EX-99.1 2 a20240726ex991pressrelease.htm EX-99.1 Document


Exhibit 99.1
                                    
             centenelogoa60a.jpg
N E W S R E L E A S E                                                                    
Contact:Investor Relations InquiriesMedia Inquiries
Jennifer GilliganShannon Susko
Senior Vice President, Finance & Investor RelationsSenior Vice President, Chief Communications Officer
(212) 549-1306(314) 445-0790

FOR IMMEDIATE RELEASE

CENTENE CORPORATION REPORTS SECOND QUARTER 2024 RESULTS
-- Diluted EPS of $2.16; Adjusted Diluted EPS of $2.42 --
-- Reaffirms 2024 Adjusted Diluted EPS Guidance Floor of Greater Than $6.80 --

•Adjusted diluted EPS of $2.42, up 15% from $2.10 in the second quarter of 2023.
•Premium and service revenues of $36.0 billion in the second quarter of 2024.
•Membership increase of 34% in Marketplace, compared to the second quarter of 2023.

ST. LOUIS, July 26, 2024 -- Centene Corporation (NYSE: CNC) ("the Company") announced today its financial results for the second quarter ended June 30, 2024. In summary, the 2024 second quarter results were as follows:
Total revenues (in millions)$39,836 
Premium and service revenues (in millions)$35,973 
Health benefits ratio87.6 %
SG&A expense ratio8.0 %
Adjusted SG&A expense ratio (1)
8.0 %
GAAP diluted EPS$2.16 
Adjusted diluted EPS (1)
$2.42 
Total cash flow provided by operations (in millions)$2,175 
(1)
Represents a non-GAAP financial measure. A full reconciliation of the adjusted diluted earnings per share (EPS) and adjusted selling, general and administrative (SG&A) expenses is shown in the Non-GAAP Financial Presentation section of this release.

"While we have work to do in Medicaid as redeterminations wind down, the overall performance of the diversified portfolio enables us to remain on track for 2024 adjusted diluted EPS guidance," said Chief Executive Officer of Centene, Sarah M. London. "At the same time, we continue to make important progress on operations and quality that positions us well to serve our members and deliver long-term profitable growth."

Other Events

•In July, Centene entered into a definitive agreement to sell Collaborative Health Systems, a management services organization, to Astrana Health, Inc. The transaction is expected to close by the end of 2024.

•In May, Centene's Kansas subsidiary, Sunflower Health Plan, was selected to continue providing managed health care services through KanCare, the State of Kansas' Medicaid and Children's Health Insurance Program (CHIP). The new, three-year contract is expected to take effect on January 1, 2025, with the option to renew for up to two, 12-month extensions.
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Awards & Community Engagement

•Centene received several recognitions in June, including being ranked No. 22 on the annual Fortune 500 List and No. 224 on Forbes Global 2000 list, up from No. 259 in 2023. US News and World Report also named Centene to its Best Companies to Work For (Health Services Industry). Centene's Chief Health Officer, Dr. Alice Hm Chen, was named to Modern Healthcare's list of 50 Most Influential Clinical Executives 2024.

•In May, Centene was named one of the Top 50 Companies for Diversity by Fair360 (formerly DiversityInc) for the fifth consecutive year. Centene ranked No. 26 on this year's list, up 11 spots from No. 37. Centene was also recognized as a Top Disability-Friendly Company 2024 by DIVERSITYCOMM Media; included as one of the Best Employers for Diversity 2024 by Forbes and for being one of America’s Greatest Workplaces for Mental Wellbeing by Newsweek.

•The Centene Foundation, the philanthropy arm of Centene Corporation, announced a partnership with McCormack Baron Salazar – one of the nation's affordable housing leaders – to increase access to affordable housing. The multi-year partnership is anticipated to create thousands of housing units and drive improved outcomes for Medicaid-eligible populations through increased access to health-related services.

Membership

The following table sets forth membership by line of business:
 June 30,
 20242023
Traditional Medicaid (1)
11,640,900 14,260,400 
High Acuity Medicaid (2)
1,499,000 1,799,200 
Total Medicaid13,139,900 16,059,600 
Commercial Marketplace4,401,300 3,295,200 
Commercial Group426,400 435,000 
Total Commercial4,827,700 3,730,200 
Medicare (3)
1,138,400 1,329,000 
Medicare PDP6,603,600 4,493,700 
Total at-risk membership25,709,600 25,612,500 
TRICARE eligibles2,768,000 2,799,300 
Total
28,477,600 28,411,800 
(1)
Membership includes Temporary Assistance for Needy Families (TANF), Medicaid Expansion, Children's Health Insurance Program (CHIP), Foster Care and Behavioral Health.
(2)
Membership includes Aged, Blind, or Disabled (ABD), Intellectual and Developmental Disabilities (IDD), Long-Term Services and Supports (LTSS) and Medicare-Medicaid Plans (MMP) Duals.
(3)
Membership includes Medicare Advantage and Medicare Supplement.

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Premium and Service Revenues

The following table sets forth supplemental revenue information ($ in millions):
Three Months Ended June 30,
20242023% Change
Medicaid$20,250 $21,895 (8)%
Commercial8,535 5,734 49 %
Medicare (1)
5,978 5,665 6 %
Other1,210 1,544 (22)%
Total premium and service revenues$35,973 $34,838 3 %
(1)
Medicare includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs) and Medicare Prescription Drug Plan (PDP).

Statement of Operations: Three Months Ended June 30, 2024

•For the second quarter of 2024, premium and service revenues increased 3% to $36.0 billion from $34.8 billion in the comparable period of 2023. The increase was primarily driven by membership growth in the Marketplace business due to strong product positioning as well as overall market growth and outperformance in Marketplace risk adjustment for the 2023 benefit year, partially offset by recent divestitures in the Other segment and lower Medicaid membership primarily due to redeterminations.

•Health benefits ratio (HBR) of 87.6% for the second quarter of 2024 represents an increase from 87.0% in the comparable period in 2023. The increase was driven by higher acuity in Medicaid as we progressed through the redetermination process and continue to work with states to match rates with acuity. The increase was also driven by Medicare Star rating impacts. The increase was partially offset by Marketplace membership growth and improved margin through strong 2024 product design and execution as well as outperformance in Marketplace risk adjustment for the 2023 benefit year.

•The SG&A expense ratio was 8.0% for the second quarter of 2024, compared to 8.7% in the second quarter of 2023. The adjusted SG&A expense ratio was 8.0% for the second quarter of 2024, compared to 8.6% in the second quarter of 2023. The decreases were driven by Marketplace risk adjustment revenue, the divestiture of Circle Health Group (Circle Health), which operated at a higher SG&A expense ratio, and ongoing SG&A reduction initiatives. The decreases were partially offset by growth in the Marketplace business, which operates at a meaningfully higher SG&A expense ratio as compared to Medicaid.

•The effective tax rate was 24.4% for the second quarter of 2024, compared to 25.4% in the second quarter of 2023. The effective tax rate for the second quarter of 2024 reflects tax effects of settlements with taxing authorities. For the second quarter of 2024, our effective tax rate on adjusted earnings was 24.4%, compared to 24.9% in the second quarter of 2023.

•Cash flow provided by operations for the second quarter of 2024 was $2.2 billion, primarily driven by net earnings and risk adjustment accruals for the 2024 benefit year.

Balance Sheet

At June 30, 2024, the Company had cash, investments and restricted deposits of $38.5 billion and maintained $217 million of cash and cash equivalents in its unregulated entities. Medical claims liabilities totaled $18.2 billion. The Company's days in claims payable was 54 days, an increase of one day as compared to the first quarter of 2024, and an increase of two days as compared to the second quarter of 2023. Total debt was $17.6 billion, which included no borrowings on the $2.0 billion Revolving Credit Facility at quarter end.

During the second quarter of 2024, the Company repurchased 10.7 million shares for $800 million. As of July 26, 2024, $4.4 billion remains available under the Company's stock repurchase program.
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Outlook

The Company reaffirms its 2024 GAAP diluted EPS guidance floor of greater than $5.94 and its 2024 adjusted diluted EPS guidance floor of greater than $6.80. A full reconciliation of adjusted diluted EPS is shown in the Non-GAAP Financial Presentation section of this release.

The Company is increasing its 2024 premium and service revenues guidance range by $5.0 billion to a range of $141.0 billion to $143.0 billion to reflect an additional $2.0 billion Commercial premium revenue, $2.0 billion Medicare premium revenue and $1.0 billion Medicaid premium revenue. The Company's total revenue guidance has been updated to $155.0 billion to $157.0 billion. Additionally, the 2024 HBR is expected to be at the high end of the previous guidance range, approximately 87.9%.

Conference Call

As previously announced, the Company will host a conference call Friday, July 26, 2024, at 8:30 a.m. ET to review the financial results for the second quarter ended June 30, 2024.

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: 4980577 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 following the completion of the call for the next 12 months or until 11:59 p.m. ET on Friday, July 25, 2025, at the aforementioned URL. In addition, a digital audio playback will be available until 9 a.m. ET on Friday, August 2, 2024, by dialing 1-877-344-7529 in the U.S., 1-855-669-9658 in Canada, or +1-412-317-0088 from abroad, and entering access code 7407521.
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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 in evaluating the Company's performance and for planning purposes, by allowing management to focus on period-to-period changes in the Company's core business operations, and in determining employee incentive compensation. Therefore, the Company believes that this information is meaningful in addition to the information contained in the GAAP presentation of financial information. The Company strongly encourages investors to review its consolidated financial statements and publicly filed reports in their entirety and cautions investors that the non-GAAP financial measures used by the Company may differ from similar measures used by other companies, even when similar terms are used to identify such measures. The presentation of non-GAAP financial measures is not intended to be considered in isolation or as a substitute for the financial information prepared and presented in accordance with GAAP.

The Company believes the presentation of non-GAAP financial measures that excludes amortization of acquired intangible assets, acquisition and divestiture related expenses, as well as other items, allows investors to develop a more meaningful understanding of the Company's core 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,
2024202320242023
GAAP net earnings attributable to Centene$1,146 $1,058 $2,309 $2,188 
Amortization of acquired intangible assets173 179 346 362 
Acquisition and divestiture related expenses6 13 67 36 
Other adjustments (1)
2 (74)(97)(127)
Income tax effects of adjustments (2)
(44)(21)(126)(135)
Adjusted net earnings $1,283 $1,155 $2,499 $2,324 

(1) Other adjustments include the following pre-tax items:
2024:
(a) for the three months ended June 30, 2024: gain on the previously reported divestiture of Circle Health of $10 million, an additional loss on the divestiture of our Spanish and Central European businesses of $7 million, severance costs due to a restructuring of $4 million, reduction to the net gain on the sale of property due to closing costs of $3 million and net gain on the finalization of working capital adjustments for the previously reported divestiture of Magellan Specialty Health of $2 million;

(b) for the six months ended June 30, 2024: net gain on the previously reported divestiture of Magellan Specialty Health due to the achievement of contingent consideration and finalization of working capital adjustments of $83 million, net gain on the sale of property of $21 million, gain on the previously reported divestiture of Circle Health of $20 million, Health Net Federal Services asset impairment due to the 2024 final ruling on the TRICARE Managed Care Support Contract of $14 million, severance costs due to a restructuring of $13 million, an additional loss on the divestiture of our Spanish and Central European businesses of $7 million and gain on the previously reported divestiture of HealthSmart due to the finalization of working capital adjustments of $7 million.

2023:
(a) for the three months ended June 30, 2023: gain on the sale of Apixio of $91 million, gain on the previously reported divestiture of Centurion of $15 million, an additional loss on the divestiture of our Spanish and Central European businesses of $13 million and real estate impairments of $19 million;

(b) for the six months ended June 30, 2023: gain on the sale of Apixio of $91 million, gain on the sale of Magellan Specialty Health of $79 million, gain on the previously reported divestiture of Centurion of $15 million, an additional loss on the divestiture of our Spanish and Central European businesses of $13 million and real estate impairments of $45 million.
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(2) The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The six months ended June 30, 2023, includes a one-time income tax benefit of $69 million resulting from the distribution of long-term stock awards to the estate of the Company's former CEO.

Three Months Ended June 30,Six Months Ended June 30,
Annual Guidance December 31, 2024
2024202320242023
GAAP diluted EPS attributable to Centene$2.16 $1.92 $4.32 $3.96 
greater than $5.94
Amortization of acquired intangible assets0.33 0.33 0.65 0.66 
~$1.32
Acquisition and divestiture related expenses0.01 0.02 0.13 0.07 
~$0.13
Other adjustments (3)
— (0.13)(0.18)(0.23)
~$(0.19)
Income tax effects of adjustments (4)
(0.08)(0.04)(0.24)(0.25)
~$(0.40)
Adjusted diluted EPS$2.42 $2.10 $4.68 $4.21 
greater than $6.80

(3) Other adjustments include the following pre-tax items:
2024:
(a) for the three months ended June 30, 2024: gain on the previously reported divestiture of Circle Health of $0.02 per share ($0.02 after-tax), an additional loss on the divestiture of our Spanish and Central European businesses of $0.01 per share ($0.01 after-tax) and severance costs due to a restructuring of $0.01 per share ($0.01 after-tax);

(b) for the six months ended June 30, 2024: net gain on the previously reported divestiture of Magellan Specialty Health due to the achievement of contingent consideration and finalization of working capital adjustments of $0.15 per share ($0.11 after-tax), net gain on the sale of property of $0.04 per share ($0.03 after-tax), gain on the previously reported divestiture of Circle Health of $0.04 per share ($0.12 after-tax), Health Net Federal Services asset impairment due to the 2024 final ruling on the TRICARE Managed Care Support Contract of $0.03 per share ($0.02 after-tax), severance costs due to a restructuring of $0.02 per share ($0.02 after-tax), an additional loss on the divestiture of our Spanish and Central European businesses of $0.01 per share ($0.01 after-tax) and gain on the previously reported divestiture of HealthSmart due to the finalization of working capital adjustments of $0.01 per share ($0.01 after-tax);

(c) for the year ended December 31, 2024, an estimated: $0.16 ($0.12 after-tax) net gain on the previously reported divestiture of Magellan Specialty Health due to the achievement of contingent consideration and finalization of working capital adjustments, $0.04 ($0.03 after-tax) net gain on the sale of property, $0.04 ($0.12 after-tax) gain on the previously reported divestiture of Circle Health, $0.03 ($0.02 after-tax) Health Net Federal Services asset impairment due to the 2024 final ruling on the TRICARE Managed Care Support Contract, $0.02 ($0.01 after-tax) severance costs due to a restructuring, $0.01 ($0.01 after-tax) additional loss on the previously reported divestiture of our Spanish and Central European businesses and $0.01 ($0.01 after-tax) gain on the previously reported divestiture of HealthSmart due to the finalization of working capital adjustments.

2023:
(a) for the three months ended June 30, 2023: gain on the sale of Apixio of $0.16 per share ($0.11 after-tax), gain on the previously reported divestiture of Centurion of $0.02 per share ($0.01 after-tax), an additional loss on the divestiture of our Spanish and Central European businesses of $0.02 per share ($0.01 after-tax) and real estate impairments of $0.03 per share ($0.02 after-tax);

(b) for the six months ended June 30, 2023: gain on the sale of Apixio of $0.16 per share ($0.11 after-tax), gain on the sale of Magellan Specialty Health of $0.14 per share ($0.12 after-tax), gain on the previously reported divestiture of Centurion of $0.03 per share ($0.02 after-tax), an additional loss on the divestiture of our Spanish and Central European businesses of $0.02 per share ($0.01 after-tax) and real estate impairments of $0.08 per share ($0.06 after-tax).

(4) The income tax effects of adjustments are based on the effective income tax rates applicable to each adjustment. The six months ended June 30, 2023, include a one-time income tax benefit of $0.12 resulting from the distribution of long-term stock awards to the estate of the Company's former CEO.
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Three Months Ended June 30,Six Months Ended June 30,
2024202320242023
GAAP selling, general and administrative expenses$2,894 $3,016 $6,112 $6,027 
Less:
Acquisition and divestiture related expenses6 13 67 36 
Restructuring costs4 — 13 — 
Real estate optimization— 1 — 7 
Adjusted selling, general and administrative expenses$2,884 $3,002 $6,032 $5,984 

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 Expense Ratio (non-GAAP) = Adjusted selling, general and administrative expenses divided by premium and service revenues.

•Adjusted Effective Tax Rate (non-GAAP) = GAAP income tax expense (benefit) excluding the income tax effects of adjustments to net earnings divided by adjusted earnings (loss) before income tax expense.

•Adjusted Net Earnings (non-GAAP) = Net earnings less amortization of acquired intangible assets, less acquisition and divestiture 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.

•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 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. In many instances, 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.
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About Centene Corporation

Centene Corporation, a Fortune 500 company, is a leading 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 more than 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 and the TRICARE program. The Company also 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 value creation as well as 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, https://investors.centene.com.

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 "guidance," "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 Corporation and its subsidiaries (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, competition, expected contract start dates and terms, expected activities in connection with completed and future acquisitions and dispositions, our 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: our ability to design and price products that are competitive and/or actuarially sound including but not limited to any impacts resulting from Medicaid redeterminations; 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; our ability to accurately predict and effectively manage health benefits and other operating expenses and reserves, including fluctuations in medical utilization rates; competition, including for providers, broker distribution networks, contract reprocurements and organic growth; our ability to adequately anticipate demand and provide for operational resources to maintain service level requirements; our ability to manage our information systems effectively; disruption, unexpected costs, or similar risks from business transactions, including acquisitions, divestitures, and changes in our relationships with third parties; impairments to real estate, investments, goodwill and intangible assets; changes in senior management, loss of one or more key personnel or an inability to attract, hire, integrate and retain skilled personnel; membership and revenue declines or unexpected trends; rate cuts or other payment reductions or delays by governmental payors and other risks and uncertainties affecting our government businesses; changes in healthcare practices, new technologies, and advances in medicine; our ability to effectively and ethically use artificial intelligence and machine learning in compliance with applicable laws; increased healthcare costs; inflation and interest rates; the effect of social, economic, and political conditions and geopolitical events, including as a result of changes in U.S. presidential administrations or Congress; changes in 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 and the Health Care and Education Affordability Reconciliation Act
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(collectively referred to as the ACA) and any regulations enacted thereunder; uncertainty concerning government shutdowns, debt ceilings or funding; tax matters; disasters, climate-related incidents, acts of war or aggression or major epidemics; changes in expected contract start dates and terms; changes in provider, broker, vendor, state, federal and other contracts and delays in the timing of regulatory approval of contracts, including due to protests; the expiration, suspension, or termination of our contracts with federal or state governments (including, but not limited to, Medicaid, Medicare or other customers); the difficulty of predicting the timing or outcome of legal or regulatory audits, investigations, proceedings or matters including, but not limited to, our ability to resolve claims and/or allegations made by states with regard to past practices on acceptable terms, or at all, or whether additional claims, reviews or investigations will be brought by states, the federal government or shareholder litigants, or government investigations; challenges to our contract awards; cyber-attacks or other data security incidents or our failure to comply with applicable privacy, data or security laws and regulations; the exertion of management's time and our resources, and other expenses incurred and business changes required in connection with complying with the terms of our contracts and the undertakings in connection with any regulatory, governmental, or third party consents or approvals for acquisitions or dispositions; any changes in expected closing dates, estimated purchase price, or accretion for acquisitions or dispositions; losses in our investment portfolio; restrictions and limitations in connection with our indebtedness; a downgrade of our corporate family rating, issuer rating or credit rating of our indebtedness; the availability of debt and equity financing on terms that are favorable to us and risks and uncertainties discussed in the reports that Centene has filed with the Securities and Exchange Commission (SEC). 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 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. The guidance in this press release is only effective as of the date given, July 26, 2024, and will not be updated or affirmed unless and until we publicly announce updated or affirmed guidance.
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CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In millions, except shares in thousands and per share data in dollars)
June 30, 2024December 31, 2023
(Unaudited)
ASSETS  
Current assets:  
Cash and cash equivalents$17,605 $17,193 
Premium and trade receivables16,587 15,532 
Short-term investments2,609 2,459 
Other current assets1,605 5,572 
Total current assets38,406 40,756 
Long-term investments16,870 16,286 
Restricted deposits1,415 1,386 
Property, software and equipment, net2,041 2,019 
Goodwill17,558 17,558 
Intangible assets, net5,755 6,101 
Other long-term assets1,092 535 
Total assets$83,137 $84,641 
LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS' EQUITY 
Current liabilities:  
Medical claims liability$18,173 $18,000 
Accounts payable and accrued expenses12,232 16,420 
Return of premium payable1,615 1,462 
Unearned revenue597 715 
Current portion of long-term debt112 119 
Total current liabilities32,729 36,716 
Long-term debt17,516 17,710 
Deferred tax liability665 641 
Other long-term liabilities4,770 3,618 
Total liabilities55,680 58,685 
Commitments and contingencies
Redeemable noncontrolling interests16 19 
Stockholders' equity:  
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at June 30, 2024 and December 31, 2023
— — 
Common stock, $0.001 par value; authorized 800,000 shares; 619,495 issued and 526,001 outstanding at June 30, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023
1 1 
Additional paid-in capital20,461 20,304 
Accumulated other comprehensive (loss)(646)(652)
Retained earnings14,352 12,043 
Treasury stock, at cost (93,494 and 80,807 shares, respectively)
(6,817)(5,856)
Total Centene stockholders' equity27,351 25,840 
Nonredeemable noncontrolling interest90 97 
Total stockholders' equity27,441 25,937 
Total liabilities, redeemable noncontrolling interests and stockholders' equity$83,137 $84,641 

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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,
2024202320242023
Revenues:
Premium$35,140 $33,713 $70,669 $67,538 
Service833 1,125 1,641 2,252 
Premium and service revenues35,973 34,838 72,310 69,790 
Premium tax3,863 2,770 7,933 6,707 
Total revenues39,836 37,608 80,243 76,497 
Expenses:  
Medical costs30,765 29,347 61,697 58,781 
Cost of services680 877 1,349 1,747 
Selling, general and administrative expenses2,894 3,016 6,112 6,027 
Depreciation expense133 146 268 288 
Amortization of acquired intangible assets173 179 346 362 
Premium tax expense3,962 2,854 8,123 6,865 
Impairment— 18 13 38 
Total operating expenses38,607 36,437 77,908 74,108 
Earnings from operations1,229 1,171 2,335 2,389 
Other income (expense):  
Investment and other income463 425 1,008 778 
Interest expense(176)(181)(354)(361)
Earnings before income tax1,516 1,415 2,989 2,806 
Income tax expense370 360 685 621 
Net earnings1,146 1,055 2,304 2,185 
Loss attributable to noncontrolling interests— 3 5 3 
Net earnings attributable to Centene Corporation$1,146 $1,058 $2,309 $2,188 

Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share$2.16 $1.93 $4.34 $3.98 
Diluted earnings per common share$2.16 $1.92 $4.32 $3.96 

Weighted average number of common shares outstanding:
Basic529,602 548,932 532,385 549,850 
Diluted530,755 550,308 534,517 551,996 

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CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In millions, unaudited)

 Six Months Ended June 30,
 20242023
Cash flows from operating activities:  
Net earnings$2,304 $2,185 
Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization614 650 
Stock compensation expense132 117 
Impairment13 38 
Deferred income taxes40 (160)
(Gain) loss on divestitures, net(103)(172)
Other adjustments, net(11)68 
Changes in assets and liabilities  
Premium and trade receivables(1,059)(319)
Other assets(404)(325)
Medical claims liabilities173 139 
Unearned revenue(118)1,895 
Accounts payable and accrued expenses(1,704)618 
Other long-term liabilities1,838 2,081 
Other operating activities, net4 — 
Net cash provided by operating activities1,719 6,815 
Cash flows from investing activities:  
Capital expenditures(337)(440)
Purchases of investments(3,434)(3,199)
Sales and maturities of investments2,497 2,293 
Divestiture proceeds, net of divested cash959 669 
Net cash used in investing activities(315)(677)
Cash flows from financing activities:  
Proceeds from long-term debt350 1,281 
Payments and repurchases of long-term debt(565)(1,322)
Common stock repurchases(954)(828)
Proceeds from common stock issuances25 21 
Purchase of noncontrolling interest— (85)
Other financing activities, net(4)— 
Net cash used in financing activities(1,148)(933)
Effect of exchange rate changes on cash, cash equivalents and restricted cash7 (7)
Net increase in cash, cash equivalents and restricted cash and cash equivalents263 5,198 
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period
17,452 12,330 
Cash, cash equivalents and restricted cash and cash equivalents, end of period
$17,715 $17,528 
Supplemental disclosures of cash flow information:  
Interest paid$352 $348 
Income taxes paid$610 $592 
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,
20242023
Cash and cash equivalents$17,605 $17,170 
Restricted cash and cash equivalents, included in restricted deposits110 358 
Total cash, cash equivalents and restricted cash and cash equivalents$17,715 $17,528 

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CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
Q2Q1Q4Q3Q2
20242024202320232023
MEMBERSHIP
Traditional Medicaid (1)
11,640,90011,750,00012,754,00013,470,90014,260,400
High Acuity Medicaid (2)
1,499,0001,547,6001,718,0001,769,6001,799,200
Total Medicaid13,139,90013,297,60014,472,00015,240,50016,059,600
Commercial Marketplace4,401,3004,348,8003,900,1003,681,6003,295,200
Commercial Group426,400422,700427,500424,200435,000
Total Commercial4,827,7004,771,5004,327,6004,105,8003,730,200
Medicare (3)
1,138,4001,146,8001,284,2001,310,6001,329,000
Medicare PDP6,603,6006,438,9004,617,8004,539,8004,493,700
Total at-risk membership25,709,60025,654,80024,701,60025,196,70025,612,500
TRICARE eligibles2,768,0002,768,0002,773,2002,773,2002,799,300
Total
28,477,60028,422,80027,474,80027,969,90028,411,800
(1)
Membership includes TANF, Medicaid Expansion, CHIP, Foster Care and Behavioral Health.
(2)
Membership includes ABD, IDD, LTSS and MMP Duals.
(3)
Membership includes Medicare Advantage and Medicare Supplement.
NUMBER OF EMPLOYEES60,00059,90067,70067,80068,300
DAYS IN CLAIMS PAYABLE
5453545352
CASH, INVESTMENTS AND RESTRICTED DEPOSITS (in millions)
Regulated$37,421$36,528$36,314$35,988$35,799
Unregulated1,0781,0181,0101,0201,046
Total$38,499$37,546$37,324$37,008$36,845
DEBT TO CAPITALIZATION39.1 %40.0 %40.7 %41.5 %41.1 %

OPERATING RATIOSThree Months Ended June 30,Six Months Ended June 30,
2024202320242023
HBR87.6 %87.0 %87.3 %87.0 %
SG&A expense ratio8.0 %8.7 %8.5 %8.6 %
Adjusted SG&A expense ratio 8.0 %8.6 %8.3 %8.6 %
HBR BY PRODUCTThree Months Ended June 30,Six Months Ended June 30,
2024202320242023
Medicaid92.8 %88.9 %91.8 %89.5 %
Commercial73.4 %81.0 %73.4 %78.7 %
Medicare (4)
89.2 %86.2 %90.0 %85.7 %
(4)
Medicare includes Medicare Advantage, Medicare Supplement, D-SNPs and Medicare PDP.

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MEDICAL CLAIMS LIABILITY

The changes in medical claims liability are summarized as follows (in millions):
Balance, June 30, 2023
$16,884 
Less: Reinsurance recoverables20 
Balance, June 30, 2023, net
16,864 
Incurred related to:
Current period123,420 
Prior periods(1,945)
Total incurred121,475 
Paid related to:
Current period107,316 
Prior periods13,243 
Total paid120,559 
Plus: Premium deficiency reserve335 
Balance, June 30, 2024, net
18,115 
Plus: Reinsurance recoverables58 
Balance, June 30, 2024
$18,173 

Centene's claims reserving process utilizes a consistent actuarial methodology to estimate Centene's ultimate liability. Any reduction in the "Incurred related to: Prior periods" amount may be offset as Centene actuarially determines the "Incurred related to: Current period." Centene believes it has consistently applied its claims reserving methodology. Additionally, approximately $354 million was recorded as a reduction to premium revenues resulting from development within "Incurred related to: Prior periods" due to minimum HBR and other return of premium programs.

The amount of the "Incurred related to: Prior periods" 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, 2023, and prior.
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