Back with another one. I'm straight spittin' screed for mah peeps. (Dig the alliteration?)
Centene's new CIO said Monday that he's looking forward to “building on the strong foundation already in place.” Sarah London added that his technology leadership will help deliver “improved outcomes for the nation's most underserved populations.” Brad's been there four days, so he gets a pass. But Centene has been talking about focus, simplification, reduced complexity, and strengthening its foundation for years. Let's inspect it.
Hawaii: Aloha, ‘Ohana. Centene's own SEC disclosures say it is transitioning Hawaii operations following Medicaid contract non-renewals. ‘Ohana's Community Care Services business moves to AlohaCare November 1, and its QUEST Integration members transition to other plans January 1. Hawaii didn't eliminate Medicaid managed care. It chose somebody else.
Florida: Sunshine Health currently operates the statewide Children's Medical Services Plan for kids with special healthcare needs. Starting October 1, Molina takes over and existing members move with it. Apparently Florida decided Molina could improve the outcomes of this particular underserved population from here.
Georgia: No interpretation required. Georgia published the procurement scores: Molina 650, CareSource 631, Humana 601, UnitedHealthcare 596, and Peach State/Centene 586. Peach State has operated Georgia Medicaid for roughly two decades. It finished fifth and is protesting the result. After operating in Georgia since 2006, having to protest your way back into your own house probably qualifies as a foundational concern.
Texas: Centene remains a major Medicaid player and retained significant business, but its 2024 STAR/CHIP intended awards covered only three service areas while several competitors received substantially broader footprints. Centene challenged that procurement too.
Centene itself now has the wonderfully efficient sentence “We are in the process of protesting the results of Medicaid procurement awards in Georgia and Texas” in its SEC disclosures. It separately acknowledges the Florida CMS loss and Hawaii transitions.
Arizona isn't one of the cracks. Centene won there before protests and litigation blew up the entire procurement. Illinois is also a legitimate recent win: Meridian received another four-year HealthChoice Illinois contract in July. Credit where credit is due. *
- Longtime readers may remember the Better Government Association's 2022 investigation revealing that the blind trust managing Gov. J.B. Pritzker's assets had purchased Centene stock while Centene was one of Illinois' largest Medicaid contractors. Pritzker's representatives said he had no involvement in either the investment decisions or Centene contracting decisions.
We'll just leave that interesting piece of Illinois history right there.
Here's what makes all of this interesting: these cracks predate Mission Simplify. Texas dates to March 2024 and Georgia to December 2024. Simplify didn't cause them. It inherited them.
That's a much more important test of the current transformation than how many positions disappear, how much work gets outsourced, or how pretty the new next org chart looks. Hawaii, Florida, Georgia, and Texas aren't anonymous employees complaining on the internet. They're customers making purchasing decisions. For a company whose core competency is administering government-sponsored healthcare, that's one he-l of a performance review.
So maybe the foundation really is strong. Mission Simplify now gets to prove it. Because you can simplify the sh-t out of a house with a cracked foundation.
Eventually you're just removing load-bearing walls.