Centene Corporation

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Centene Corporation
TypePublic company
IndustryManaged healthcare
Insurance
Founded1984; 38 years ago (1984)
FounderElizabeth "Betty" Brinn
Headquarters,
U.S.
Key people
ProductsHealthcare services
Health insurance
Revenue Increase US$111.115 billion (2020)[1]
Increase US$3.082 billion (2020)[1]
Increase US$1.808 billion (2020)[1]
Total assetsIncrease US$68.719 billion (2020)[1]
Total equityIncrease US$25.885 billion (2020)[1]
Number of employees
Increase ~71,300 (December 2020)[1]
Websitewww.centene.com Edit this at Wikidata

Centene Corporation is a publicly traded managed care company based in St. Louis, Missouri. It serves as an intermediary for government-sponsored and privately insured health care programs. Centene ranked No. 24 on the 2021 Fortune 500 .[2]

History[edit]

Centene was founded by Elizabeth Brinn as the Managed Health Services in Milwaukee, Wisconsin in 1984.[3] After the death of Brinn, the non-profit organization was sold to investors, with the proceeds going to the Betty Brinn Foundation, which subsequently became a major shareholder in Centene. In 1996, Michael F. Neidorff joined the company as chief executive.[4]

Centene went public in December 2001.[5] In 2006, the firm acquired US Script, a pharmacy benefits manager.[6] The company later merged US Script with subsidiaries to form its Envolve divisions.[6] In 2011, the firm formed Centurion, a provider of correctional health care services, as a joint venture with MHM Services.[6] In 2018, it acquired MHM Services, including its stake in Centurion.[6] Centene began offering state-run Medicaid programs. through Affordable Care Act exchanges in 2014.[7]

On July 2, 2015, Centene announced it would acquire Health Net.[8][9][10] In March 2016, it finalized its acquisition [11] On September 12, 2017, it announced that it would acquire Fidelis Care, a nonprofit insurer in New York, for US$3.75 billion.[12] In March 2019, it announced plans to acquire WellCare for US$17.3 billion.[13][14] On January 4, 2021, it was announced that it would acquire Magellan Health for $2.2 billion.[15] On January 4, 2022, the acquisition was completed.[16]

In the United Kingdom, Centene began to acquire local healthcare services in 2017.[17] In 2019, Centene, through its subsidiary MH Services, took a 40% stake in Circle Health,[17] as part of a deal which created a national network of over 50 private hospitals.[18] In early 2021, Operose Health, a UK subsidiary of Centene, took over a group of London practices, AT Medics.[19]

In May 2022, Centene announced that they have divested in two pharmacy organisations as the company exits the pharmacy benefit management business. Centene divested Mangellan Rx and PANTHERx Rare for a total of $2.8 billion.[20]

Business segments[edit]

The main lines of Centene include:

Leadership[edit]

In June 2021, an article in the Ohio Capital Journal reported that CEO Michael Neidorff was the highest paid healthcare executive in the United States in 2020, earning nearly $25 million.[26][27][28]

In December 2021, Politan Capital Management took a $900 million stake in Centene. Following the agreement, CEO Michael Neidorff announced plans to retire by the end of 2022.[29]

In March 2022, Sarah London was named chief executive officer of the company, replacing Neidorff.[30]

Controversies[edit]

In 2014, Fox News alleged that Superior HealthPlan of Texas denied coverage of an infant's surgery for brain cancer at Texas Children's Hospital. Superior HealthPlan is a joint-venture of Centene and Community Health Centers Network LP, which provides services for Medicaid recipients.[31] The article reported that Superior HealthPlan had previously paid healthcare claims for the infant at the hospital, although Superior HealthPlan stated that it did not cover procedures at the facility.[32] Three days after the article was published, Superior HealthPlan reversed its decision and covered the surgery.[33]

In January 2018, a class action lawsuit accused Centene's Ambetter marketplace healthcare plans of misleading enrollees about plan benefits.[34][35] According to the lawsuit, people who bought Centene's plans had difficulty finding medical providers that accepted patients covered under Centene's policies.[36]

In December 2018, Centene was sued by two pension funds alleging that Centene's acquisition of Health Net resulted in damages to Centene and exposed the company to potential liability. The suit also alleged that Centene concealed that Health Net owed approximately $1B in past tax liabilities to California and was under investigation for Medicare fraud at the time of the acquisition.[37]

In 2022 Operose Health had almost 600,000 NHS patients and was the largest supplier of GP services to the NHS. It was accused of putting patients at risk by prioritising profit, specifically by hiring physician associates, because they were cheaper than GPs. At Operose practices the average number of full time equivalent GPs per patients is about half the average in English practices. Sir Sam Everington said he was worried to see physician associates saying they were not receiving the supervision they needed. The practice had a backlog of thousands of medical test results and hospital letters on their computer systems. Operose said 97% of its practices were rated "good" or "outstanding" by the Care Quality Commission.[38]

Settlements[edit]

In April 2021, Health Net Federal Services, a subsidiary of Centene, agreed to pay $97M to settle allegations that it had duplicated or inflated claims submitted to the Department of Veterans Affairs.[39]

Between June 2021 and January 2022, Centene agreed to settlements with several states on behalf of their subsidiary, Envolve, a pharmacy benefit manager, including Ohio, Mississippi, Illinois, Arkansas, and New Hampshire to resolve allegations of overpayments to the PBM from the states' Medicaid programs.[40] The settlements have totaled over $191 million.[41][42][43]

In December 2021, Centene agreed to pay $27.6M to Kansas to settle allegations that it had failed to disclose discounts and used other strategies to obtain more profit from Kansas' Medicaid program.[44]

See also[edit]

References[edit]

  1. ^ a b c d e f "Centene Corporation 2020 Annual Report (Form 10-K)". sec.gov. U.S. Securities and Exchange Commission. February 2021.
  2. ^ "Fortune 500 Companies 2018: Who Made the List". Fortune. Retrieved 2018-11-10.
  3. ^ Trewyn, Phill (17 February 2002). "Managed Health's new parent plots Medicaid growth". www.bizjournals.com. Archived from the original on February 2, 2003. Retrieved 2021-09-09.
  4. ^ "Health services: Michael Neidorff, Centene Corp". St. Louis Business Journal. 16 June 2002.
  5. ^ "Centene launches IPO at $14 per share". www.bizjournals.com. 13 December 2001. Archived from the original on January 31, 2003. Retrieved 2021-09-09.
  6. ^ a b c d Japsen, Bruce. "Centene Invests Stake In Pharmacy Benefit Manager RxAdvance". Forbes. Retrieved 2021-09-09.
  7. ^ "Centene's Neidorff: WellCare acquisition has cleared final state approvals". FierceHealthcare. December 5, 2019. Retrieved 2021-09-09.
  8. ^ "Corporation - Home". Centene.com.
  9. ^ "Centene to Combine with Health Net in Transaction Valued at Approximately $6.8 Billion" (PDF). 4 July 2015. Archived from the original (PDF) on 4 July 2015.
  10. ^ "Centene completes Health Net deal after protracted review". Modernhealthcare.com. March 24, 2016.
  11. ^ Bray, Chad (2015-07-02). "Centene to Acquire Its Managed Care Rival Health Net for $6.8 Billion". The New York Times. ISSN 0362-4331. Retrieved 2021-09-09.
  12. ^ Mathews, Anna Wilde; Armental, Maria (September 12, 2017). "Centene Agrees to Buy Fidelis Care in $3.75 Billion Deal". The Wall Street Journal. New York City, United States. Retrieved September 13, 2017.
  13. ^ Tobin, Ben. "Centene to buy smaller rival WellCare Health Plans in deal worth $17.3 billion". USA TODAY. Retrieved 2021-09-09.
  14. ^ Ward, Brendan (23 January 2020). "Centene completes $17B acquisition of Tampa's WellCare". www.bizjournals.com. Retrieved 2021-09-09.{{cite web}}: CS1 maint: url-status (link)
  15. ^ "Centene acquires Phoenix-based Magellan Health". Retrieved 2021-01-04.
  16. ^ "Centene Completes Acquisition of Magellan Health, Establishing a Leading Behavioral Health Platform at a Critical Time". PR Newswire. 2022-01-04. Retrieved 2022-01-04.
  17. ^ a b "US company in takeover of network of GP practices". The Lowdown. 2021-02-04. Retrieved 2021-04-11.
  18. ^ Plimmer, Gill (29 November 2019). "Takeover of BMI Healthcare by hedge fund-backed Circle Health is part of expansion push". Financial Times. Retrieved 2 December 2019.
  19. ^ Kollewe, Julia (26 February 2021). "NHS GP practice operator with 500,000 patients passes into hands of US health insurer". The Guardian.
  20. ^ "Centene divesting two pharmacy businesses for combined $2.8 billion". Healthcare Finance. 6 May 2022. Retrieved 9 May 2022.{{cite journal}}: CS1 maint: url-status (link)
  21. ^ "Centene slapped with lawsuit over provider networks in ACA exchange plans". FierceHealthcare. January 12, 2018. Retrieved 2019-06-22.
  22. ^ "Centene completes Fidelis Care buy". Healthcare Dive. Retrieved 2021-09-09.
  23. ^ "How the WellCare acquisition is driving Centene's approach to Medicare Advantage". FierceHealthcare. October 8, 2020. Retrieved 2021-09-09.
  24. ^ "DOD Releases Draft RFP for New $58 Billion Health Care Contracts". Bloomberg Government. Retrieved 2021-09-09.
  25. ^ Japsen, Bruce. "Centene Acquisition Bolsters Its Prison Healthcare Business". Forbes. Retrieved 2021-09-09.
  26. ^ Schladen, Marty (2021-06-28). "Lavishly paid and unapologetic. Company at center of Medicaid scandal focuses on profits". Ohio Capital Journal. Retrieved 2021-06-28.
  27. ^ "18 highest-paid CEOs in healthcare". www.beckershospitalreview.com. Retrieved 2021-06-28.
  28. ^ Minemyer, Paige (2021-04-30). "Centene CEO Neidorff raked in nearly $25M last year. Take a look what other insurance execs earned". Fierce Healthcare. Retrieved 2022-02-23.
  29. ^ Japsen, Bruce. "Centene's Neidorff To Step Down As CEO Amid Deal With Activist Investor". Forbes. Retrieved 2022-02-23.
  30. ^ Japsen, Bruce. "Centene Promotes Tech And Healthcare Strategist Sarah London To CEO Job". Forbes. Retrieved 2022-04-20.
  31. ^ "Superior HealthPlan names CEO". www.bizjournals.com. 20 March 2002. Archived from the original on September 18, 2002. Retrieved 2021-09-09.
  32. ^ Corbin, Cristina (2015-03-24). "Parents fight insurance company to keep baby's cancer surgery docs". Fox News. Retrieved 2021-09-09.
  33. ^ Corbin, Cristina (12 July 2014). "Texas baby improves after brain surgery allowed by insurer's change of heart". Foxnews.com.
  34. ^ Small, Leslie (2018-01-12). "Centene slapped with lawsuit over provider networks in ACA exchange plans". Fierce Healthcare. Retrieved 2022-02-23.
  35. ^ Bryant, Meg (January 12, 2018). "Lawsuit accuses Centene of misleading customers on narrow ACA plans". Healthcare Dive. Retrieved 26 April 2019.
  36. ^ Abelson, Reed (2018-01-11). "Health Insurer Centene Is Sued Over Lack of Medical Coverage". The New York Times. ISSN 0362-4331. Retrieved 2022-02-23.
  37. ^ www.bizjournals.com https://www.bizjournals.com/sacramento/news/2018/12/24/lawsuit-accuses-centene-of-concealing-health-net.html. Retrieved 2022-02-23. {{cite web}}: Missing or empty |title= (help)
  38. ^ "UK's biggest GP chain replacing doctors with less qualified staff". BBC. 13 June 2022. Retrieved 13 June 2022.
  39. ^ "Health Net Federal Services Pays over $97M for Overstated Billings to the VA". www.justice.gov. 2021-04-06. Retrieved 2022-02-23.
  40. ^ Minemyer, Paige (2021-06-14). "Centene to pay more than $140M to settle Medicaid overpayment allegations in Ohio, Mississippi". Fierce Healthcare. Retrieved 2022-02-23.
  41. ^ Minemyer, Paige (2021-06-14). "Centene to pay more than $140M to settle Medicaid overpayment allegations in Ohio, Mississippi". Fierce Healthcare. Retrieved 2022-04-20.
  42. ^ Minemyer, Paige (2021-09-30). "Centene to pay more than $71M to settle Medicaid overpayment cases in Illinois, Arkansas". Fierce Healthcare. Retrieved 2022-04-20.
  43. ^ Raymond, Nate (2022-01-07). "Centene to pay $21 mln to settle New Hampshire overcharge claims". Reuters. Retrieved 2022-04-20.
  44. ^ Minemyer, Paige (2021-12-07). "Centene to pay $27.6M to settle PBM investigation in Kansas". Fierce Healthcare. Retrieved 2022-02-23.

External links[edit]