Centene's Medicare Advantage star ratings for 2023 "are going to be disappointing and unacceptable," according to executives during the company's second-quarter earnings call July 26.
Centene Executive Vice President and CFO Drew Asher said the final scores from CMS will drive 2024 Medicare revenue and that work is ongoing to address the issue and create a rebound in the long-term.
Centene CEO Sarah London said on the call that the reason for the lowered star ratings stems from the company's acquisition of WellCare Health Plans in 2020 for $17 billion, which tripled Medicare business.
The two companies were "operating in fundamentally different models," and WellCare was centralized while Centene was not.
"It's very hard to run an enterprise quality program at our level of size and scale in a decentralized model. And then we send everybody home for COVID," Ms. London said.
Ms. London said the company has now baked in quality performance as a top priority and short-term incentive for all employees, and executives are analyzing 2022 performance to determine how to improve 2025 revenues.