate adjustments and cost trends [62][64]

Financial Data and Key Metrics Changes - The company reported an adjusted loss per share of $2.75 on $10.7 billion of premium revenue for Q4 2025, which was below expectations due to strong trend pressure in Medicare and Marketplace, along with retroactive items in Medicaid totaling $2 per share [6][19] - For the full year 2025, premium revenue was $43 billion, representing an 11% year-over-year growth, while adjusted earnings per share were $11.03, with a pretax margin of 1.6% [7][8] - The Medicaid MCR for Q4 was 93.5%, impacted by unfavorable retroactive premium rate actions, while the full year MCR was 91.8% with a pretax margin of 2.8% [7][21] Business Line Data and Key Metrics Changes - In Medicaid, the MCR for Q4 was 93.5%, and adjusting for retroactive items, it restates to 92.3% with a pretax margin of 2% [19][20] - The Medicare MCR for Q4 was 97.5%, reflecting elevated utilization of LTSS and high-cost drugs, while the full year MCR was 92.4% [21] - The Marketplace MCR for Q4 was 99%, impacted by elevated utilization and prior period claim settlements, with a full year MCR of 90.6% [22] Market Data and Key Metrics Changes - The company secured a historic RFP win in Florida, expected to yield $6 billion in annual run rate premium, complementing previous contract wins in Wisconsin, Georgia, and Texas, representing over $9 billion of Medicaid premium [10][11] - The company anticipates 2026 premium revenue of approximately $42 billion, slightly lower than 2025, driven by new contracts and planned reductions in the Marketplace segment [12][13] Company Strategy and Development Direction - The company aims to focus on dual-eligible members in Medicare, planning to exit the traditional MAPD product for 2027 [14] - The acquisition pipeline contains actionable opportunities, with the company remaining opportunistic about deploying capital for accretive acquisitions [12] - The company expects Medicaid rates and medical cost trends to eventually reach equilibrium, with a forecast for low single-digit margins in Medicaid [17][18] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term outlook for the business despite disappointing 2025 results, citing that the medical cost trend in 2025 was an anomaly [10][17] - The company believes that Medicaid rates are underfunded by 300-400 basis points and anticipates that actuarial soundness will prevail, allowing for target margins to be achieved [17][18] - Management expects 2026 to be a trough year for managed Medicaid margins, projecting a low single-digit margin rather than losses [17] Other Important Information - The company reported a capital foundation remains strong, with a parent company cash balance of approximately $223 million at year-end [23] - The adjusted G&A ratio for Q4 was 6.9%, reflecting disciplined cost management [22] Q&A Session Summary Question: Variance in Medicaid margins across states and potential exit considerations - Management indicated that rates are generally underfunded across the portfolio, and there are no states where an exit is being contemplated [37] - The negative retro adjustments in California were due to situational factors, including a retroactive corridor for undocumented populations and a risk adjustment update [38][39] Question: Adjustments to benefit design in Medicaid - Management noted some sporadic adjustments to benefit design but emphasized that there is no wholesale shift occurring [48] Question: Membership attrition assumptions for 2026 - Management projected a 2% membership attrition, believing that the effects of redetermination are largely over [51][54] Question: Size of Medicaid expansion enrollment and attrition sources - The Medicaid expansion population is about 1.3 million members, with expected attrition of 15%-20% due to new policies [59][60] Question: Potential negative dynamics affecting 2026 guidance - Management acknowledged that while there are potential upside components, they believe rates at 4% are a floor, with no significant downside expected [64]

Molina Healthcare (NYSE:MOH) Q4 2025 Earnings call February 06, 2026 08:00 AM ET Speaker11day, and welcome to the Molina Healthcare Fourth Quarter 2025 conference call. All participants will be in a listen-only mode. Should 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 a touch-tone phone. To withdraw your question, please press ...

CENTENE CORPORATION 2026 GUIDANCE $7.5 $0 ($ IN BILLIONS) Medicaid $88 $34.5 $45 $4.5 Medicaid Com mercial Medicare Other Marketplace Medicare Advantage $174.6 $172.0 2026 Estimated Segment Premium & Service Revenue1 2026 Guidance Mid-point 2025 Actual Medicare PDP ($8.1) ($2.0) FEBRUARY 2026 Forward-Looking Statements All statements, other than statements of current or historical fact, contained in this presentation are forward-looking statements. Without limiting the foregoing, forward-looking statements ...

Core Insights - Molina Healthcare, Inc. operates in the managed healthcare services sector, focusing on low-income families and individuals through government-sponsored programs, serving approximately 5.2 million members across 18 states as of the end of 2021 [1] Price Target and Analyst Expectations - The consensus price target for Molina's stock has varied, with an initial average of $204, adjusted to $195.2 in the last quarter, reflecting concerns or changes in analyst expectations [3] - Over the past year, the average price target was significantly higher at $234.57, indicating a downward revision possibly due to shifts in the company's performance or broader market conditions [3][6] Earnings Outlook - Molina anticipates a 92.5% decline in earnings per share (EPS) for its fourth-quarter earnings report compared to the previous year, primarily due to rising costs despite expected growth in revenues and premiums [3][6] - Analyst Scott Fidel from Stephens maintains a long-term price target of $300 for Molina, indicating confidence in its future performance despite short-term challenges [4][6] Medicare Segment Impact - Molina's Medicare segment, which accounts for 14.5% of its revenue and contributes 14.6% to its operating medical margin profit, is affected by proposed changes in Medicare Advantage rates by the Centers for Medicare & Medicaid Services (CMS) [5] - The proposed flat 0.09% increase in Medicare Advantage rates for 2027 is significantly lower than the expected 5%, contributing to sector volatility [4] Future Earnings Report - Molina Healthcare will release its earnings report for the fourth quarter and full year ending December 31, 2025, after the market closes on February 5, 2026, followed by a conference call and webcast on February 6, 2026 [5]