CNC · 10-Q · 2026Q1

CENTENE CORP

Filed 2026-04-28 · Healthcare

Ranked Events

• Liquidity and cash positionImportance 83 · Surprise 82
  Operating activities provided cash of $4.4 billion in the three months ended March 31, 2026, compared to $1.5 billion in the prior year period, driven by net earnings, the partial sale of 2025 CMS PDP receivables, and…
• Operating Cash Flow ImprovementImportance 77 · Surprise 82
  Operating cash flows improved materially in Q1 2026 to $4.4 billion from $1.5 billion in Q1 2025, an increase of $2.9 billion driven by net earnings and the partial sale of 2025 CMS PDP receivables. Management also…
• Medicare Part D changesImportance 74 · Surprise 84
  The Inflation Reduction Act materially changed Medicare Part D starting in 2025, including elimination of the coverage gap and capping members' annual out‑of‑pocket costs at $2,100 in 2026, shifting cost‑sharing among…
• Medicare PDP Growth / Gross MarginImportance 74 · Surprise 58
  Centene's Medicare segment revenues rose 18% year‑over‑year in Q1 2026, primarily driven by higher stand‑alone Medicare PDP premiums and increased PDP membership. Medicare PDP membership reached 8.78 million and…
• Medicare Revenue GrowthImportance 74 · Surprise 58
  Medicare total revenues were $10,326 million in Q1 2026, an 18% increase versus $8,759 million in Q1 2025, primarily driven by increased PDP premiums and PDP membership.,Medicare PDP membership was 8,780,600 at March 31, 2026, up from 7,867,800 at March 31, 2025, contributing meaningfully to premium yield and revenue growth.,Medicare gross margin rose $350 million in Q1 2026 versus Q1 2025, aided by rate increases and the absence of a premium deficiency reserve (PDR) in 2026 that had been present in 2025.
• Outstanding IndebtednessImportance 69 · Surprise 50
  As of March 31, 2026, Centene had $14.5 billion aggregate principal amount of senior notes issued and outstanding, with maturities between December 2027 and August 2031.,During Q1 2026 the company repurchased $1.0 billion par value of Senior Notes under its senior note repurchase program (program increase authorized February 2026) and had $484 million available under that debt repurchase program as of March 31, 2026.,Centene had $2.0 billion outstanding under its Term Loan Facility, no borrowings under its $4.0 billion Revolving Credit Facility, $113 million of letters of credit outstanding, surety bonds of $787 million, and a debt‑to‑capital ratio of 43.2% at March 31, 2026 (down from 46.5% at December 31, 2025).
• Part D receivable purchase programImportance 65 · Surprise 60
  In February 2026 Centene entered into a master receivable purchase agreement permitting the company to offer up to the full amount of its 2025 plan year stand‑alone Part D risk‑sharing programs receivable for sale,…
• Medicaid policy changesImportance 65 · Surprise 60
  The One Big Beautiful Bill Act (OBBBA), passed in July 2025, includes requirements that may reduce Medicaid Expansion eligibility by requiring work or community engagement and more frequent eligibility…
• Part D Receivables FinancingImportance 65 · Surprise 60
  Centene has a master receivable purchase agreement (February 2026 Receivable Purchase Agreement) that permits selling up to $4.25 billion of 2025 plan year stand‑alone Part D risk‑sharing program receivables; $3.0…
• Marketplace Pricing and ICHRA StrategyImportance 60 · Surprise 74
  Centene cites expiration of enhanced APTCs and changes from the Final Rule as drivers of higher Marketplace morbidity and reduced membership; in response it implemented corrective pricing actions for 2026 covering 95%…
• Dual‑eligible D‑SNP integrationImportance 59 · Surprise 60
  CMS finalized rules in its calendar year 2025 Medicare and Part D policy requiring dually enrolled Medicare and Medicaid beneficiaries to receive integrated care through the Medicaid company's Medicare Advantage Dual…
• Marketplace APTC changesImportance 59 · Surprise 60
  Enhanced Advance Premium Tax Credits (APTCs) initially expanded under ARPA and extended by the Inflation Reduction Act expired at the end of 2025, reducing subsidy levels available in the Health Insurance Marketplace.…
• Divestiture of Magellan AssetsImportance 58 · Surprise 68
  In December 2025 Centene signed a definitive agreement to divest the remaining Magellan Health businesses.,Other segment revenues decreased 8% in Q1 2026 versus Q1 2025 driven by Magellan Health, and the company recorded adjustments to previously reported gains related to Magellan Rx totaling $10 million.,The divestiture is explicitly referenced as a completed definitive agreement (December 2025) and is expected to materially affect Other segment composition and related revenue recognition going forward.
• Medical Cost Trend / Benefit RatioImportance 58 · Surprise 42
  Centene reports elevated medical cost trends driven by increasing medical demand, expanded access to care from state program changes (including carve-ins for behavioral health and home and community-based services),…
• Membership / Enrollment TrendsImportance 57 · Surprise 50
  Managed care membership declined by 1.7 million, or (6)%, from March 31, 2025 to March 31, 2026, to 26.2729 million members as of March 31, 2026. Marketplace membership fell sharply to 3.5822 million from 5.6260…
• Receivable Purchase AgreementImportance 53 · Surprise 60
  In February 2026 Centene entered into a master receivable purchase agreement to offer up to the full amount of its 2025 plan year stand‑alone Part D risk‑sharing programs receivable to a purchaser, with the purchaser not obligated to accept any offer.,The purchase price for each purchased portion is the net estimated invoice amount minus a discount determined by reference to SOFR plus a spread, and Centene acts as servicer for transferred receivables; the maximum outstanding purchase amount permitted is $4.25 billion.,In March 2026 Centene sold a participating interest of $1.0 billion of 2025 plan year Part D receivables and received net cash proceeds of $970 million, recording a pre‑tax loss on sale of receivables of $30 million; as of March 31, 2026 there were $3.0 billion of eligible receivables outstanding and $3.25 billion remaining under the agreement.
• State Medicaid contracts & protestsImportance 51 · Surprise 42
  Centene disclosed multiple state Medicaid contract commencements and procurements: SilverSummit began a Nevada Medicaid managed care contract in January 2026 (five‑year term plus an optional two‑year extension), Health…
• Medicaid Contract Awards and ProtestsImportance 51 · Surprise 42
  Centene began several state Medicaid contracts in late 2024–2026 including SilverSummit (Nevada ALTCS expansion into rural/frontier areas), Health Net Community Solutions (Medi‑Cal dental in Los Angeles and…
• Capital Return ProgramImportance 50 · Surprise 24
  The Board authorized up to a cumulative $10.0 billion of common stock repurchases in 2023; Centene made no stock repurchases in Q1 2026 and had $1.8 billion available under the program as of March 31, 2026.,The company reserves the right to discontinue the repurchase program and has not placed a duration on the program as of the filing date.,Separately, a Board‑authorized senior note debt repurchase program (originally $1.0 billion in 2022) was increased by $1.0 billion in February 2026 to support debt repurchases.
• Medicaid Revenue and Acuity TrendsImportance 49 · Surprise 32
  Medicaid total revenues increased 9% in Q1 2026 to $28.9 billion, driven primarily by state‑directed payments and rate increases intended to reflect higher acuity and medical cost trends. These revenue increases were…

Revenue by Product (in millions)