- St. Louis-based Centene reported revenue rose 36% to $16.2 billion for the third quarter, while income fell significantly to $19 million from $205 million during the previous quarter. The decline was "obscured" by three offsetting adjustments, two of which were related to expired contracts, CEO Michael Neidorff told investors Tuesday morning.
- Revenue growth came in part from the payer's acquisition of New-York based Fidelis Care in July.
- Total managed care membership increased 17% to 14.4 million members. Centene now covers more than 1.5 members on the Affordable Care Act exchanges.
Centene now has a major foothold in the health insurance exchange marketplace with more than 1.5 million members. The individual mandate penalty will soon zero out, but Neidorff said he does not expect it to have a "meaningful impact" on the business. Exchange members have an 80% re-enrollment rate, suggesting many are happy with their coverage, he said.
Centene's contract to provide healthcare coordination to the U.S. Department of Veterans Affairs under the Patient-Centered Community Care and Veterans Choice Programs has expired. The company had a pre-tax charge of $110 million for negotiated settlements and severance costs, officials said.
The payer also recorded a $30 million pre-tax expenses related to a commitment to its charitable foundation.
Centene now covers about 417,000 Medicare beneficiaries, which includes supplemental plan members and Medicare Advantage members. Neidorff said he's committed to growing the MA business and believes it will fuel the company's growth over the next decade. But he said it's important to "get the fundamentals right," before expanding too quickly.
The company did increase some of its guidance. Dissecting the figures is complicated by the Fidelis buy, Jefferies noted.
By the Jefferies' accounting, Centene reported a slightly higher revenue outlook, modestly lower MLR guidance, and a 25 basis point increase to the SG&A forecast.
Many of the nation's payers gathered in D.C. last week to discuss these fundamentals and better ways to coordinate care. Much focus was on social determinants of health and how plans can better intervene to improve members' health. The expansion on benefit opportunities in MA plans may offer a chance to insurers to do more on that front.
A potential positive for Centene heading in the midterms is the prospect of voters choosing to expand Medicaid in a number of states where the policy is on the ballot.
Expanding the program in additional states provides a potential benefit for increased business for Medicaid managed care companies like Centene.