-- Diluted EPS of $1.27; Adjusted Diluted EPS of $1.30 --
- Total revenues up 11% from the third quarter of 2021 driven
by organic Medicaid and Medicare growth.
- Health benefits ratio (HBR) of 88.3%, driven by strong
Medicare results and inline performance from Medicaid and
Commercial.
- Value Creation Plan gaining momentum:
-
- Pulling margin levers including Medicare and Marketplace bid
discipline, real estate and cost rationalization;
- Executing on capital deployment initiatives including
$1.7 billion and $300 million year-to-date share repurchase and
debt repurchase, respectively; and
- Award of the new pharmacy benefits management (PBM) contract
to Express Scripts, Inc., commencing in 2024.
- 4th guidance raise in 2022 totaling a cumulative
$0.30, or 5.5%,
increase to the mid-point of the 2022 full-year adjusted diluted
EPS guidance to a range of $5.65 to
$5.75.
ST.
LOUIS, Oct. 25, 2022 /PRNewswire/ -- Centene
Corporation (NYSE: CNC) announced today its financial results for
the third quarter ended September 30,
2022. In summary, the 2022 third quarter results were as
follows:
Total revenues (in
millions)
|
$
35,865
|
Premium and service
revenues (in millions)
|
$
33,726
|
Health benefits
ratio
|
88.3 %
|
SG&A expense
ratio
|
8.4 %
|
Adjusted SG&A
expense ratio (1)
|
8.3 %
|
GAAP diluted
EPS
|
$
1.27
|
Adjusted diluted EPS
(1)
|
$
1.30
|
Total cash flow
provided by operations (in millions)
|
$
3,332
|
|
|
(1) A full
reconciliation of the adjusted diluted earnings per share (EPS) and
adjusted selling, general and administrative (SG&A) expenses is
shown in the Non-GAAP Financial Presentation section of this
release.
|
"Our strong third quarter and year-to-date results provide
Centene with positive momentum as we move towards 2023," said
Sarah M. London, Chief Executive
Officer of Centene. "Selecting our future PBM partner represents a
major Value Creation Plan milestone and positions us to capture
significant value for our members, partners, and stakeholders in
2024 and beyond."
Other Events
- Since the second quarter, the Company has continued to execute
on key Value Creation Plan initiatives with the award of the new
PBM contract commencing in 2024, the closing of the PANTHERx Rare
(PANTHERx) divestiture, stock and debt repurchases, along with
ongoing focus on quality improvement actions.
- In October 2022, Centene
announced that its Health Insurance Marketplace product, Ambetter
Health, will expand into Alabama
and extend its footprint by more than 60 counties across 12
existing states in 2023. It also announced its updated brand name,
Ambetter Health, reflecting its commitment to putting better health
at the forefront of its mission. In total, the Marketplace plan
will be available in more than 1,500 counties across 28 states in
2023.
- In October 2022, the Centers for
Medicare and Medicaid Services (CMS) published updated Medicare
Star quality ratings for the 2023 rating year, which impacts the
2024 revenue year. The decrease in Star quality ratings is driven
by the expiration of certain disaster relief provisions as well as
deterioration in select metrics. Over the past year, Centene's
leadership team launched a multi-year plan to build and improve
quality across the enterprise with a strong focus on enhanced
patient experience and access to care. The Company expects to begin
to see the results of these efforts with the 2024 rating year (2025
revenue year).
- In September 2022, Centene's
Nebraska subsidiary, Nebraska
Total Care, was awarded the Nebraska Department of Health and Human
Services statewide Medicaid managed care contract. Under the new
contract, Nebraska Total Care will continue serving the state's
Medicaid Managed Care Program, known as Heritage Health. The new
contract term is five years and includes the option for two,
one-year renewals. The contract is anticipated to begin in
January 2024, subject to the
resolution of third-party protests.
- In September 2022, Centene's
Texas subsidiary, Superior
HealthPlan (Superior), was awarded a new, six-year contract by the
Texas Health and Human Services Commission to continue providing
youth in foster care with healthcare coverage through the STAR
Health Medicaid program. Superior has been the sole provider of
STAR Health coverage since the program launched in 2008. The
contract is anticipated to begin in September 2023.
- In August 2022, Centene's
California subsidiary, Health Net
of California, was awarded
contracts by the California Department of Health Care Services to
continue serving members in nine counties across California. However, Health Net of
California was not awarded
contracts in Los Angeles,
Sacramento and Kern counties. The Company is actively
protesting the decision to protect members and their access to
quality healthcare. The contracts are anticipated to begin in
January 2024, subject to the
resolution of the protest process.
- In August 2022, Centene's
Mississippi subsidiary, Magnolia
Health Plan (Magnolia), was awarded the Mississippi Division of
Medicaid contract. Under the new contract, Magnolia will continue
serving the state's Coordinated Care Organization Program, which
will consist of the Mississippi Coordinated Access Network and the
Mississippi Children's Health Insurance Program. The contract is
anticipated to begin in July 2023,
subject to the resolution of third-party protests.
Accreditations & Awards
- In October 2022, Centene's Chief
Executive Officer, Sarah London, was
selected for Fortune magazine's 2022 Most Powerful Women in
Business.
- In September 2022, Centene was
named a 2022 Best Workplaces in Health Care by Great Place to Work
and Fortune magazine.
- In August 2022, Centene's health
plan, Ambetter from Sunflower Health Plan, earned Accreditation
from the National Committee for Quality Assurance (NCQA).
- In July 2022, several Centene
health plans earned Accreditation from NCQA, including Ambetter of
Oklahoma, Ambetter from WellCare
of Kentucky, and WellCare of
North Carolina.
Membership
The following table sets forth our membership by line of
business:
|
September
30,
|
|
2022
|
|
2021
|
Traditional Medicaid
(1)
|
14,000,100
|
|
13,202,500
|
High Acuity Medicaid
(2)
|
1,698,100
|
|
1,566,000
|
Total
Medicaid
|
15,698,200
|
|
14,768,500
|
Commercial
Marketplace
|
2,087,800
|
|
2,177,000
|
Commercial
Group
|
439,800
|
|
468,500
|
Total
Commercial
|
2,527,600
|
|
2,645,500
|
Medicare
(3)
|
1,517,900
|
|
1,248,300
|
Medicare PDP
|
4,186,200
|
|
4,064,400
|
Total at-risk
membership (4)
|
23,929,900
|
|
22,726,700
|
TRICARE
eligibles
|
2,832,300
|
|
2,874,700
|
Total
|
26,762,200
|
|
25,601,400
|
|
|
|
|
(1) Membership includes Temporary
Assistance for Needy Families (TANF), Medicaid Expansion,
Children's Health Insurance Program (CHIP), Foster Care, and
Behavioral Health.
(2)
Membership includes Aged, Blind, and Disabled (ABD), Intellectual
and Developmental Disabilities (IDD), Long-Term Services and
Supports (LTSS), and Medicare-Medicaid Plans (MMP)
Duals.
(3)
Membership includes Medicare Advantage and Medicare
Supplement.
(4)
Membership includes 1,285,600 and 1,168,400 dual-eligible
beneficiaries for the periods ending September 30, 2022, and
September 30, 2021, respectively.
|
Revenues
The following table sets forth supplemental revenue information
($ in millions):
|
Three Months Ended
September 30,
|
|
2022
|
|
2021
|
|
%
Change
|
Medicaid
|
$
23,293
|
|
$
21,624
|
|
8 %
|
Commercial
|
4,292
|
|
4,383
|
|
(2) %
|
Medicare
(5)
|
5,639
|
|
4,322
|
|
30 %
|
Other
|
2,641
|
|
2,077
|
|
27 %
|
Total
Revenues
|
$
35,865
|
|
$
32,406
|
|
11 %
|
(5) Medicare
includes Medicare Advantage, Medicare Supplement, and Medicare
Prescription Drug Plan (PDP).
|
Statement of Operations: Three Months Ended September 30, 2022
- For the third quarter of 2022, total revenues increased 11% to
$35.9 billion from $32.4 billion in the comparable period of 2021.
The increase was driven by organic Medicaid growth, primarily due
to the ongoing suspension of eligibility redeterminations, 22%
membership growth in the Medicare business, and our acquisition of
Magellan Health, Inc. (Magellan), partially offset by the PANTHERx
divestiture.
- HBR of 88.3% for the third quarter of 2022 represents an
increase from 88.1% in the comparable period in 2021. The increase
was primarily due to a return to more normalized Medicaid
utilization compared to the third quarter of 2021. The increase is
partially offset by the impact of Marketplace and Medicare
healthcare affordability initiatives as well as disciplined
Marketplace pricing.
- The SG&A expense ratio was 8.4% for the third quarter of
2022, compared to 8.3% in the third quarter of 2021. The adjusted
SG&A expense ratio was 8.3% for the third quarter of 2022,
compared to 8.1% in the third quarter of 2021. The increases were
due to the addition of Magellan, which operates at a higher
SG&A expense ratio due to the nature of its business, and the
PANTHERx divestiture. Increases were also driven by costs
associated with Medicare marketing and value creation investment
spending, partially offset by savings due to real estate
optimization efforts and the leveraging of expenses over higher
revenues as a result of increased membership.
- The effective tax rate was 26.6% for the third quarter of 2022,
compared to 19.3% in the third quarter of 2021. The 2021 effective
rate was driven by the non-taxable gain related to the acquisition
of the remaining 60% interest of Circle Health. For the third
quarter of 2022, our effective tax rate on adjusted earnings was
26.3%, compared to 24.5% in the third quarter of 2021.
- Operating cash flow for the third quarter of 2022 was
$3.3 billion, driven by the receipt
of $2.9 billion in CMS payments for
October on the last day of September. Year-to-date operating cash
flow for 2022 was $7.8 billion.
Excluding the early receipt of $2.9
billion in CMS payments, year-to-date operating cash flow
would have been $4.9 billion, or 3.5x
net earnings.
Balance Sheet
At September 30, 2022, the Company had cash, investments
and restricted deposits of $32.4
billion and maintained $436
million of cash and cash equivalents in our unregulated
entities. Medical claims liabilities totaled $16.5 billion. The Company's days in claims
payable was 54 days, which is a decrease of one day over the second
quarter of 2022, primarily due to the timing of pharmacy payments,
and an increase of three days over the third quarter of 2021. Total
debt was $18.3 billion, which
included $120 million of borrowings
on our $2.0 billion revolving credit
facility at quarter end. The debt to capital ratio was 41.6% at
September 30, 2022, excluding $181
million of non-recourse debt, which increased 30 basis
points over the second quarter of 2022.
During the third quarter of 2022, the Company utilized a portion
of the PANTHERx divestiture proceeds to initiate an accelerated
share repurchase (ASR) agreement to purchase $1.0 billion of the Company's common stock. In
July 2022, 8.6 million shares were
delivered to the Company, representing 80% of the notional
amount under the ASR. In October, 3.0 million shares were
delivered upon settlement of the ASR based upon the volume-weighted
average price (VWAP) over the term of the agreement less a
discount. In total, 11.6 million shares were purchased through the
$1.0 billion ASR. The Company also
repurchased an additional 2.9 million shares for $240 million during the third quarter.
In October 2022, the Company
repurchased an additional 828 thousand shares for $66 million. As of October 25, 2022, the
Company has a remaining amount of $2.2
billion available under the stock repurchase program.
During the third quarter of 2022, the Company repurchased
$259 million of its par value Senior
Notes for $247 million through its
debt repurchase program and an additional $58 million for $53
million in October 2022. As of
October 25, 2022, there was $700
million available under the debt repurchase program.
Outlook
The Company's guidance has been updated to increase the bottom
of the adjusted EPS range by $0.05.
In addition, the guidance metrics also now include the third
quarter impairment of assets associated with the pending
divestiture of the Spanish and Central European businesses.
The items below will be discussed further on our conference
call. The Company's annual guidance for 2022 is as follows:
|
|
Full Year
2022
|
|
|
|
Low
|
|
High
|
|
Total revenues (in
billions)
|
|
$
142.7
|
|
$
144.7
|
|
Premium and service
revenues (in billions)
|
|
$
134.0
|
|
$
136.0
|
|
GAAP diluted
EPS
|
|
$ 2.78
|
|
$ 2.88
|
|
Adjusted diluted EPS
(1)
|
|
$ 5.65
|
|
$ 5.75
|
|
HBR
|
|
87.6 %
|
|
88.0 %
|
|
SG&A expense
ratio
|
|
8.1 %
|
|
8.6 %
|
|
Adjusted SG&A
expense ratio (2)
|
|
8.0 %
|
|
8.5 %
|
|
Effective tax
rate
|
|
25.3 %
|
|
26.3 %
|
|
Adjusted effective tax
rate (3)
|
|
25.3 %
|
|
26.3 %
|
|
Diluted shares
outstanding (in millions)
|
|
582.5
|
|
585.5
|
|
|
|
|
|
|
|
(1) A
full reconciliation of adjusted diluted EPS is shown in the
Non-GAAP Financial Presentation section of this
release.
|
(2)
Adjusted SG&A expense ratio excludes acquisition and
divestiture related expenses of $147 million to
$175 million.
|
(3)
Adjusted effective tax rate excludes income tax effects of
adjustments of $583 million to $595 million.
|
Conference Call
As previously announced, the Company will host a conference call
Tuesday, October 25, 2022, at approximately 8:30 AM (Eastern Time) to review the financial
results for the third quarter ended September 30, 2022.
Investors and other interested parties are invited to listen to
the conference call by dialing 1-877-883-0383 in the U.S. and
Canada; +1-412-902-6506 from
abroad, including the following Elite Entry Number: 6216529 to
expedite caller registration; or via a live, audio webcast on the
Company's website at www.centene.com, under the Investors
section.
A webcast replay will be available for on-demand listening
shortly after the completion of the call for the next twelve months
or until 11:59 PM (Eastern Time) on
Tuesday, October 24, 2023, at the aforementioned URL. In
addition, a digital audio playback will be available until
9:00 AM (Eastern Time) on Tuesday,
November 1, 2022, by dialing 1-877-344-7529 in the U.S.,
1-855-669-9658 in Canada, or
+1-412-317-0088 from abroad, and entering access code 1820691.
Non-GAAP Financial Presentation
The Company is providing certain non-GAAP financial measures in
this release as the Company believes that these figures are helpful
in allowing investors to more accurately assess the ongoing nature
of the Company's operations and measure the Company's performance
more consistently across periods. The Company uses the presented
non-GAAP financial measures internally in evaluating the Company's
performance and for planning purposes, by allowing management to
focus on period-to-period changes in the Company's core business
operations, and in determining employee incentive compensation.
Therefore, the Company believes that this information is meaningful
in addition to the information contained in the GAAP presentation
of financial information. The presentation of this additional
non-GAAP financial information is not intended to be considered in
isolation or as a substitute for the financial information prepared
and presented in accordance with GAAP.
Specifically, the Company believes the presentation of non-GAAP
financial information that excludes amortization of acquired
intangible assets and acquisition and divestiture related expenses,
as well as other items, allows investors to develop a more
meaningful understanding of the Company's core performance over
time. The tables below provide reconciliations of non-GAAP items ($
in millions, except per share data):
|
Three Months
Ended
September 30,
|
|
Nine Months
Ended
September 30,
|
|
2022
|
|
2021
|
|
2022
|
|
2021
|
GAAP net earnings
attributable to Centene
|
$
738
|
|
$
584
|
|
$
1,415
|
|
$
748
|
Amortization of
acquired intangible assets
|
211
|
|
198
|
|
609
|
|
581
|
Acquisition and
divestiture related expenses
|
30
|
|
54
|
|
149
|
|
141
|
Other adjustments
(1)
|
(222)
|
|
11
|
|
1,225
|
|
1,427
|
Income tax effects of
adjustments (2)
|
(2)
|
|
(102)
|
|
(521)
|
|
(455)
|
Adjusted net
earnings
|
$
755
|
|
$
745
|
|
$
2,877
|
|
$
2,442
|
(1)
|
Other adjustments
include the following pre-tax items:
|
|
|
|
|
|
2022:
|
|
|
|
|
|
|
|
|
(a)
|
for the three months
ended September 30, 2022: PANTHERx divestiture gain of $490
million, the impairment of assets associated with the pending
divestiture of the Spanish and Central European businesses of $165
million, real estate impairments of $127 million, an increase to
the previously reported gain on the divestiture of U.S. Medical
Management (USMM) due to the finalization of working capital
adjustments of $13 million, gain on debt extinguishment related to
the repurchases of senior notes of $10 million, and an adjustment
to the costs related to the PBM legal settlement of $1
million;
|
|
|
|
|
|
|
(b)
|
for the nine months
ended September 30, 2022: real estate impairments of $1,581
million, PANTHERx divestiture gain of $490 million, the impairment
of assets associated with the pending divestiture of the Spanish
and Central European businesses of $165 million, gain on debt
extinguishment of $23 million, an increase to the previously
reported gain related to the divestiture of USMM due to the
finalization of working capital adjustments of $13 million, and
costs related to the PBM legal settlement of $5 million.
|
|
|
|
|
|
2021:
|
|
|
|
|
|
|
|
|
(a)
|
for the three months
ended September 30, 2021: non-cash gain related to the acquisition
of the remaining 60% interest of Circle Health of $309 million,
non-cash impairment of our equity method investment in RxAdvance of
$229 million, debt extinguishment costs of $79 million, PBM legal
settlement expense of $11 million, and severance costs due to a
restructuring of $1 million;
|
|
|
|
|
|
|
(b)
|
for the nine months
ended September 30, 2021: PBM legal settlement expense of $1,261
million, non-cash gain related to the acquisition of the remaining
60% interest of Circle Health of $309 million, non-cash impairment
of our equity method investment in RxAdvance of $229 million, debt
extinguishment costs of $125 million, a reduction to the previously
reported gain on divestiture of certain products of our Illinois
health plan of $62 million, and severance costs due to a
restructuring of $59 million.
|
|
|
(2)
|
The income tax effects
of adjustments are based on the effective income tax rates
applicable to each adjustment. The nine months ended September 30,
2022 also include an $18 million increase to the tax benefit on the
previously reported non-cash impairment of our equity method
investment in RxAdvance.
|
|
Three Months
Ended
September 30,
|
|
Nine Months
Ended
September 30,
|
|
Annual Guidance
December 31, 2022
|
|
2022
|
|
2021
|
|
2022
|
|
2021
|
|
GAAP diluted EPS
attributable to Centene
|
$
1.27
|
|
$
0.99
|
|
$
2.41
|
|
$
1.27
|
|
$2.78
- $2.88
|
Amortization of
acquired intangible assets
|
0.36
|
|
0.34
|
|
1.04
|
|
0.98
|
|
~$1.39
|
Acquisition and
divestiture related expenses
|
0.05
|
|
0.09
|
|
0.25
|
|
0.24
|
|
~$0.27
|
Other adjustments
(3)
|
(0.38)
|
|
0.01
|
|
2.09
|
|
2.42
|
|
~$2.22
|
Income tax effects of
adjustments (4)
|
—
|
|
(0.17)
|
|
(0.89)
|
|
(0.77)
|
|
~$(1.01)
|
Adjusted diluted
EPS
|
$
1.30
|
|
$
1.26
|
|
$
4.90
|
|
$
4.14
|
|
$5.65
- $5.75
|
(3)
|
Other adjustments
include the following pre-tax items:
|
|
|
|
|
|
2022:
|
|
|
|
|
(a)
|
for the three months
ended September 30, 2022: PANTHERx divestiture gain of $0.84 ($0.65
after-tax), the impairment of assets associated with the pending
divestiture of the Spanish and Central European businesses of $0.28
($0.23 after-tax), real estate impairments of $0.22 ($0.16
after-tax), an increase to the previously reported gain related to
the divestiture of USMM due to the finalization of working capital
adjustments of $0.02 ($0.01 after-tax), and gain on debt
extinguishment of $0.02 ($0.01 after-tax);
|
|
|
|
|
|
|
(b)
|
for the nine months
ended September 30, 2022: real estate impairments of $2.69 ($1.98
after-tax), PANTHERx divestiture gain of $0.83 ($0.65 after-tax),
the impairment of assets associated with the pending divestiture of
the Spanish and Central European businesses of $0.28 ($0.23
after-tax), gain on debt extinguishment of $0.04 ($0.03 after-tax),
an increase to the previously reported gain related to the
divestiture of USMM due to the finalization of working capital
adjustments of $0.02 ($0.02 after-tax), and costs related to the
PBM legal settlement of $0.01 ($0.01 after-tax);
|
|
|
|
|
|
|
(c)
|
for the year ended
December 31, 2022, an estimated: $2.83 ($2.08 after-tax) of real
estate impairments, $0.84 ($0.65 after-tax) PANTHERx divestiture
gain, $0.28 ($0.23 after-tax) related to the impairment of assets
associated with the pending divestiture of the Spanish and Central
European businesses, $0.04 ($0.03 after-tax) gain on debt
extinguishment, $0.02 ($0.02 after-tax) associated to an increase
to the previously reported gain related to the divestiture of USMM
due to the finalization of working capital adjustments, and $0.01
($0.01 after-tax) of costs related to the PBM legal
settlement.
|
|
|
|
|
|
2021:
|
|
|
|
|
|
|
|
|
(a)
|
for the three months
ended September 30, 2021: non-cash gain related to the acquisition
of the remaining 60% interest of Circle Health of $0.52 ($0.52
after-tax), non-cash impairment of our equity method investment in
RxAdvance of $0.38 ($0.35 after-tax), debt extinguishment costs of
$0.13 ($0.10 after-tax), and PBM legal settlement expense of $0.02
($0.01 after-tax) per share.
|
|
|
|
|
|
|
(b)
|
for the nine months
ended September 30, 2021: PBM legal settlement expense of $2.13
($1.79 after-tax), non-cash gain related to the acquisition of the
remaining 60% interest of Circle Health of $0.52 ($0.52 after-tax),
non-cash impairment of our equity method investment in RxAdvance of
$0.39 ($0.35 after-tax), debt extinguishment costs of $0.21 ($0.16
after-tax), a reduction to the previously reported gain on
divestiture of certain products of our Illinois health plan of
$0.11 per share ($0.08 after-tax), and severance costs due to a
restructuring of $0.10 ($0.07 after-tax).
|
|
|
|
|
(4)
|
The income tax effects
of adjustments are based on the effective income tax rates
applicable to each adjustment. The nine months ended September 30,
2022 also include a $0.03 per share increase to the tax benefit on
the previously reported non-cash impairment of our equity method
investment in RxAdvance.
|
|
Three Months
Ended
September 30,
|
|
Nine Months
Ended
September 30,
|
|
2022
|
|
2021
|
|
2022
|
|
2021
|
|
|
|
|
|
|
|
|
GAAP selling, general
and administrative expenses
|
$
2,846
|
|
$
2,537
|
|
$
8,391
|
|
$
6,910
|
Less:
|
|
|
|
|
|
|
|
Acquisition and
divestiture related expenses
|
28
|
|
41
|
|
149
|
|
126
|
Restructuring
costs
|
—
|
|
1
|
|
—
|
|
59
|
Costs related to the
PBM legal settlement
|
1
|
|
11
|
|
5
|
|
11
|
Real estate
optimization
|
3
|
|
—
|
|
7
|
|
—
|
Adjusted selling,
general and administrative expenses
|
$
2,814
|
|
$
2,484
|
|
$
8,230
|
|
$
6,714
|
Note: Beginning in
2022, we have included a separate line item for depreciation
expense on the Consolidated Statements of Operations, which was
previously included in SG&A expenses. Prior period SG&A
expenses have been conformed to the current
presentation.
|
To provide clarity on the way management defines certain key
metrics and ratios, the Company is providing a description of how
the metric or ratio is calculated as follows:
- Health Benefits Ratio (HBR) (GAAP) = Medical costs
divided by premium revenues.
- SG&A Expense Ratio (GAAP) = Selling, general and
administrative expenses divided by premium and service
revenues.
- Adjusted SG&A Expense Ratio (non-GAAP) = Adjusted
selling, general and administrative expenses divided by premium and
service revenues.
- Adjusted Effective Tax Rate (non-GAAP) = GAAP income tax
expense (benefit) excluding the income tax effects of adjustments
to net earnings divided by adjusted earnings (loss) before income
tax expense.
- Adjusted Net Earnings (non-GAAP) = Net earnings less
amortization of acquired intangible assets, less acquisition and
divestiture related expenses, as well as adjustments for other
items, net of the income tax effect of the adjustments.
- Adjusted Diluted EPS (non-GAAP) = Adjusted net earnings
divided by weighted average common shares outstanding on a fully
diluted basis.
- Debt to Capitalization Ratio (GAAP) = Total debt,
divided by total debt plus total stockholder's equity.
- Debt to Capitalization Ratio Excluding Non-Recourse Debt
(non-GAAP) = Total debt less non-recourse debt, divided by
total debt less non-recourse debt plus total stockholder's
equity.
- Average Medical Claims Expense (GAAP) = Medical costs
for the period divided by number of days in such period. Average
Medical Claims Expense is most often calculated for the quarterly
reporting period.
- Days in Claims Payable (GAAP) = Medical claims
liabilities divided by average medical claims expense. Days in
Claims Payable is most often calculated for the quarterly reporting
period.
In addition, the following terms are defined as follows:
- State Directed Payments: Payments directed by a state
that have minimal risk, but are administered as a premium
adjustment. These payments are recorded as premium revenue and
medical costs at close to a 100% HBR. The Company has little
visibility to the timing of these payments until they are paid by a
state.
- Pass Through Payments: Non-risk supplemental payments
from a state that the Company is required to pass through to
designated contracted providers. These payments are recorded as
premium tax revenue and premium tax expense.
About Centene Corporation
Centene Corporation, a Fortune 500 company, is a leading
healthcare enterprise that is committed to helping people live
healthier lives. The Company takes a local approach – with local
brands and local teams – to provide fully integrated, high-quality,
and cost-effective services to government-sponsored and commercial
healthcare programs, focusing on under-insured and uninsured
individuals. Centene offers affordable and high-quality
products to nearly 1 in 15 individuals across the nation, including
Medicaid and Medicare members (including Medicare Prescription Drug
Plans) as well as individuals and families served by
the Health Insurance Marketplace, the TRICARE program, and
individuals in correctional facilities. The Company also serves
several international markets, and contracts with other healthcare
and commercial organizations to provide a variety of specialty
services focused on treating the whole
person. Centene focuses on long-term growth and value
creation as well as the development of its people, systems, and
capabilities so that it can better serve its members, providers,
local communities, and government partners.
Centene uses its investor relations website to publish important
information about the Company, including information that may be
deemed material to investors. Financial and other information about
Centene is routinely posted and is accessible on Centene's investor
relations website, https://investors.centene.com/.
Forward-Looking Statements
All statements, other than statements of current or
historical fact, contained in this press release are
forward-looking statements. Without limiting the foregoing,
forward-looking statements often use words such as "believe,"
"anticipate," "plan," "expect," "estimate," "intend," "seek,"
"target," "goal," "may," "will," "would," "could," "should," "can,"
"continue" and other similar words or expressions (and the negative
thereof). Centene (the Company, our, or we) intends such
forward-looking statements to be covered by the safe-harbor
provisions for forward-looking statements contained in the Private
Securities Litigation Reform Act of 1995, and we are including this
statement for purposes of complying with these safe-harbor
provisions. In particular, these statements include, without
limitation, statements about our future operating or financial
performance, market opportunity, value creation strategy,
competition, expected activities in connection with completed and
future acquisitions and dispositions, including statements about
the impact of our recently completed acquisition of Magellan
Health, Inc. (the Magellan Acquisition), other recent and future
acquisitions and dispositions, our investments and the adequacy of
our available cash resources. These forward-looking statements
reflect our current views with respect to future events and are
based on numerous assumptions and assessments made by us in light
of our experience and perception of historical trends, current
conditions, business strategies, operating environments, future
developments and other factors we believe appropriate. By their
nature, forward-looking statements involve known and unknown risks
and uncertainties and are subject to change because they relate to
events and depend on circumstances that will occur in the future,
including economic, regulatory, competitive and other factors that
may cause our or our industry's actual results, levels of activity,
performance or achievements to be materially different from any
future results, levels of activity, performance or achievements
expressed or implied by these forward-looking
statements. These statements are not guarantees of future
performance and are subject to risks, uncertainties and
assumptions. All forward-looking statements included in this press
release are based on information available to us on the date
hereof. Except as may be otherwise required by law, we undertake no
obligation to update or revise the forward-looking statements
included in this press release, whether as a result of new
information, future events or otherwise, after the date
hereof. You should not place undue reliance on any forward-looking
statements, as actual results may differ materially from
projections, estimates, or other forward-looking statements due to
a variety of important factors, variables and events including, but
not limited to: our ability to accurately predict and effectively
manage health benefits and other operating expenses and reserves,
including fluctuations in medical utilization rates due to the
ongoing impact of COVID-19;our ability to maintain or achieve
improvement in the Centers for Medicare and Medicaid Services (CMS)
Star ratings and maintain or achieve improvement in other quality
scores in each case that can impact revenue and future growth; the
risk that the election of new directors, changes in senior
management, and any inability to retain key personnel may create
uncertainty or negatively impact our ability to execute quickly and
effectively; uncertainty as to the expected financial performance
of the combined company following the recent completion of the
Magellan Acquisition; the possibility that the expected
synergies and value creation from the Magellan Acquisition or the
acquisition of WellCare Health Plans, Inc. (the WellCare
Acquisition) or other acquired businesses will not be realized, or
will not be realized within the respective expected time periods;
disruption from the integration of the Magellan Acquisition or the
WellCare Acquisition, unexpected costs, or similar risks from other
acquisitions or dispositions we may announce or complete from time
to time, including potential adverse reactions or changes to
business relationships with customers, employees, suppliers or
regulators, making it more difficult to maintain business and
operational relationships; the risk that the closing conditions,
including applicable regulatory approvals, for the pending
dispositions of Magellan Rx and our Spanish and Central European
businesses, may be delayed or not obtained; impairments to real
estate, investments, goodwill and intangible assets; a downgrade of
the credit rating of our indebtedness; competition; membership and
revenue declines or unexpected trends; changes in healthcare
practices, new technologies, and advances in medicine; increased
healthcare costs; changes in economic, political or market
conditions; changes in federal or state laws or regulations,
including changes with respect to income tax reform or government
healthcare programs as well as changes with respect to the Patient
Protection and Affordable Care Act and the Health Care and
Education Affordability Reconciliation Act (collectively referred
to as the ACA) and any regulations enacted thereunder that may
result from changing political conditions, the current
administration or judicial actions; rate cuts or other payment
reductions or delays by governmental payors and other risks and
uncertainties affecting our government businesses; our ability to
adequately price products; tax matters; disasters or major
epidemics; changes in expected contract start dates; provider,
state, federal, foreign and other contract changes and timing of
regulatory approval of contracts; the expiration, suspension, or
termination of our contracts with federal or state governments
(including, but not limited to, Medicaid, Medicare, TRICARE or
other customers); the difficulty of predicting the timing or
outcome of legal or regulatory proceedings or matters, including,
but not limited to, our ability to resolve claims and/or
allegations made by states with regard to past practices, including
at Envolve Pharmacy Solutions, Inc. (Envolve), as our pharmacy
benefits manager (PBM) subsidiary, within the reserve estimate we
previously recorded and on other acceptable terms, or at all, or
whether additional claims, reviews or investigations relating to
our PBM business will be brought by states, the federal government
or shareholder litigants, or government investigations; the timing
and extent of benefits from our value creation strategy, including
the possibility that the benefits received may be lower than
expected, may not occur, or will not be realized within the
expected time periods; challenges to our contract awards;
cyber-attacks or other privacy or data security incidents; the
exertion of management's time and our resources, and other expenses
incurred and business changes required in connection with complying
with the undertakings in connection with any regulatory,
governmental or third party consents or approvals for acquisitions
or dispositions; any changes in expected closing dates, estimated
purchase price and accretion for acquisitions or dispositions;
restrictions and limitations in connection with our indebtedness;
the availability of debt and equity financing on terms that are
favorable to us; inflation; foreign currency fluctuations; and
risks and uncertainties discussed in the reports that Centene has
filed with the Securities and Exchange Commission. This list of
important factors is not intended to be exhaustive. We discuss
certain of these matters more fully, as well as certain other
factors that may affect our business operations, financial
condition and results of operations, in our filings with the
Securities and Exchange Commission (SEC), including our annual
report on Form 10-K, quarterly reports on Form 10-Q and current
reports on Form 8-K. Due to these important factors and risks, we
cannot give assurances with respect to our future performance,
including without limitation our ability to maintain adequate
premium levels or our ability to control our future medical and
selling, general and administrative costs.
CENTENE CORPORATION
AND SUBSIDIARIES
CONSOLIDATED BALANCE
SHEETS
(In millions, except
shares in thousands and per share data in dollars)
|
|
|
September 30,
2022
|
|
December 31,
2021
|
|
(Unaudited)
|
|
|
ASSETS
|
|
|
|
Current
assets:
|
|
|
|
Cash and cash
equivalents
|
$
14,987
|
|
$
13,118
|
Premium and trade
receivables
|
13,770
|
|
12,238
|
Short-term
investments
|
2,191
|
|
1,539
|
Other current
assets
|
2,327
|
|
1,602
|
Total current
assets
|
33,275
|
|
28,497
|
Long-term
investments
|
14,053
|
|
14,043
|
Restricted
deposits
|
1,205
|
|
1,068
|
Property, software and
equipment, net
|
2,479
|
|
3,391
|
Goodwill
|
20,040
|
|
19,771
|
Intangible assets,
net
|
7,523
|
|
7,824
|
Other long-term
assets
|
2,597
|
|
3,781
|
Total
assets
|
$
81,172
|
|
$
78,375
|
LIABILITIES,
REDEEMABLE NONCONTROLLING INTERESTS AND
STOCKHOLDERS' EQUITY
|
|
|
|
Current
liabilities:
|
|
|
|
Medical claims
liability
|
$
16,465
|
|
$
14,243
|
Accounts payable and
accrued expenses
|
9,995
|
|
8,493
|
Return of premium
payable
|
2,205
|
|
2,328
|
Unearned
revenue
|
2,416
|
|
434
|
Current portion of
long-term debt
|
249
|
|
267
|
Total current
liabilities
|
31,330
|
|
25,765
|
Long-term
debt
|
18,084
|
|
18,571
|
Deferred tax
liability
|
480
|
|
1,407
|
Other long-term
liabilities
|
5,678
|
|
5,610
|
Total
liabilities
|
55,572
|
|
51,353
|
Commitments and
contingencies
|
|
|
|
Redeemable
noncontrolling interests
|
66
|
|
82
|
Stockholders'
equity:
|
|
|
|
Preferred stock,
$0.001 par value; authorized 10,000 shares; no shares issued or
outstanding at September 30, 2022 and
December 31, 2021
|
—
|
|
—
|
Common stock, $0.001
par value; authorized 800,000 shares; 606,931 issued and
570,091 outstanding at September 30, 2022,
and 602,704 issued and 582,479
outstanding at December 31,
2021
|
1
|
|
1
|
Additional paid-in
capital
|
19,774
|
|
19,672
|
Accumulated other
comprehensive earnings
|
(1,394)
|
|
77
|
Retained
earnings
|
9,554
|
|
8,139
|
Treasury stock, at
cost (36,840 and 20,225 shares, respectively)
|
(2,557)
|
|
(1,094)
|
Total Centene
stockholders' equity
|
25,378
|
|
26,795
|
Nonredeemable
noncontrolling interest
|
156
|
|
145
|
Total stockholders'
equity
|
25,534
|
|
26,940
|
Total liabilities,
redeemable noncontrolling interests and stockholders'
equity
|
$
81,172
|
|
$
78,375
|
CENTENE CORPORATION
AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF OPERATIONS
(In millions, except
shares in thousands and per share data in dollars)
(Unaudited)
|
|
|
Three Months
Ended
September 30,
|
|
Nine Months
Ended
September 30,
|
|
2022
|
|
2021
|
|
2022
|
|
2021
|
Revenues:
|
|
|
|
|
|
|
|
Premium
|
$
31,848
|
|
$
28,876
|
|
$
95,247
|
|
$
83,436
|
Service
|
1,878
|
|
1,638
|
|
6,679
|
|
4,054
|
Premium and service
revenues
|
33,726
|
|
30,514
|
|
101,926
|
|
87,490
|
Premium tax
|
2,139
|
|
1,892
|
|
7,060
|
|
5,924
|
Total
revenues
|
35,865
|
|
32,406
|
|
108,986
|
|
93,414
|
Expenses:
|
|
|
|
|
|
|
|
Medical
costs
|
28,111
|
|
25,430
|
|
83,261
|
|
73,210
|
Cost of
services
|
1,571
|
|
1,355
|
|
5,658
|
|
3,510
|
Selling, general and
administrative expenses
|
2,846
|
|
2,537
|
|
8,391
|
|
6,910
|
Depreciation
expense
|
150
|
|
147
|
|
470
|
|
414
|
Amortization of
acquired intangible assets
|
211
|
|
198
|
|
609
|
|
581
|
Premium tax
expense
|
2,211
|
|
1,965
|
|
7,258
|
|
6,129
|
Impairment
|
289
|
|
229
|
|
1,739
|
|
229
|
Legal
settlement
|
—
|
|
—
|
|
—
|
|
1,250
|
Total operating
expenses
|
35,389
|
|
31,861
|
|
107,386
|
|
92,233
|
Earnings from
operations
|
476
|
|
545
|
|
1,600
|
|
1,181
|
Other income
(expense):
|
|
|
|
|
|
|
|
Investment and other
income
|
692
|
|
424
|
|
786
|
|
566
|
Debt
extinguishment
|
10
|
|
(79)
|
|
26
|
|
(125)
|
Interest
expense
|
(169)
|
|
(170)
|
|
(491)
|
|
(503)
|
Earnings before income
tax
|
1,009
|
|
720
|
|
1,921
|
|
1,119
|
Income tax
expense
|
269
|
|
139
|
|
500
|
|
376
|
Net
earnings
|
740
|
|
581
|
|
1,421
|
|
743
|
(Earnings) loss
attributable to noncontrolling interests
|
(2)
|
|
3
|
|
(6)
|
|
5
|
Net earnings
attributable to Centene Corporation
|
$
738
|
|
$
584
|
|
$
1,415
|
|
$
748
|
|
|
|
|
|
|
|
|
Net earnings per
common share attributable to Centene Corporation:
|
|
|
|
|
Basic earnings per
common share
|
$
1.29
|
|
$
1.00
|
|
$
2.44
|
|
$
1.28
|
Diluted earnings per
common share
|
$
1.27
|
|
$
0.99
|
|
$
2.41
|
|
$
1.27
|
|
|
|
|
|
|
|
|
Weighted average
number of common shares outstanding:
|
|
|
|
|
|
|
Basic
|
573,961
|
|
583,244
|
|
580,277
|
|
582,636
|
Diluted
|
580,607
|
|
590,702
|
|
587,084
|
|
590,154
|
CENTENE CORPORATION
AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF CASH FLOWS
(In millions,
unaudited)
|
|
|
Nine Months
Ended
September 30,
|
|
2022
|
|
2021
|
Cash flows from
operating activities:
|
|
|
|
Net earnings
|
$
1,421
|
|
$
743
|
Adjustments to
reconcile net earnings to net cash provided by operating
activities
|
Depreciation and
amortization
|
1,178
|
|
1,098
|
Stock compensation
expense
|
180
|
|
127
|
Impairment
|
1,739
|
|
229
|
(Gain) loss on debt
extinguishment
|
(26)
|
|
125
|
(Gain) on
acquisition
|
(2)
|
|
(309)
|
Deferred income
taxes
|
(682)
|
|
(143)
|
(Gain) loss on
divestitures
|
(503)
|
|
62
|
Other adjustments,
net
|
164
|
|
(6)
|
Changes in assets and
liabilities
|
|
|
|
Premium and trade
receivables
|
(1,274)
|
|
(1,723)
|
Other
assets
|
152
|
|
(124)
|
Medical claims
liabilities
|
1,976
|
|
1,661
|
Unearned
revenue
|
1,964
|
|
(169)
|
Accounts payable and
accrued expenses
|
686
|
|
993
|
Other long-term
liabilities
|
863
|
|
964
|
Other operating
activities, net
|
1
|
|
2
|
Net cash provided by
operating activities
|
7,837
|
|
3,530
|
Cash flows from
investing activities:
|
|
|
|
Capital
expenditures
|
(771)
|
|
(662)
|
Purchases of
investments
|
(5,118)
|
|
(5,253)
|
Sales and maturities of
investments
|
2,842
|
|
4,069
|
Acquisitions, net of
cash acquired
|
(1,457)
|
|
(534)
|
Divestiture proceeds,
net of divested cash
|
1,362
|
|
(62)
|
Net cash used in
investing activities
|
(3,142)
|
|
(2,442)
|
Cash flows from
financing activities:
|
|
|
|
Proceeds from long-term
debt
|
357
|
|
9,247
|
Payments and
repurchases of long-term debt
|
(1,202)
|
|
(7,411)
|
Common stock
repurchases
|
(1,663)
|
|
(49)
|
Payments for debt
extinguishment
|
(14)
|
|
(157)
|
Debt issuance
costs
|
—
|
|
(72)
|
Other financing
activities, net
|
57
|
|
39
|
Net cash (used in)
provided by financing activities
|
(2,465)
|
|
1,597
|
Effect of exchange rate
changes on cash, cash equivalents, and restricted cash
|
(37)
|
|
(8)
|
Net increase in cash,
cash equivalents, and restricted cash and cash
equivalents
|
2,193
|
|
2,677
|
Cash and cash
equivalents reclassified from (to) held for sale
|
(192)
|
|
—
|
Cash, cash
equivalents, and restricted cash and cash equivalents,
beginning of period
|
13,214
|
|
10,957
|
Cash, cash
equivalents, and restricted cash and cash equivalents, end of
period
|
$
15,215
|
|
$
13,634
|
Supplemental
disclosures of cash flow information:
|
|
|
|
Interest
paid
|
$
462
|
|
$
479
|
Income taxes
paid
|
$
448
|
|
$
477
|
|
|
|
|
The following table
provides a reconciliation of cash, cash equivalents, and restricted
cash and cash equivalents reported within the
Consolidated Balance Sheets to the totals above:
|
|
September
30,
|
|
2022
|
|
2021
|
Cash and cash
equivalents
|
$
14,987
|
|
$
13,423
|
Restricted cash and
cash equivalents, included in restricted deposits
|
228
|
|
211
|
Total cash, cash
equivalents, and restricted cash and cash equivalents
|
$
15,215
|
|
$
13,634
|
CENTENE
CORPORATION
SUPPLEMENTAL
FINANCIAL DATA
|
|
|
Q3
|
|
Q2
|
|
Q1
|
|
Q4
|
|
Q3
|
|
2022
|
|
2022
|
|
2022
|
|
2021
|
|
2021
|
MEMBERSHIP
|
|
|
|
|
|
|
|
|
|
Traditional Medicaid
(1)
|
14,000,100
|
|
13,758,000
|
|
13,590,100
|
|
13,328,400
|
|
13,202,500
|
High Acuity Medicaid
(2)
|
1,698,100
|
|
1,688,000
|
|
1,682,800
|
|
1,686,100
|
|
1,566,000
|
Total
Medicaid
|
15,698,200
|
|
15,446,000
|
|
15,272,900
|
|
15,014,500
|
|
14,768,500
|
Commercial
Marketplace
|
2,087,800
|
|
2,033,300
|
|
2,031,000
|
|
2,140,500
|
|
2,177,000
|
Commercial
Group
|
439,800
|
|
448,700
|
|
449,700
|
|
462,100
|
|
468,500
|
Total
Commercial
|
2,527,600
|
|
2,482,000
|
|
2,480,700
|
|
2,602,600
|
|
2,645,500
|
Medicare
(3)
|
1,517,900
|
|
1,483,900
|
|
1,452,500
|
|
1,252,200
|
|
1,248,300
|
Medicare PDP
|
4,186,200
|
|
4,165,500
|
|
4,169,700
|
|
4,070,500
|
|
4,064,400
|
Total at-risk
membership (4)
|
23,929,900
|
|
23,577,400
|
|
23,375,800
|
|
22,939,800
|
|
22,726,700
|
TRICARE
eligibles
|
2,832,300
|
|
2,862,400
|
|
2,862,400
|
|
2,874,700
|
|
2,874,700
|
Total
|
26,762,200
|
|
26,439,800
|
|
26,238,200
|
|
25,814,500
|
|
25,601,400
|
|
|
|
|
|
|
|
|
|
|
(1)
Membership includes TANF, Medicaid Expansion, CHIP, Foster Care,
and Behavioral Health.
(2)
Membership includes ABD, IDD, LTSS, and MMP Duals.
(3)
Membership includes Medicare Advantage and Medicare
Supplement.
(4) Membership includes 1,285,600,
1,252,600, 1,231,500, 1,178,000, and 1,168,400 dual-eligible
beneficiaries for the periods ending September 30, 2022,
June 30, 2022, March 31, 2022, December 31, 2021, and September 30,
2021, respectively.
|
|
|
|
|
|
|
|
|
|
|
NUMBER OF
EMPLOYEES
|
83,200
|
|
82,400
|
|
80,100
|
|
72,500
|
|
75,900
|
|
|
|
|
|
|
|
|
|
|
DAYS IN CLAIMS
PAYABLE
|
54
|
|
55
|
|
53
|
|
52
|
|
51
|
|
|
|
|
|
|
|
|
|
|
CASH, INVESTMENTS
AND RESTRICTED DEPOSITS (in millions)
|
Regulated
|
$
31,447
|
|
$
28,817
|
|
$
26,982
|
|
$
26,416
|
|
$
26,392
|
Unregulated
|
989
|
|
1,308
|
|
1,262
|
|
3,352
|
|
3,223
|
Total
|
$
32,436
|
|
$
30,125
|
|
$
28,244
|
|
$
29,768
|
|
$
29,615
|
|
|
|
|
|
|
|
|
|
|
DEBT TO
CAPITALIZATION
|
41.8 %
|
|
41.5 %
|
|
40.9 %
|
|
41.2 %
|
|
41.5 %
|
DEBT TO
CAPITALIZATION EXCLUDING NON-RECOURSE DEBT
|
41.6 %
|
|
41.3 %
|
|
40.7 %
|
|
40.9 %
|
|
41.2 %
|
NON-RECOURSE DEBT
(in millions)
|
$
181
|
|
$
181
|
|
$
182
|
|
$
184
|
|
$
188
|
OPERATING
RATIOS
|
|
|
Three Months
Ended
September 30,
|
|
Nine Months
Ended
September 30,
|
|
2022
|
|
2021
|
|
2022
|
|
2021
|
HBR
|
88.3 %
|
|
88.1 %
|
|
87.4 %
|
|
87.7 %
|
SG&A expense
ratio
|
8.4 %
|
|
8.3 %
|
|
8.2 %
|
|
7.9 %
|
Adjusted SG&A
expense ratio
|
8.3 %
|
|
8.1 %
|
|
8.1 %
|
|
7.7 %
|
Note: Prior period
SG&A and adjusted SG&A expense ratios have been restated to
conform to current presentation, which excludes depreciation
expense.
|
HBR BY
PRODUCT
|
|
|
Three Months
Ended
September 30,
|
|
2022
|
|
2021
|
Medicaid
|
90.2 %
|
|
88.4 %
|
Commercial
|
84.2 %
|
|
88.7 %
|
Medicare
(1)
|
83.9 %
|
|
85.4 %
|
|
|
|
|
(1) Medicare
includes Medicare Advantage, Medicare Supplement, and Medicare
PDP.
|
MEDICAL CLAIMS
LIABILITY
The changes in medical
claims liability are summarized as follows (in
millions):
|
|
Balance,
September 30, 2021
|
|
$
14,099
|
Less: Reinsurance
recoverable
|
|
23
|
Balance,
September 30, 2021, net
|
|
14,076
|
Acquisitions and
divestitures
|
|
249
|
Incurred related
to:
|
|
|
Current
period
|
|
110,095
|
Prior
period
|
|
(1,442)
|
Total
incurred
|
|
108,653
|
Paid related
to:
|
|
|
Current
period
|
|
95,355
|
Prior
period
|
|
11,166
|
Total paid
|
|
106,521
|
Balance,
September 30, 2022, net
|
|
16,457
|
Plus: Reinsurance
recoverable
|
|
8
|
Balance,
September 30, 2022
|
|
$
16,465
|
|
|
|
Centene's claims reserving process utilizes a consistent
actuarial methodology to estimate Centene's ultimate liability. Any
reduction in the "Incurred related to: Prior period" amount may be
offset as Centene actuarially determines "Incurred related to:
Current period." As such, only in the absence of a consistent
reserving methodology would favorable development of prior period
claims liability estimates reduce medical costs. Centene believes
it has consistently applied its claims reserving methodology.
Additionally, approximately $256
million was recorded as a reduction to premium revenues
resulting from development within "Incurred related to: Prior
period" due to minimum HBR and other return of premium
programs.
The amount of the "Incurred related to: Prior period" above
represents favorable development and includes the effects of
reserving under moderately adverse conditions, new markets where we
use a conservative approach in setting reserves during the initial
periods of operations, receipts from other third party payors
related to coordination of benefits and lower medical utilization
and cost trends for dates of service September 30, 2021, and
prior.
View original
content:https://www.prnewswire.com/news-releases/centene-corporation-reports-third-quarter-2022-results-301657911.html
SOURCE Centene Corporation