MMIT Payer Portrait: Centene Corp.

Centene Corp. is the fourth-largest health insurer in the U.S., serving more than 20 million lives nationwide. About 70% of Centene’s members are enrolled in public-sector health insurance products. Nationally, the company is No. 1 in managed Medicaid, holding contracts with 26 states (see map below). The insurer also dominates the Affordable Care Act exchanges, leading the national market with 2.2 million members in 20 states. In Sept. 2020, Centene unveiled plans to expand its exchange products to two new states, Michigan and New Mexico, plus 400 new counties in its existing markets for the 2021 plan year.

Centene made headlines in recent weeks, revealing two deals that would boost its solutions business. In Dec. 2020, Centene entered an agreement to acquire PANTHERx, a specialty pharmacy that focuses on rare-disease and orphan drugs. The deal was completed Dec. 30, making PANTHERx an independent unit of Envolve Pharmacy Solutions, Centene’s in-house PBM. The company made an even bigger splash Jan. 4, when it unveiled a $2.2 billion deal to acquire Magellan Health. The transaction, which is expected to close in the second half of 2021, would be a boon to Centene’s behavioral health unit, Cenpatico.

The Magellan deal continues a pattern for Centene, which has completed several major acquisitions in recent years: Health Net in 2016, Fidelis Care in 2018 and WellCare Health Plans, Inc. in 2020. The WellCare deal offered a significant boost to Centene’s Medicare Advantage (MA) presence, a recent area of focus for the company. In 2021, Centene expanded its MA geographic footprint by 30%, offering products in 1,249 counties across 33 states.

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