Centene shares slide after fourth-quarter loss and elevated medical costs

Centene Corporation (NYSE: CNC) closed at $39.92, down 2.54% on the day, after reporting fourth-quarter and full-year 2025 results. The company’s market capitalization was approximately $19.60 billion at the latest market close.

Latest Quarterly Results (Q4 2025)

Total revenue for the quarter ended December 31, 2025, was $49,725 million. Premium and service revenues accounted for $44,727 million of the total. The health benefits ratio for the quarter was 94.3%, reflecting higher medical costs during the period. The SG&A expense ratio was 7.5%. Centene reported a GAAP diluted loss per share of $-2.24 for the quarter. Adjusted diluted loss per share was $-1.19. Cash flow provided by operating activities totaled $437 million.

Segment Highlights

Medicaid premium and service revenues totaled $23,045 million in the quarter. Commercial revenues were $10,792 million, while Medicare revenues, including Medicare Advantage and PDP products, were $9,610 million. Other revenue contributed $1,280 million.

Financial Trends

For the full year 2025, total revenue was $194,777 million, and premium and service revenues were $174,581 million. The company reported a GAAP diluted loss per share of $-13.53 for the year and adjusted diluted earnings per share of $2.08. Full-year operating cash flow totaled $5,088 million.

Business & Operations Update

Management highlighted progress in Marketplace normalization and improving Medicaid trends. Medicare PDP membership growth remained a positive contributor during the year. The company continued to focus on claims management, cost discipline, and operating leverage while maintaining a strong liquidity position.

M&A or Strategic Moves

In December 2025, Centene signed a definitive agreement to divest its remaining Magellan Health businesses. The transaction resulted in impairment charges recorded during the quarter. No additional acquisitions were announced.

Equity Analyst Commentary

During the earnings call, discussion focused on drivers of the elevated health benefits ratio, Marketplace morbidity, pharmacy rebate timing, and capital allocation priorities.

Guidance & Outlook — what to watch for

Key items to watch include medical cost trends, health benefits ratio progression, execution of the company’s 2026 earnings plan, and updates related to divestiture timing and reserve development.

Performance Summary

Centene reported higher revenue but a quarterly loss amid elevated medical costs. Fourth-quarter revenue totaled $49,725 million, while adjusted loss per share was $-1.19. Shares declined following the earnings release.