I wasn’t planning on posting twice today, but some new numbers crossed the NoCenteam desk, and they definitely need to be discussed.
Bear with me, because I’m diving right in. We’ve already explored a few pieces of this story separately. The new information is what starts tying them together. And when you put the pieces next to each other, the picture isn’t pretty.
Centene recently reaffirmed adjusted EPS guidance above $4.80.[1] Great, that means Wall Street can unclench.
Now let's look at the other report card. CMS just released its 2027 Medicare Advantage Star Ratings, and seven Wellcare contracts landed at just 2.5 stars, covering more than 64,000 members across seven states.[2][3]
Oppenheimer says Centene's average ratings fell 9% year over year.[4] Meanwhile, Humana says approximately 95% of its Medicare Advantage members are now in plans rated four stars or higher, up from just 20% for 2026.[5] Same CMS. Same rating year. So spare us the excuses about the environment being difficult.
Centene paid $17.3 BILLION for WellCare.[6] Now it's cutting roughly a third of its MA plans, bailing out of hundreds of counties, reorganizing the company, eliminating employees, shipping work to vendors, and betting harder on dual-eligible members.[7]
And somehow we're supposed to applaud because EPS is holding up? That's the fu--ing point. The financial numbers can look better because you cut things. Let’s discuss what was cut:
People.
Markets.
Products.
Overhead.
Internal expertise.
Quality doesn't work that way. You don't lay off your way to better care coordination. You don't outsource your way to institutional knowledge. And you sure as he-l don't get four stars because somebody found another few hundred million dollars of "efficiency."
These ratings also aren't some meaningless Consumer Reports sticker. They affect 2028 Medicare Advantage quality bonus payments.[2]
Four stars matters.
2.5 stars matters too. Just not in the way SLT would like.
And remember what Centene keeps selling investors: get Medicare Advantage back toward break-even in 2027 while focusing more heavily on D-SNPs.[7]
In other words, take on more members with complex needs while simultaneously squeezing the operation hard enough to repair the economics.
What could possibly go wrong?
Industry-leading health outcomes with an industry-leading cost structure.
How about we nail the health outcomes part before taking a victory lap on the cost structure?
Centene reports earnings October 27.[8]
Wall Street will undoubtedly ask about EPS, margins, Medicaid rates, and the MA turnaround.
Here's a free question:
If the Medicare Advantage turnaround is actually working, why did the newest quality report card get worse?
You can cut your way to an EPS target. You can’t cut your way to four stars.
Sources
[1] Centene SEC filing, Sept. 16, 2026 — 2026 adjusted EPS guidance reaffirmed above $4.80:
https://www.sec.gov/Archives/edgar/data/1071739/000107173926000172/cnc-20260916.htm
[2] CMS, 2027 Medicare Advantage and Part D Star Ratings, Oct. 8, 2026:
https://www.cms.gov/newsroom/fact-sheets/2027-medicare-advantage-part-d-star-ratings
[3] Becker's Payer Issues, Medicare Advantage contracts rated 2.5 stars or lower, Oct. 9, 2026:
https://www.beckerspayer.com/payer/medicare-advantage/medicare-advantage-plans-with-2-5-stars-or-lower-in-2027/
[4] Reuters, Oct. 8, 2026 — Oppenheimer analysis of 2027 Star Ratings, including Centene's year-over-year decline:
https://www.reuters.com/business/healthcare-pharmaceuticals/cms-says-71-medicare-advantage-prescription-dr-g-enrollees-4-star-or-higher-2026-10-08/
[5] Reuters, Oct. 9, 2026 — Humana reports approximately 95% of MA membership in four-star-or-better plans for 2027 versus 20% for 2026:
https://www.reuters.com/legal/litigation/humana-surges-after-emerging-top-beneficiary-2027-medicare-star-ratings-2026-10-09/
[6] Centene, WellCare acquisition announcement — transaction valued at approximately $17.3 billion:
https://investors.centene.com/2020-01-23-Centene-Completes-Acquisition-of-WellCare
[7] Centene/Wellcare, 2027 Medicare Advantage offerings, Oct. 1, 2026:
https://investors.centene.com/2026-10-01-Wellcare-Unveils-2027-Medicare-Offerings-Focused-on-Affordability-and-Integrated-Care
[8] Centene Investor Relations — Q3 2026 earnings scheduled for Oct. 27:
https://investors.centene.com/