Centene Corporation

Centene Corporation
Company type	Public
Industry	Healthcare
Predecessor	Managed Health Services
Founded	1984; 42 years ago in Milwaukee, Wisconsin, United States
Founder	Elizabeth Brinn
Headquarters	St. Louis, United States
Area served	United States, United Kingdom
Key people	Sarah London (CEO), Susan Smith (COO)
Products	Medicaid, ACA health insurance marketplace, Medicare, Tricare, Correctional healthcare
Revenue	$163 billion (2024)
Net income	$3.31 billion (2024)
Number of employees	60,500 (2024)
Website	www.centene.com

Centene Corporation is a U.S.-based for-profit healthcare organization headquartered in St. Louis, Missouri. Acting as a facilitator for government-funded and privately insured healthcare programs, it was positioned at No. 25 on the 2023 Fortune 500 ranking.

History

Established in 1984 by entrepreneur Elizabeth Brinn under the name Managed Health Services in Milwaukee, Wisconsin, Centene evolved from a non-profit entity into a publicly traded company following Brinn's passing, with the proceeds benefiting the Betty Brinn Foundation, a principal shareholder. Michael Neidorff took the helm as CEO in 1996 and steered the company through substantial expansion. Centene launched its initial public offering in December 2001.

Centene’s growth approach involves broadening its managed care offerings alongside pharmacy benefit management services. The acquisition of US Script in 2006 led to the creation of its Envolve subsidiaries. In 2011, Centene entered the correctional healthcare sector with Centurion and completed the full acquisition of MHM Services by 2018. The company also extended its reach into state Medicaid programs through Affordable Care Act marketplaces beginning in 2014.

Major acquisitions have been instrumental in increasing Centene’s market presence: Health Net and Trillium Community Health Plan between 2015 and 2016; Fidelis Care for $3.75 billion in 2017; WellCare for $17.3 billion in 2019; and Magellan Health for $2.2 billion, finalized in 2022. These purchases expanded Centene’s portfolio across health insurance and behavioral health services.

On the international front, Centene commenced acquiring healthcare assets in the United Kingdom starting in 2017. Its subsidiary MH Services acquired a 40% share of Circle Health in 2019, gained full ownership by 2021, and later sold it to PureHealth in August 2023. Additionally, Operose Health, another UK-based subsidiary, acquired AT Medics early in 2021 to broaden its primary care network.

In May 2022, Centene divested its pharmacy benefit management units Magellan Rx and PANTHERx Rare for $2.8 billion, marking a strategic withdrawal from that market segment.

Current leadership includes CEO Sarah London and COO Susan Smith. As of 2024, Centene reports revenues of $163 billion with net earnings of $3.31 billion and employs about 60,500 individuals worldwide.

Business segments

Centene’s core operational areas encompass:

Leadership

In 2020, CEO Michael Neidorff was recognized as the top-earning executive within the U.S. healthcare industry, receiving nearly $25 million in compensation. Following Politan Capital Management's acquisition of a $900 million stake in Centene in December 2021, Neidorff announced his intention to retire by the close of 2022.

Sarah London assumed the role of CEO in March 2022, succeeding Neidorff and bringing specialized knowledge in technology and healthcare strategy to advance Centene’s growth and market position.

Controversies

In 2014, Fox News highlighted that Superior HealthPlan of Texas—a joint venture between Centene and Community Health Centers Network LP serving Medicaid patients—initially denied authorization for brain cancer surgery for an infant at Texas Children's Hospital. Despite previously covering claims for this patient, Superior HealthPlan asserted that procedures at that hospital were excluded from coverage. Three days post-reporting, the plan reversed its stance and approved the procedure.

A class action lawsuit filed in January 2018 alleged that Centene’s Ambetter marketplace plans misled enrollees regarding benefits availability, citing challenges patients faced when seeking providers accepting Centene insurance.

In December 2018, two pension funds initiated legal action against Centene related to its acquisition of Health Net, accusing the company of hiding approximately $1 billion in historical tax obligations alongside an ongoing Medicare fraud probe that could expose significant liabilities.

By 2022, Operose Health—a Centene subsidiary and the largest general practitioner service provider to the NHS with nearly 600,000 registered patients—faced scrutiny over prioritizing profitability by employing physician associates instead of fully qualified GPs. Criticisms included inadequate oversight of these associates and delays in processing medical test results and hospital communications. Operose maintained that 97% of its practices received "good" or "outstanding" ratings from the Care Quality Commission.

Settlements

In April 2021, Health Net Federal Services, a subsidiary of Centene, consented to a $97 million payment to resolve accusations of submitting duplicate or exaggerated claims to the Department of Veterans Affairs.

From June 2021 through January 2022, Centene reached agreements with multiple states—including Ohio, Mississippi, Illinois, Arkansas, and New Hampshire—on behalf of its pharmacy benefit manager unit, Envolve. These agreements addressed Medicaid overpayment allegations and collectively amounted to over $191 million.

In December 2021, Centene disbursed $27.6 million to the state of Kansas to settle disputes regarding undisclosed discounts and profit tactics connected to the state's Medicaid program.

By September 2022, Centene agreed to remit more than $14 million to Massachusetts in order to settle allegations of excessive billing for pharmacy benefits provided through its subsidiaries under the MassHealth Medicaid program.

Additionally, Centene voluntarily informed Florida in 2021 about an overbilling totaling $67 million. Following negotiations with the Agency for Health Care Administration that concluded in 2024, Centene consented to refund this amount, allocating $10 million to the Hope Florida Foundation rather than paying directly to the state.

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