— 2023 Full Year Diluted EPS of $4.95; Adjusted Diluted EPS of $6.68 —
2023 adjusted diluted EPS of $6.68, up over 15% from $5.78 in 2022.
2023 health benefits ratio of 87.7%, consistent with 2022.
Executed on capital deployment with $1.6 billion of share repurchases in 2023.
Successful portfolio review execution, completing the final two international divestitures in the past two months: Circle Health and Operose Health.
Increased 2024 premium and service revenues guidance by $2.5 billion.
ST. LOUIS, Feb. 6, 2024 /PRNewswire/ — Centene Corporation (NYSE:CNC) (“the Company”) announced today its financial results for the fourth quarter and year ended December 31, 2023. In summary, the 2023 fourth quarter and full year results were as follows:
2023 Results
Q4
Full Year
Total revenues (in millions)
$ 39,460
$ 153,999
Premium and service revenues (in millions)
$ 35,338
$ 140,095
Health benefits ratio
89.5 %
87.7 %
SG&A expense ratio
9.9 %
9.0 %
Adjusted SG&A expense ratio (1)
9.7 %
8.9 %
GAAP diluted EPS
$ 0.08
$ 4.95
Adjusted diluted EPS (1)
$ 0.45
$ 6.68
Total cash flow provided by operations (in millions)
$ 217
$ 8,053
(1)
Represents a non-GAAP financial measure. 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 fourth quarter and full year 2023 adjusted EPS results are slightly ahead of previous guidance, providing our organization with tangible, positive momentum as we enter 2024. Looking ahead, we are excited by the opportunities we see within our core businesses as we execute against our strategic plan, fortify our foundational assets and drive cost savings. With increased focus and reduced complexity, Centene is well positioned to continue navigating the dynamic operating landscape while creating shareholder value,” said Chief Executive Officer of Centene, Sarah M. London.
Other Events
In January 2024 and December 2023, we completed the divestitures of Circle Health Group (Circle Health) and Operose Health Group (Operose Health), respectively.
In January 2024, Centene’s New Hampshire subsidiary, NH Healthy Families, was selected by the New Hampshire Department of Health and Human Services to continue providing physical health, behavioral health and pharmacy services for New Hampshire’s Medicaid managed care program, known as Medicaid Care Management (MCM). The contract is expected to begin in September 2024 for a five-year term.
In January 2024, Centene announced the appointment of Michael Carson as President and Chief Executive Officer of its Medicare business, Wellcare. Carson succeeds Richard Fisher, who was appointed Senior Vice President of Financial Operations, reporting to Centene’s Chief Operating Officer, Susan Smith.
In December 2023, Centene’s Arizona subsidiary, Arizona Complete Health, the largest Medicaid health plan in Arizona, was selected by the Arizona Health Care Cost Containment System – Arizona’s single state Medicaid agency – to provide managed care for the Arizona Long Term Care System (ALTCS). The program supports nearly 26,000 Arizonans who are elderly and/or have a physical disability (E/PD) with physical and behavioral healthcare, as well as provides pharmacy benefits. The new ALTCS-E/PD contract is anticipated to begin in October 2024, subject to the resolution of third-party protests, and is a three-year term with four optional one-year extensions, for a total of seven possible contract years.
In November 2023, Centene announced the appointment of Susan Smith as its Chief Operating Officer, effective January 1, 2024.
Awards & Community Engagement
In January 2024, Fortune named Centene to its 2024 list of World’s Most Admired Companies. This marks the sixth consecutive year Centene has been named to Fortune’s list, which includes the most respected and reputable companies around the world, as ranked by peers within their respective industries.
In January 2024, Centene’s Georgia subsidiary, Peach State Health Plan, and the Centene Foundation announced a $2.2 million funding commitment to Augusta University. The funding will facilitate the expansion of the University’s Medical College of Georgia 3+ Primary Care Pathway Program, as well as support the launch of a new loan forgiveness program for the university’s Dental College of Georgia students who commit to five years of practice in rural and underserved areas.
In December 2023, Centene’s Chief Executive Officer, Sarah M. London, was named one of Modern Healthcare’s 100 Most Influential People of 2023. Now in its 22nd year, the list honors individuals in healthcare for their leadership and impact on the industry.
In November 2023, Centene’s subsidiary, Iowa Total Care, and the Centene Foundation, announced a partnership with Central Iowa Shelter & Services to create an on-the-ground Housing Command Center and a mobile application designed to address certain challenges people and communities face as a result of social determinants of health. The Centene Foundation and Iowa Total Care are funding these initiatives and will invest $2.55 million over the course of two years.
In October 2023, Centene was named to the 2023 Fortune Best Workplaces for Women list, ranking 67 out of 100 companies in the Large Company category. This marks the first time Centene has appeared on the annual list, which recognizes companies that demonstrate high employee-ranked scores in trust, fairness and pride among women employees.
Membership
The following table sets forth membership by line of business:
December 31,
2023
2022
Traditional Medicaid (1)
12,754,000
14,264,800
High Acuity Medicaid (2)
1,718,000
1,710,000
Total Medicaid (4)
14,472,000
15,974,800
Commercial Marketplace
3,900,100
2,076,100
Commercial Group
427,500
441,100
Total Commercial
4,327,600
2,517,200
Medicare (3) (4)
1,284,200
1,511,100
Medicare PDP
4,617,800
4,226,000
Total at-risk membership
24,701,600
24,229,100
TRICARE eligibles
2,773,200
2,832,300
Total
27,474,800
27,061,400
(1)
Membership includes Temporary Assistance for Needy Families (TANF), Medicaid Expansion, Children’s Health Insurance Program (CHIP), Foster Care and Behavioral Health.
(2)
Membership includes Aged, Blind, or Disabled (ABD), Intellectual and Developmental Disabilities (IDD), Long-Term Services and Supports (LTSS) and Medicare-Medicaid Plans (MMP) Duals.
(3)
Membership includes Medicare Advantage and Medicare Supplement.
(4)
Medicaid and Medicare membership includes 1,276,700 and 1,291,300 Dual Eligible Special Needs Plans (D-SNPs) beneficiaries for the periods ending December 31, 2023, and December 31, 2022, respectively.
Premium and Service Revenues
The following table sets forth supplemental revenue information ($ in millions):
Three Months Ended December 31,
Year Ended December 31,
2023
2022
% Change
2023
2022
% Change
Medicaid
$ 21,114
$ 21,321
(1) %
$ 86,855
$ 84,083
3 %
Commercial
7,406
4,401
68 %
24,845
17,380
43 %
Medicare (1)
5,290
5,449
(3) %
22,261
22,484
(1) %
Other
1,528
2,382
(36) %
6,134
11,532
(47) %
Total premium and service revenues
$ 35,338
$ 33,553
5 %
$ 140,095
$ 135,479
3 %
(1)
Medicare includes Medicare Advantage, Medicare Supplement, D-SNPs and Medicare Prescription Drug Plan (PDP).
Statement of Operations: Three Months Ended December 31, 2023
For the fourth quarter of 2023, premium and service revenues increased 5% to $35.3 billion from $33.6 billion in the comparable period of 2022. The increase was driven by membership growth in the Marketplace business due to strong product positioning as well as overall market growth, partially offset by recent divestitures in the Other segment and lower Medicaid membership due to redeterminations.
Health benefits ratio (HBR) of 89.5% for the fourth quarter of 2023 represents an increase from 88.7% in the comparable period in 2022. The increase is primarily driven by the $250 million premium deficiency reserve recorded in connection with the 2024 Medicare Advantage business.
The SG&A expense ratio was 9.9% for the fourth quarter of 2023, compared to 9.5% in the fourth quarter of 2022. The adjusted SG&A expense ratio was 9.7% for the fourth quarter of 2023, compared to 9.3% in the fourth quarter of 2022. The increases were driven by growth in the Marketplace business, which operates at a meaningfully higher SG&A ratio as compared to Medicaid, along with Medicare distribution costs. The increases were partially offset by ongoing SG&A reduction initiatives and continued leveraging of expenses over higher revenues. The SG&A expense ratio in the fourth quarter of 2023 was also impacted by severance costs due to a restructuring partially offset by lower acquisition and divestiture related costs.
The effective tax rate was (61.9)% for the fourth quarter of 2023, compared to 644.4% in the fourth quarter of 2022. The effective tax rate for the fourth quarter of 2023 reflects lower state taxes and tax effects of divestitures. The effective tax rate for the fourth quarter of 2022 reflects the tax effects of previously pending and completed divestitures, including the Magellan Rx divestiture gain, and impairments, including the non-deductible impairment of our Health Net Federal Services business. For the fourth quarter of 2023, our effective tax rate on adjusted earnings was 30.6%, compared to 23.6% in the fourth quarter of 2022.
Cash flow provided by operations for the fourth quarter of 2023 was $217 million, primarily driven by net earnings, partially offset by decreased unearned revenue driven by the early receipt of payments from CMS in the third quarter pertaining to the fourth quarter.
Statement of Operations: Year Ended December 31, 2023
For the full year 2023, premium and service revenues increased 3% to $140.1 billion from $135.5 billion in the comparable period of 2022 driven by 88% membership growth in the Marketplace business as a result of strong product positioning as well as overall market growth and Medicaid rate increases and organic growth. The increases were partially offset by divestitures, Medicaid membership redeterminations and pharmacy carve outs in early 2023.
HBR of 87.7% for the full year 2023 was flat compared to 87.7% in 2022. The 2023 HBR was positively impacted by growth in the Marketplace business, which runs at a lower HBR, and strong performance from pricing discipline and execution, offset by the $250 million premium deficiency reserve recorded in connection with the 2024 Medicare Advantage business.
The SG&A expense ratio was 9.0% for the full year 2023, compared to 8.6% for the full year 2022. The adjusted SG&A expense ratio was 8.9% for the full year 2023, compared to 8.4% for the full year 2022. The increases were driven by growth in the Marketplace business, which operates at a meaningfully higher SG&A ratio as compared to Medicaid, along with Medicare distribution costs. The increases were partially offset by ongoing SG&A reduction initiatives and continued leveraging of expenses over higher revenues.
The effective tax rate was 25.0% for 2023, compared to 38.7% for 2022. The effective tax rate for 2023 reflects the tax effects of the distribution of long-term stock awards to the estate of the Company’s former CEO, divestiture gains and losses, lower state taxes and the pending divestiture of Circle Health. The 2022 effective tax rate reflects the tax effects of previously pending and completed divestitures, including the Magellan Rx divestiture gain, and impairments, including the non-deductible impairment of our Health Net Federal Services business. For the full year 2023, our effective tax rate on adjusted earnings was 24.9%, compared to 25.8% in 2022.
Cash flow provided by operations for the full year 2023 was $8.1 billion, or 3.0 times net earnings and 2.2 times adjusted net earnings.
Balance Sheet
At December 31, 2023, the Company had cash, investments and restricted deposits of $37.3 billion and maintained $200 million of cash and cash equivalents in its unregulated entities. Medical claims liabilities totaled $18.0 billion. The Company’s days in claims payable was 54 days, which is an increase of one day as compared to the third quarter of 2023, and flat as compared to the fourth quarter of 2022. Total debt was $17.8 billion, which included $150 million of borrowings on the $2.0 billion Revolving Credit Facility at year end.
During the fourth quarter of 2023, the Company repurchased 397 thousand shares for $27 million. In total, the Company repurchased 22.9 million shares for $1.6 billion through the stock repurchase program for the full year 2023. As of February 6, 2024, $5.2 billion remains available under the Company’s stock repurchase program.
Outlook
The Company is increasing its 2024 premium and service revenues guidance range by $2.5 billion to a range of $134.5 billion to $137.5 billion to reflect additional Commercial premium revenue from a stronger than expected Marketplace open enrollment. The Company reiterates its 2024 adjusted diluted EPS guidance floor of greater than $6.70.
Conference Call
As previously announced, the Company will host a conference call Tuesday, February 6, 2024, at 8:30 a.m. ET to review the financial results for the fourth quarter and year ended December 31, 2023.
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: 3061147 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 following the completion of the call for the next 12 months or until 11:59 p.m. ET on Tuesday, February 4, 2025, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Tuesday, February 13, 2024, 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 7739225.
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 Company strongly encourages investors to review its consolidated financial statements and publicly filed reports in their entirety and cautions investors that the non-GAAP financial measures used by the Company may differ from similar measures used by other companies, even when similar terms are used to identify such measures. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.
The Company is unable to provide a reconciliation of its 2024 adjusted diluted EPS target to the corresponding GAAP measure without unreasonable effort due to the difficulty of predicting the timing and amounts of various items within a reasonable range. As such, this has been excluded from the reconciliation below.
The Company believes the presentation of non-GAAP financial measures that excludes amortization of acquired intangible assets, 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
December 31,
Year Ended
December 31,
2023
2022
2023
2022
GAAP net earnings (loss) attributable to Centene
$ 45
$ (213)
$ 2,702
$ 1,202
Amortization of acquired intangible assets
176
208
718
817
Acquisition and divestiture related expenses
18
64
70
213
Other adjustments (1)
119
315
464
1,540
Income tax effects of adjustments (2)
(118)
111
(308)
(410)
Adjusted net earnings
$ 240
$ 485
$ 3,646
$ 3,362
(1)
Other adjustments include the following pre-tax items:
2023:
(a)
for the three months ended December 31, 2023: severance costs due to a restructuring of $57 million, Circle Health impairment of $41 million, real estate impairments of $13 million, a reduction to the previously reported gain on the sale of Magellan Rx of $12 million, gain on the sale of Apixio of $2 million and gain on the divestiture of Operose Health of $2 million;
(b)
for the twelve months ended December 31, 2023: Circle Health impairment of $292 million, Operose Health impairment of $140 million, real estate impairments of $105 million, gain on the sale of Apixio of $93 million, severance costs due to a restructuring of $79 million, gain on the sale of Magellan Specialty Health of $79 million, a reduction to the previously reported gain on the sale of Magellan Rx of $22 million, gain on the previously reported divestiture of Centurion of $15 million and an additional loss on the divestiture of our Spanish and Central European businesses of $13 million.
2022:
(a)
for the three months ended December 31, 2022: impairments of assets associated with the divestitures of our Centurion and HealthSmart businesses of $293 million, Magellan Rx divestiture gain of $269 million, Health Net Federal Services asset impairment of $233 million, real estate impairments of $61 million, gain on debt extinguishment related to the repurchases of senior notes of $4 million and costs related to the pharmacy benefits management (PBM) legal settlement of $1 million;
(b)
for the twelve months ended December 31, 2022: real estate impairments of $1,642 million, gain on the sale of PANTHERx Rare (PANTHERx) of $490 million, impairments of assets associated with the divestitures of our Spanish and Central European, Centurion and HealthSmart businesses of $458 million, Magellan Rx divestiture gain of $269 million, Health Net Federal Services asset impairment of $233 million, gain on debt extinguishment of $27 million, 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 and costs related to the PBM legal settlement of $6 million.
(2)
The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. In addition, the three and twelve months ended December 31, 2023 include tax expense of $9 million and $3 million, respectively, related to tax adjustments on previously reported divestitures. The year ended December 31, 2023 also includes a one-time income tax benefit of $69 million resulting from the distribution of long-term stock awards to the estate of the Company’s former CEO. The three and twelve months ended December 31, 2022, include a tax expense of $3 million and a tax benefit of $15 million, respectively, related to the previously reported impairment of our equity method investment in RxAdvance. The three and twelve months ended December 31, 2022 also include tax expense of $107 million related to the Magellan Specialty Health …
Leave a Reply