Centene

What Centene does

Centene Corporation (NYSE: CNC) is a Fortune 500 managed care organization exclusively focused on government-sponsored healthcare programs. Founded in 1984 and headquartered in St. Louis, Missouri, the company is the largest Medicaid managed care organization and the longest-running carrier on the ACA Health Insurance Marketplace in the United States. Centene serves over 26 million members across all 50 states through locally branded subsidiaries including Health Net (California), WellCare (Medicare), Ambetter (Marketplace), Sunshine Health (Florida), Superior HealthPlan (Texas), Meridian (Michigan), Coordinated Care (Washington), and others. Core product lines include Medicaid managed care, Medicare Advantage and Part D prescription drug plans, and ACA Marketplace plans, with supplementary offerings in long-term services and supports, foster care (Foster Care Centers of Excellence), behavioral healthcare coordination (METS program), and whole-health solutions addressing social determinants of health.

The company's revenue model is built on fixed per-member per-month payments from state Medicaid agencies, the federal government (Medicare/ACA), generating approximately $189.5 billion in projected 2026 revenue. Centene contracts directly with state governments and CMS, distributing healthcare services through contracted provider networks. Technology infrastructure includes advanced analytics and AI/ML tools deployed for forecasting, medical economics analysis, payment integrity, and risk adjustment. The company co-chairs the Coalition for Health AI (CHAI) for responsible AI deployment in Medicaid eligibility workflows. Distribution is primarily through government contracts and state-based exchanges, with emerging channels including ICHRA products, Oscar Health's Lucie Marketplace integration, and Parsley Health in-network coverage.

Centene is currently executing a turnaround following a $6.7 billion net loss in 2025 and 6% membership decline to 26.3 million members. Management has implemented voluntary buyouts to 61,000 employees, restructured executive leadership with new Group President positions (Daniel Finke and Michael Carson, April 2026), and consolidated North Carolina subsidiaries. The company faces regulatory headwinds including an $11.2 million cybersecurity settlement (February 2025), an Arizona price-fixing lawsuit, and OIG findings on maternal health provider directory accuracy. Q1 2026 showed early turnaround signals with $1.5 billion in net earnings, 50bps Medicaid HBR improvement, and SG&A reduction to 7.6% of revenue.

Name

Centene

Legal name

Centene Corporation

Website

https://centene.com

Company type

Public

Founded year

1984

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Centene Corporation is a Fortune 500 government-sponsored managed care organization serving over 26 million members across Medicaid, Medicare, and ACA Marketplace plans in all 50 states, operating as the largest Medicaid MCO in the U.S.

Ownership category

akta.pro rank

Product category

Managed Healthcare Services

NAICS

Direct Life, Health, and Medical Insurance Carriers (52411), Direct Health and Medical Insurance Carriers (524114)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

Medicaid Managed Care HMOs (HLAEAMAI)

akta.pro secondary industries

Medicare Provider Networks & Delegated Medical Groups (MA-focused) (FSAIAGAK), Network-Model HMOs (HLAEAMAC)

Keywords

• Managed care services
• Government-sponsored healthcare
• Medicaid managed care
• Medicare Advantage plans
• ACA Marketplace insurance

Headquarters

HQ city

St Louis

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others

Revenue model

1. Government-Sponsored Healthcare Premium Revenue: Centene receives fixed per-member per-month payments from state Medicaid agencies and the federal government to manage healthcare services while controlling costs. Revenue is derived from Medicaid, Medicare Advantage, Medicare Part D, and ACA Marketplace premiums.
2. Service Revenue: Revenue from providing healthcare services and care coordination through its network of providers

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Centene is a government-sponsored managed care company that provides health insurance and care coordination services through Medicaid, Medicare Advantage/Part D, and ACA Marketplace plans. It serves more than 26 million members across all 50 states via locally branded health plan subsidiaries, delivering access to affordable healthcare, behavioral health, long-term services and supports, and integrated programs addressing social determinants of health.

Product overview

Centene operates as a government-sponsored healthcare enterprise offering a platform of managed care products spanning Medicaid, Medicare Advantage/Part D, and ACA Marketplace plans. The portfolio includes flagship brands (Ambetter marketplace plans, WellCare Medicare plans) alongside locally-branded Medicaid plans (Health Net in California, Superior HealthPlan in Texas, Sunshine Health in Florida, Meridian in Michigan, Coordinated Care in Washington, and others), collectively serving over 26 million members. Whole Health Solutions provides an integrated care layer addressing social determinants of health. Specialty programs include Foster Care Centers of Excellence, the METS behavioral healthcare coordination program, and Long-Term Services & Supports. The company operates as a single platform of government healthcare programs unified by local market branding rather than distinct product lines.

Differentiator

Problem solved

Functional benefit

Brands

• Ambetter Health: Health Insurance Marketplace plans offered by Centene
• METS (Members Empowered to Succeed)

Products and services

• Medicaid Managed Care
• Medicare Advantage and Part D
• ACA Health Insurance Marketplace (Ambetter)
• Whole Health Solutions
• Long-Term Services and Supports
• Foster Care Centers of Excellence
• METS (Members Empowered to Succeed) Program Behavioral healthcare coordination program proactively reaching members with complex behavioral health needs to address care gaps and connect them with benefits and community resources. Active in select Ambetter and Medicaid markets.
• ICHRA (Individual Coverage HRA) Health reimbursement arrangement product allowing employers to provide tax-exempt subsidies for employees to purchase Obamacare coverage, offered in partnership with Ambetter marketplace plans.

Quantifiable outcome

• METS program addressed more than 16,000 preventive and follow-up care gaps in 2025 and over 5,600 additional care gaps in early 2026 while connecting over 2,500 new members to ongoing support
• +4 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability4 records

Feature3 records

Partnerships

Eight partnerships are on record, tiered core and minor.

• McCormack Baron SalazarcoreStrategic or Co-development Partner · 21 May 2024Multi-year partnership with McCormack Baron Salazar (MBS), one of the nation's leading developers of affordable housing, to provide predevelopment loans to advance low-income housing projects. The initiative is anticipated to enable approximately $900 million of direct construction-related activity, supporting the creation of thousands of affordable housing units in low-income communities. MBS has completed 239 housing developments across 27 states and territories over 50 years.
• Self-Help EnterprisescoreStrategic or Co-development PartnerHealth Net, a Centene subsidiary, partnered with Self-Help Enterprises for the Morris Village affordable housing project in Stanislaus County, California, providing $4 million investment to support 45-unit affordable housing development with construction beginning Q4 2026.
• SACOG (Sacramento Area Council of Governments)coreStrategic or Co-development PartnerHealth Net provided $2 million to SACOG's Green Means Go program to support infrastructure for at least 50 affordable housing units in the Sacramento region.
• Mutual Housing CaliforniacoreStrategic or Co-development PartnerHealth Net invested $1 million to Mutual Housing California for phase two of San Juan Apartments, providing permanent affordable housing for over 100 seniors.
• Neighborhood Service Organization (NSO)coreStrategic or Co-development PartnerMeridian in Michigan and the Centene Foundation provided $1.1 million grant to NSO's Medical Respite program at Detroit Healthy Housing Center, serving individuals experiencing homelessness who are too frail to recuperate in an unhoused environment. Expected to serve 165 individuals annually.
• Florida Colleges and Healthcare ProviderscoreStrategic or Co-development PartnerSunshine Health Works workforce development program partners with 12 organizations across Florida including Tallahassee State College, Hillsborough College, Broward College, Florida A&M, Florida State College at Jacksonville, Valencia College, USF Colleges of Nursing and Social Work, G.R.O.W. Doula/Healthy Start, NAMI Florida, Hispanic Unity Florida, and United HomeCare.
• Encompass Housing and National Health Care and Housing AdvisorscoreStrategic or Co-development PartnerHealth Net and Centene Foundation invested $10 million in the Community Care Campus Long Beach partnership to improve health outcomes and accelerate pathways to stable housing for individuals experiencing homelessness.
• Oscar HealthminorChannel Partner/ Reseller/ DistributorOscar Health's Lucie Health Marketplace integrates plans from Centene and other carriers for AI-powered consumer marketplace enabling individuals to shop for major individual health insurance plans.

Scale indicators15 records

Recent moves6 records

Expansion highlights7 records

Broad incumbents

• UnitedHealth Group: The largest U.S. health insurer and managed care company with significant Medicaid, Medicare Advantage, and commercial presence through UnitedHealthcare, plus Optum health services. Directly competes with Centene across all major government-sponsored product lines and is the dominant incumbent in the broader managed care category.
• CVS Health (Aetna): Integrated healthcare company combining Aetna's health insurance business (including Medicaid and Medicare Advantage) with CVS retail pharmacy and Caremark PBM. Competes with Centene across government-sponsored managed care while offering broader integrated care delivery.
• Cigna Group: Major health insurer with Medicare Advantage and ACA Marketplace presence through its Evernorth services business. Less concentrated in Medicaid than Centene but increasingly competing in government-sponsored products.

Direct peers

• Elevance Health: One of the Blue Cross Blue Shield licensees and a major direct competitor to Centene across Medicaid managed care, Medicare Advantage, and ACA Marketplace plans through its Anthem Blue Cross plans. Operates with similar scale and product mix.
• Humana: A leading Medicare Advantage-focused health insurer that also offers Medicaid and commercial group plans. Directly comparable to Centene's Medicare Advantage and Part D businesses and competes in many of the same state Medicaid markets.
• Molina Healthcare: A pure-play government-sponsored managed care company focused on Medicaid and Medicare Advantage, making it the closest direct competitor to Centene's core Medicaid book with similar member demographics and contract structures.
• Oscar Health: Technology-focused ACA Marketplace insurer with growing Medicare Advantage presence. Direct competitor to Centene's Ambetter brand on the individual market exchanges and has been expanding government-sponsored product offerings.

Emerging players

• Alignment Healthcare: Medicare Advantage-focused insurtech company serving seniors in select western states with technology-driven care coordination. Smaller and more focused than Centene's Medicare business but increasingly relevant as a tech-enabled MA competitor.
• Bright Health Group: Technology-enabled health plan offering Medicare Advantage and ACA Marketplace plans in select markets. Represents a smaller, focused competitor to Centene's government-sponsored insurance products in specific geographies.

Others

• Kaiser Permanente: Integrated managed care consortium providing both insurance and care delivery, with significant Medicaid and Medicare Advantage presence in select states. While structured very differently (integrated provider-insurer model), it competes with Centene for government-sponsored members in overlapping geographies.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/centenecorporation
• LinkedInlinkedin.com/company/centene-corporation
• Xx.com/Centene

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Subsidiaries12 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A16 records

Investments14 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Centene