Centene to exit 'handful' of Medicare Advantage markets in 2025

Centene will exit a handful of state Medicare Advantage markets in 2025, CEO Sarah London said. 

On a July 26 investor call, Ms. London said the exits are designed to align with the company's longer-term strategy. 

"We think the team has done a really good job in terms of thoughtfully designing bids consistent with our long-term strategy, even in a challenging rate year. [We're] being thoughtful about how to streamline that book in further alignment with our Medicaid footprint, because that's where the puck is going," she said. 

Centene is focused on MA plans for beneficiaries eligible for Medicaid and Medicare, Ms. London said. 

Other payers have said they plan to exit Medicare Advantage markets in 2025, as they face rising medical costs and a tougher reimbursement environment. In April, Humana CFO Susan Diamond said the company anticipates leaving some counties and markets in 2025, and expects a decline in membership. 

CVS Health executives said the company could lose up to 10% of its MA members, because of market exits and cuts to supplemental benefits. 

Centene has been working to recover its Medicare Advantage star ratings since 2022, when the percentage of Centene members with four-star or higher plans dropped from 48% to 3%. 

Ms. London told investors the company was making progress toward its goal of having 85% of its members in  plans rated 3.5 stars higher by fall 2025. Currently, 23% of Centene MA members are in contracts rated 3.5 or higher. The insurer's star ratings got a small boost from CMS's recalculated ratings, Ms. London said. 

Centene is tracking to improve its star ratings when CMS publishes new ratings in the fall, Ms. London said. 

"As we sit here today, we are pleased with the progress against our internal expectations and expect [October 2024] ratings to be a meaningful step toward our ultimate goal," she said.

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