Centene
36 named things its latest annual report says its results depend on, each in the company's own words. 16 of them are also named by other companies we've read.
Suppliers
Change Healthcare, Inc.
depends onnamed as a riskFor example, in 2024, Change Healthcare, Inc. experienced a cybersecurity incident that disrupted its ability to provide services, impacting payers, providers and pharmacies nationwide, including Centene and some of its subsidiaries.Risk factors (Item 1A)
Also named by MCK
Other companies
Goodwill impairment
$6.7 billionnamed as a riskFor example, as a result of market conditions in July 2025, including the OBBBA and the decline in our stock price, we performed a quantitative impairment analysis during the third quarter to determine whether goodwill was impaired, which resulted in a non-cash goodwill impairment of $6.7 billion in the third quarter of 2025.Risk factors (Item 1A)
Also named by TFC
AcariaHealth
operates innamed as a riskOur specialty pharmacy business would be materially and adversely affected by an inability to contract on favorable terms with pharmaceutical manufacturers and other suppliers, though we use a network of specialty pharmacies beyond AcariaHealth.Risk factors (Item 1A)
Magellan Health, Inc.
We signed a definitive agreement to divest the remaining Magellan Health businesses in December 2025.Business (Item 1)
Places
Florida
concentrated in · approximately 10% or more of our consolidated Medicaid premium revenuesnamed as a riskOur Medicaid contracts with the states of Florida and New York accounted for approximately 10% or more of our consolidated Medicaid premium revenues individually in the year ended December 31, 2025.Business (Item 1)
Also named by ABR, ALLY, AN, AXP, AZO, BBY, BJ, BRO and 54 more
New York
concentrated in · approximately 10% or more of our consolidated Medicaid premium revenuesnamed as a riskOur Medicaid contracts with the states of Florida and New York accounted for approximately 10% or more of our consolidated Medicaid premium revenues individually in the year ended December 31, 2025.Business (Item 1)
Also named by ABR, AXP, BJ, BPOP, BRO, BWA, CHE, CINF and 12 more
Texas
operates innamed as a riskFor example, we are currently protesting the Texas and Georgia Medicaid reprocurements in which we were not a successful bidder.Risk factors (Item 1A)
Also named by ABR, AFRM, ALLY, AN, ASO, ASTS, ATO, AXP and 70 more
Georgia
operates innamed as a riskFor example, we are currently protesting the Texas and Georgia Medicaid reprocurements in which we were not a successful bidder.Risk factors (Item 1A)
Also named by ABR, ACHR, AXP, BRO, ELV, IMKTA, MKL, MLM and 7 more
Arkansas
operates inWe also operate under a Memorandum of Understanding with the Arkansas Department of Human Services Division of Medical Services and the Arkansas Insurance Department to participate in the Medicaid expansion model that Arkansas has adopted (referred to as AR Health and Opportunity for Me program).Business (Item 1)
Commodities and inputs
Fixed income investment portfolio
exposed to its price · approximately $650 millionnamed as a riskAssuming a hypothetical and immediate 1% increase in market interest rates at December 31, 2025, the fair value of our fixed income investments would decrease by approximately $650 million.Market risk (Item 7A)
Specialty drugs
exposed to its pricenamed as a riskIntroduction of new high-cost specialty drugs and sudden cost spikes for existing drugs increase the risk that the pharmacy cost assumptions used to develop our capitation rates are not adequate to cover the actual pharmacy costs, which jeopardizes the overall actuarial soundness of our rates.Risk factors (Item 1A)
Behavioral health and home health services
exposed to its pricenamed as a riskIn addition, during 2025, our Medicaid membership had higher than expected medical costs, including due to unanticipated increased costs in behavioral health, home health and high-cost drugs.Risk factors (Item 1A)
Regulators
Centers for Medicare & Medicaid Services (CMS)
earns fromnamed as a riskRevenues from CMS are significant to the segment.Business (Item 1)
Also named by A, ABT, AMGN, AXGN, BAX, BWIN, COO, COR and 23 more
CMS risk adjustment data validation audits
subject tonamed as a riskAdditionally in 2025, CMS announced the intent to accelerate the timing and expand the scope of risk adjustment data validation audits.Risk factors (Item 1A)
Also named by UNH
CMS Medicare Advantage rate announcement
subject tonamed as a riskWe believe these rates are insufficient to reflect the increases in continuing medical cost trend.Risk factors (Item 1A)
CMS Part D risk-sharing receivable
named as a riskIf the payments from CMS are delayed, our cash flows may be materially adversely affected.Risk factors (Item 1A)
Laws and programs
Medicaid
earns from · 57%named as a riskFor the year ended December 31, 2025, our Medicaid, Commercial, Medicare and Other segments accounted for 57%, 21%, 19% and 3%, respectively, of our total external revenues.Business (Item 1)
Also named by ABBV, ABT, ARE, ARWR, BAX, BMY, BSX, CHE and 39 more
Inflation Reduction Act (IRA)
subject to · from 80% to 20%named as a riskUnder the IRA, PDP plan costs increased significantly due to a reduction in members cost share (close of coverage gap, and the $2,000 cap on member out-of-pocket expenses) and a decrease in federal reinsurance (from 80% to 20%, while a greater portion of the plan drug costs fall into the catastrophic phase).Risk factors (Item 1A)
Also named by AEE, AMGN, ARWR, BIIB, BKNG, BMY, CAH, CI and 26 more
Medicare Part D
earns from · 8.1 million membersnamed as a riskWe offer stand-alone PDPs in 50 states and the District of Columbia and served 8.1 million members as of December 31, 2025, making us the country's largest stand-alone PDP provider.Business (Item 1)
Also named by ABBV, AMGN, BMY, CI, CVS, ELV, INCY, JNJ and 5 more
Medicare Advantage
earns from · 1.0 million Medicare Advantage members across 32 statesnamed as a riskAs of December 31, 2025, we served 1.0 million Medicare Advantage members across 32 states, primarily under the brand name Wellcare.Business (Item 1)
Also named by BWIN, CDNA, CHE, CVS, DGX, DOC, DVA, ELV and 3 more
Medicare sequestration (Budget Control Act of 2011)
subject to · 2% capnamed as a riskMedicare remains subject to the automatic spending reductions imposed by the Budget Control Act of 2011 and the American Taxpayer Relief Act of 2012 (sequestration), subject to a 2% cap, which was extended by the Bipartisan Budget Act of 2019 through 2029, which was reinstated on July 1, 2022, after a temporary suspension due to the COVID pandemic.Risk factors (Item 1A)
Health Insurance Marketplace
earns from · 5.5 million members across 29 statesnamed as a riskWe are the largest Marketplace carrier, serving 5.5 million members across 29 states as of December 31, 2025, under the brand name Ambetter Health.Business (Item 1)
CMS PDP auto-assignment benchmarks
earns from · over 8.7 million PDP membersnamed as a riskIf our future Part D premium bids are not below the CMS benchmarks, we risk losing PDP members who were previously assigned to us and we may not have additional PDP members auto-assigned to us, which could materially reduce our revenue.Risk factors (Item 1A)
Medicare Star Ratings
subject to · approximately 60% of our Medicare Advantage membershipnamed as a riskAs of December 2025, approximately 60% of our Medicare Advantage membership was associated with contracts rated 3.5 stars or better.Risk factors (Item 1A)
Medicaid managed care minimum MLR rule
subject to · 85%named as a riskIn April 2016, CMS issued final regulations that revised existing Medicaid managed care rules by establishing a minimum MLR standard for Medicaid of 85% and strengthening provisions related to network adequacy and access to care, enrollment and disenrollment protections, beneficiary support information, continued service during beneficiary appeals, and delivery system and payment reform initiatives, among others.Risk factors (Item 1A)
Federal Medicaid funding share
depends on · approximately 60%named as a riskSince Medicaid was created in 1965, the federal government and states have shared the costs for this program, with the federal government share currently averaging approximately 60%.Risk factors (Item 1A)
One Big Beautiful Bill Act (OBBBA)
subject tonamed as a riskWe anticipate that the combined effect of the expiration of the Enhanced APTCs, the Final Rule, and the OBBBA will reduce 2026 Marketplace membership and continue to increase the overall morbidity of the Marketplace population.Business (Item 1)
Also named by AA, ABR, ADI, ADM, ALB, AMAT, AMGN, AMKR and 121 more
ACA risk adjustment program
subject tonamed as a riskFor example, late in the second quarter of 2025, we made a significant negative adjustment to our expected net risk adjustment revenue attributable to the 2025 Marketplace plan year.Risk factors (Item 1A)
Also named by OSCR
Enhanced Advance Premium Tax Credits (APTCs)
subject tonamed as a riskExtended eligibility for the Enhanced APTC for Marketplace members expired on December 31, 2025.Risk factors (Item 1A)
Marketplace Integrity and Affordability Final Rule
subject tonamed as a riskThe Final Rule makes changes to policies to strengthen program integrity measures in the Marketplace.Business (Item 1)
Medicare Part D Premium Stabilization Demonstration
subject tonamed as a riskDue to the uncertainty of the new Part D pricing structure, Centene has elected into the Part D Premium Stabilization Demonstration program, which subsidizes member premiums and provides additional protection through the risk corridor in the event of unforeseen losses, but such election may not be sufficient to offset the uncertainty or risks relating to our experience with M3P as well as the increased risk exposure.Risk factors (Item 1A)
Medicare Prescription Payment Plan (M3P)
subject tonamed as a riskThis change may lead to increased bad debt exposure along with potential challenges with collecting deductibles and other cost-sharing amounts from beneficiaries.Risk factors (Item 1A)
New York Essential Plan
earns fromnamed as a riskIn particular, New York intends to terminate its Essentials Plan-5, which provided state-subsidized healthcare for individuals from 200% to 250% of the Federal Poverty Level (FPL) by July 1, 2026.Business (Item 1)
Dual Eligible Special Needs Plans (D-SNPs)
subject tonamed as a riskIn addition, CMS regulations will require beneficiaries dually enrolled in Medicare and in a Medicaid managed care plan to receive integrated care through the Medicaid company's Medicare Advantage D-SNPs beginning in 2030, with certain restrictions beginning in 2027, which may restrict our product offerings in some geographic service areas.Risk factors (Item 1A)
Section 1115 waivers
subject tonamed as a riskIn July 2025, CMS indicated that it would no longer approve new Section 1115 waivers for continuous care coverage or workforce assistance.Risk factors (Item 1A)
State premium taxes on Medicaid MCOs
subject tonamed as a riskIf the states increase the tax rates applicable to our Marketplace line of business during 2026, we cannot offset those increases by increasing premiums, as our Marketplace rates were approved and determined in 2025, which could have a material impact on the profitability of our Marketplace products, results of operations, financial condition and cash flows.Risk factors (Item 1A)