Centene Corporation Reports 2015 Fourth Quarter And Full Year Results

-- 2015 diluted earnings per share of $2.89; $3.03 excluding $0.14 of Health Net merger related expenses --

-- Premium and service revenues increased 36% year over year --

09 Feb, 2016, 06:00 ET from Centene Corporation

ST. LOUIS, Feb. 9, 2016 /PRNewswire/ -- Centene Corporation (NYSE: CNC) today announced its financial results for the fourth quarter and year ended December 31, 2015, which are consistent with the results provided in our press release dated January 26, 2016.  The following discussions, with the exception of cash flow information, are in the context of continuing operations.

 

2015 Results

Q4

Full Year

Premium and Service Revenues (in millions)

$

5,857

$

21,265

Consolidated Health Benefits Ratio

88.0

%

88.9

%

General & Administrative expense ratio excluding Health Net merger related expenses

8.7

%

8.5

%

Diluted earnings per share (EPS)

$

0.91

$

2.89

Diluted EPS excluding Health Net merger related expenses

$

0.95

$

3.03

Total cash flow from operations (in millions)

$

201

$

658

 

Michael F. Neidorff, Centene's Chairman and Chief Executive Officer, stated, "2015 marked another year of growth and accomplishment for Centene - capped off by an especially strong fourth quarter.  We look forward to closing our Health Net acquisition and maintaining this positive momentum in 2016 and beyond."

Fourth Quarter and Full Year Highlights

  • December 31, 2015 managed care membership of 5.1 million, an increase of over 1.0 million members, or 26% over 2014.
  • Premium and service revenues for the fourth quarter of $5.9 billion, representing 33% growth compared to the fourth quarter of 2014 and $21.3 billion for the full year 2015, representing 36% growth year over year.
  • Health Benefits Ratio of 88.0% for the fourth quarter of 2015, compared to 89.3% in the fourth quarter of 2014 and 88.9% for the full year 2015 compared to 89.3% for the full year 2014.
  • General and Administrative expense ratio excluding Health Net merger related expenses of 8.7% for the fourth quarter of 2015, compared to 8.2% in the fourth quarter of 2014 and 8.5% for the full year 2015 compared to 8.4% for 2014.
  • Operating cash flow of $201 million and $658 million for the fourth quarter and full year of 2015, respectively, representing 1.8 times net earnings for both periods.
  • Diluted EPS for the fourth quarter of 2015 of $0.91, or $0.95 excluding $0.04 of diluted EPS associated with Health Net merger related expenses, compared to $0.87 in 2014, or $0.63 when excluding a $0.24 benefit for recording the health insurer fee reimbursement for Texas for all of 2014 in the fourth quarter.

Other Events

  • In February 2016, our Nebraska subsidiary, Nebraska Total Care, was recommended by the Nebraska Department of Health and Human Services' Division of Medicaid and Long-Term Care as one of three managed care organizations to administer its new Heritage Health program for Medicaid and CHIP enrollees. The contract is expected to commence in the first quarter of 2017, pending regulatory approvals.
  • In February 2016, Centurion of Florida, LLC reached a formal agreement to provide correctional healthcare services for the Florida Department of Corrections in Regions 1, 2 and 3. The contract is expected to commence in the second quarter of 2016.
  • In January 2016, the Company announced the pricing of an offering by its a wholly owned subsidiary, Centene Escrow Corporation (Escrow Issuer), of $1.4 billion of 5.625% Senior Notes due 2021 at par and $1.0 billion of 6.125% Senior Notes due 2024 at par. The Company intends to use the net proceeds of the offering, along with borrowings under the revolving credit facility and cash on hand, to fund the cash consideration for the Health Net merger, to pay merger and offering related fees and expenses, and for general corporate purposes. The proceeds of the debt issuance will be held in escrow until the closing of the Health Net merger. If the Health Net merger is not consummated, the Escrow Issuer will be required to redeem each series of Notes at a redemption price equal to 100% of the principal amount of such series of Notes, plus accrued and unpaid interest to the redemption date.
  • In January 2016, the governor of Louisiana signed an executive order to expand Medicaid coverage under the Affordable Care Act by July 1, 2016.
  • In December 2015, our Louisiana subsidiary, Louisiana Healthcare Connections, began operating under an expanded contract to include behavioral health benefits.
  • In December 2015, our Mississippi subsidiary, Magnolia Health, began operating under an expanded contract to include the inpatient benefit for Medicaid and ABD members.

Accreditations & Awards

  • In January 2016, our Arkansas subsidiary, Arkansas Health & Wellness Solutions, received Accreditation from the National Committee for Quality Assurance for its Health Insurance Marketplace Exchange plan, Ambetter of Arkansas.
  • In December 2015, two of our subsidiaries were recognized for their programs by the Medicaid Health Plans of America. U.S. Medical Management received the Long Term Services and Supports Award for their Home-Based Primary Care Program, and our Ohio subsidiary, Buckeye Health Plan, received the Maternal Health Award for their Addiction in Pregnancy Program.
  • In November 2015, Centene and Cenpatico received national recognition by Modern Healthcare and Advertising Age for their anti-bullying campaign, "No Bullying Zone." The companies received the Gold Award for Community Outreach Campaign of the Year at Modern Healthcare's Marketing Impact Awards.

Membership

The following table sets forth the Company's membership by state for its managed care organizations:

 

December 31,

2015

2014

Arizona

440,900

204,000

Arkansas

41,900

38,400

California

186,000

163,900

Florida

510,400

425,700

Georgia

408,600

389,100

Illinois

207,500

87,800

Indiana

282,100

197,700

Kansas

141,000

143,300

Louisiana

381,900

152,900

Massachusetts

61,500

48,400

Michigan

4,800

Minnesota

9,600

9,500

Mississippi

302,200

108,700

Missouri

95,100

71,000

New Hampshire

71,400

62,700

Ohio

302,700

280,100

Oregon

98,700

South Carolina

104,000

109,700

Tennessee

20,000

21,000

Texas

983,100

971,000

Vermont

1,700

Washington

209,400

194,400

Wisconsin

77,100

83,200

Total at-risk membership

4,941,600

3,762,500

Non-risk membership

166,300

298,400

Total

5,107,900

4,060,900

 

At December 31, 2015, the Company served 449,000 members in Medicaid expansion programs in eight states compared to 201,300 members at December 31, 2014 in six states, included in the table above.

The following table sets forth our membership by line of business:

 

December 31,

2015

2014

Medicaid

3,497,500

2,754,900

CHIP & Foster Care

260,900

222,700

ABD, Medicare & Duals

446,000

392,700

Long Term Care (LTC)

75,000

60,800

Health Insurance Marketplaces

146,100

74,500

Hybrid Programs 1

18,900

Behavioral Health

456,800

197,000

Correctional Healthcare Services

59,300

41,000

Total at-risk membership

4,941,600

3,762,500

Non-risk membership

166,300

298,400

Total

5,107,900

4,060,900

1 In February 2015, hybrid programs were converted to Medicaid expansion contracts.

 

The following table identifies our dual-eligible membership by line of business.  The membership tables above include these members.

 

December 31,

2015

2014

ABD

112,300

118,300

LTC

55,100

35,900

Medicare

11,100

7,200

Medicaid / Medicare Duals

26,300

3,200

Total

204,800

164,600

 

The reduction in ABD is the result of members transitioning to Medicaid / Medicare Duals.

Statement of Operations: Three Months Ended December 31, 2015

  • For the fourth quarter of 2015, Premium and Service Revenues increased 33% to $5.9 billion from $4.4 billion in the fourth quarter of 2014. The increase was primarily a result of the impact from expansions, acquisitions or new programs in many of our states.
  • Consolidated HBR of 88.0% for the fourth quarter of 2015 represents a decrease from 89.3% in the comparable period in 2014 and a decrease from 89.0% in the third quarter of 2015. The year over year HBR decrease is primarily attributable to improvement in the overall HBR for higher acuity membership, premium rate increases and a milder flu season in the fourth quarter of this year. Sequentially, consolidated HBR decreased from 89.0% in the third quarter of 2015, reflecting rate increases and adjustments received during the third and fourth quarters.
  • The following table compares the results for new business and existing business for the quarters ended December 31:

 

2015

2014

Premium and Service Revenue

New business

20

%

30

%

Existing business

80

%

70

%

HBR

New business

88.2

%

89.4

%

Existing business

88.0

%

89.2

%

 

    • The new business HBR decreased compared to last year primarily due to the movement of the Florida LTC and MMA business, which operated at a higher HBR, into existing business.
  • Consolidated G&A expense ratio for the fourth quarter of 2015 was 8.8%, compared to 8.2% in the prior year. The G&A ratio for the three months ended December 31, 2015 was 8.7% excluding the impact of the Health Net merger related expenses. The increase over the prior year is primarily related to the expansion of our Health Insurance Marketplace business which operates at a higher G&A ratio and incurred higher open enrollment costs in the fourth quarter of the current year.
  • Diluted earnings per share for the fourth quarter of 2015 of $0.91, or $0.95 excluding $0.04 of diluted EPS associated with Health Net merger related expenses. This compares to diluted EPS for the fourth quarter of 2014 of $0.87, or $0.63 when excluding a $0.24 benefit for recording the health insurer fee reimbursement for Texas for all of 2014 in the fourth quarter.

Statement of Operations: Year Ended December 31, 2015

  • Premium and service revenues increased 36% in the year ended December 31, 2015 over the corresponding period in 2014 primarily as a result of the impact from expansions or new programs in many of our states, particularly, Florida, Illinois, Indiana, Louisiana, Mississippi, Ohio and Texas.
  • The consolidated HBR for the year ended December 31, 2015 was 88.9%, a decrease of 40 basis points over the comparable period in 2014. The decrease compared to last year is primarily attributable to improvement in medical expense in the high acuity populations (LTC/MMP) and membership growth in Medicaid expansion programs and Health Insurance Marketplace, which operate at a lower HBR than traditional Medicaid businesses.
  • The consolidated G&A expense ratio excluding the Health Net merger expenses for the year ended December 31, 2015 was 8.5% compared to 8.4% in 2014. The increase over prior year is primarily related to the expansion of our Health Insurance Marketplace business which operates at a higher G&A ratio and incurred higher open enrollment costs in the fourth quarter of the current year.
  • Diluted earnings per share of $2.89, or $3.03 excluding $0.14 of diluted EPS associated with Health Net merger related expenses. This compares to diluted EPS for the year ended December 31, 2014 of $2.23.

Balance Sheet and Cash Flow

At December 31, 2015, the Company had cash, investments and restricted deposits of $4.0 billion, including $78 million held by its unregulated entities.  Medical claims liabilities totaled $2.3 billion.  The Company's days in claims payable was 44.3.  Total debt was $1.2 billion, which includes $225 million of borrowings on the $500 million revolving credit facility at quarter end.  Debt to capitalization was 34.7% at December 31, 2015, excluding the $67 million non-recourse mortgage note. 

Cash flow from operations for the three months ended December 31, 2015, was $201 million, or 1.8 times net earnings.

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, September 30, 2015

44.5

Timing of claim payments

(0.2)

Days in claims payable, December 31, 2015

44.3

 

Outlook

For 2016 guidance purposes, the Company is providing combined guidance for Centene and Health Net and has adjusted the guidance to assume the Health Net transaction closes on March 1, 2016. The Health Net transaction remains subject to California regulatory approval and the Company continues to expect the transaction to close early in 2016. The guidance amounts are subject to adjustment, dependent on the actual closing date.  The table below depicts the Company's annual guidance for 2016.

 

Full Year 2016

Low

High

Total Revenues (in billions)

$

40.0

$

40.8

GAAP diluted EPS

$

2.80

$

3.15

Adjusted diluted EPS1

$

4.05

$

4.40

1Adjusted earnings per diluted share excludes approximately $0.70 to $0.75 per diluted share of Health Net merger related expenses and total intangible amortization associated with acquisitions of $0.50 to $0.55 per diluted share.

 

The guidance in the table above includes the recently announced Centurion contract in Florida.

Conference Call

As previously announced, the Company will host a conference call Tuesday, February 9, 2016, at 8:30 AM (Eastern Time) to review the financial results for the fourth quarter and year ended December 31, 2015, and to discuss its business outlook.  Michael Neidorff, William Scheffel 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; +1-412-902-6577 from abroad, including the following Elite Entry Number: 1765464 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, February 9, 2017, at the aforementioned URL. In addition, a digital audio playback will be available until 9:00 AM Eastern Time on Tuesday, February 16, 2016, by dialing 1-877-344-7529 in the U.S. and Canada, or +1-412-317-0088 from abroad, and entering access code 10078696.

Other Information

The discussion in the third bullet under the heading "Statement of Operations: Three Months Ended December 31, 2015" contains financial information for new and existing businesses.  Existing businesses are primarily state markets or significant geographic expansion in an existing state or product that we have managed for four complete quarters.  New businesses are primarily new state markets or significant geographic expansion in an existing state or product that conversely, we have not managed for four complete quarters.

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 individuals to more accurately assess the ongoing nature of the Company's operations and measure the Company's performance more consistently. 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.

About Centene Corporation

Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals.  Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare.  The Company operates local health plans and offers a range of health insurance solutions.  It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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.

The information provided in this press release contains forward-looking statements that relate to future events and future financial performance of Centene.  Subsequent events and developments may cause the Company's estimates to change.  The Company disclaims any obligation to update this forward-looking financial information in the future.  Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory, competitive and other factors that may cause Centene's, Health Net's, or its 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. Actual results may differ from projections or estimates due to a variety of important factors, including Centene's or Health Net's ability to accurately predict and effectively manage health benefits and other operating expenses and reserves; competition; membership and revenue projections; timing of regulatory contract approval; changes in healthcare practices; changes in federal or state laws or regulations, including the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act and any regulations enacted thereunder; changes in expected contract start dates; changes in expected closing dates, estimated purchase price and accretion for acquisitions. including our proposed merger with Health Net (Proposed Merger); inflation; foreign currency fluctuations; provider and state contract changes; new technologies; advances in medicine; reduction in provider payments by governmental payors; major epidemics; disasters and numerous other factors affecting the delivery and cost of healthcare; the expiration, cancellation or suspension of our or Health Net's managed care contracts by federal or state governments (including but not limited to Medicare and Medicaid); the outcome of our or Health Net's pending legal proceedings; availability of debt and equity financing, on terms that are favorable to us; and changes in economic, political and market conditions; the ultimate closing date of the Proposed Merger; the possibility that the expected synergies and value creation from the Proposed Merger will not be realized, or will not be realized with the expected time period; the risk that acquired businesses will not be integrated successfully; disruption from the Proposed Merger making it more difficult to maintain business and operational relationships; the risk that unexpected costs related to the Proposed Merger will be incurred; and the possibility that the Proposed Merger does not close, including, but not limited to, due to the failure to satisfy the closing conditions thereto as well as those factors disclosed in the Company's publicly filed documents.

This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain risk factors that may affect our business operations, financial condition and results of operations, in our filings with the Securities and Exchange Commission, including our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K.

[Tables Follow]

 

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In millions, except share data)

(Unaudited)

December 31, 2015

December 31, 2014

ASSETS

Current assets:

Cash and cash equivalents

$

1,760

$

1,610

Premium and related receivables

1,279

912

Short term investments

176

177

Other current assets

390

252

Total current assets

3,605

2,951

Long term investments

1,927

1,280

Restricted deposits

115

100

Property, software and equipment, net

518

445

Goodwill

842

754

Intangible assets, net

155

120

Other long term assets

177

174

Total assets

$

7,339

$

5,824

LIABILITIES AND STOCKHOLDERS' EQUITY

Current liabilities:

Medical claims liability

$

2,298

$

1,723

Accounts payable and accrued expenses

976

768

Return of premium payable

207

236

Unearned revenue

143

168

Current portion of long term debt

5

5

Total current liabilities

3,629

2,900

Long term debt

1,216

874

Other long term liabilities

170

159

Total liabilities

5,015

3,933

Commitments and contingencies

Redeemable noncontrolling interest

156

148

Stockholders' equity:

Preferred stock, $0.001 par value; authorized 10,000,000 shares; no shares issued or outstanding at December 31, 2015 and December 31, 2014

Common stock, $.001 par value; authorized 400,000,000 shares; 126,855,477 issued and 120,342,981 outstanding at December 31, 2015, and 124,274,864 issued and 118,433,416 outstanding at December 31, 2014

Additional paid-in capital

956

840

Accumulated other comprehensive loss

(10)

(1)

Retained earnings

1,358

1,003

Treasury stock, at cost (6,512,496 and 5,841,448 shares, respectively)

(147)

(98)

Total Centene stockholders' equity

2,157

1,744

Noncontrolling interest

11

(1)

Total stockholders' equity

2,168

1,743

Total liabilities and stockholders' equity

$

7,339

$

5,824

 

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS

(In millions, except share data)

(Unaudited)

Three Months Ended December 31,

Year Ended

December 31,

2015

2014

2015

2014

Revenues:

Premium

$

5,415

$

4,016

$

19,389

$

14,198

Service

442

399

1,876

1,469

Premium and service revenues

5,857

4,415

21,265

15,667

Premium tax and health insurer fee

445

310

1,495

893

Total revenues

6,302

4,725

22,760

16,560

Expenses:

Medical costs

4,767

3,585

17,242

12,678

Cost of services

387

345

1,621

1,280

General and administrative expenses

517

364

1,826

1,314

Premium tax expense

357

206

1,151

698

Health insurer fee expense

54

31

215

126

Total operating expenses

6,082

4,531

22,055

16,096

Earnings from operations

220

194

705

464

Other income (expense):

Investment and other income

8

10

35

28

Interest expense

(11)

(10)

(43)

(35)

Earnings from continuing operations, before income tax expense

217

194

697

457

Income tax expense

105

90

339

196

Earnings from continuing operations, net of income tax expense

112

104

358

261

Discontinued operations, net of income tax expense (benefit) of $0, $0, $(1), and $1, respectively

(1)

1

(1)

3

Net earnings

111

105

357

264

(Earnings) loss attributable to noncontrolling interests

2

(2)

7

Net earnings attributable to Centene Corporation

$

111

$

107

$

355

$

271

Amounts attributable to Centene Corporation common shareholders:

Earnings from continuing operations, net of income tax expense

$

112

$

106

$

356

$

268

Discontinued operations, net of income tax expense (benefit)

(1)

1

(1)

3

Net earnings

$

111

$

107

$

355

$

271

Net earnings (loss) per common share attributable to Centene Corporation:

Basic:

Continuing operations

$

0.94

$

0.90

$

2.99

$

2.30

Discontinued operations

(0.01)

0.01

(0.01)

0.03

Basic earnings per common share

$

0.93

$

0.91

$

2.98

$

2.33

Diluted:

Continuing operations

$

0.91

$

0.87

$

2.89

$

2.23

Discontinued operations

(0.01)

0.01

(0.01)

0.02

Diluted earnings per common share

$

0.90

$

0.88

$

2.88

$

2.25

Weighted average number of common shares outstanding:

Basic

119,486,183

117,632,012

119,100,744

116,345,764

Diluted

123,350,506

121,715,786

123,066,370

120,360,212

 

CENTENE CORPORATION AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(In millions)

(Unaudited)

Year Ended December 31,

2015

2014

Cash flows from operating activities:

Net earnings

$

357

$

264

Adjustments to reconcile net earnings to net cash provided by operating activities

Depreciation and amortization

111

89

Stock compensation expense

71

48

Deferred income taxes

(17)

(42)

Gain on contingent consideration

(44)

Goodwill and intangible adjustment

38

Changes in assets and liabilities

Premium and related receivables

(360)

(463)

Other current assets

(96)

(5)

Other assets

(9)

(8)

Medical claims liabilities

536

609

Unearned revenue

(27)

129

Accounts payable and accrued expenses

39

506

Other long term liabilities

51

89

Other operating activities

8

7

Net cash provided by operating activities

658

1,223

Cash flows from investing activities:

Capital expenditures

(150)

(103)

Purchases of investments

(1,321)

(1,015)

Sales and maturities of investments

669

406

Proceeds from asset sale

7

Investments in acquisitions, net of cash acquired

(18)

(136)

Net cash used in investing activities

(813)

(848)

Cash flows from financing activities:

Proceeds from exercise of stock options

13

8

Proceeds from borrowings

1,925

1,875

Payment of long term debt

(1,583)

(1,674)

Excess tax benefits from stock compensation

25

19

Common stock repurchases

(53)

(29)

Contribution from noncontrolling interest

11

6

Debt issue costs

(4)

(7)

Payment of contingent consideration obligation

(29)

Net cash provided by financing activities

305

198

Effect of exchange rate changes on cash and cash equivalents

(1)

Net increase in cash and cash equivalents

150

572

Cash and cash equivalents, beginning of period

1,610

1,038

Cash and cash equivalents, end of period

$

1,760

$

1,610

Supplemental disclosures of cash flow information:

Interest paid

$

55

$

40

Income taxes paid

$

328

$

237

Equity issued in connection with acquisitions

$

12

$

190

 

CENTENE CORPORATION

SUPPLEMENTAL FINANCIAL DATA FROM CONTINUING OPERATIONS

Q4

Q3

Q2

Q1

Q4

2015

2015

2015

2015

2014

MANAGED CARE MEMBERSHIP

Arizona

440,900

223,600

210,900

202,200

204,000

Arkansas

41,900

40,900

45,400

43,200

38,400

California

186,000

183,900

178,700

171,200

163,900

Florida

510,400

486,500

470,300

463,100

425,700

Georgia

408,600

406,700

405,000

405,600

389,100

Illinois

207,500

211,300

209,100

184,800

87,800

Indiana

282,100

276,700

250,400

227,700

197,700

Kansas

141,000

137,500

143,000

143,700

143,300

Louisiana

381,900

358,800

358,900

359,500

152,900

Massachusetts

61,500

63,700

61,500

64,500

48,400

Michigan

4,800

6,600

2,700

Minnesota

9,600

9,400

10,900

9,500

9,500

Mississippi

302,200

301,000

250,600

141,900

108,700

Missouri

95,100

88,400

82,600

75,600

71,000

New Hampshire

71,400

71,900

70,800

67,500

62,700

Ohio

302,700

308,100

287,100

296,000

280,100

Oregon

98,700

99,800

South Carolina

104,000

104,800

112,600

106,000

109,700

Tennessee

20,000

20,200

21,400

20,800

21,000

Texas

983,100

976,500

969,700

974,900

971,000

Vermont

1,700

1,500

2,800

1,600

Washington

209,400

208,600

214,100

207,100

194,400

Wisconsin

77,100

78,100

78,600

82,100

83,200

Total at-risk membership

4,941,600

4,664,500

4,437,100

4,248,500

3,762,500

Non-risk membership

166,300

169,900

176,600

153,200

298,400

TOTAL

5,107,900

4,834,400

4,613,700

4,401,700

4,060,900

Medicaid

3,497,500

3,469,800

3,300,600

3,133,900

2,754,900

CHIP & Foster Care

260,900

245,200

230,500

233,600

222,700

ABD, Medicare & Duals

446,000

444,100

414,300

410,400

392,700

LTC

75,000

73,800

72,800

71,200

60,800

Health Insurance Marketplaces

146,100

155,600

167,400

161,700

74,500

Hybrid Programs

18,900

Behavioral Health

456,800

216,700

203,900

195,100

197,000

Correctional Healthcare Services

59,300

59,300

47,600

42,600

41,000

Total at-risk membership

4,941,600

4,664,500

4,437,100

4,248,500

3,762,500

Non-risk membership

166,300

169,900

176,600

153,200

298,400

TOTAL

5,107,900

4,834,400

4,613,700

4,401,700

4,060,900

REVENUE PER MEMBER PER MONTH(a)

$

365

$

361

$

356

$

349

$

360

CLAIMS(a)

Period-end inventory

1,294,159

1,564,000

1,501,600

1,217,000

1,086,600

Average inventory

1,054,281

989,300

946,500

841,000

806,000

Period-end inventory per member

0.27

0.34

0.34

0.29

0.29

(a) Revenue per member and claims information are presented for the Managed Care at-risk members.

NUMBER OF EMPLOYEES

18,200

17,100

15,800

14,800

13,400

 

Q4

Q3

Q2

Q1

Q4

2015

2015

2015

2015

2014

DAYS IN CLAIMS PAYABLE (b)

44.3

44.5

45.5

45.5

44.2

(b) 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.

CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)

Regulated

$

3,900

$

3,834

$

3,667

$

3,345

$

3,082

Unregulated

78

91

82

97

85

TOTAL

$

3,978

$

3,925

$

3,749

$

3,442

$

3,167

DEBT TO CAPITALIZATION

36.0

%

38.4

%

37.1

%

38.0

%

33.5

%

DEBT TO CAPITALIZATION EXCLUDING NON-RECOURSE DEBT(c)

34.7

%

37.1

%

35.7

%

36.6

%

31.7

%

(c) The non-recourse debt represents the Company's mortgage note payable ($67 million at December 31, 2015).

Debt to Capitalization is calculated as follows: total debt divided by (total debt + total equity).

 

Operating Ratios:

 

Three Months Ended December 31,

Year Ended December 31,

2015

2014

2015

2014

Health Benefits Ratios:

Medicaid, CHIP, Foster Care & Health Insurance Marketplaces

85.2

%

86.9

%

86.0

%

86.3

%

ABD, LTC & Medicare

91.8

92.3

92.9

93.5

Specialty Services

86.2

87.2

85.8

85.5

  Total

88.0

89.3

88.9

89.3

Total General & Administrative Expense Ratio

8.8

%

8.2

%

8.6

%

8.4

%

 

MEDICAL CLAIMS LIABILITY (In millions)

The changes in medical claims liability are summarized as follows:

 

Balance, December 31, 2014

$

1,723

Acquisitions

79

Incurred related to:

Current period

17,471

Prior period

(229)

Total incurred

17,242

Paid related to:

Current period

15,279

Prior period

1,467

Total paid

16,746

Balance, December 31, 2015

$

2,298

 

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 in each of the periods presented.  Additionally, as a result of minimum HBR and other return of premium programs, approximately $47 million of the "Incurred related to: Prior period" was recorded as a reduction to premium revenues.

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 December 31, 2014 and prior.

 

SOURCE Centene Corporation



RELATED LINKS

http://www.centene.com