RELEASE: Centene Corporation reports 2017 results and increases 2018 guidance

ST. LOUIS/PRNewswire/ — Centene Corporation (NYSE: CNC) announced today its financial results for the fourth quarter and year ended December 31, 2017, reporting diluted earnings per share (EPS) of $1.30 and $4.69, respectively, and Adjusted Diluted EPS of $0.97 and $5.03, respectively.

In summary, the 2017 fourth quarter and full year results were as follows:

2017 Results

Q4

Full Year

Total revenues (in millions)

$

12,806

$

48,382

Health benefits ratio

87.3

%

87.3

%

SG&A expense ratio

10.9

%

9.7

%

GAAP diluted EPS

$

1.30

$

4.69

Adjusted Diluted EPS (1)

$

0.97

$

5.03

Total cash flow provided by operations (in millions)

$

450

$

1,489

 

(1) A full reconciliation of Adjusted Diluted EPS is shown on page eight of this release.

Michael F. Neidorff, Centene’s Chairman and Chief Executive Officer, stated, “The strong fourth quarter and full year results for 2017 provide positive momentum heading into 2018 as we continue to focus on revenue growth and margin expansion.”

As a result of the Tax Cuts and Jobs Act of 2017 (Income Tax Reform), the Company’s fourth quarter and full year results include a nonrecurring benefit associated with the revaluation of the Company’s net deferred tax liabilities. The benefit of Income Tax Reform has been partially offset by a contribution to the Company’s charitable foundation and additional expense due to the lack of cost sharing reduction (CSR) subsidy funding by the Federal Government in the fourth quarter and full year 2017. These items, among others, have been excluded from Adjusted Diluted EPS for the fourth quarter and full year results. A full reconciliation of Adjusted Diluted EPS is shown on page eight of this release.

The following discussions, with the exception of cash flow information, are in the context of continuing operations.

Fourth Quarter and Full Year Highlights

  • December 31, 2017 managed care membership of 12.2 million, an increase of 765,300 members, or 7% over 2016.
  • Total revenues for the fourth quarter of 2017 of $12.8 billion, representing 8% growth, compared to the fourth quarter of 2016 and $48.4 billion for the full year 2017, representing 19% growth year-over-year.
  • Health benefits ratio (HBR) of 87.3% for the fourth quarter of 2017, compared to 84.8% in the fourth quarter of 2016 and 87.3% for the full year 2017, compared to 86.5% for the full year 2016.
  • Selling, general and administrative (SG&A) expense ratio of 10.9% for the fourth quarter of 2017, compared to 10.0% for the fourth quarter of 2016. SG&A expense ratio of 9.7% for the full year 2017, compared to 9.8% for the full year 2016.
  • Adjusted SG&A expense ratio of 10.5% for the fourth quarter of 2017, compared to 9.4% for the fourth quarter of 2016. Adjusted SG&A expense ratio of 9.5% for the full year 2017, compared to 9.0% for the full year 2016.
  • Operating cash flow of $450 million and $1.5 billion for the fourth quarter and full year 2017, respectively, representing 1.8x net earnings for the full year 2017.
  • Diluted EPS for the fourth quarter of 2017 of $1.30, compared to $1.45 for the fourth quarter of 2016. Diluted EPS for the full year 2017 of $4.69, compared to $3.41 for the full year 2016.
  • Adjusted Diluted EPS for the fourth quarter of 2017 of $0.97, compared to $1.19for the fourth quarter of 2016. Adjusted Diluted EPS for the full year 2017 of $5.03, compared to $4.43 for the full year 2016.

Other Events

  • In February 2018, Jessica L. Blume was elected to serve on our Board of Directors. Ms. Blume was appointed to both the Audit Committee and the Technology Committee. Previously, Ms. Blume held the position of Vice Chairman for Deloitte, where she was a partner until retirement in 2015.
  • In February 2018, our Arkansas subsidiary, Arkansas Total Care began managing a Medicaid special needs population comprised of people with high behavioral health needs and individuals with developmental/intellectual disabilities. Arkansas Total Care will assume full-risk on this population beginning in January 2019.
  • In January 2018, our New Mexico subsidiary, Western Sky Community Care, was awarded a statewide contract in New Mexico for the Centennial Care 2.0 Program. The new contract is expected to commence membership operations in January 2019.
  • In January 2018, our Illinois subsidiary, IlliniCare Health, began operating under a state-wide contract for the Medicaid Managed Care Program including children who are in need through the Department of Children and Family Services (DCFS)/Youth in Care by the Illinois Department of Healthcare and Family Services (HFS). Implementation dates vary by region and will be fully implemented statewide by April 2018. Foster Care will be implemented by July 2018.
  • In January 2018, we expanded our offerings in the 2018 Health Insurance Marketplace. We entered Kansas, Missouri and Nevada, and expanded our footprint in the following six existing markets: Florida, Georgia, Indiana, Ohio, Texas, and Washington.
  • In January 2018, we expanded our offerings in Medicare. We entered Arkansas, Indiana, Kansas, Louisiana, Missouri, Pennsylvania, South Carolina, and Washington and expanded our footprint in Ohio.
  • In January 2018, our subsidiary, Health Net Federal Services, began operating under the TRICARE West Region contract to provide administrative services to Military Health System eligible beneficiaries.
  • In January 2018, our Washington subsidiary, Coordinated Care of Washington, began providing managed care services to Apple Health’s Fully Integrated Managed Care (FIMC) beneficiaries in the North Central Region.
  • In January 2018, our Pennsylvania subsidiary, Pennsylvania Health & Wellness, began serving enrollees in the Community HealthChoices program. Contract commencement dates vary by zone and will be fully implemented statewide by January 2020.
  • In November 2017, The People’s Healthcare Services Clinic, our full-service health center partnership with Schnuck Markets Inc. and Betty Jean Kerr People’s Health Centers, had its grand opening in Ferguson, Missouri.
  • In November 2017, we announced the appointment of Cynthia Brinkley to President and Chief Operating Officer, Jesse Hunter to Executive Vice President of Mergers & Acquisitions and Chief Strategy Officer, Mark Brooks to Executive Vice President and Chief Information Officer, and Kevin Counihan to Senior Vice President of Products.

Accreditations & Awards

  • In December 2017, Health Net Federal Services, LLC, earned the Health Utilization Management and Case Management Accreditations from URAC.
  • In November 2017, FORTUNE magazine announced Michael Neidorff’s ranking of #17 on its “Businessperson of the Year” list. This list focuses on the largest public companies in the world, evaluating their increases in revenues and profits, as well as stock performance and return on capital.
  • In October 2017, Forbes announced Centene’s position of #36 on its “Global 2000: Growth Champions” list. The top 250 public companies are identified and awarded based on compound annual growth rates in revenues from 2013 through 2016.

Membership

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

December 31,

2017

2016

Medicaid:

TANF, CHIP & Foster Care

5,807,300

5,630,000

ABD & LTSS

846,200

785,400

Behavioral Health

463,700

466,600

  Total Medicaid

7,117,200

6,882,000

Commercial

1,558,300

1,239,100

Medicare & MMP (1)

333,700

334,300

Correctional

157,500

139,400

  Total at-risk membership

9,166,700

8,594,800

TRICARE eligibles

2,824,100

2,847,000

Non-risk membership

216,300

  Total

12,207,100

11,441,800

 

(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:

December 31,

2017

2016

Dual-eligible (2)

474,500

441,400

Health Insurance Marketplace

959,600

537,200

Medicaid Expansion

1,091,500

1,080,500

 

(2) Membership includes dual-eligible ABD & LTSS and dual-eligible Medicare membership in the table above.

 

Statement of Operations: Three Months Ended December 31, 2017

  • For the fourth quarter of 2017, total revenues increased 8% to $12.8 billion from $11.9 billion in the comparable period in 2016. The increase over prior year was primarily a result of growth in the Health Insurance Marketplace business in 2017 and expansions and new programs in many of our states in 2016 and 2017. This was partially offset by the fourth quarter of 2016 benefiting from $195 million of additional revenue associated with the minimum medical loss ratio (MLR) amendment in California, as well as the moratorium of the health insurer fee in 2017 and lower 2017 membership in the commercial business in California as a result of margin improvement actions taken in 2016.
  • Sequentially, total revenues increased 8% over the third quarter of 2017 mainly due to approximately $700 million associated with pass through payments from the State of California being received in the fourth quarter that were recorded in premium tax revenue and premium tax expense.
  • HBR of 87.3% for the fourth quarter of 2017 represents an increase from 84.8% in the comparable period in 2016. The year-over-year increase was primarily a result of the $195 million of revenue recognized in the fourth quarter of 2016, relating to the minimum MLR amendment in California, which reduced the fourth quarter of 2016 HBR by 170 basis points. In addition, the year-over-year increase was attributable to new or expanded health plans, which initially operate at a higher HBR, a premium rate reduction for California Medicaid Expansion effective July 1, 2017, an increase in flu related costs over the fourth quarter of 2016, and the additional expense recognized in the fourth quarter of 2017 due to the lack of funding of CSR subsidy payments by the Federal Government.
  • HBR decreased sequentially from 88.0% in the third quarter of 2017. The decrease was primarily attributable to improved performance in Medicaid, including the impacts of rate adjustments, as well as performance in the Health Insurance Marketplace business. These HBR improvements were partially offset by the increase in flu related costs over the third quarter of 2017 and additional expense recognized in the fourth quarter due to the lack of funding of CSR subsidy payments by the Federal Government.
  • The SG&A expense ratio was 10.9% for the fourth quarter of 2017, compared to 10.0% for the fourth quarter of 2016 and 9.0% for the third quarter of 2017. The year-over-year increase was primarily a result of increased business expansion costs over the fourth quarter of 2016, and revenue recognized in the fourth quarter of 2016, relating to the minimum MLR amendment in California, which reduced the fourth quarter of 2016 SG&A expense ratio. Sequentially, the SG&A expense ratio increased primarily due to increased selling costs associated with open enrollment and the $40 million contribution to our charitable foundation in the fourth quarter of 2017.
  • The Adjusted SG&A expense ratio was 10.5% for the fourth quarter of 2017, compared to 9.4% for the fourth quarter of 2016 and 8.9% for the third quarter of 2017. The year-over-year increase was primarily a result of increased business expansion costs over the fourth quarter of 2016, and revenue recognized in the fourth quarter of 2016, relating to the minimum MLR amendment in California, which reduced the fourth quarter of 2016 Adjusted SG&A expense ratio. Sequentially, the Adjusted SG&A expense ratio increased primarily due to increased selling costs associated with open enrollment in the fourth quarter of 2017.

Statement of Operations: Year Ended December 31, 2017

  • For the full year 2017, total revenues increased 19% to $48.4 billion from $40.6 billion in the comparable period of 2016. The increase over prior year was primarily a result of a full year of Health Net’s results, as well as the impact of growth in the Health Insurance Marketplace business in 2017 and expansions and new programs in many of our states in 2016 and 2017. This was partially offset by the moratorium of the health insurer fee in 2017, lower membership in the commercial business in California as a result of margin improvement actions taken in 2016, and lower specialty pharmacy revenues.
  • HBR of 87.3% for the full year 2017 represents an increase from 86.5% in the comparable period in 2016. The increase compared to last year was primarily a result of the $195 million of revenue recognized in 2016 relating to the minimum MLR change in California, which reduced the 2016 HBR by 50 basis points, a premium rate reduction for California Medicaid Expansion effective July 1, 2017, an increase in flu related costs over 2016, and the impact of new or expanded health plans, which initially operate at a higher HBR. These increases were partially offset by growth in the Health Insurance Marketplace business, which operates at a lower HBR.
  • The SG&A expense ratio was 9.7% for the full year 2017, compared to 9.8% for the full year 2016. The decrease in the SG&A expense ratio was primarily attributable to lower acquisition related expenses, partially offset by higher business expansion costs over 2016, the Penn Treaty assessment and our results including a full year of the Health Net business, which operates at a higher SG&A expense ratio due to a greater mix of commercial and Medicare business.
  • The Adjusted SG&A expense ratio was 9.5% for the full year 2017, compared to 9.0% for the full year 2016. The increase in the Adjusted SG&A expense ratio was primarily attributable to higher business expansion costs over 2016 and a full year of the Health Net business in our 2017 results, which operates at a higher SG&A expense ratio due to a greater mix of commercial and Medicare business.

Balance Sheet and Cash Flow

At December 31, 2017, the Company had cash, investments and restricted deposits of $10.1 billion, including $310 million held by unregulated entities. Medical claims liabilities totaled $4.3 billion. The Company’s days in claims payable was 41. Total debt was $4.7 billion, which includes $150 million of borrowings on the $1.5 billionrevolving credit facility at quarter-end. The debt to capitalization ratio was 40.3% at December 31, 2017, excluding the $61 million non-recourse mortgage note.

Cash flow provided by operations for the three months ended December 31, 2017 was $450 million, primarily due to net earnings and a decrease in premium and trade receivables, partially offset by a decrease in unearned revenue.

Outlook

The Company’s annual guidance for 2018 has been updated for the following items:

  • The benefit of Income Tax Reform that was signed into law in December 2017, partially offset by additional costs associated with the reinvestment of a portion of the tax reform benefit;
  • An increase in total revenues and earnings associated with higher membership expectations for the Health Insurance Marketplace business; and
  • A change in the timing of the equity issuance from February 1, 2018 to March 1, 2018 for the $2.3 billion of equity to finance the acquisition of New York StateCatholic Health Plan, Inc. d/b/a Fidelis Care New York (Fidelis Care) (Proposed Fidelis Acquisition), which reduces diluted shares outstanding. The ultimate timing will depend on market conditions.

A rollforward of certain captions of the Company’s current 2018 guidance from its previous guidance is as follows (Total Revenues in billions, per share data in dollars):

Total Revenues

GAAP diluted EPS

Adjusted Diluted EPS

Previous Guidance Range

$60.0 – $60.8

$4.63 – $4.97

$5.47 – $5.87

Income Tax Reform

(0.1)

1.38

1.58

Additional Investment

(0.30)

(0.30)

Marketplace Membership

0.7

0.14

0.14

Timing of Fidelis Care Equity

0.06

0.06

Revised Guidance Range

$60.6 – $61.4

$5.91 – $6.25

$6.95 – $7.35

The Company’s full updated annual guidance for 2018 is as follows:

Full Year 2018

Low

High

Total revenues (in billions)

$

60.6

$

61.4

GAAP diluted EPS

$

5.91

$

6.25

Adjusted Diluted EPS (1)

$

6.95

$

7.35

HBR

86.2

%

86.7

%

SG&A expense ratio

9.3

%

9.8

%

Adjusted SG&A expense ratio (2)

9.2

%

9.7

%

Effective tax rate

31.0

%

33.0

%

Diluted shares outstanding (in millions)

199.1

200.1

(1)

Adjusted Diluted EPS excludes amortization of acquired intangible assets of $0.79 to $0.81 per diluted share and acquisition related expenses of $0.25 to $0.29 per diluted share.

(2)

Adjusted SG&A expense ratio excludes acquisition related expenses of $70 million to $75 million.

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