Centene (CNC) Q3 2026 Earnings: EPS -$0.14, Cash Flow -$3.67B
By Chad Hartman
Published · Last updated
Centene (CNC) filed its 10-Q on October 27, 2026 for the quarter ended September 30, showing Q3 2026 revenue of $50.65 billion, up 1.9% year over year, and a diluted loss of $0.14 per share against a $13.50 loss a year earlier. Premium and service revenues grew only 0.5%, and operating cash flow was -$3.67 billion, the lowest of the last 66 quarters. The earnings release, also dated October 27, led with adjusted EPS of $0.58 and a higher outlook; the filing shows what the revenue growth was made of and where the cash went.
| Field | Value |
|---|---|
| Company | Centene ($CNC) |
| Quarter | Q3 FY2026, period ended September 30, 2026 |
| Earnings release | October 27, 2026 (Form 8-K) |
| 10-Q filed | October 27, 2026 |
| Revenue | $50.65 Billion (+1.9% YoY) |
| Diluted EPS | -$0.14 (+99.0% YoY) |
| Operating margin | -0.6% (+13.4 pts YoY) |
| Operating cash flow (TTM) | $4.72 Billion |
| Operating cash flow (Q3) | -$3.67 Billion |
Centene Q3 2026 Revenue, EPS and Margins
Centene's Q3 2026 total revenue was $50.65 billion, up 1.9% from $49.69 billion a year earlier, and diluted EPS was -$0.14 against -$13.50 in Q3 2025. The 99% EPS improvement measures a charge dropping out, not earnings rebuilding.
A reader who saw EPS improve 99% would expect margins to have rebuilt. Instead operating margin was -0.6%, the sixth-lowest of the last 16 quarters, down from 2.2% in Q2 2026.
The Data: The year-ago loss carried a $6,723 million goodwill impairment, or $13.69 per share in the 8-K's reconciliation. Operating income was -$307 million, against $1.20 billion in Q2 2026 and -$6.95 billion in Q3 2025. The health benefits ratio, medical costs as a share of premium revenue, was 92.7%, unchanged from Q3 2025.
Why: Severance and third-party vendor costs of $311 million, which the 10-Q's MD&A ties to enterprise optimization and contract exits, were larger than the $307 million operating loss. Without them the quarter sits near breakeven. An unchanged medical cost ratio means claims did not improve; the impairment left the comparison. The 8-K's adjusted EPS of $0.58 adds back $0.62 per share of those other adjustments and $0.33 of intangible amortization.
The restructuring bill is not finished: the 8-K's guidance footnote expects roughly $355 million to $405 million of severance for 2026, against $294 million booked through nine months.
What Centene's Q3 2026 10-Q Shows Beyond the Press Release
Centene's Q3 2026 premium and service revenues rose 0.5% to $45.1 billion while total revenues rose 1.9%, because premium tax revenue rose 16% to $5.54 billion. Most of the revenue growth is a pass-through.
The Data: Premium tax revenue added $750 million of the $957 million increase in total revenues, about 78%. Premium tax expense rose 15% to $5.62 billion, $75 million more than the revenue it matched. Underneath, total at-risk membership fell 8% to 25.7 million; Marketplace membership dropped from 5.83 million to 3.40 million, and Commercial revenue fell 21%.
Why: The release attributes revenue growth to premium yield, rates and state directed payments; the 10-Q adds that premium tax revenue is driven by state pass-through payments. The pass-through carries no margin. Management's own explanation holds on the Medicare segment, where gross margin rose $161 million; it fails on Commercial, where it fell $158 million.
The filing also carries a cost the release's headline does not: CMS's October 2026 star ratings put about 42% of Centene's Medicare Advantage members in plans rated 3.5 stars or higher, down from about 60%, and the 10-Q says those ratings feed 2028 plan-year revenue.
Centene Q3 2026 Operating Cash Flow, Free Cash Flow and Debt
Centene's Q3 2026 operating cash flow was -$3.67 billion, against $3.59 billion in Q2 2026 and $1.36 billion in Q3 2025. After $194 million of capital expenditure, GeminIQ's pre-calculated Free Cash Flow was -$3.86 billion, the lowest of the last 66 quarters.
The Data: Trailing twelve-month operating cash flow was $4.72 billion, up 16.2% from $4.06 billion, and trailing free cash flow was $3.94 billion. Total debt fell to $15.5 billion from $17.4 billion at December 31, 2025, after $558 million of senior note repurchases in Q3.
Why: The 8-K and the 10-Q both attribute the outflow to the timing of pass-through payments, the same pass-through that lifted revenue. The filing gives no dollar split of that timing, so the explanation is management's and untested by a number. Trailing cash flow staying positive is consistent with it. The release also states $175 million of cash available for general corporate use, against $39.9 billion of cash, investments and restricted deposits, which are largely committed to claims.
Centene's 2026 Guidance After Q3
In its October 27 8-K, Centene guided 2026 adjusted diluted EPS to greater than $5.20, up $0.40 from the greater than $4.80 floor in its prior outlook, and GAAP diluted EPS to greater than $3.46, up from $3.11.
The Data: Nine-month adjusted EPS was $6.45 and GAAP EPS $5.15, both per the 8-K. A floor of $5.20 leaves Q4 adjusted EPS bounded below at about -$1.25; the prior floor allowed about -$1.65. Total revenue guidance rose to $196.5 billion to $200.5 billion from $193.5 billion to $197.5 billion. With $154.17 billion booked through nine months, that implies Q4 revenue of $42.3 billion to $46.3 billion, 9% to 16% below Q3's $50.65 billion.
Why: The company guides a floor, not a range, so it bounds the fourth quarter only from below. The full-year 2026 HBR range of 90.4% to 91.1% sits above the nine-month 89.9%, so the company is guiding to a higher medical cost ratio in Q4.
How CNC Stock Has Moved After Past Earnings Reports
Across Centene's last 12 10-Q filings with completed windows, filed October 24, 2023 to July 28, 2026, the median one-month return was +2.9%, positive after 8 of 12, with a range from -16.4% to +19.3%. These figures describe how Centene's stock moved after its past filings; they are a historical association, not a forecast.
The Data: The three-month median was +10.2%, positive after 7 of 12, from -45.5% to +35.7%. After past Q3 filings the one-month returns were +4.2% (2023), -10.5% (2024) and -2.3% (2025). This filing has no return yet because its window has not elapsed. The GeminIQ Earnings Reaction Heat Map shows each window.
Why: Dispersion dominates direction: the one-month range spans 35.7 points, about 12 times the median.
Institutional holders owned 94.36% of Centene at June 30, 2026 (465.99 million of 493.82 million shares), up 1.56 points from 92.81% a year earlier and the highest of the 12 quarter ends shown. The September 30 13F had not been filed at publication.
In SEC Form 4 filings from August 26, 2025 to August 26, 2026, Centene insiders made 5 sales totaling $14.6 million and no purchases; Kenneth Burdick accounted for $7.7 million and Christopher Koster $6.9 million. In the prior 12 months insiders made 9 purchases totaling $4.0 million, the last on August 8, 2025. The data ends August 26, 2026 and does not cover the weeks after the release.
Whenever revenue growth comes from pass-through payments, the following quarter's cash flow statement is where that growth is confirmed or reversed.
Frequently Asked Questions
Is Centene doing well financially?
Centene's trailing twelve-month net profit margin was 0.72% and operating profit margin 0.49% at September 30, 2026, up from -2.66% and -2.87% a year earlier. Q3 2026 itself was a $71 million net loss, against net earnings of $2.56 billion for the nine months. Trailing ROIC was 3.31% against -19.49% a year earlier, and the current ratio was 1.16x.
What is Centene's current revenue?
Centene's Q3 2026 total revenue was $50.65 billion, and nine-month revenue was $154.17 billion, up 6% from $145.05 billion. By segment in Q3, Medicaid was $29.58 billion, Medicare $11.26 billion, Commercial $8.70 billion and Other $1.10 billion.
Does Centene pay a dividend?
Centene paid no dividends in Q3 2026 or in the trailing twelve months. It reduced debt instead, repurchasing $1.85 billion of par value senior notes in the first nine months of 2026 and redeeming the remaining $569 million of its 2027 notes in October.
When does Centene report earnings?
Centene reported Q3 2026 results and filed its 10-Q on October 27, 2026. Last year it filed its fourth-quarter 2025 results on February 17, 2026, a pattern from the filing record and not a forecast of the next date.
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All financial figures cited in this article reference CENTENE CORPORATION's Q3 2026 10-Q (filed October 27, 2026, period ending September 30, 2026), with guidance and management commentary drawn from the company's Form 8-K earnings release (filed October 27, 2026). All SEC filings are publicly available at SEC EDGAR and SEC EDGAR.
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