Centene Corporation has announced its decision to withdraw its previously issued 2025 guidance regarding GAAP and adjusted diluted earnings per share $(EPS)$, along with the underlying guidance elements. The decision follows an analysis of 2025 industry Health Insurance Marketplace data from Wakely, an independent actuarial firm, covering 22 of Centene's 29 Marketplace states. The data indicated that market growth in these states is lower than expected, while the overall market morbidity is significantly higher and inconsistent with the company's previous assumptions for risk adjustment revenue transfer. As a result, Centene anticipates a reduction in its expected full-year net risk adjustment revenue transfer by an estimated $1.8 billion, impacting the adjusted diluted EPS by approximately $2.75. The company is also addressing a step-up in medical cost trends within its Medicaid business, particularly in areas such as behavioral health, home health, and high-cost drugs, with pronounced effects in geographies like New York and Florida. Looking ahead to 2026, Centene is in the process of refiling Marketplace rates to accommodate a higher projected baseline of morbidity, aiming to implement corrective pricing actions in states representing the majority of its Marketplace membership.
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