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Centene
Centene (CNC) investor relations material
Centene Q4 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q4 2025 earnings summary6 Feb, 2026
Executive summary
2025 adjusted diluted EPS was $2.08, with a GAAP diluted loss per share of $(13.53) due to a $6.7 billion goodwill impairment and a $513 million Magellan Health impairment; Q4 adjusted diluted loss per share was $1.19, slightly ahead of expectations.
Total revenues for 2025 increased 20% year-over-year to $194.8 billion, driven by growth in PDP and Marketplace businesses and Medicaid rate increases.
Medicaid profitability improved in the back half of 2025, with Marketplace and Medicare segments performing in line or better than expectations.
2026 guidance projects total revenues of $186.5–$190.5 billion, with premium and service revenues of $170.0–$174.0 billion and adjusted diluted EPS above $3.00, targeting over 40% year-over-year growth.
Medicaid net rate increase anticipated in the mid-4% range, supporting revenue growth.
Financial highlights
2025 premium and service revenue reached $174.6 billion, with Q4 revenues up 23% year-over-year.
Q4 GAAP diluted loss per share was $2.24, including a $389 million net loss from a Magellan business divestiture.
Full-year adjusted SG&A expense ratio was 7.4%, down from 8.5% in 2024; 2026 forecast is 7.1%–7.7%.
Cash flow from operations was $5.1 billion for 2025, up from $154 million in 2024.
Ended 2025 with $400 million in available cash and a debt-to-capital ratio of 46.5%.
Outlook and guidance
2026 revenue guidance is $186.5–$190.5 billion, with premium and service revenue expected between $170 billion and $174 billion.
Adjusted diluted EPS for 2026 is projected to exceed $3.00, with GAAP diluted EPS above $1.98.
Medicaid premium revenue projected to decline by $2 billion due to member attrition, partially offset by rate increases.
Marketplace revenue expected to decrease by $8 billion, reflecting policy changes and expiration of Enhanced APTCs.
Medicare segment premium revenue to grow by $7.5 billion, mainly from PDP business and yield increases.
HBR for 2026 forecasted at 90.9%–91.7%, with cost of services expense ratio between 91.4% and 92.0%.
SG&A expense ratio expected between 7.1% and 7.7%.
Effective tax rate projected at 27.0%–28.0%, with adjusted effective tax rate at 26.0%–27.0%.
No share buybacks included in guidance; continued focus on debt reduction.
Marketplace profitability restoration plan
Medicaid membership stabilization strategy
Impact of One Big Beautiful Bill Act
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Next Centene earnings date
Q1 202628 Apr, 2026
Centene
Next Centene earnings date
Q1 202628 Apr, 2026
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Frequently asked questions
Government-sponsored Healthcare Services
Centene Corporation is an American multinational healthcare company providing a range of health insurance products and related services. Centene specializes in government-sponsored healthcare programs, including Medicaid, Medicare, and the Health Insurance Marketplace, making it a significant player in public sector healthcare in the United States. The company is headquartered in St Louis, Missouri, and its shares are traded on the NYSE.
Founding and Re-focusing
The company was founded in 1984 as Family Hospital Physician Associates, it was initially a single health plan provider. In 1997, the company rebranded to Centene Corporation and relocated its headquarters to St. Louis, Missouri. During this time, Centene recognized the growing need and opportunity to serve low-income and vulnerable populations, which were often underserved in the healthcare market. This realization led to a strategic pivot towards government-sponsored programs like Medicaid and Medicare, something that proved to be a success. Some of the closest competitors to Centene are Molina, UnitedHealth Group, and Humana.
Medicare and Medicaid
As previously mentioned, Centene specializes in providing government-sponsored healthcare plans, primarily focusing on Medicaid and Medicare. The company offers a range of services tailored to meet the needs of low-income, underinsured, and uninsured individuals.
For Medicaid recipients, Centene provides managed care services, which include comprehensive health coverage and specialized programs. These programs often cater to specific groups, such as children, pregnant women, elderly individuals, and people with disabilities.
In the Medicare sector, Centene offers Medicare Advantage plans, which are alternatives to traditional Medicare. These plans combine Medicare Parts A (hospital insurance) and B (medical insurance), often including Part D (prescription drug coverage). Centene's Medicare Advantage plans are designed to offer additional benefits, like vision, dental, and wellness programs, which are not typically covered under standard Medicare.
Other Services
Outside of government-sponsored healthcare plans, Centene Corporation offers a variety of health solutions through its subsidiaries. These include commercial health insurance under the Health Net brand, serving individuals, families, and small businesses. Centene also provides specialty services, including behavioral health, pharmacy benefits management, and care management for complex medical conditions. Additionally, the company is active in telehealth services and international healthcare operations, broadening its scope beyond traditional health insurance.
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