CENTENE CORPORATION: BUCKING THE TREND

John G. Baresky

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… U.S. Healthcare: A Wild Ride …

Over $40 billion in annual sales, Centene forges ahead in building a multidimensional organization which outperforms the strategy and execution of its competitors

Centene is a unique managed care conglomerate based in St. Louis, Missouri which has quietly grown into an industry leader. Founded in 1984, Centene has over 30,000 employees and generates over $40 billion in annual sales. Their book of business includes 12 million members located across 28 states; a large number of them covered via government-sponsored health plans. Centene’s many accreditations include NCQA, URAC and Phase III/CAHQ Core.

Specialized markets, services and plans; Centene flourishes where other managed care plans have failed

Centene is well known in the Medicaid and Medicare markets. Their Medicaid business unit supports TANF, CHIP, foster care, ABD and long term care sectors. Centene’s Medicare business is centered on Medicare Advantage dual-eligible special needs and Medicare/Medicaid plans. Centene’s health insurance marketplace unit (HIM) offers benefits through which some members qualify for government subsidies; these benefit programs are marketed via their Ambetter brands.

Centene operates in an array of unique markets:

  • Casenet: population health and care management software
  • Celtic: commercial insurance for the uninsured
  • Centurion: correctional systems healthcare
  • Evolve: supplemental health benefits, administrative support
  • Health Net Federal Services: military and veteran communities
  • LifeShare: integrated long term care
  • U.S. Medical Management (USMM): integrated home health care

Centene masters business challenges other companies barely manage or entirely avoid

Much of Centene’s business is considered to be more complex to administer with potentially lower revenues when compared to conventional health plans and market sectors. In many cases, other insurers have reduced focus in these segments to avoid the burden of complex benefit management tied to government funding. They equate this business equation with higher operating costs, lower premiums/margins resulting in less revenue/profit.

Various insurers including Aetna, Anthem, Cigna, Humana, UHC and a number of others have a business in these areas but limit the scope of their exposure. They prefer to allocate organizational resources to more predictable, traditional, profitable health insurance offerings and customer segments. Centene successfully engages government-sponsored healthcare and other non-mainstream markets as a routine, well-executed core strategy of their business model.

A growing organization, Centene has steadily become a respected competitor in the ranks of healthcare insurance companies and managed care organizations

Centene has been able to grow organically and through a series of strategic acquisitions. Their latest expansion purchases are sizable. In September 2017, they announced their acquisition of Fidelis Care (New York State Catholic Health Plan) for $3.7 billion. In 2016 they completed their deal to buy Health Net for $6.8 billion. Despite the scale of these additions to an already formidable corporate entity, Centene is not on the radar of most businesses and consumers when it comes to healthcare insurance / managed care.

Centene’s empire, excelling in offbeat healthcare market sectors, continues to pursue business and grow where other companies failed to meet their goals

In 2018 the company projects to do business in 3 additional states (Kansas, Missouri and Nevada) by offering plans on those states’ health insurance exchanges. They seek to expand business in several states including Florida, Ohio, Texas and Washington next year. As other insurers reduce or entirely exit Obamacare markets, Centene sizes up those gaps as opportunities. They strategically develop benefit plans to introduce to those areas and execute effective go-to-market strategies to launch and promote their offerings and capture new business.

Moving ahead, Centene has more opportunities to build its commercial enterprise in a market sector other companies avoid

Centene’s low-key, ongoing growth is impressive and it appears to be well-positioned to continue the trend. It has built up considerable administrative, clinical, financial, marketing, operational and sales experience over the years with successful results. Complex risk management is something they take in stride. This enables it to accurately assess difficult markets and develop viable health insurance and other solutions for consumers plus additional customer stakeholders.

Their tolerance for unconventional markets and higher risk is greater because that is their specialty; they assertively manage this business to their advantage to generate sales and profits where others can’t.

Centene is ranked 66th in the Fortune 500 and 27th in Fortune’s 100 fastest growing companies

New or established competitors find it challenging to perform at Centene’s level given the markets they have to play in. As medical and pharmacy costs increase, government-sponsored plans change and healthcare insurance industry churn continues, Centene has a promising future ahead with a fluid business model that productively generates sales and grows the organization.

Thank you for reading this story

Learn more about the healthcare industry; read my articles about its medical and business trends, content marketing and digital strategy, brand and product management, mergers and acquisitions, consumer wellness, managed care and market access strategy.

About me

Hi, my name is John Baresky and I have over 20 years of experience in healthcare.

Throughout my career, I have been writing about healthcare while developing and sharing important information with physicians, nurses, pharmacists and other clinicians plus consumers, patients, healthcare business professionals, investors and other stakeholders.​​

Healthcare is a vast industry. I organize its clinical, business, academic, technical and consumer topics into precise messages and stories that are easily understood and immediately useful. The content I write resonates across audiences with objective accuracy and clarity.

Visit my website and connect with me via LinkedIn and Twitter

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