First Quarter Highlights
- Quarter-end managed care at-risk membership of 1.25 million.
- Revenues of
$932.4 million , or$908.9 million net of premium taxes. - Health Benefits Ratio (HBR), which reflects medical costs as a percent of premium revenues, of 83.5%.
- General and administrative (G&A) expense ratio of 13.5%.
- Cash flow from operations of
$23.4 million . - Days in claims payable of 45.3.
- Diluted earnings per share from continuing operations of
$0.43 .
Other Events
- In
February 2009 , we began converting non-risk managed care membership inFlorida fromAccess Health Solutions, LLC , or Access, to our wholly owned subsidiary, Sunshine State Health Plan on an at-risk basis. We previously accounted for ourFlorida investment using the equity method of accounting. Beginning with the first quarter of 2009, we have reported our investment in Access as a consolidated subsidiary in our financial statements. - In
March 2009 , we completed the previously announced acquisition of certain assets of Amerigroup Community Care ofSouth Carolina . - In
March 2009 , our Celtic unit was awarded a contract inMassachusetts to serve uninsured individuals through a joint venture with a leading, local provider, Caritas Christi Health Care. EffectiveJuly 1, 2009 , the joint venture will serve the Central, Northern,Boston and Southern regions operating as CeltiCare Health Plan ofMassachusetts . - We were awarded Silver Honors for Best Practices in
Health Management by URAC, a leading healthcare accreditation organization, for Connections PLUS, a free, pre-programmed cell phone program developed for high-risk members who do not have steady access to a telephone.
The following table depicts membership in Centene’s managed care organizations, by state, at
March 31, | ||||||
2009 | 2008 | |||||
Arizona | 15,500 | — | ||||
Florida | 29,100 | — | ||||
Georgia | 289,300 | 282,700 | ||||
Indiana | 179,100 | 161,300 | ||||
Ohio | 137,000 | 131,100 | ||||
South Carolina | 48,500 | 2,200 | ||||
Texas | 421,100 | 365,500 | ||||
Wisconsin | 127,700 | 126,900 | ||||
Total at-risk membership | 1,247,300 | 1,069,700 | ||||
Non-risk membership | 96,000 | 30,600 | ||||
Total | 1,343,300 | 1,100,300 |
The following table depicts membership in Centene’s managed care organizations, by member category, at
March 31, | ||||||
2009 | 2008 | |||||
Medicaid | 921,100 | 802,400 | ||||
CHIP & Foster Care | 256,900 | 206,300 | ||||
ABD & Medicare | 69,300 | 61,000 | ||||
Total at-risk membership |
1,247,300 | 1,069,700 | ||||
Non-risk membership | 96,000 | 30,600 | ||||
Total | 1,343,300 | 1,100,300 |
Statement of Operations
- For the 2009 first quarter, revenues, net of premium taxes, increased 20.0% to
$908.9 million from$757.3 million in the 2008 first quarter. The increase was primarily driven by membership growth, especially related to the Foster Care contract inTexas , the commencement of ourArizona acute care contract inOctober 2008 , the consolidation of Access and conversion of members to at-risk, premium rate increases and the recent acquisition of Celtic inJuly 2008 . - The consolidated HBR, which reflects medical costs as a percent of premium revenues, was 83.5%, an increase from 82.7% in the 2008 first quarter. The retroactive
Georgia premium rate increase in the first quarter of 2008 had the effect of decreasing the HBR for this period by 2.4%. Adjusting for the impact due to theGeorgia rate increase, our HBR decreased from 85.1% in 2008 to 83.5% in 2009. This is due to a decrease in respiratory illness as a result of a lighter cold and flu season. Sequentially, our consolidated HBR increased from 82.3% in the 2008 fourth quarter to 83.5% as a result of normal seasonality and the addition of a new state and acquired members. - Consolidated G&A expense as a percent of premium and service revenues was 13.5% in the first quarter of 2009, an increase from 12.6% in the first quarter of 2008. The retroactive
Georgia premium rate increase in the first quarter of 2008 had the effect of decreasing the G&A ratio for this period by 0.4%. Adjusting for the impact due to theGeorgia rate increase, our G&A expense ratio increased from 13.0% in 2008 to 13.5% in 2009. G&A increased in the quarter endedMarch 31, 2009 compared to 2008 primarily due to the acquisition of Celtic. Sequentially, our G&A ratio decreased from 13.8% in the fourth quarter of 2008 to 13.5% in the first quarter of 2009.
Balance Sheet and Cash Flow
At
A reconciliation of the Company’s change in days in claims payable from the immediately preceding quarter-end is presented below:
Days in claims payable, December 31, 2008 | 48.5 | |||
Timing of claims payments | (1.4 | ) | ||
Change in medical cost mix | (1.0 | ) | ||
High dollar claims inventory reduction | (0.7 | ) | ||
Other | (0.1 | ) | ||
Days in claims payable, March 31, 2009 * | 45.3 | |||
* The Company has used a consistent and conservative actuarial reserving methodology and the decline in days in claims payable was not the result of a reserve release. |
Outlook
The table below depicts the Company’s annual guidance for 2009:
Full Year 2009 | ||||||||
Low | High | |||||||
Revenue (in millions)1 | $ | 3,650 | $ | 3,775 | ||||
Earnings per diluted share | $ | 1.84 | $ | 1.94 | ||||
|
||||||||
1 Revenue net of premium tax |
The Company is adjusting the lower end of its earnings guidance to reflect a lower effective tax rate which is partially offset by the startup costs associated with the new Massachusetts CeltiCare contract that commences
Conference Call
As previously announced, the Company will host a conference call
About
The information provided in this press release contains forward-looking statements that relate to future events and future financial performance of
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS (In thousands, except share data) |
||||||||
March 31, 2009 |
December 31, 2008 |
|||||||
(Unaudited) | ||||||||
ASSETS | ||||||||
Current assets: | ||||||||
Cash and cash equivalents of continuing operations | $ | 334,623 | $ | 370,999 | ||||
Cash and cash equivalents of discontinued operations | 7,606 | 8,100 | ||||||
Total cash and cash equivalents | 342,229 | 379,099 | ||||||
Premium and related receivables, net of allowance for uncollectible accounts of $138 and $595, respectively | 147,899 | 92,531 | ||||||
Short-term investments, at fair value (amortized cost $74,780 and $108,469, respectively) | 75,400 | 109,393 | ||||||
Other current assets | 63,497 | 75,333 | ||||||
Current assets of discontinued operations other than cash | 8,226 | 9,987 | ||||||
Total current assets | 637,251 | 666,343 | ||||||
Long-term investments, at fair value (amortized cost $416,265 and $329,330, respectively) | 422,873 | 332,411 | ||||||
Restricted deposits, at fair value (amortized cost $12,660 and $9,124, respectively) | 12,774 | 9,254 | ||||||
Property, software and equipment, net of accumulated depreciation of $80,742 and $74,194, respectively | 176,719 | 175,858 | ||||||
Goodwill | 218,216 | 163,380 | ||||||
Intangible assets, net | 23,603 | 17,575 | ||||||
Other long-term assets | 34,077 | 59,083 | ||||||
Long-term assets of discontinued operations | 27,317 | 27,248 | ||||||
Total assets | $ | 1,552,830 | $ | 1,451,152 | ||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||
Current liabilities: | ||||||||
Medical claims liability | $ | 372,522 | $ | 373,037 | ||||
Accounts payable and accrued expenses | 194,132 | 219,566 | ||||||
Unearned revenue | 63,336 | 17,107 | ||||||
Current portion of long-term debt | 20,608 | 255 | ||||||
Current liabilities of discontinued operations | 30,865 | 31,013 | ||||||
Total current liabilities | 681,463 | 640,978 | ||||||
Long-term debt | 269,711 | 264,637 | ||||||
Other long-term liabilities | 51,434 | 43,539 | ||||||
Long-term liabilities of discontinued operations | 700 | 726 | ||||||
Total liabilities | 1,003,308 | 949,880 | ||||||
Commitments and contingencies | ||||||||
Stockholders’ equity: | ||||||||
Common stock, $.001 par value; authorized 100,000,000 shares; issued and outstanding 43,159,131 and 42,987,764 shares, respectively | 43 | 43 | ||||||
Additional paid-in capital | 227,327 | 222,841 | ||||||
Accumulated other comprehensive income: | ||||||||
Unrealized gain on investments, net of tax | 5,136 | 3,152 | ||||||
Retained earnings | 293,694 | 275,236 | ||||||
Total Centene stockholder’s equity | 526,200 | 501,272 | ||||||
Non-controlling interest | 23,322 | — | ||||||
Total stockholders’ equity | 549,522 | 501,272 | ||||||
Total liabilities and stockholders’ equity | $ | 1,552,830 | $ | 1,451,152 |
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS (In thousands, except share data) |
||||||||||
Three Months Ended
March 31, |
||||||||||
2009 | 2008 | |||||||||
(Unaudited) | ||||||||||
Revenues: | ||||||||||
Premium | $ | 885,006 | $ | 736,814 | ||||||
Premium tax | 23,580 | 21,884 | ||||||||
Service | 23,849 | 20,530 | ||||||||
Total revenues | 932,435 | 779,228 | ||||||||
Expenses: | ||||||||||
Medical costs | 739,340 | 609,374 | ||||||||
Cost of services | 15,962 | 16,176 | ||||||||
General and administrative expenses | 122,279 | 95,493 | ||||||||
Premium tax | 23,942 | 21,884 | ||||||||
Total operating expenses | 901,523 | 742,927 | ||||||||
Earnings from operations | 30,912 | 36,301 | ||||||||
Other income (expense): | ||||||||||
Investment and other income | 3,613 | 7,582 | ||||||||
Interest expense | (3,986 | ) | (3,994 | ) | ||||||
Earnings from continuing operations, before income tax expense | 30,539 | 39,889 | ||||||||
Income tax expense | 10,845 | 14,956 | ||||||||
Earnings from continuing operations, net of income tax expense | 19,694 | 24,933 | ||||||||
Discontinued operations, net of income tax (benefit) expense of $(160) and $264 | (449 | ) | 690 | |||||||
Net earnings | 19,245 | 25,623 | ||||||||
Less: Non-controlling interest | 787 | ― | ||||||||
Net earnings attributable to Centene Corporation | $ | 18,458 | $ | 25,623 | ||||||
Amounts attributable to Centene Corporation common shareholders: | ||||||||||
Earnings from continuing operations, net of income tax expense | 18,907 | 24,933 | ||||||||
Discontinued operations, net of income tax (benefit) expense | (449 | ) | 690 | |||||||
Net earnings | $ | 18,458 | $ | 25,623 | ||||||
Net earnings (loss) per share attributable to Centene Corporation: | ||||||||||
Basic: | ||||||||||
Continuing operations | $ | 0.44 | $ | 0.57 | ||||||
Discontinued operations | (0.01 | ) | 0.02 | |||||||
Earnings per common share | $ | 0.43 | $ | 0.59 | ||||||
Diluted: | ||||||||||
Continuing operations | $ | 0.43 | $ | 0.56 | ||||||
Discontinued operations | (0.01 | ) | 0.01 | |||||||
Earnings per common share | $ | 0.42 | $ | 0.57 | ||||||
Weighted average number of shares outstanding: | ||||||||||
Basic | 43,067,992 | 43,538,207 | ||||||||
Diluted | 44,238,863 | 44,742,893 |
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS (In thousands) |
||||||||||
Three Months Ended March 31, | ||||||||||
2009 | 2008 | |||||||||
(Unaudited) | ||||||||||
Cash flows from operating activities: | ||||||||||
Net earnings | $ | 19,245 | $ | 25,623 | ||||||
Adjustments to reconcile net earnings to net cash provided by operating activities | ||||||||||
Depreciation and amortization | 10,233 | 7,798 | ||||||||
Stock compensation expense | 3,789 | 4,013 | ||||||||
Loss on sale of investments, net | 439 | 28 | ||||||||
Deferred income taxes | 2,282 | 9,472 | ||||||||
Changes in assets and liabilities — | ||||||||||
Premium and related receivables | (39,396 | ) | 8,612 | |||||||
Other current assets | (1,397 | ) | (2,634 | ) | ||||||
Other assets | (497 | ) | (1,031 | ) | ||||||
Medical claims liabilities | (1,232 | ) | 11,608 | |||||||
Unearned revenue | 44,507 | (41,788 | ) | |||||||
Accounts payable and accrued expenses | (15,277 | ) | 4,489 | |||||||
Other operating activities | 722 | 526 | ||||||||
Net cash provided by operating activities | 23,418 | 26,716 | ||||||||
Cash flows from investing activities: | ||||||||||
Capital expenditures | (11,157 | ) | (19,879 | ) | ||||||
Purchases of investments | (292,964 | ) | (86,025 | ) | ||||||
Sales and maturities of investments | 224,312 | 70,888 | ||||||||
Investments in acquisitions, net of cash acquired, and investment in equity method investee | (5,191 | ) | (2,194 | ) | ||||||
Net cash used in investing activities | (85,000 | ) | (37,210 | ) | ||||||
Cash flows from financing activities: | ||||||||||
Proceeds from exercise of stock options | 890 | 1,148 | ||||||||
Proceeds from borrowings | 108,000 | 26,005 | ||||||||
Payment of long-term debt | (82,573 | ) | (17,148 | ) | ||||||
Dividend to non-controlling interest | (1,181 | ) | ― | |||||||
Excess tax benefits from stock compensation | (17 | ) | 2,638 | |||||||
Common stock repurchases | (407 | ) | (6,953 | ) | ||||||
Net cash provided by financing activities | 24,712 | 5,690 | ||||||||
Net decrease in cash and cash equivalents | (36,870 | ) | (4,804 | ) | ||||||
Cash and cash equivalents, beginning of period | 379,099 | 268,584 | ||||||||
Cash and cash equivalents, end of period | $ | 342,229 | $ | 263,780 | ||||||
Supplemental disclosures of cash flow information: | ||||||||||
Interest paid | $ | 724 | $ | 463 | ||||||
Income taxes paid | $ | 18,602 | $ | 792 |
CENTENE CORPORATION
CONTINUING OPERATIONS SUPPLEMENTAL FINANCIAL DATA |
|||||||||||||||||||||||||
Q1 | Q4 | Q3 | Q2 | Q1 | |||||||||||||||||||||
2009 | 2008 | 2008 | 2008 | 2008 | |||||||||||||||||||||
MEMBERSHIP | |||||||||||||||||||||||||
Managed Care: | |||||||||||||||||||||||||
Arizona | 15,500 | 14,900 | — | — | — | ||||||||||||||||||||
Florida | 29,100 | — | — | — | — | ||||||||||||||||||||
Georgia | 289,300 | 288,300 | 283,900 | 278,800 | 282,700 | ||||||||||||||||||||
Indiana | 179,100 | 175,300 | 172,400 | 161,700 | 161,300 | ||||||||||||||||||||
Ohio | 137,000 | 133,400 | 132,500 | 137,300 | 131,100 | ||||||||||||||||||||
South Carolina | 48,500 | 31,300 | 26,600 | 22,500 | 2,200 | ||||||||||||||||||||
Texas | 421,100 | 428,000 | 433,200 | 423,700 | 365,500 | ||||||||||||||||||||
Wisconsin | 127,700 | 124,800 | 122,500 | 124,800 | 126,900 | ||||||||||||||||||||
Total at-risk membership | 1,247,300 | 1,196,000 | 1,171,100 | 1,148,800 | 1,069,700 | ||||||||||||||||||||
Non-risk membership | 96,000 | 3,700 | 3,700 | 3,500 | 30,600 | ||||||||||||||||||||
TOTAL | 1,343,300 | 1,199,700 | 1,174,800 | 1,152,300 | 1,100,300 | ||||||||||||||||||||
Medicaid | 921,100 | 877,400 | 850,500 | 828,700 | 802,400 | ||||||||||||||||||||
SCHIP & Foster Care | 256,900 | 257,300 | 261,800 | 256,900 | 206,300 | ||||||||||||||||||||
ABD & Medicare | 69,300 | 61,300 | 58,800 | 63,200 | 61,000 | ||||||||||||||||||||
Total at-risk membership | 1,247,300 | 1,196,000 | 1,171,100 | 1,148,800 | 1,069,700 | ||||||||||||||||||||
Non-risk membership | 96,000 | 3,700 | 3,700 | 3,500 | 30,600 | ||||||||||||||||||||
TOTAL | 1,343,300 | 1,199,700 | 1,174,800 | 1,152,300 | 1,100,300 | ||||||||||||||||||||
Specialty Services(a): | |||||||||||||||||||||||||
Cenpatico Behavioral Health | |||||||||||||||||||||||||
Arizona | 104,700 | 105,000 | 102,400 | 99,400 | 97,900 | ||||||||||||||||||||
Kansas | 40,600 | 41,100 | 40,100 | 40,000 | 39,400 | ||||||||||||||||||||
Bridgeway Health Solutions | |||||||||||||||||||||||||
Long-term Care | 2,300 | 2,100 | 1,900 | 1,800 | 1,700 | ||||||||||||||||||||
TOTAL | 147,600 | 148,200 | 144,400 | 141,200 | 139,000 | ||||||||||||||||||||
(a) Includes external Specialty Service membership only. |
|||||||||||||||||||||||||
REVENUE PER MEMBER(b) | $ | 220.29 | $ | 218.52 | $ | 213.28 | $ | 214.76 | $ | 215.39 | |||||||||||||||
CLAIMS(b) | |||||||||||||||||||||||||
Period-end inventory |
325,000 |
|
269,300 |
|
323,200 |
|
389,100 |
|
411,700 |
|
|||||||||||||||
Average inventory | 267,600 | 288,600 | 298,400 | 235,300 | 285,700 | ||||||||||||||||||||
Period-end inventory per member | 0.26 | 0.23 | 0.28 | 0.34 | 0.37 | ||||||||||||||||||||
(b) Revenue per member and claims information are presented for the Medicaid Managed Care segment for at-risk members. |
Q1 | Q4 | Q3 | Q2 | Q1 | |||||||||||||||||||||
2009 | 2008 | 2008 | 2008 | 2008 | |||||||||||||||||||||
DAYS IN CLAIMS PAYABLE(c) |
45.3 | 48.5 | 47.9 | 47.8 | 48.3 | ||||||||||||||||||||
(c) Days in Claims Payable is a calculation of Medical Claims Liabilities at the end of the period divided by average claims expense per calendar day for such period. | |||||||||||||||||||||||||
CASH AND INVESTMENTS (in millions) | |||||||||||||||||||||||||
Regulated | $ | 816.8 | $ | 798.0 | $ | 692.6 | $ | 653.1 | $ | 627.1 | |||||||||||||||
Unregulated | 28.9 | 24.1 | 26.8 | 29.0 | 25.8 | ||||||||||||||||||||
TOTAL | $ | 845.7 | $ | 822.1 | $ | 719.4 | $ | 682.1 | $ | 652.9 | |||||||||||||||
DEBT TO CAPITALIZATION(d) |
34.6 | % | 34.6 | % | 34.4 | % | 32.6 | % | 32.8 | % | |||||||||||||||
(d) Debt to Capitalization is calculated as follows: total debt divided by (total debt + total equity). |
OPERATING RATIOS: |
||||||||
Three Months Ended
March 31, |
||||||||
2009 | 2008 | |||||||
Health Benefits Ratios | ||||||||
Medicaid and SCHIP | 84.8 | % | 79.2 | % | ||||
ABD and Medicare | 81.4 | 97.5 | ||||||
Specialty Services | 78.3 | 84.1 | ||||||
Total | 83.5 | 82.7 | ||||||
General & Administrative Expense Ratios | ||||||||
Medicaid Managed Care | 10.3 | % | 9.9 | % | ||||
Specialty Services | 15.7 | 14.9 | ||||||
Total | 13.5 | 12.6 |
MEDICAL CLAIMS LIABILITIES (In thousands) | |||||
Four rolling quarters of the changes in medical claims liabilities are summarized as follows: | |||||
Balance, March 31, 2008 | $ | 323,302 | |||
Acquisitions | 15,398 | ||||
Incurred related to: | |||||
Current period | 2,793,935 | ||||
Prior period | (23,634 | ) | |||
Total incurred | 2,770,301 | ||||
Paid related to: | |||||
Current period | 2,448,657 | ||||
Prior period | 287,822 | ||||
Total paid | 2,736,479 | ||||
Balance, March 31, 2009 | $ | 372,522 |
Centene’s claims reserving process utilizes a consistent actuarial methodology to estimate Centene’s ultimate liability. Any reduction in the “Incurred related to: Prior period” claims may be offset as
Source:
Centene Corporation
Investor Relations Inquiries
Edmund E. Kroll, 212-759-0382
Senior Vice President, Finance & Investor Relations
or
Media Inquiries
Sandy McBride, 314-725-4477
Senior Director, Corporate Marketing & Communications