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 reported third quarter adjusted EPS of $0.50, exceeding previous expectations, and increased the full-year adjusted EPS forecast to at least $2 from $1.75 [4][5][25] - Premium and service revenue for the third quarter was $44.9 billion, with a GAAP loss per share of $13.50 due to a $6.7 billion non-cash goodwill impairment charge [25][32] - The adjusted effective tax rate was temporarily low, contributing approximately $0.10 to adjusted EPS, with an expected full-year adjusted tax rate of 20% to 21% [25][10] Business Line Data and Key Metrics Changes - The Medicaid segment achieved a third quarter HBR of 93.4%, aided by improved revenue from Florida's Children's Medical Services, which included a net $150 million positive revenue adjustment [10][25][26] - The Medicare segment's HBR was reported at 94.3%, reflecting typical cost patterns, with Medicare Advantage showing elevated medical cost trends consistent with expectations [18][25] - The Marketplace segment ended the quarter with approximately 5.8 million members, slightly better than expectations, despite experiencing medical cost pressure in September [15][25] Market Data and Key Metrics Changes - Medicaid membership stood at 12.7 million, with expectations of slight attrition in the coming quarters [27] - The company anticipates a 2025 Medicaid composite rate adjustment of roughly 5.5%, up from earlier estimates [8] - The Marketplace segment is preparing for potential market contraction in the high teens to mid-30s range due to the expiration of EAPTCs [40][45] Company Strategy and Development Direction - The company is focused on margin recovery over membership growth, particularly in the Marketplace segment, with pricing actions taken to support margin expansion in 2026 [39][51] - Continued advocacy for improved Medicaid rates and program changes is a priority, with efforts to manage high-cost drugs and enhance clinical management [11][14][57] - The company plans to provide detailed 2026 guidance in early February, emphasizing operational improvements and efficiency gains [22][23] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the overall performance of the business, despite challenges in the operating environment, and highlighted the importance of being responsible stewards of taxpayer dollars [24][60] - The company is closely monitoring trends in Medicaid and Marketplace utilization, with proactive measures in place to address potential challenges [10][37] - Management remains optimistic about the long-term viability of the individual health insurance market, despite uncertainties surrounding EAPTCs [17][40] Other Important Information - The company reported strong cash flow from operations of $1.4 billion in Q3, with unregulated cash on hand at $357 million [33] - The medical claims liability totaled $21.5 billion, representing 48 days in claims payable, an increase of one day compared to the previous quarter [33] - The company is prepared to harvest unrealized losses in Q4 to improve investment income trajectory for 2026 [31] Q&A Session Summary Question: How does the company ensure stability in the Marketplace amid competitor exits? - Management noted a slight uptick in utilization in September, correlating with national discussions on rate increases and EAPTCs, and emphasized prudent coverage for Q4 [36][37][40] Question: What efforts are in place to re-engage potential enrollees in the Marketplace? - The company is prepared to mobilize marketing efforts and broker relationships to recapture members who may not re-engage during open enrollment [42][44] Question: What is the outlook for Medicaid margins in 2026? - Management indicated that while 2026 is expected to be a trough year, they are focused on maintaining consistent profitability and margin improvement [68]

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 [6][31] - Total premium and service revenue for Q2 2025 was $42.5 billion, reflecting challenges in the marketplace and Medicaid segments [31][39] - The adjusted diluted EPS forecast for the full year 2025 is now approximately $1.75, significantly down from the previous guidance of $7.25 [22][38] 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 [7][8] - The Medicaid health benefits ratio (HBR) was reported at 94.9%, driven by increased medical costs in behavioral health, home health, and high-cost drugs [14][18] - Medicare Advantage is on track for breakeven in 2027, with PDP membership stable at 7.8 million and showing improved performance [20][21] Market Data and Key Metrics Changes - The company anticipates a $2.4 billion headwind to 2025 pretax earnings due to a shift in marketplace risk pool, with morbidity increasing by 16% to 17% in some states [10][22] - Medicaid rate adjustments are expected to be around 5% for 2025, an increase from the previous expectation of 4% [18][22] - The overall market is expected to contract further, with membership projected to decrease to 5.4 million by the end of 2025 [67] Company Strategy and Development Direction - The company is focused on restoring profitability in the Marketplace business by repricing for 2026 to account for morbidity shifts and enhancing operational efficiency [12][26] - In Medicaid, the strategy includes advocating for rate adjustments and managing costs through improved provider networks and fraud prevention [15][17] - The company aims to leverage its size and scale to create transparency in the market and ensure stability in pricing and risk adjustment processes [75] 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 [6][31] - The company is actively engaging with state partners to address Medicaid cost trends and is optimistic about securing sufficient rates to support sustainable margins [19][60] - Future earnings potential is seen in the long-term stability of Medicaid, Medicare, and the individual marketplace, despite current challenges [39][30] Other Important Information - The company has filed 2026 pricing in 17 states and expects to submit additional filings soon, aiming for a comprehensive repricing strategy [12][33] - Cash flow from operations for Q2 was $1.8 billion, with unregulated cash on hand at $234 million [37] - The company does not anticipate further share buybacks in 2025 but remains open to opportunistic actions based on market conditions [37] 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 [42][44] Question: Risk adjustment impacts and repricing strategy - Management acknowledged the significant morbidity shift affecting the marketplace and is adjusting expectations for 2026 pricing accordingly, aiming for profitability [48][51] Question: Medicaid margin improvement expectations - Management expects to deliver margin improvement in Medicaid, focusing on specific states that contributed to Q2 underperformance [56][59] Question: Market size and membership trends - The company anticipates further market contraction and membership attrition, projecting a decrease to 5.4 million members by year-end [67][68] Question: Strategy for risk adjustment payables - The company is considering product and benefit structure adjustments to optimize for sustainable margins while addressing risk adjustment dynamics [71][75]

Core Insights - The large screen splicing system industry has experienced rapid growth and has become an essential core infrastructure for information visualization, driven by increasing demand for information technology in critical areas such as monitoring and command centers [1][13] - The market size of the large screen splicing system in China is expected to reach 423 thousand units in sales volume and 8.82 billion yuan in sales revenue by 2024, representing year-on-year increases of 8.43% and 9.02% respectively [1][13] Industry Overview - The large screen splicing system consists of high-brightness, high-resolution display walls made up of individual projection display units, controlled by image processing software [3][7] - The main components include the projection wall, projector array, and control system, with the control system being the core [3][7] Product Types and Applications - The main types of products in the market include LCD, DLP, and PDP, each with distinct advantages and disadvantages [5][6] - LCD: Low power consumption, lightweight, long lifespan, but cannot achieve seamless splicing [5][6] - DLP: Very small seams, better full-screen image display, but has lower brightness and higher costs [5][6] - PDP: Uniform brightness and color, but lower reliability and higher power consumption [5][6] Industry Chain - The industry chain consists of upstream raw materials and components, midstream assembly companies, and downstream application fields such as public security, transportation, government, finance, and energy [7][9] Market Trends - The integration of artificial intelligence technology is expected to diversify application scenarios, enhancing the functionality of large screen splicing systems [21] - The industry is witnessing increasing concentration, with domestic and international companies intensifying R&D and market expansion efforts [22] - Collaborative development within the industry chain is anticipated to drive technological innovation and market growth [24] Competitive Landscape - The competitive landscape is characterized by both international brands with strong technological advantages and domestic companies focusing on cost-effectiveness and service quality [15][19] - Key players include GQY Vision, Weichuang Group, and Beijing CaiXun Technology, among others, each specializing in various aspects of the large screen splicing system [17][19]

Financial Data and Key Metrics Changes - The company reported first quarter adjusted diluted EPS of $2.90, consistent with previous expectations, with full-year 2025 adjusted EPS expectations remaining unchanged at greater than $7.25 [5][24][37] - Premium and service revenue for Q1 was $42.5 billion, with an increase in full-year revenue guidance to a midpoint of $165 billion, up from $159 billion [26][38] - The adjusted SG&A expense ratio decreased to 7.9% from 8.7% year-over-year, driven by revenue growth and expense discipline [35] Business Line Data and Key Metrics Changes - Medicaid membership was stable at approximately 12.9 to 13 million members, with a Medicaid HBR of approximately 93%, showing slight improvement from 93.4% in Q4 2024 [27][28] - The Medicare segment performed in line with expectations, with Medicare Advantage membership contributing an additional $1 billion to the 2025 revenue outlook due to better-than-expected retention [16][31] - The commercial segment saw strong growth, with a Q1 HBR of 75.0%, up from 73.3% the previous year, driven by new marketplace members [34] Market Data and Key Metrics Changes - The company noted an increase in bipartisan support for extending health care premium tax credits, with 78% of swing voters supporting the extension [9] - The expiration of enhanced premium tax credits is anticipated to be addressed by Congress, with significant implications for the marketplace [10][23] - The company is preparing for potential impacts from proposed marketplace integrity and affordability rules, which could influence market dynamics starting in 2026 [22][42] Company Strategy and Development Direction - The company is focused on margin recovery and aligning rates with member acuity, with expectations that Medicaid will return to pre-pandemic margin levels [11][13] - Strategic initiatives include expanding Medicaid managed care into rural areas and enhancing the Medicare Advantage value proposition [14][16] - The company is committed to navigating the evolving policy landscape while advocating for sound health care policy [7][11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to manage through a dynamic policy landscape, noting that broad support for Medicaid benefit cuts is lacking [7][8] - The company anticipates continued momentum in discussions with state partners regarding rate negotiations and acuity data [75] - Management remains optimistic about long-term growth prospects, emphasizing the attractiveness of end markets and the potential for market share capture [24][25] Other Important Information - The company experienced $130 million in incremental medical expenses due to an active flu season, which offset underlying improvements in medical loss ratio [12][28] - The company is actively engaging with CMS on proposed rules that could impact the marketplace and is preparing for various potential outcomes [22][23] Q&A Session Summary Question: Details on flu-related costs - Management clarified that the $130 million in flu-related costs was tracked using a consistent definition and was isolated to Medicaid, with some flu impact seen in Medicare but not at the same level [49][51] Question: Long-term earnings outlook - Management confirmed that the long-term earnings potential remains optimistic, with opportunities for margin expansion in Medicaid and Medicare segments [54][56] Question: Impact of public exchange subsidies - Management indicated that the estimate of a $1 impact per share from the potential loss of enhanced APTCs remains valid, with ongoing discussions about the implications of work requirements [57][61] Question: Risk adjustment and membership growth - Management noted that risk adjustment numbers are consistent with expectations, and the majority of new membership remains subsidized, aligning with the company's focus on low-income populations [99][96] Question: Specialty drug trends - Management highlighted that specialty drug utilization trends are being closely monitored, particularly in Medicaid, with high-cost drugs impacting overall costs [118][120]