ST. LOUIS, July 28, 2020 /PRNewswire/ -- Centene Corporation
(NYSE: CNC) announced today its financial results for the second
quarter ended June 30, 2020, reporting diluted earnings per
share (EPS) of $2.05 and Adjusted
Diluted EPS of $2.40.
In summary, the 2020 second quarter results were as follows:
Total revenues (in
millions)
|
$
|
27,712
|
|
Health benefits
ratio
|
82.1
|
%
|
SG&A expense
ratio
|
8.8
|
%
|
Adjusted SG&A
expense ratio (1)
|
8.5
|
%
|
GAAP diluted
EPS
|
$
|
2.05
|
|
Adjusted Diluted EPS
(1)
|
$
|
2.40
|
|
Total cash flow
provided by operations (in millions)
|
$
|
3,714
|
|
|
|
(1) A full
reconciliation of the Adjusted SG&A expense ratio and Adjusted
Diluted EPS are shown on pages six and seven of this
release.
|
The 2020 second quarter results benefited from lower medical
utilization as a result of the COVID-19 pandemic.
"I am pleased with our solid second quarter performance, which
came in line with our expectations. Our performance underscores the
impact of shelter in place policies on our diversified platform in
addition to our team's solid execution in what continues to be a
challenging operating landscape," said Michael F. Neidorff, Chairman, President and
Chief Executive Officer of Centene.
"Looking ahead, while we expect the national economic trajectory
to remain choppy as we move through the second half of the year, we
believe that the return of utilization by our members seeking
treatments will be regionally driven. We continue to provide the
highest quality of care to our members during this critical time
and are well-positioned to respond quickly to evolving dynamics as
we execute on our growth strategy. We are further supported by the
strength of our balance sheet and solid financial position."
Second Quarter Highlights
- June 30, 2020 managed care
membership of 24.6 million, an increase of 9.6 million members, or
64%, over June 30, 2019.
- Total revenues of $27.7 billion
for the second quarter of 2020, representing 51% growth compared to
the second quarter of 2019.
- Health benefits ratio (HBR) of 82.1% for the second quarter of
2020, compared to 86.7% in the second quarter of 2019.
- Selling, general and administrative (SG&A) expense ratio of
8.8% for the second quarter of 2020, compared to 9.1% for the
second quarter of 2019.
- Adjusted SG&A expense ratio of 8.5% for the second quarter
of 2020, compared to 9.0% for the second quarter of 2019.
- Diluted EPS for the second quarter of 2020 of $2.05, compared to $1.18 for the second quarter of 2019.
- Adjusted Diluted EPS for the second quarter of 2020 of
$2.40, compared to $1.34 for the second quarter of 2019.
- Operating cash flow of $3.7
billion for the second quarter 2020, representing 3.1x net
earnings.
Other Events
- In July 2020, Centene announced
that it will establish an East Coast headquarters in Charlotte, North Carolina. The Company expects
to begin construction on the new campus in August and plans to
create 3,200 new jobs, with eventual accommodations for up to 6,000
employees, and invest $1 billion in
the Charlotte community over
time.
- In July 2020, Centene's
subsidiary, Meridian Health Plan of Illinois, Inc. (Meridian), began serving
Medicaid members in Cook County,
Illinois as a result of a Member Transfer Agreement under
which Meridian was assigned 100% of NextLevel Health Partners,
Inc.'s approximately 54,000 members who access benefits from the
Illinois Department of Healthcare and Family Services' HealthChoice
Illinois Program.
- In July 2020, Centene's
subsidiary, Centurion, commenced a two-year contract with the
Kansas Department of Administration to provide healthcare services
in the Department of Corrections' facilities.
- In June 2020, Centene's
subsidiary, WellCare of Kentucky,
was selected by the state of Kentucky to continue serving the
Commonwealth's Medicaid managed care program statewide. The new
four-year contract is anticipated to begin on January 1, 2021 running through December 31, 2024 with the option for six,
two-year renewal extensions.
Accreditations & Awards
- In July 2020, for the third
consecutive year, Centene was recognized with a 100 percent score
on the Disability Equality Index (DEI) as one of the Best Places to
Work for People with Disabilities.
- In July 2020, Forbes announced
Centene's position of #14 on its Corporate Responders list, which
assesses how well the 100 largest publicly-held companies in the
U.S. have responded to COVID-19.
- In June 2020, Centene's
subsidiary, Envolve Dental, earned Accreditation from the National
Committee for Quality Assurance (NCQA).
- In May 2020, FORTUNE announced
Centene's position of #42 in its annual ranking of America's
largest companies based on 2019 revenue.
- In April 2020, several Centene
health plans earned Accreditation from NCQA, including Ambetter
from Arkansas Health and Wellness, Sunflower Health Plan and
QualChoice Health Insurance.
COVID-19 Pandemic
Beginning in March 2020, Centene
announced a series of actions in support of various populations
impacted by the COVID-19 pandemic. A detailed list of specific
actions taken by the Company in response to the pandemic is shown
on page 15 of this release.
Membership
The following table sets forth our membership by line of
business:
|
June
30,
|
|
2020
|
|
2019
|
Medicaid:
|
|
|
|
TANF, CHIP &
Foster Care
|
10,894,200
|
|
|
7,388,700
|
|
ABD &
LTSS
|
1,496,000
|
|
|
997,900
|
|
Behavioral
Health
|
173,900
|
|
|
68,800
|
|
Total
Medicaid
|
12,564,100
|
|
|
8,455,400
|
|
Medicare
PDP
|
4,443,100
|
|
|
—
|
|
Commercial
|
2,763,300
|
|
|
2,449,400
|
|
Medicare
(1)
|
996,100
|
|
|
398,500
|
|
International
|
600,400
|
|
|
463,100
|
|
Correctional
|
166,000
|
|
|
153,900
|
|
Total at-risk
membership
|
21,533,000
|
|
|
11,920,300
|
|
TRICARE
eligibles
|
2,864,700
|
|
|
2,855,800
|
|
Non-risk
membership
|
223,300
|
|
|
228,100
|
|
Total
|
24,621,000
|
|
|
15,004,200
|
|
|
|
|
|
(1)
Membership includes Medicare Advantage, Medicare Supplement,
Special Needs Plans, and Medicare-Medicaid Plans (MMP).
|
The following table sets forth additional membership statistics,
which are included in the membership information above:
|
June
30,
|
|
2020
|
|
2019
|
Dual-eligible
(2)
|
969,700
|
|
|
600,800
|
|
Health Insurance
Marketplace
|
2,245,600
|
|
|
1,910,700
|
|
Medicaid
Expansion
|
1,931,600
|
|
|
1,290,200
|
|
|
|
|
|
(2)
Membership includes dual-eligible ABD & LTSS and dual-eligible
Medicare.
|
Revenues
The following table sets forth supplemental revenue information
($ in millions):
|
Three Months Ended
June 30,
|
|
2020
|
|
2019
|
|
%
Change
|
Medicaid
|
$
|
18,129
|
|
|
$
|
12,119
|
|
|
50
|
%
|
Commercial
|
4,136
|
|
|
3,872
|
|
|
7
|
%
|
Medicare
(3)
|
3,538
|
|
|
1,465
|
|
|
142
|
%
|
Medicare
PDP
|
674
|
|
|
—
|
|
|
n.m.
|
|
Other
|
1,235
|
|
|
900
|
|
|
37
|
%
|
Total
Revenues
|
$
|
27,712
|
|
|
$
|
18,356
|
|
|
51
|
%
|
|
|
|
|
|
|
(3)
Medicare includes Medicare Advantage, Medicare Supplement, Special
Needs Plans, and MMP.
|
n.m.: not
meaningful
|
Statement of Operations: Three Months Ended June 30,
2020
- For the second quarter of 2020, total revenues increased 51% to
$27.7 billion from $18.4 billion in the comparable period in 2019.
The increase over the prior year was due to the acquisition of
WellCare, growth in the Health Insurance Marketplace business,
expansions, new programs and growth in many of our states,
particularly Iowa and Pennsylvania, and the reinstatement of the
health insurer fee in 2020, partially offset by the divestiture of
our Illinois health plan.
- HBR of 82.1% for the second quarter of 2020 represents a
decrease from 86.7% in the comparable period in 2019. The
substantial decrease was attributable to lower medical utilization
due to the COVID-19 pandemic, partially offset by the Health
Insurance Marketplace business, where margins continue to
normalize.
- The SG&A expense ratio was 8.8% for the second quarter of
2020, compared to 9.1% in the second quarter of 2019. The decrease
to the SG&A expense ratio was driven by the addition of the
WellCare business, which operates at a lower SG&A ratio, and
the leveraging of expenses over higher revenues. The decrease was
partially offset by higher acquisition related expenses due to the
recent closing of the WellCare acquisition and additional support
provided to our Health Insurance Marketplace members through the
extension of grace periods for member premiums for those impacted
by the COVID-19 pandemic.
- The Adjusted SG&A expense ratio was 8.5% for the second
quarter of 2020, compared to 9.0% in the second quarter of 2019.
The Adjusted SG&A expense ratio benefited from the addition of
the WellCare business, which operates at a lower SG&A ratio,
and the leveraging of expenses over higher revenues. The decrease
was partially offset by additional support provided to our Health
Insurance Marketplace members through the extension of grace
periods for member premiums for those impacted by the COVID-19
pandemic.
- The effective tax rate was 38.2% for the second quarter of
2020, compared to 25.7% in the second quarter of 2019. The increase
in the effective tax rate was driven by the reinstatement of the
health insurer fee in 2020. For the second quarter of 2020, our
effective tax rate on adjusted earnings was 36.1%.
Balance Sheet
At June 30, 2020, the Company had cash, investments and
restricted deposits of $25.6 billion
and maintained $1.1 billion of cash
and cash equivalents held by unregulated entities. Medical claims
liabilities totaled $11.4 billion.
Total debt was $16.8 billion, which
included $89 million of borrowings on
our $2.0 billion revolving credit
facility at quarter end. The debt to capitalization ratio was 39.7%
at June 30, 2020, excluding $217
million of non-recourse debt. Our debt to capital ratio
would have been 38.1% at June 30, 2020, when netting
unregulated cash and cash equivalents with debt, and excluding
non-recourse debt.
A reconciliation of the Company's change in days in claims
payable from the immediately preceding quarter-end is presented
below:
Days in claims
payable, March 31, 2020(1)
|
47
|
|
|
Impact of the
COVID-19 Pandemic
|
4
|
|
|
Days in claims
payable, June 30, 2020
|
51
|
|
|
|
|
|
(1) A
pro-forma adjustment has been made to medical costs to include a
full quarter of WellCare medical costs. Using actual medical costs,
days in claims payable was 51.
|
|
|
The Company's days in claims payable was 51 days, an increase of
four days over the pro-forma first quarter of 2020. The increase in
days in claims payable is due to lower medical expense in April and
May as a result of shelter-in-place orders resulting from
COVID-19. A significant portion of the quarter end Medical
Claims Liability includes June dates of service where claims were
near normalized levels.
Outlook
The Company's annual guidance for 2020 is as follows:
|
|
Full Year
2020
|
|
|
|
Low
|
|
High
|
|
Total revenues (in
billions)
|
|
$
|
109.0
|
|
|
$
|
111.4
|
|
|
GAAP diluted
EPS
|
|
$
|
3.04
|
|
|
$
|
3.18
|
|
|
Adjusted Diluted EPS
(1)
|
|
$
|
4.76
|
|
|
$
|
4.96
|
|
|
Diluted shares
outstanding (in millions)
|
|
577.9
|
|
|
580.9
|
|
|
|
|
|
|
|
|
|
|
(1)
|
Adjusted Diluted EPS
excludes estimated amortization of acquired intangible assets of
$0.98 to $1.00 per diluted share, acquisition related expenses of
$0.67 to $0.71 per diluted share, the gain on the sale of the
Illinois health plan of approximately $0.10 per diluted share, debt
extinguishment costs of approximately $0.07 per diluted share, and
non-cash asset impairment of $0.10 per diluted share.
|
Conference Call
As previously announced, the Company will host a conference call
Tuesday, July 28, 2020, at approximately 8:30 AM (Eastern Time) to review the financial
results for the second quarter ended June 30,
2020. Michael Neidorff and Jeffrey
Schwaneke will host the conference call.
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: 0580014 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 after the completion of the call for the next twelve months
or until 11:59 PM (Eastern Time) on
Tuesday, July 27, 2021, at the aforementioned URL. In
addition, a digital audio playback will be available until
9:00 AM (Eastern Time) on Tuesday,
August 4, 2020, by dialing 1-877-344-7529 in the U.S. and
Canada, or +1-412-317-0088 from
abroad, and entering access code 10145373.
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 to allow management to focus
on period-to-period changes in the Company's core business
operations. Therefore, the Company believes that this information
is meaningful in addition to the information contained in the GAAP
presentation of financial information. The presentation of this
additional non-GAAP financial information 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 information that excludes amortization of acquired
intangible assets and acquisition related expenses, as well as
other items, allows investors to develop a more meaningful
understanding of the Company's performance over time. The tables
below provide reconciliations of non-GAAP items ($ in millions,
except per share data):
|
Three Months Ended
June 30,
|
|
Six Months Ended
June 30,
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
GAAP net earnings
attributable to Centene
|
$
|
1,206
|
|
|
$
|
495
|
|
|
$
|
1,252
|
|
|
$
|
1,017
|
|
Amortization of
acquired intangible assets
|
197
|
|
|
64
|
|
|
363
|
|
|
129
|
|
Acquisition related
expenses
|
71
|
|
|
23
|
|
|
384
|
|
|
41
|
|
Other adjustments
(1)
|
(11)
|
|
|
—
|
|
|
12
|
|
|
—
|
|
Income tax effects of
adjustments (2)
|
(53)
|
|
|
(21)
|
|
|
(125)
|
|
|
(41)
|
|
Adjusted net
earnings
|
$
|
1,410
|
|
|
$
|
561
|
|
|
$
|
1,886
|
|
|
$
|
1,146
|
|
|
|
(1)
|
Other adjustments for
the three months ended June 30, 2020 include an adjustment to
the gain related to the divestiture of certain products of our
Illinois health plan of $11 million, or $0.00 per diluted share,
net of income tax expense $0.02. Other adjustments include the
following adjustments for the six months ended June 30, 2020: (a)
divestiture gain of $104 million, or $0.11 per diluted share, (b)
non-cash impairment of $72 million, or $0.10 per diluted share, and
(c) debt extinguishment costs of $44 million, or $0.06 per diluted
share.
|
(2)
|
The income tax
effects of adjustments are based on the effective income tax rates
applicable to each adjustment.
|
|
Three Months
Ended June
30,
|
|
Six Months
Ended
June 30,
|
|
Annual Guidance
December 31, 2020
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
|
GAAP diluted EPS
attributable to Centene
|
$
|
2.05
|
|
|
$
|
1.18
|
|
|
$
|
2.20
|
|
|
$
|
2.42
|
|
|
$3.04 -
$3.18
|
Amortization of
acquired intangible assets (3)
|
0.25
|
|
|
0.12
|
|
|
0.48
|
|
|
0.24
|
|
|
$0.98 -
$1.00
|
Acquisition related
expenses (4)
|
0.10
|
|
|
0.04
|
|
|
0.58
|
|
|
0.07
|
|
|
$0.67 -
$0.71
|
Other adjustments
(5)
|
—
|
|
|
—
|
|
|
0.05
|
|
|
—
|
|
|
$0.07
|
Adjusted Diluted
EPS
|
$
|
2.40
|
|
|
$
|
1.34
|
|
|
$
|
3.31
|
|
|
$
|
2.73
|
|
|
$4.76 -
$4.96
|
|
|
(3)
|
The amortization of
acquired intangible assets per diluted share presented above is net
of an income tax benefit of $0.09 and $0.04 for the three months
ended June 30, 2020 and 2019, respectively, and $0.16 and
$0.07 for the six months ended June 30, 2020 and 2019,
respectively, and an estimated $0.30 to $0.32 for the year ended
December 31, 2020.
|
(4)
|
The acquisition
related expenses per diluted share presented above are net of an
income tax benefit of $0.02 and $0.01 for the three months ended
June 30, 2020 and 2019, respectively, and $0.09 and $0.03 for
the six months ended June 30, 2020 and 2019, respectively, and
an estimated $0.11 to $0.12 for the year ended December 31,
2020.
|
(5)
|
Other adjustments
include the following items:
|
|
(1)
|
gain related to the
divestiture of certain products of the Company's Illinois health
plan of $0.11 per diluted share, net of income tax expense of $0.08
for the six months ended June 30, 2020, and an estimated $0.10
per diluted share, net of income tax expense of $0.08 for the year
ended December 31, 2020;
|
|
(2)
|
non-cash impairment
of our third party-care management software system of $0.10 per
diluted share, net of an income tax benefit of $0.03 for the six
months ended June 30, 2020, and an estimated $0.10 per diluted
share, net of an income tax benefit of $0.03 for the year ended
December 31, 2020; and
|
|
(3)
|
debt extinguishment
costs of $0.06 per diluted share, net of an income tax benefit of
$0.02 for the six months ended June 30, 2020, and an estimated
$0.07 per diluted share, net of an income tax benefit of $0.02 for
the year ended December 31, 2020.
|
|
Three Months Ended
June 30,
|
|
Six Months Ended
June 30,
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
GAAP SG&A
expenses
|
$
|
2,255
|
|
|
$
|
1,574
|
|
|
$
|
4,639
|
|
|
$
|
3,183
|
|
Acquisition related
expenses
|
70
|
|
|
21
|
|
|
365
|
|
|
38
|
|
Adjusted SG&A
expenses
|
$
|
2,185
|
|
|
$
|
1,553
|
|
|
$
|
4,274
|
|
|
$
|
3,145
|
|
To provide clarity on the way management defines certain key
metrics and ratios, the Company is providing a description of how
the metric or ratio is calculated as follows:
- Health Benefits Ratio (HBR) (GAAP) = Medical costs
divided by premium revenues.
- SG&A Expense Ratio (GAAP) = Selling, general and
administrative expenses divided by premium and service
revenues.
- Adjusted SG&A Expenses (non-GAAP) = Selling, general
and administrative expenses, less acquisition related
expenses.
- Adjusted SG&A Expense Ratio (non-GAAP) = Adjusted
selling, general and administrative expenses divided by premium and
service revenues.
- Adjusted Net Earnings (non-GAAP) = Net earnings less
amortization of acquired intangible assets, less acquisition
related expenses, as well as adjustments for other items, net of
the income tax effect of the adjustments.
- Adjusted Diluted EPS (non-GAAP) = Adjusted net earnings
divided by weighted average common shares outstanding on a fully
diluted basis.
- Debt to Capitalization Ratio (GAAP) = Total debt,
divided by total debt plus total stockholder's equity.
- Debt to Capitalization Ratio Excluding Non-Recourse Debt
(non-GAAP) = Total debt less non-recourse debt, divided by
total debt less non-recourse debt plus total stockholder's
equity.
- Average Medical Claims Expense (GAAP) = Medical costs
for the period, divided by number of days in such period. Average
Medical Claims Expense is most often calculated for the quarterly
reporting period.
- Days in Claims Payable (GAAP) = Medical claims
liabilities, divided by average medical claims expense. Days in
Claims Payable is most often calculated for the quarterly reporting
period.
In addition, the following terms referenced in this press
release and other Company filings are defined as follows:
- State Directed Payments: Payments directed by a state
that have minimal risk, but are administered as a premium
adjustment. These payments are recorded as premium revenue and
medical costs at close to a 100% HBR. The Company has little
visibility to the timing of these payments until they are paid by a
state.
- Pass Through Payments: Non-risk supplemental payments
from a state that the Company is required to pass through to
designated contracted providers. These payments are recorded as
premium tax revenue and premium tax expense.
About Centene Corporation
Centene Corporation, a Fortune 50 company, is a leading
multi-national healthcare enterprise that is committed to helping
people live healthier lives. The Company takes a local approach –
with local brands and local teams – to provide fully integrated,
high-quality, and cost-effective services to government-sponsored
and commercial healthcare programs, focusing on under-insured and
uninsured individuals. Centene offers affordable and
high-quality products to nearly 1 in 15 individuals across the
nation, including Medicaid and Medicare members (including Medicare
Prescription Drug Plans) as well as individuals and families served
by the Health Insurance Marketplace, the TRICARE program, and
individuals in correctional facilities. The Company also serves
several international markets, and contracts with other healthcare
and commercial organizations to provide a variety of specialty
services focused on treating the whole
person. Centene focuses on long-term growth and the
development of its people, systems and capabilities so that it can
better serve its members, providers, local communities, and
government partners.
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
All statements, other than statements of current or
historical fact, contained in this press release are
forward-looking statements. Without limiting the foregoing,
forward-looking statements often use words such as "believe,"
"anticipate," "plan," "expect," "estimate," "intend," "seek,"
"target," "goal," "may," "will," "would," "could," "should," "can,"
"continue" and other similar words or expressions (and the negative
thereof). Centene (the Company, our, or we) intends such
forward-looking statements to be covered by the safe-harbor
provisions for forward-looking statements contained in the Private
Securities Litigation Reform Act of 1995, and we are including this
statement for purposes of complying with these safe-harbor
provisions. In particular, these statements include, without
limitation, statements about our future operating or financial
performance, market opportunity, growth strategy, competition,
expected activities in completed and future acquisitions, including
statements about the impact of our recently completed acquisition
(the WellCare Acquisition) of WellCare Health Plans, Inc.
(WellCare), other recent and future acquisitions, investments and
the adequacy of our available cash resources. These forward-looking
statements reflect our current views with respect to future events
and are based on numerous assumptions and assessments made by us in
light of our experience and perception of historical trends,
current conditions, business strategies, operating environments,
future developments and other factors we believe 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, including economic, regulatory, competitive and other
factors that may cause our or our industry's actual results, levels
of activity, performance or achievements to be materially different
from any future results, levels of activity, performance or
achievements expressed or implied by these forward-looking
statements. These statements are not guarantees of future
performance and are subject to risks, uncertainties and
assumptions. All forward-looking statements included in this press
release are based on information available to us on the date
hereof. Except as may be otherwise required by law, we undertake no
obligation to update or revise the forward-looking statements
included in this press release, whether as a result of new
information, future events or otherwise, after the date
hereof. You should not place undue reliance on any forward-looking
statements, as actual results may differ materially from
projections, estimates, or other forward-looking statements due to
a variety of important factors, variables and events including but
not limited to: the impact of COVID-19 on global markets, economic
conditions, the healthcare industry and our results of operations,
which is unknown, and the response by governments and other third
parties; uncertainty as to our expected financial
performance during the period of integration of the WellCare
Acquisition; the possibility that the expected synergies and value
creation from the WellCare Acquisition will not be realized, or
will not be realized within the expected time period; the risk that
unexpected costs will be incurred in connection with the
integration of the WellCare Acquisition or that the integration of
WellCare will be more difficult or time consuming than expected;
unexpected costs, charges or expenses resulting from the WellCare
Acquisition; the inability to retain key personnel; disruption from
the integration of the WellCare Acquisition, including potential
adverse reactions or changes to business relationships with
customers, employees, suppliers or regulators, making it more
difficult to maintain business and operational relationships; the
risk that we may not be able to effectively manage our expanded
operations; our ability to accurately predict and effectively
manage health benefits and other operating expenses and reserves,
including fluctuations in medical utilization rates due to the
impact of COVID-19; 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 income tax reform or government healthcare programs as
well as changes with respect to the Patient Protection and
Affordable Care Act (ACA) and the Health Care and Education
Affordability Reconciliation Act, collectively referred to as the
ACA and any regulations enacted thereunder that may result from
changing political conditions or judicial actions, including the
ultimate outcome in "Texas v. United
States of America" regarding the constitutionality of the
ACA; rate cuts or other payment reductions or delays by
governmental payors and other risks and uncertainties affecting our
government businesses; our ability to adequately price products on
the Health Insurance Marketplaces and other commercial and Medicare
products; tax matters; disasters or major epidemics; the
outcome of legal and regulatory proceedings; changes in expected
contract start dates; provider, state, federal, foreign and other
contract changes and timing of regulatory approval of contracts;
the expiration, suspension, or termination of our contracts with
federal or state governments (including but not limited to
Medicaid, Medicare, TRICARE or other customers); the difficulty of
predicting the timing or outcome of pending or future litigation or
government investigations; challenges to our contract awards;
cyber-attacks or other privacy or data security incidents; the
possibility that the expected synergies and value creation from
acquired businesses, including businesses we may acquire in the
future, will not be realized, or will not be realized within the
expected time period; the exertion of management's time and our
resources, and other expenses incurred and business changes
required in connection with complying with the undertakings in
connection with any regulatory, governmental or third party
consents or approvals for acquisitions; disruption caused by
significant completed and pending acquisitions, including, among
others, the WellCare Acquisition, making it more difficult to
maintain business and operational relationships; the risk that
unexpected costs will be incurred in connection with the completion
and/or integration of acquisition transactions; changes in expected
closing dates, estimated purchase price and accretion for
acquisitions; the risk that acquired businesses will not be
integrated successfully; restrictions and limitations in connection
with our indebtedness; our ability to maintain or 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;
availability of debt and equity financing, on terms that are
favorable to us; inflation; foreign currency fluctuations and risks
and uncertainties discussed in the reports that Centene has filed
with the Securities and Exchange Commission. This list of important
factors is not intended to be exhaustive. We discuss certain of
these matters more fully, as well as certain other factors that may
affect our business operations, financial condition and results of
operations, in our filings with the Securities and Exchange
Commission (SEC), including our annual report on Form 10-K,
quarterly reports on Form 10-Q and current reports on Form 8-K. Due
to these important factors and risks, we cannot give assurances
with respect to our future performance, including without
limitation our ability to maintain adequate premium levels or our
ability to control our future medical and selling, general and
administrative costs.
[Tables Follow]
CENTENE
CORPORATION AND SUBSIDIARIES
CONSOLIDATED
BALANCE SHEETS
(In millions,
except shares in thousands and per share data in
dollars)
|
|
|
June 30,
2020
|
|
December 31,
2019
|
ASSETS
|
|
|
|
Current
assets:
|
|
|
|
Cash and cash
equivalents
|
$
|
12,798
|
|
|
$
|
12,123
|
|
Premium and trade
receivables
|
10,339
|
|
|
6,247
|
|
Short-term
investments
|
1,558
|
|
|
863
|
|
Other current
assets
|
2,127
|
|
|
1,090
|
|
Total current
assets
|
26,822
|
|
|
20,323
|
|
Long-term
investments
|
10,231
|
|
|
7,717
|
|
Restricted
deposits
|
1,050
|
|
|
658
|
|
Property, software
and equipment, net
|
2,544
|
|
|
2,121
|
|
Goodwill
|
17,434
|
|
|
6,863
|
|
Intangible assets,
net
|
8,702
|
|
|
2,063
|
|
Other long-term
assets
|
1,564
|
|
|
1,249
|
|
Total
assets
|
$
|
68,347
|
|
|
$
|
40,994
|
|
LIABILITIES,
REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS'
EQUITY
|
|
|
|
Current
liabilities:
|
|
|
|
Medical claims
liability
|
$
|
11,418
|
|
|
$
|
7,473
|
|
Accounts payable and
accrued expenses
|
8,704
|
|
|
4,164
|
|
Return of premium
payable
|
1,242
|
|
|
824
|
|
Unearned
revenue
|
448
|
|
|
383
|
|
Current portion of
long-term debt
|
106
|
|
|
88
|
|
Total current
liabilities
|
21,918
|
|
|
12,932
|
|
Long-term
debt
|
16,708
|
|
|
13,638
|
|
Other long-term
liabilities
|
4,516
|
|
|
1,732
|
|
Total
liabilities
|
43,142
|
|
|
28,302
|
|
Commitments and
contingencies
|
|
|
|
Redeemable
noncontrolling interests
|
33
|
|
|
33
|
|
Stockholders'
equity:
|
|
|
|
Preferred stock,
$0.001 par value; authorized 10,000 shares; no shares issued or
outstanding at June 30, 2020 and December 31, 2019
|
—
|
|
|
—
|
|
Common stock, $0.001
par value; authorized 800,000 shares; 595,160 issued and 579,345
outstanding at June 30, 2020, and 421,508 issued and 415,048
outstanding at December 31, 2019
|
—
|
|
|
—
|
|
Additional paid-in
capital
|
19,333
|
|
|
7,647
|
|
Accumulated other
comprehensive earnings
|
245
|
|
|
134
|
|
Retained
earnings
|
6,236
|
|
|
4,984
|
|
Treasury stock, at
cost (15,815 and 6,460 shares, respectively)
|
(758)
|
|
|
(214)
|
|
Total Centene
stockholders' equity
|
25,056
|
|
|
12,551
|
|
Noncontrolling
interest
|
116
|
|
|
108
|
|
Total stockholders'
equity
|
25,172
|
|
|
12,659
|
|
Total liabilities,
redeemable noncontrolling interests and stockholders'
equity
|
$
|
68,347
|
|
|
$
|
40,994
|
|
CENTENE
CORPORATION AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF OPERATIONS
(In millions,
except shares in thousands and per share data in
dollars)
(Unaudited)
|
|
|
Three Months Ended
June 30,
|
|
Six Months Ended
June 30,
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
Revenues:
|
|
|
|
|
|
|
|
Premium
|
$
|
24,745
|
|
|
$
|
16,554
|
|
|
$
|
47,959
|
|
|
$
|
32,757
|
|
Service
|
979
|
|
|
745
|
|
|
1,937
|
|
|
1,380
|
|
Premium and service
revenues
|
25,724
|
|
|
17,299
|
|
|
49,896
|
|
|
34,137
|
|
Premium tax and
health insurer fee
|
1,988
|
|
|
1,057
|
|
|
3,841
|
|
|
2,663
|
|
Total
revenues
|
27,712
|
|
|
18,356
|
|
|
53,737
|
|
|
36,800
|
|
Expenses:
|
|
|
|
|
|
|
|
Medical
costs
|
20,307
|
|
|
14,354
|
|
|
40,727
|
|
|
28,236
|
|
Cost of
services
|
833
|
|
|
615
|
|
|
1,658
|
|
|
1,159
|
|
Selling, general and
administrative expenses
|
2,255
|
|
|
1,574
|
|
|
4,639
|
|
|
3,183
|
|
Amortization of
acquired intangible assets
|
197
|
|
|
64
|
|
|
363
|
|
|
129
|
|
Premium tax
expense
|
1,723
|
|
|
1,106
|
|
|
3,348
|
|
|
2,765
|
|
Health insurer fee
expense
|
379
|
|
|
—
|
|
|
724
|
|
|
—
|
|
Impairment
|
—
|
|
|
—
|
|
|
72
|
|
|
—
|
|
Total operating
expenses
|
25,694
|
|
|
17,713
|
|
|
51,531
|
|
|
35,472
|
|
Earnings from
operations
|
2,018
|
|
|
643
|
|
|
2,206
|
|
|
1,328
|
|
Other income
(expense):
|
|
|
|
|
|
|
|
Investment and other
income
|
113
|
|
|
120
|
|
|
280
|
|
|
219
|
|
Debt extinguishment
costs
|
—
|
|
|
—
|
|
|
(44)
|
|
|
—
|
|
Interest
expense
|
(187)
|
|
|
(101)
|
|
|
(367)
|
|
|
(200)
|
|
Earnings from
operations, before income tax expense
|
1,944
|
|
|
662
|
|
|
2,075
|
|
|
1,347
|
|
Income tax
expense
|
742
|
|
|
170
|
|
|
827
|
|
|
336
|
|
Net
earnings
|
1,202
|
|
|
492
|
|
|
1,248
|
|
|
1,011
|
|
Loss attributable
to noncontrolling interests
|
4
|
|
|
3
|
|
|
4
|
|
|
6
|
|
Net earnings
attributable to Centene Corporation
|
$
|
1,206
|
|
|
$
|
495
|
|
|
$
|
1,252
|
|
|
$
|
1,017
|
|
|
|
|
|
|
|
|
|
Net earnings per
common share attributable to Centene Corporation:
|
Basic earnings per
common share
|
$
|
2.08
|
|
|
$
|
1.20
|
|
|
$
|
2.23
|
|
|
$
|
2.46
|
|
Diluted earnings per
common share
|
$
|
2.05
|
|
|
$
|
1.18
|
|
|
$
|
2.20
|
|
|
$
|
2.42
|
|
|
|
|
|
|
|
|
|
Weighted average
number of common shares outstanding:
|
|
|
|
|
|
|
Basic
|
579,189
|
|
|
413,370
|
|
|
561,623
|
|
|
413,144
|
|
Diluted
|
587,498
|
|
|
419,671
|
|
|
569,559
|
|
|
419,707
|
|
CENTENE
CORPORATION AND SUBSIDIARIES
CONSOLIDATED
STATEMENTS OF CASH FLOWS
(In millions,
unaudited)
|
|
|
Six Months Ended
June 30,
|
|
2020
|
|
2019
|
Cash flows from
operating activities:
|
|
|
|
Net
earnings
|
$
|
1,248
|
|
|
$
|
1,011
|
|
Adjustments to
reconcile net earnings to net cash provided by operating
activities
|
Depreciation and
amortization
|
618
|
|
|
313
|
|
Stock compensation
expense
|
164
|
|
|
72
|
|
Impairment
|
72
|
|
|
—
|
|
Loss on debt
extinguishment
|
44
|
|
|
—
|
|
Deferred income
taxes
|
17
|
|
|
(10)
|
|
Gain on
divestiture
|
(104)
|
|
|
—
|
|
Other adjustments,
net
|
2
|
|
|
—
|
|
Changes in assets and
liabilities
|
|
|
|
Premium and trade
receivables
|
(1,159)
|
|
|
234
|
|
Other
assets
|
202
|
|
|
(47)
|
|
Medical claims
liabilities
|
146
|
|
|
558
|
|
Unearned
revenue
|
(127)
|
|
|
(138)
|
|
Accounts payable and
accrued expenses
|
1,309
|
|
|
(616)
|
|
Other long-term
liabilities
|
1,028
|
|
|
869
|
|
Other operating
activities, net
|
14
|
|
|
(13)
|
|
Net cash provided by
operating activities
|
3,474
|
|
|
2,233
|
|
Cash flows from
investing activities:
|
|
|
|
Capital
expenditures
|
(412)
|
|
|
(336)
|
|
Purchases of
investments
|
(1,849)
|
|
|
(1,280)
|
|
Sales and maturities
of investments
|
1,768
|
|
|
719
|
|
Acquisitions, net of
cash acquired
|
(3,000)
|
|
|
(32)
|
|
Divestiture proceeds,
net of divested cash
|
466
|
|
|
—
|
|
Other investing
activities, net
|
(5)
|
|
|
—
|
|
Net cash used in
investing activities
|
(3,032)
|
|
|
(929)
|
|
Cash flows from
financing activities:
|
|
|
|
Proceeds from
long-term debt
|
2,630
|
|
|
5,617
|
|
Payments of long-term
debt
|
(1,598)
|
|
|
(5,353)
|
|
Common stock
repurchases
|
(561)
|
|
|
(37)
|
|
Payments for debt
extinguishment
|
(21)
|
|
|
—
|
|
Debt issuance
costs
|
(93)
|
|
|
—
|
|
Other financing
activities, net
|
22
|
|
|
9
|
|
Net cash provided by
financing activities
|
379
|
|
|
236
|
|
Effect of exchange
rate changes on cash, cash equivalents, and restricted
cash
|
3
|
|
|
2
|
|
Net increase in cash,
cash equivalents and restricted cash and cash
equivalents
|
824
|
|
|
1,542
|
|
Cash, cash
equivalents, and restricted cash and cash equivalents,
beginning of period
|
12,131
|
|
|
5,350
|
|
Cash, cash
equivalents, and restricted cash and cash equivalents, end of
period
|
$
|
12,955
|
|
|
$
|
6,892
|
|
Supplemental
disclosures of cash flow information:
|
|
|
|
Interest
paid
|
$
|
360
|
|
|
$
|
132
|
|
Income taxes
paid
|
$
|
75
|
|
|
$
|
381
|
|
Equity issued in
connection with acquisitions
|
$
|
11,526
|
|
|
$
|
—
|
|
|
|
|
|
The following table
provides a reconciliation of cash, cash equivalents, and restricted
cash and cash equivalents reported within the Consolidated Balance
Sheets to the totals above:
|
|
June
30,
|
|
2020
|
|
2019
|
Cash and cash
equivalents
|
$
|
12,798
|
|
|
$
|
6,875
|
|
Restricted cash and
cash equivalents, included in restricted deposits
|
157
|
|
|
17
|
|
Total cash, cash
equivalents, and restricted cash and cash equivalents
|
$
|
12,955
|
|
|
$
|
6,892
|
|
CENTENE
CORPORATION
SUPPLEMENTAL
FINANCIAL DATA
|
|
|
Q2
|
|
Q1
|
|
Q4
|
|
Q3
|
|
Q2
|
|
2020
|
|
2020
|
|
2019
|
|
2019
|
|
2019
|
|
|
|
|
|
|
|
|
|
|
Medicaid:
|
|
|
|
|
|
|
|
|
|
TANF, CHIP &
Foster Care
|
10,894,200
|
|
|
10,259,700
|
|
|
7,528,700
|
|
|
7,623,400
|
|
|
7,388,700
|
|
ABD &
LTSS
|
1,496,000
|
|
|
1,410,100
|
|
|
1,043,500
|
|
|
1,045,700
|
|
|
997,900
|
|
Behavioral
Health
|
173,900
|
|
|
158,000
|
|
|
66,500
|
|
|
73,300
|
|
|
68,800
|
|
Total
Medicaid
|
12,564,100
|
|
|
11,827,800
|
|
|
8,638,700
|
|
|
8,742,400
|
|
|
8,455,400
|
|
Medicare
PDP
|
4,443,100
|
|
|
4,416,500
|
|
|
—
|
|
|
—
|
|
|
—
|
|
Commercial
|
2,763,300
|
|
|
2,728,200
|
|
|
2,331,100
|
|
|
2,388,500
|
|
|
2,449,400
|
|
Medicare
(1)
|
996,100
|
|
|
976,700
|
|
|
404,500
|
|
|
404,500
|
|
|
398,500
|
|
International
|
600,400
|
|
|
599,900
|
|
|
599,800
|
|
|
462,400
|
|
|
463,100
|
|
Correctional
|
166,000
|
|
|
172,000
|
|
|
180,000
|
|
|
187,200
|
|
|
153,900
|
|
Total at-risk
membership
|
21,533,000
|
|
|
20,721,100
|
|
|
12,154,100
|
|
|
12,185,000
|
|
|
11,920,300
|
|
TRICARE
eligibles
|
2,864,700
|
|
|
2,864,800
|
|
|
2,860,700
|
|
|
2,860,700
|
|
|
2,855,800
|
|
Non-risk
membership
|
223,300
|
|
|
216,200
|
|
|
227,000
|
|
|
227,800
|
|
|
228,100
|
|
Total
|
24,621,000
|
|
|
23,802,100
|
|
|
15,241,800
|
|
|
15,273,500
|
|
|
15,004,200
|
|
|
|
|
|
|
|
|
|
|
|
(1)
Membership includes Medicare Advantage, Medicare Supplement,
Special Needs Plans, and MMP.
|
|
|
|
|
|
|
|
|
|
|
NUMBER OF
EMPLOYEES
|
71,800
|
|
|
69,700
|
|
|
56,600
|
|
|
53,600
|
|
|
52,000
|
|
|
|
|
|
|
|
|
|
|
|
DAYS IN CLAIMS
PAYABLE (2)
|
51
|
|
|
51
|
|
|
45
|
|
|
48
|
|
|
47
|
|
(2) Days
in Claims Payable is a calculation of Medical Claims Liabilities at
the end of the period divided by average claims expense per
calendar day for such period. On a pro-forma basis, DCP for Q1 2020
was 47, reflecting adjusted medical costs to include a full quarter
of WellCare operations.
|
|
|
|
|
|
|
|
|
|
|
CASH, INVESTMENTS
AND RESTRICTED DEPOSITS (in millions)
|
Regulated
|
$
|
23,655
|
|
|
$
|
19,358
|
|
|
$
|
14,204
|
|
|
$
|
14,734
|
|
|
$
|
15,101
|
|
Unregulated
|
1,982
|
|
|
2,871
|
|
|
7,157
|
|
|
855
|
|
|
801
|
|
Total
|
$
|
25,637
|
|
|
$
|
22,229
|
|
|
$
|
21,361
|
|
|
$
|
15,589
|
|
|
$
|
15,902
|
|
|
|
|
|
|
|
|
|
|
|
DEBT TO
CAPITALIZATION
|
40.0
|
%
|
|
42.2
|
%
|
|
52.0
|
%
|
|
36.2
|
%
|
|
36.8
|
%
|
DEBT TO
CAPITALIZATION EXCLUDING NON-RECOURSE DEBT
(3)
|
39.7
|
%
|
|
41.9
|
%
|
|
51.7
|
%
|
|
35.6
|
%
|
|
36.3
|
%
|
(3)
The non-recourse debt represents the Company's mortgage note
payable ($52 million at June 30, 2020) and construction loan
payable ($165 million at June 30, 2020). As of December 31, 2019,
excluding non-recourse debt and the senior debt issued to fund the
WellCare acquisition in advance of closing, our debt to capital was
34.3%. The non-recourse debt represents the Company's mortgage note
payable ($54 million at December 31, 2019) and construction loan
payable ($140 million at December 31, 2019). The WellCare related
senior notes represent $6,921 million of long-term debt as of
December 31, 2019.
|
OPERATING RATIOS
|
Three Months Ended
June 30,
|
|
Six Months Ended
June 30,
|
|
2020
|
|
2019
|
|
2020
|
|
2019
|
HBR
|
82.1
|
%
|
|
86.7
|
%
|
|
84.9
|
%
|
|
86.2
|
%
|
SG&A expense
ratio
|
8.8
|
%
|
|
9.1
|
%
|
|
9.3
|
%
|
|
9.3
|
%
|
Adjusted SG&A
expense ratio
|
8.5
|
%
|
|
9.0
|
%
|
|
8.6
|
%
|
|
9.2
|
%
|
MEDICAL CLAIMS LIABILITY
The changes in medical claims liability are summarized as
follows (in millions):
Balance, June 30,
2019
|
|
$
|
7,447
|
|
Less: reinsurance
recoverable
|
|
19
|
|
Balance, June 30,
2019, net
|
|
7,428
|
|
Acquisitions and
divestitures
|
|
3,744
|
|
Incurred related
to:
|
|
|
Current
period
|
|
71,919
|
|
Prior
period
|
|
(566)
|
|
Total
incurred
|
|
71,353
|
|
Paid related
to:
|
|
|
Current
period
|
|
64,761
|
|
Prior
period
|
|
6,363
|
|
Total paid
|
|
71,124
|
|
Balance, June 30,
2020, net
|
|
11,401
|
|
Plus: reinsurance
recoverable
|
|
17
|
|
Balance, June 30,
2020
|
|
$
|
11,418
|
|
|
|
|
Centene's claims reserving process utilizes a consistent
actuarial methodology to estimate Centene's ultimate liability. Any
reduction in the "Incurred related to: Prior period" amount may be
offset as Centene actuarially determines "Incurred related to:
Current period." As such, only in the absence of a consistent
reserving methodology would favorable development of prior period
claims liability estimates reduce medical costs. Centene believes
it has consistently applied its claims reserving methodology.
Additionally, approximately $23
million was recorded as a decrease to premium revenues
resulting from development within "Incurred related to: Prior
period" due to minimum HBR and other return of premium
programs.
The amount of the "Incurred related to: Prior period" above
represents favorable development and includes the effects of
reserving under moderately adverse conditions, new markets where we
use a conservative approach in setting reserves during the initial
periods of operations, receipts from other third party payors
related to coordination of benefits and lower medical utilization
and cost trends for dates of service June 30, 2019, and
prior.
Our Response to COVID-19
Demonstrating our commitment to our members and the
communities we serve, employees, and providers and government
partners.
Members and
Communities
|
Waiving COVID-19
related prior authorizations and member cost sharing
for related screening, testing and treatment for all Medicare,
Medicaid and Marketplace members.
|
Delivering 50,000
gift cards, with $35 of value each, to be used to purchase
essential
healthcare and educational items including diapers,
over-the-counter medicines, cleaning supplies and books.
|
Donating 1 million
meals a month for 12 months to feed our neighbors in communities
all over the country.
|
Providing grants to
Area Agencies on Aging to enable grocery and
meal deliveries for members with disabilities who are unable to
access nutritious food.
|
Matching funds in
partnership with workforce development boards and other safety net
organizations
to prepare them for a career in healthcare to support the direct
care workforce and newly unemployed individuals.
|
Investment in new
technology and supplies to improve access to quality healthcare for
the incarcerated population, including expanding PPE supplies in
prisons and expanding the partnership with the Concordance Academy
and other charitable agencies to enhance long-term outcomes for
incarcerated individuals.
|
Creation of Health
Disparities Task Force, focused on studying the causes of
healthcare disparities, recommending improvements in policies and
practices and performing outreach to key leaders in impacted areas
to increase education.
|
Waiving all cost
sharing for in-network primary care, behavioral health and
telehealth costs for Medicare Advantage members for the remainder
of 2020. In addition, offering our Community Connections Help
Line, available to anyone in need of help beyond medical care, as
well as expanded benefits including extended meal program benefits,
over-the-counter (OTC) allowances, and annual wellness visit
incentives to help members in need of extra support.
|
Formed partnership
with the National Minority Quality Forum (NMQF) to study the impact
of COVID on racial minorities and underserved
communities.
|
Expanded partnership
with Quartet Health to help members quickly and easily access
behavioral health care.
|
Employees
|
10 additional working
days of paid leave to support employees
|
Waiving prior
authorizations and employee cost sharing for COVID-19 related
screening, testing and treatment
|
Encouraging employees
to work from home, with approximately 90% working
remotely
|
Providing essential
workers with a one-time payment of $750
in appreciation and
recognition of their willingness to serve in their important office
roles
|
Scheduling essential
workers to preserve social distancing,
and enhancing health
and safety protocols such as daily cleaning and disinfecting for
essential workers
|
Establishing a
Medical Reserve Leave policy to support clinical staff
paid leave and
benefits for up to three months of volunteer COVID pandemic
service
|
Hiring continues
across the country to fill nearly 2,000 open positions
|
Providers and
Government Partners
|
Expediting the
rollout of FirstNet that will streamline access to affordable,
high-speed wireless broadband services for primary care providers
in rural and underserved communities.
|
Dedicating funds to
the Medicaid Telehealth Partnership's efforts,
which will be used to purchase equipment and provide training and
technical assistance to FQHCs.
|
Expediting the
distribution of approximately 2 million pieces of PPE
including safety goggles, facemasks, hand sanitizers and disaster
kits.
|
Extending grants to
providers to assist with the upfront investment costs of new
devices and equipment.
|
Developing a new
Provider Accessibility Initiative (PAI) COVID-19 Web Series to
provide timely recommendations on how
providers and organizations can deliver disability-competent care
during the pandemic and beyond.
|
In partnership with
Quest Diagnostics, distributing 25,000 COVID test kits each week to
FQHCs in ten states or districts across the country.
|
Investments in Mental
Health Resources, including training and support to thousands of
front-line providers, donations to local organizations with
increased demand for 'warmline' call centers, and an investment in
the National Council for Behavioral Health for a virtual training
program.
|
Donated $500,000 to
the National Domestic Violence Hotline.
|
View original
content:http://www.prnewswire.com/news-releases/centene-corporation-reports-second-quarter-2020-results-301100694.html
SOURCE Centene Corporation