ST. LOUIS, Oct. 11, 2017 /PRNewswire/ -- Centene
Corporation (NYSE: CNC) commented on updated Medicare Star quality
ratings for the 2018 rating year published today by the Centers for
Medicare and Medicaid Services (CMS). The 2018 rating year will
affect quality bonus payments for Medicare Advantage plans in 2019.
The results indicate that Health Net of California, Inc.'s Medicare Advantage
plan (H0562) will move to a 3.5 Star rating from a 4.0 Star rating
for the 2018 rating year. The effect of this Star rating
change will lower Centene Corporation's parent Star rating for the
2018 rating year from 4.0 Stars to 3.5 Stars.
The reduction in the Star rating for Health Net of California is the result of a 2015 program
audit. Health Net of California's
underlying rating reflects 4.0 Star performance; however, CMS
lowered a single measure (BAPP – Beneficiary Access and Performance
Problem) because of a penalty associated with a plan audit in 2015,
which caused a decline in the overall score to 3.5 Stars. While
overall quality measures improved on a year-over-year basis, such
improvement was insufficient to compensate for the lower BAPP
measure. The penalty related to the 2015 program audit will
only impact the 2018 rating year and will not have a continuing
impact on the Star ratings in future rating years. The
Company intends to appeal the application of the penalty.
"Our commitment to quality remains as strong as ever. We
are working to evaluate and mitigate the potential impact on the
Company's revenue in 2019 as a result of the lowered 2018
rating and working to implement year-over-year quality
improvements. We believe we will return to a 4.0 Star parent
rating in future periods," said Marcela
Manjarrez-Hawn, Senior Vice President, Chief Communications
Officer. "To fulfill our commitment, we continue investing in
staffing, technology, plan benefits and the consumer
experience."
The Company will provide an update on this topic during the
third quarter 2017 earnings call on October
24, 2017.
About Centene Corporation
Centene Corporation, a
Fortune 100 company, is a diversified, multi-national healthcare
enterprise that provides a portfolio of services to government
sponsored and commercial healthcare programs, focusing on
under-insured and uninsured individuals. Many receive benefits
provided under Medicaid, including the State Children's Health
Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD),
Foster Care and Long Term Care
(LTC), in addition to other state-sponsored programs, Medicare
(including the Medicare prescription drug benefit commonly known as
"Part D"), dual eligible programs and programs with the U.S.
Department of Defense and U.S. Department of Veterans Affairs.
Centene also provides healthcare services to groups and individuals
delivered through commercial health plans. Centene operates local
health plans and offers a range of health insurance solutions. It
also contracts with other healthcare and commercial organizations
to provide specialty services including behavioral health
management, care management software, correctional healthcare
services, dental benefits management, in-home health services, life
and health management, managed vision, pharmacy benefits
management, specialty pharmacy and telehealth services.
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, http://www.centene.com/investors.
Forward-Looking Statements
The company and its
representatives may from time to time make written and oral
forward-looking statements within the meaning of the Private
Securities Litigation Reform Act ("PSLRA")
of 1995, including statements in this and other press releases,
in presentations, filings with the Securities and Exchange
Commission ("SEC"), reports to
stockholders and in meetings with investors and analysts. In
particular, the information provided in this press release may
contain certain forward-looking statements with respect to the
financial condition, results of operations and business of Centene
and certain plans and objectives of Centene with respect thereto,
including but not limited to the expected benefits of the
acquisition of Health Net, Inc. or Fidelis Care. These
forward-looking statements can be identified by the fact that they
do not relate only to historical or current facts. Without limiting
the foregoing, forward-looking statements often use words such
as "anticipate", "seek",
"target", "expect",
"estimate", "intend",
"plan", "goal",
"believe", "hope", "aim",
"continue", "will",
"may", "can", "would",
"could" or "should"
or other words of similar meaning or the negative thereof. We
intend such forward-looking statements to be covered by the
safe-harbor provisions for forward-looking statements contained in
PSLRA. A number of factors, variables or events could cause actual
plans and results to differ materially from those expressed or
implied in forward-looking statements. Such factors include, but
are not limited to, Centene's ability to accurately predict and
effectively manage health benefits and other operating expenses and
reserves; 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 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 and any
regulations enacted thereunder that may result from changing
political conditions; rate cuts or other payment reductions or
delays by governmental payors and other risks and uncertainties
affecting Centene's government businesses; Centene's ability to
adequately price products on federally facilitated and state based
Health Insurance Marketplaces; tax matters; disasters or major
epidemics; the outcome of legal and regulatory proceedings; changes
in expected contract start dates; provider, state, federal and
other contract changes and timing of regulatory approval of
contracts; the expiration, suspension or termination of Centene's
contracts with federal or state governments (including but not
limited to Medicaid, Medicare, and TRICARE); the difficulty of
predicting the timing or outcome of pending or future litigation or
government investigations; challenges to Centene's contract awards;
cyber-attacks or other privacy or data security incidents; the
possibility that the expected synergies and value creation from
acquired businesses, including, without limitation, the Health Net
acquisition and the Fidelis Care acquisition, will not be realized,
or will not be realized within the expected time period, including,
but not limited to, as a result of conditions, terms, obligations
or restrictions imposed by regulators in connection with their
approval of, or consent to, the acquisition; the exertion of
management's time and Centene's resources, and other expenses
incurred and business changes required in connection with complying
with the undertakings in connection with certain regulatory
approvals for the Health Net acquisition and the Fidelis Care
acquisition; disruption from acquisitions, including the Health Net
acquisition and the Fidelis Care acquisition, making it more
difficult to maintain business and operational relationships; the
risk that unexpected costs will be incurred in connection with,
among other things, the Health Net acquisition, the Fidelis Care
acquisition and/or the successful integration of acquisitions;
changes in expected closing dates, estimated purchase price and
accretion for acquisitions; the risk that acquired businesses will
not be integrated successfully, including the Health Net
acquisition and the Fidelis Care acquisition; the risk that the
conditions of the Fidelis Care acquisition may not be satisfied or
completed on a timely basis, or at all; inability to pursue
alternatives to the Fidelis Care acquisition, or the risk that
potential competing acquirers of Centene may be discouraged from
making favorable alternative transaction proposals due to certain
provisions in the Fidelis Care asset purchase agreement; failure to
obtain expiration or termination of applicable waiting periods or
to receive any required regulatory approvals, consents or
clearances for the Fidelis Care acquisition, and the risk that,
even if so obtained or received, regulatory authorities impose
conditions on the completion of the transaction that could require
the exertion of management's time and Centene's resources or
otherwise have an adverse effect on Centene or the combined
company; business uncertainties and contractual restrictions while
the Fidelis Care acquisition is pending, which could adversely
affect Centene's business and operations; change of control
provisions or other provisions in certain agreements to which
Fidelis Care is a party, which may be triggered by the completion
of the Fidelis Care acquisition; loss of management personnel and
other key employees due to uncertainties associated with the
Fidelis Care acquisition; the risk that, following completion of
the Fidelis Care acquisition, the combined company may not be able
to effectively manage its expanded operations; restrictions and
limitations that may stem from the financing arrangements that the
combined company will enter into in connection with the Fidelis
Care acquisition; Centene's ability to 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; additional
indebtedness incurred or equity issued to finance the Fidelis Care
acquisition; availability of debt and equity financing, on terms
that are favorable to Centene; inflation; foreign currency
fluctuations; and risks and uncertainties discussed in the reports
that Centene has filed with the SEC. These forward-looking
statements reflect Centene's current views with
respect to future events and are based on numerous assumptions and
assessments made by Centene in light of its experience and
perception of historical trends, current conditions, business
strategies, operating environments, future developments and other
factors it believes 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. The factors described
in the context of such forward-looking statements in this press
release could cause Centene's plans with respect to
the Health Net acquisition, actual results, performance or
achievements, industry results and developments to differ
materially from those expressed in or implied by such
forward-looking statements. Although it is currently believed that
the expectations reflected in such forward-looking statements are
reasonable, no assurance can be given that such expectations will
prove to have been correct and persons reading this press release
are therefore cautioned not to place undue reliance on these
forward-looking statements which speak only as of the date of this
press release. Centene does not assume any obligation to update the
information contained in this press release (whether as a result of
new information, future events or otherwise), except as required by
applicable law. This list of important factors is not intended to
be exhaustive. We discuss certain of these matters more fully, as
well as certain other risk factors that may affect Centene's
business operations, financial condition and results of operations,
in Centene's filings with the SEC, including the annual reports on
Form 10-K, quarterly reports on Form 10-Q and current reports on
Form 8-K.
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SOURCE Centene Corporation