— 2025 Full Year GAAP Diluted Loss Per Share of $(13.53); Adjusted Diluted Earnings Per Share of $2.08 —
— 2026 Adjusted Diluted Earnings Per Share Guidance of Greater than $3.00 —
- Consolidated HBR of 94.3% in the fourth quarter of 2025, which includes a Commercial HBR of 95.4% that was 100 basis points higher than expectations driven by net out of period items.
- Medicaid HBR of 93.0% in the fourth quarter of 2025, reflecting continued progress and representing 40 basis points of sequential improvement compared to the third quarter.
- Fundamental fourth quarter 2025 trend was consistent with expectations in Medicaid and Medicare Advantage, and slightly favorable in Marketplace and Medicare PDP.
- Strong SG&A management throughout 2025 with an adjusted SG&A expense ratio of 7.4% for the full year.
ST. LOUIS, Feb. 6, 2026 /PRNewswire/ — Centene Corporation (NYSE:CNC) (the Company) announced today its financial results for the fourth quarter and year ended December 31, 2025. In summary, the 2025 fourth quarter and full year results were as follows:
|
2025 Results |
||||
|
Q4 |
Full Year |
|||
|
Total revenues (in millions) |
$ 49,725 |
$ 194,777 |
||
|
Premium and service revenues (in millions) |
$ 44,727 |
$ 174,581 |
||
|
Health benefits ratio |
94.3 % |
91.9 % |
||
|
SG&A expense ratio |
7.5 % |
7.4 % |
||
|
Adjusted SG&A expense ratio (1) |
7.5 % |
7.4 % |
||
|
GAAP diluted loss per share |
$ (2.24) |
$ (13.53) |
||
|
Adjusted diluted earnings (loss) per share (1) |
$ (1.19) |
$ 2.08 |
||
|
Total cash flow provided by operations (in millions) |
$ 437 |
$ 5,088 |
||
|
(1) |
Represents a non-GAAP financial measure. A full reconciliation of the adjusted diluted earnings (loss) per share and adjusted selling, general and administrative (SG&A) expenses is shown in the Non-GAAP Financial Presentation section of this release. |
“We are pleased to end a challenging year carrying positive momentum from the extensive and decisive actions taken in the back half of 2025 with the goal of restoring Marketplace profitability and stabilizing the trajectory of our Medicaid business,” said Chief Executive Officer of Centene, Sarah M. London. “As we look to 2026, we are positioned to deliver meaningful margin improvement and renewed adjusted diluted EPS growth. We expect full year 2026 adjusted diluted EPS to be greater than $3.00, marking important progress toward restoring the enterprise’s embedded earnings power all while continuing to work to provide access to affordable, high-quality care for our members.”
Other Events
- In December 2025, Centene signed a definitive agreement to divest the remaining Magellan Health businesses. As a result, the Company recorded non-cash impairment charges associated with the pending divestiture totaling $513 million, or $389 million after-tax.
Awards & Community Engagement
- In November, the Centene Foundation and five Centene subsidiaries – Buckeye Health Plan, Sunshine Health, Carolina Complete Health, Meridian Health Plan of Illinois, and Superior HealthPlan – announced a number of contributions to support food banks and community-based organizations addressing food insecurity following disruptions to the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
- In November, Health Net, a Centene subsidiary, announced the renewal of its partnership with LA Family Housing to support initiatives aimed at increasing access to stable, affordable housing and to build infrastructure for whole-person health for individuals experiencing homelessness in parts of Los Angeles County.
- In October, Iowa Total Care, a Centene subsidiary, in partnership with Central Iowa Shelter & Services, announced the opening of a new Empowerment Command Center and Affordable Housing Project, aimed at providing essential services, including job training, health and wellness services, housing support, and more, to residents of Wapello County, Iowa.
- In October, Home State Health, a Centene subsidiary, launched a Foster Care Center of Excellence (FCCOE) in partnership with Jordan Valley Community Health Center in Missouri. The pediatric clinic provides comprehensive care – including behavioral and physical health, vision, and dental services – for children and youth. Centene’s FCCOEs are also operational in Texas, Washington, and Oklahoma.
Membership
The following table sets forth membership by line of business:
|
December 31, |
||||
|
2025 |
2024 |
|||
|
Traditional Medicaid (1) |
10,932,600 |
11,408,100 |
||
|
High Acuity Medicaid (2) |
1,585,800 |
1,595,400 |
||
|
Total Medicaid |
12,518,400 |
13,003,500 |
||
|
Marketplace |
5,541,400 |
4,382,100 |
||
|
Individual and Commercial Group (3) |
452,500 |
431,400 |
||
|
Total Commercial |
5,993,900 |
4,813,500 |
||
|
Medicare (4) |
1,002,600 |
1,110,900 |
||
|
Medicare Prescription Drug Plan (PDP) |
8,118,600 |
6,925,700 |
||
|
Total at-risk membership |
27,633,500 |
25,853,600 |
||
|
TRICARE eligibles |
— |
2,747,000 |
||
|
Total |
27,633,500 |
28,600,600 |
||
|
(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 Commercial Group, Individual Coverage Health Reimbursement Arrangement (ICHRA) and Other Off-Exchange Individual. |
|||
|
(4) |
Membership includes Medicare Advantage and Medicare Supplement. |
|||
Premium and Service Revenues
The following table sets forth supplemental revenue information ($ in millions):
|
Three Months Ended December 31, |
Year Ended December 31, |
|||||||||||
|
2025 |
2024 |
% Change |
2025 |
2024 |
% Change |
|||||||
|
Medicaid |
$ 23,045 |
$ 20,825 |
11 % |
$ 90,238 |
$ 83,851 |
8 % |
||||||
|
Commercial |
10,792 |
8,723 |
24 % |
42,003 |
33,702 |
25 % |
||||||
|
Medicare (1) |
9,610 |
5,476 |
75 % |
37,210 |
23,032 |
62 % |
||||||
|
Other |
1,280 |
1,272 |
1 % |
5,130 |
4,920 |
4 % |
||||||
|
Total premium and service revenues |
$ 44,727 |
$ 36,296 |
23 % |
$ 174,581 |
$ 145,505 |
20 % |
||||||
|
(1) |
Medicare includes Medicare Advantage, Medicare PDP and Medicare Supplement. |
Statement of Operations: Three Months Ended December 31, 2025
- For the fourth quarter of 2025, premium and service revenues increased 23% to $44.7 billion from $36.3 billion in the comparable period of 2024. The increase was primarily driven by premium yield and membership growth in the PDP business, overall market growth in the Marketplace business, as well as rate increases and state-directed payments in the Medicaid business, partially offset by lower Medicaid membership.
- Health benefits ratio (HBR) of 94.3% for the fourth quarter of 2025 represents an increase from 89.6% in the comparable period in 2024. The increase was primarily driven by the impact of higher Marketplace morbidity in 2025 on medical costs and program changes in the PDP business as a result of the Inflation Reduction Act (IRA) compared to the fourth quarter of 2024. The Medicaid HBR decreased by 40 basis points, primarily driven by rate and revenue increases, partially offset by higher medical costs largely related to behavioral health and home health.
- The SG&A expense ratio was 7.5% for the fourth quarter of 2025, compared to 8.9% in the fourth quarter of 2024. The adjusted SG&A expense ratio was 7.5% for the fourth quarter of 2025, compared to 8.9% in the fourth quarter of 2024. The decreases were primarily driven by continued discipline, leveraging of expenses over higher revenues and growth in the PDP business, which operates at a meaningfully lower SG&A expense ratio as compared to the overall company. The decreases were partially offset by growth in the Marketplace business, which operates at a meaningfully higher SG&A expense ratio.
- The effective tax rate was 28.7% for the fourth quarter of 2025, compared to 19.2% in the fourth quarter of 2024. The effective tax rate for the fourth quarter of 2025 reflects the impact of the Magellan Health impairment and the release of state uncertain tax position liabilities resulting from statute of limitations expirations. For the fourth quarter of 2025, our effective tax rate on adjusted earnings was 32.1%, compared to 20.7% in the fourth quarter of 2024. The adjusted effective tax rate for the fourth quarter of 2025 reflects the release of state uncertain tax position liabilities resulting from statute of limitations expirations.
- In December 2025, Centene signed a definitive agreement to divest the remaining Magellan Health businesses. As a result, the Company recorded impairment charges associated with the pending divestiture totaling $513 million, or $389 million after-tax.
- GAAP diluted loss per share of $(2.24) for the fourth quarter of 2025.
- Adjusted diluted loss per share of $(1.19) for the fourth quarter of 2025.
- Cash flow provided by operations for the fourth quarter of 2025 was $437 million, primarily driven by the timing of pharmacy rebates, CMS and state remittances, as well as claims and other payments.
Statement of Operations: Year Ended December 31, 2025
- For the full year 2025, premium and service revenues increased 20% to $174.6 billion from $145.5 billion in the comparable period of 2024 primarily driven by premium yield and membership growth in the PDP business, overall market growth in the Marketplace business, and rate increases in the Medicaid business, partially offset by lower Medicaid membership and lower Marketplace estimated risk adjustment revenue. The full year 2024 benefited from outperformance in Marketplace risk adjustment for the 2023 benefit year.
- HBR of 91.9% for the full year 2025 represents an increase compared to 88.3% in 2024. The increase was primarily driven by lower Marketplace estimated risk adjustment revenue, increased Marketplace medical costs, program changes in the PDP business as a result of the IRA and higher medical costs in Medicaid driven primarily by behavioral health, home health and high-cost drugs, partially offset by Medicaid rate increases.
- The SG&A expense ratio was 7.4% for the full year 2025, compared to 8.5% for the full year 2024. The adjusted SG&A expense ratio was 7.4% for the full year 2025, compared to 8.5% for the full year 2024. The decreases were primarily driven by continued discipline, leveraging of expenses over higher revenues and growth in the PDP business, which operates at a meaningfully lower SG&A expense ratio as compared to the overall company. The decreases were partially offset by growth in the Marketplace business, which operates at a meaningfully higher SG&A expense ratio.
- As a result of market conditions in July 2025, including the One Big Beautiful Bill Act and the decline in the Company’s stock price, we performed a quantitative impairment analysis during the third quarter to determine whether goodwill was impaired. In October 2025, we completed our quantitative goodwill impairment analysis and recorded a non-cash goodwill impairment of $6.7 billion in the third quarter of 2025.
- The effective tax rate was 0.8% for 2025, compared to 22.6% for 2024. The effective tax rate for 2025 reflects the non-deductible nature of the goodwill impairment and the release of state uncertain tax position liabilities resulting from statute of limitations expirations. The effective tax rate for 2024 reflects tax effects of the Circle Health Group (Circle Health) divestiture, settlements with tax authorities and valuation allowance releases. For the full year 2025, our effective tax rate on adjusted earnings was 20.4%, compared to 23.8% in 2024. The adjusted effective tax rate for 2025 reflects the release of state uncertain tax position liabilities resulting from statute of limitations expirations.
- GAAP diluted loss per share was $(13.53) for the full year 2025, driven by the goodwill impairment.
- Adjusted diluted earnings per share (EPS) of $2.08 for the full year 2025.
- Cash flow provided by operations for the full year 2025 was $5.1 billion, which was primarily driven by net earnings, improved pharmacy rebate timing and higher medical claims liabilities primarily driven by higher membership.
Balance Sheet
At December 31, 2025, the Company had cash, investments and restricted deposits of $38.8 billion and maintained $400 million of cash available for general corporate use. Medical claims liabilities totaled $20.5 billion. The Company’s days in claims payable (DCP) was 46 days, a decrease of two days as compared to the third quarter of 2025, driven by the impact of state-directed payments and the elimination of the Medicare Advantage premium deficiency reserve. Total debt was $17.4 billion, which included no borrowings on the $4.0 billion Revolving Credit Facility at year end.
Outlook
Please refer to the Forward-Looking Statements, which should be reviewed in conjunction with the Company’s 2026 outlook.
For its 2026 fiscal year, the Company’s guidance is as follows.
|
Full Year 2026 |
|||||
|
GAAP diluted EPS |
> $1.98 |
||||
|
Adjusted diluted EPS (1) |
> $3.00 |
||||
|
(1) A full reconciliation of adjusted diluted EPS is shown in the Non-GAAP Financial Presentation section of this release. |
|||||
|
Full Year 2026 |
|||||
|
Low |
High |
||||
|
Total revenues (in billions) |
$ 186.5 |
$ 190.5 |
|||
|
Premium and service revenues (in billions) |
$ 170.0 |
$ 174.0 |
|||
|
HBR |
90.9 % |
91.7 % |
|||
|
SG&A expense ratio |
7.1 % |
7.7 % |
|||
|
Adjusted SG&A expense ratio (2) |
7.1 % |
7.7 % |
|||
|
Effective tax rate |
27.0 % |
28.0 % |
|||
|
Adjusted effective tax rate (3) |
26.0 % |
27.0 % |
|||
|
Diluted shares outstanding (in millions) |
495.6 |
498.6 |
|||
|
(2) Adjusted SG&A expense ratio excludes acquisition and divestiture related expenses of approximately $300 thousand. |
|||||
|
(3) Adjusted effective tax rate excludes income tax effects of adjustments of approximately $161 million to $164 million. |
|||||
For additional guidance details, please see the 2026 Guidance Presentation, which can be accessed on the Company’s website at www.centene.com, under the Investors section.
Conference Call
As previously announced, the Company will host a conference call Friday, February 6, 2026, at 9:00 a.m. ET to review the financial results for the fourth quarter and year ended December 31, 2025.
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: 2815529 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 9, 2027, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Friday, February 13, 2026, 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 3210284.
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.
Specifically, 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 |
Year Ended December 31, |
||||||
|
2025 |
2024 |
2025 |
2024 |
||||
|
GAAP net earnings (loss) attributable to Centene |
$ (1,101) |
$ 283 |
$ (6,674) |
$ 3,305 |
|||
|
Amortization of acquired intangible assets |
169 |
173 |
685 |
692 |
|||
|
Acquisition and divestiture related expenses |
3 |
7 |
4 |
82 |
|||
|
Other adjustments (1) |
513 |
(20) |
7,328 |
(117) |
|||
|
Income tax effects of adjustments (2) |
(167) |
(39) |
(315) |
(209) |
|||
|
Adjusted net earnings (loss) |
$ (583) |
$ 404 |
$ 1,028 |
$ 3,753 |
|||
|
(1) |
Other adjustments include the following pre-tax items: |
||
|
2025: |
|||
|
(a) |
for the three months ended December 31, 2025: Magellan Health impairment of $513 million, exit costs related |
||
|
(b) |
for the twelve months ended December 31, 2025: goodwill impairment of $6,723 million, Magellan Health |
||
|
2024: |
|||
|
(a) |
for the three months ended December 31, 2024: gain on the sale of Collaborative Health Systems (CHS) of |
||
|
(b) |
for the twelve months ended December 31, 2024: net gain on the previously reported divestiture of Magellan |
||