Latest news with #ManagedCare
Globe and Mail
2 days ago
- Business
- Globe and Mail
Is CNC Banking on Membership Growth to Boost Scale & Profitability?
Membership growth is a core driver of Centene Corporation 's CNC earnings model. As a managed-care provider focused on Medicaid, Medicare and ACA marketplace plans, each additional enrollee directly contributes to premium revenues despite rising cost pressure. Expanding the member base not only strengthens top-line growth but also maximizes scale efficiencies by spreading administrative expenses and improving operational productivity. Amid elevated medical inflation and reimbursement headwinds, consistent membership gains are essential for sustaining revenue stability and protecting margins. Centene is delivering solid membership expansion through strong Marketplace and Medicare PDP enrollment, a widened Medicare Advantage presence via its WellCare platform—introducing plans in new counties—upgraded star ratings, innovative benefit features, and focused local and regional growth and retention strategies. Contract wins and market expansion further support medical membership gains. Although Medicaid enrollment has softened, total membership reached 28 million as of June 30, 2025, driven by growth in Marketplace, Individual and Commercial Group, Medicare, and Medicare PDP plans. Membership growth strengthens Centene's scale, profitability and resilience, enabling it to manage market uncertainty with a diverse payer mix and strong positions in government-sponsored programs. While Medicaid provides relative stability, Medicare Advantage offers rapid expansion potential. With healthcare costs trending upward, ongoing membership momentum—fueled by product innovation, geographic reach and community-focused retention—remains a key driver of Centene's sustained earnings power and competitive advantage. What About its Peers? Humana Inc. HUM continues to grow its membership, fueled by Medicare Advantage and state-based programs. As of June 30, 2025, 68% of Humana's 3,542,300 individual Medicare Advantage members were in value-based care. Humana projects a 175,000-250,000 increase in state-based contract membership in 2025. UnitedHealth Group UNH is seeing robust growth in medical membership, fueled by strong demand for commercial and government-supported health plans. UnitedHealth's vertically integrated model delivers coordinated, value-based care, appealing to seniors and employer-sponsored members. To maintain growth, UnitedHealth must emphasize strategic planning and enforce disciplined cost management across its operations. CNC's Price Performance Shares of CNC have lost 55.3% year to date, underperforming the industry. CNC's Cheap Valuation CNC trades at a forward 12-month price-to-earnings of 7.2, below the industry average of 12.1. Estimate Movements for CNC The Zacks Consensus Estimate for CNC's third-quarter and fourth-quarter 2025 EPS witnessed a southward revision over the past seven days. The consensus estimate for full-year 2025 and 2026 EPS also followed suit. The consensus estimate for CNC's 2025 revenues indicates a year-over-year increase but the same for EPS suggests a decline. For 2026, the case is exactly the opposite. CNC stock currently carries a Zacks Rank #5 (Strong Sell). You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here. 7 Best Stocks for the Next 30 Days Just released: Experts distill 7 elite stocks from the current list of 220 Zacks Rank #1 Strong Buys. They deem these tickers "Most Likely for Early Price Pops." Since 1988, the full list has beaten the market more than 2X over with an average gain of +23.5% per year. So be sure to give these hand picked 7 your immediate attention. See them now >> Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report UnitedHealth Group Incorporated (UNH): Free Stock Analysis Report Humana Inc. (HUM): Free Stock Analysis Report Centene Corporation (CNC): Free Stock Analysis Report
Yahoo
5 days ago
- Health
- Yahoo
CareSource hiring nearly 200 employees in Nevada as nonprofit scales to serve new members
New to Nevada nonprofit health plan will provide Medicaid Managed Care and Marketplace options statewide Jayme Puu, CEO of CareSource Nevada LAS VEGAS, Aug. 11, 2025 (GLOBE NEWSWIRE) -- CareSource is actively hiring nearly 200 new employees across Nevada, with offices opening in Las Vegas and Reno later this year and roles available statewide, including rural regions and communities. Open positions span multiple departments and experience levels, including medical and clinical roles such as medical directors, registered nurses, and licensed social workers, as well as mobile care managers, call center representatives, community engagement and marketing professionals, health partners, and rural liaisons. 'We are focused on building a Nevada-based team that reflects the communities we serve,' said Jayme Puu, CEO of CareSource Nevada. 'We're hiring mission-driven professionals who believe health care should be rooted in compassion, dignity, and impact and who will deliver the best service for our members.' This hiring initiative marks a major milestone in CareSource's Nevada expansion. CareSource was recently awarded a contract to implement Nevada's Medicaid Managed Care Program as the program expands statewide, in addition to serving Medicaid members in Nevada's two most populous counties, Clark and Washoe, home to the Las Vegas metropolitan area and the City of Reno. CareSource is Nevada's only nonprofit managed care organization; beginning January 1, 2026 CareSource will provide managed care services in all 17 Nevada counties, as well as qualified health plans through the state's health insurance marketplace, Nevada Health Link. CareSource has received national recognition for its workplace culture. Recent accolades include: Great Place to Work® Certified Military Times Best for Vets: Employers 2024 Fortune Best Workplaces in Health Care 2024 Forbes 2024 America's Best-In-State Employers Interested candidates can apply at ### CareSource Nevada CareSource Nevada is a nonprofit managed care organization that provides access to high quality care to Nevada Medicaid and Nevada Check-Up-eligible residents of the Silver State. CareSource Nevada transforms health care for Nevadans throughout the state through innovative programs that address the social determinants of health, prevention and access to care. Through a robust provider network and partnerships with community-based organizations in every region of Nevada, CareSource Nevada delivers care with heart. Learn more at or follow us at Attachment Jayme Puu, CEO of CareSource Nevada CONTACT: Hannah Krafka CareSource 937-751-4862
Yahoo
26-07-2025
- Business
- Yahoo
HCA Healthcare Inc (HCA) Q2 2025 Earnings Call Highlights: Strong EPS Growth and Strategic ...
Diluted Earnings Per Share: Increased 24% to $6.84. Revenue Growth: 6.4% increase driven by greater demand, improved payer mix, and consistent patient acuity levels. Equivalent Admissions: Increased 1.7% for the quarter and 2.3% for the year. Managed Care Equivalent Admissions: Grew 4% year-to-date. Medicare Growth: 3%, slightly below expectations. Adjusted EBITDA Margin: Improved by 30 basis points compared to the prior-year quarter. Adjusted EBITDA Growth: 8.4% over the prior-year quarter. Cash Flow from Operations: $4.2 billion in the quarter. Capital Expenditures: $1.2 billion in the second quarter. Share Repurchases: $2.5 billion in the second quarter. Dividends: $171 million in the second quarter. 2025 Revenue Guidance: Expected to range between $74 billion and $76 billion. 2025 Net Income Guidance: Expected to range between $6.11 billion and $6.48 billion. 2025 Adjusted EBITDA Guidance: Expected to range between $14.7 billion and $15.3 billion. 2025 Diluted EPS Guidance: Expected to range between $25.50 and $27. 2025 Capital Spending Guidance: Approximately $5 billion. Warning! GuruFocus has detected 4 Warning Signs with UVE. Release Date: July 25, 2025 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Positive Points HCA Healthcare Inc (NYSE:HCA) reported a strong financial performance for the second quarter of 2025, with a 24% increase in diluted earnings per share to $6.84. The company experienced solid revenue growth of 6.4%, driven by increased demand for services, improved payer mix, and consistent patient acuity levels. HCA Healthcare Inc (NYSE:HCA) improved quality outcomes, throughput measures in emergency rooms, and patient satisfaction during the quarter. The company increased its 2025 guidance, reflecting a positive demand environment and the effectiveness of strategic initiatives. HCA Healthcare Inc (NYSE:HCA) maintained a strong balance sheet and executed a balanced capital allocation strategy, including $4.2 billion in cash flow from operations and $2.5 billion in share repurchases. Negative Points Medicaid volumes were down slightly, and self-pay volumes were below expectations, representing the lowest reimbursing payers. The company anticipates some people will lose insurance coverage due to the expiration of enhanced premium tax credits, which could impact financial performance. HCA Healthcare Inc (NYSE:HCA) faces challenges from the One Big Beautiful Bill Act, which includes potential adverse impacts from Medicaid components and exchange provisions. The company experienced underperformance in a couple of markets, which offset some of the better performance in hurricane-affected markets. Supply expenses increased slightly as a percentage of revenue due to increased spending on cardiac-related devices. Q & A Highlights Q: Can you elaborate on the guidance update, particularly regarding the Tennessee DPP program and the modest tweak on admissions numbers? A: Michael Marks, CFO, explained that the $300 million increase in guidance is split equally between state supplemental payment programs, including the new Tennessee program, and better-than-expected performance in their portfolio. The Tennessee program is expected to start contributing cash in the latter half of the year. The admissions number was adjusted due to lower-than-expected Medicaid and self-pay volumes, but overall, the portfolio is performing well. Q: Could you provide more details on your resiliency programs, especially in light of the potential expiration of subsidies? A: Michael Marks stated that HCA is developing resiliency programs to offset potential adverse impacts from the expiration of enhanced premium tax credits (EPTCs). These efforts include benchmarking corporate departments, operational improvements, and leveraging automation and digital transformation. More details will be provided in the fourth-quarter earnings call. Q: What are you seeing in terms of commercial volume trends, and how might consumer confidence affect this? A: Michael Marks noted that managed care equivalent admissions are up 4% year-to-date, aligning with expectations. Exchange volumes are slightly better than expected, while traditional commercial volumes are slightly below. CEO Sam Hazen added that healthcare demand appears inelastic, and they haven't observed significant changes in consumer confidence affecting volumes. Q: How is HCA managing market share and local market dynamics, especially with high utilization rates reported by payers? A: CEO Sam Hazen highlighted sustained market share gains across service lines and markets. HCA is investing in network integrity and capacity to meet demand and achieve share gains. Despite some competitive dynamics, HCA remains agile and confident in its market positioning. Q: Can you provide insights into the impact of the One Big Beautiful Bill Act and the expiration of EPTCs on long-term guidance? A: Michael Marks stated that HCA's financial resiliency program should offset near-term impacts from the Act's exchange provisions. Long-term, HCA expects to manage impacts through phased reforms and potential supplemental payment approvals. The outcome of EPTCs is uncertain, but HCA is preparing resiliency plans to mitigate adverse effects. For the complete transcript of the earnings call, please refer to the full earnings call transcript. This article first appeared on GuruFocus. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Associated Press
10-06-2025
- Business
- Associated Press
Black Book Research Demonstrates Two-Decade Commitment to Excellence in Managed Care Industry Insights
In-Depth, Transparent Industry Studies Highlight Leading IT Solutions, Managed Services, Outsourcing, and Advisory Firms Serving Health Plans Since 2004; AHIP Conference to Showcase Top Vendor Recognitions LAS VEGAS, NV / ACCESS Newswire / June 10, 2025 / Ahead of next week's AHIP Annual Conference in Las Vegas, Black Book Research highlights its long-standing commitment to providing comprehensive, unbiased, and actionable insights within the Managed Care sector. Since 2004, Black Book has conducted rigorous surveys and studies focused on IT solutions, managed services, outsourcing partners, and consulting and advisory firms dedicated to supporting health plan operations. Renowned for its detailed methodology and transparency for commercial insurance tech, Black Book surveys delve deeply into the operational efficiencies, technological advancements, and strategic complexities faced by health plan organizations. Its extensive surveys evaluate more than 50 specific categories of software and services within managed care, capturing the unfiltered voice of end-users and stakeholders. Black Book's unbiased results offer unmatched clarity, empowering managed care organizations to make informed decisions based on real-world experiences. At the upcoming AHIP conference, June 16 - 18, 2025, in Las Vegas, Black Book Research will spotlight the top-performing IT vendors serving the managed care industry, recognizing outstanding performance in user satisfaction, innovation, and operational excellence in dozens of software and managed services categories. Curently Featured Q2 2025 Reports and Deep-Dive Analyses (Each of these detailed studies is available for full and complimentary access to all managed care stakeholders through Black Book Research's website, facilitating transparent knowledge sharing and industry growth. All four press releases are also available in the Black Book Newswire media room at providing direct access for industry stakeholders.) Ensuring Real-Time Compliance and Operational Excellence: Technology Strategies Used by 5-Star Medicare Advantage Plans (Released May 2025) This report explores strategic technological deployments in Medicare Advantage (MA) organizations that consistently achieve top-tier star ratings. It emphasizes how leading MA plans employ IT for real-time compliance, provider integration, and efficient operational management under intensified CMS audit pressures. Optimizing Member Experience: Technology Strategies Behind Elite Medicare Advantage Plans' Success (Released May 2025) Detailing digital strategies that underpin superior member engagement and satisfaction, this study underscores best practices and IT innovations adopted by elite MA plans to improve CAHPS and NPS performance scores. Technology Driving Performance: How Elite MA Plans Leverage Data, Care Coordination, and Advanced Analytics (Released May 2025) This comprehensive analysis outlines the impactful use of data analytics, AI-driven insights, and sophisticated care coordination technologies by high-performing MA plans, demonstrating their strategies to achieve operational excellence and regulatory compliance. The Elite 50 Technology Vendors Driving Medicare Advantage 5-Star Ratings Amid Heightened CMS Audit Standards: An Industry Resource (Released May 2025) A pivotal report identifying and ranking the top 50 IT vendors whose solutions directly contribute to achieving and sustaining high Medicare Advantage star ratings. The detailed vendor evaluations reveal critical technology capabilities that ensure CMS compliance and performance success. Each of these detailed studies is available for full and complimentary access to all managed care stakeholders through Black Book Research's website, facilitating transparent knowledge sharing and industry growth. See The Rapid Expansion of Healthcare Outsourcing (Released April 2025) Also includes vendor evaluations and insights into the managed services and outsourced/offshored niches of the managed care industry. It is available for download at AHIP Conference Recognition and Ongoing Commitment Black Book Research will publicly acknowledge the distinguished IT vendors who have consistently demonstrated superior client satisfaction, measurable outcomes, and innovation at the AHIP 2025 Conference. Additionally, Black Book experts will be on-site to engage with attendees, offer strategic insights, and further deepen the conversation about industry trends shaping the future of managed care. 'We have maintained an unwavering commitment to provide the managed care industry with actionable insights derived directly from healthcare leaders and technology users,' said Doug Brown, Founder of Black Book Research. 'Our detailed approach ensures stakeholders access the most relevant and transparent evaluations available, positioning them effectively to respond to emerging challenges and capitalize on transformative opportunities.' To explore these comprehensive managed care industry studies and access the reports at no cost, visit About Black Book Research For over twenty years, Black Book Research has delivered impartial, robust market research and industry analysis across international managed services, outsourcing and the healthcare technology sectors. Known for transparency, meticulous data collection, and unmatched industry expertise, Black Book is trusted by health plans, providers, technology vendors, investors, and consulting firms globally. Several gratis reports on industry top vendors and current trends are available for download on the Black Book website. Contact InformationPress Office 8008637590 SOURCE: Black Book Research press release
