Centene is the largest Medicaid and Marketplace managed care organization (MCO) in the U.S., serving roughly 1 in 15 Americans. Centene acts as a middleman between state and federal governments and healthcare providers: governments pay Centene a fixed monthly premium per member (capitation), and Centene is responsible for delivering healthcare benefits to enrolled members through contracted provider networks. Centene's members are predominantly low-income or medically complex individuals who access healthcare through government-sponsored programs. Centene operates through four segments: Medicaid (~57% of revenue), Commercial (~21%), Medicare (~19%), and Other (~3%). Medicaid covers low-income families, disabled individuals, and dual-eligibles across 30 states, with Centene serving 12.5M members. The Commercial segment is primarily the ACA Marketplace business under the Ambetter brand, where Centene is the largest insurer with 5.5M members. Medicare includes Medicare Advantage under the Wellcare brand and stand-alone Medicare Part D Prescription Drug Plans, where Centene is the largest stand-alone provider with 8.1M members. Centene's economics are driven by the spread between capitation rates paid by governments and the actual cost of healthcare delivered — known as the Health Benefits Ratio (HBR). Centene builds local health plan brands with local leadership while leveraging national scale for data analytics, claims processing, and compliance. Key growth priorities include capturing dual-eligible members through integrated plans, improving Medicare Advantage profitability toward breakeven by 2027, and expanding Individual Coverage Health Reimbursement Arrangement (ICHRA) offerings.