Centene Corporation Reports Fifteenth Consecutive Quarter of Increased Profitability and Implements Multi-Line Strategy.Business Editors ST. LOUIS--(BUSINESS WIRE)--April 30, 2003 Centene Corporation Centene Corporation is in the industry of Medicaid managed care. Centene is a multi-line healthcare enterprise operating primarily in two segments: Medicaid Managed Care and Specialty Services. (Nasdaq: CNTE) today announced its financial results for the quarter ended March 31, 2003. First Quarter Highlights -- Revenues of $177.4 million, an 85% increase over the first quarter of 2002. -- Earnings from operations of $10.1 million, a 62% increase over the first quarter of 2002. -- Earnings per diluted di·lute tr.v. di·lut·ed, di·lut·ing, di·lutes 1. To make thinner or less concentrated by adding a liquid such as water. 2. To lessen the force, strength, purity, or brilliance of, especially by admixture. share of $0.60. -- Organic membership growth of 38% over first quarter of 2002. -- Operating cash flows Operating cash flow Earnings before depreciation minus taxes. Measures the cash generated from operations, not counting capital spending or working capital requirements. of $9.9 million. -- Days in claims payable of 58.1, reflecting reduced claims inventory per member, continuing efficiencies in claims processing, a full quarter consolidation of New Jersey and physician quality bonuses. -- Acquisition of a 63.7% ownership interest in Group Practice Affiliates, an Atlanta-based behavioral behavioral pertaining to behavior. behavioral disorders see vice. behavioral seizure see psychomotor seizure. healthcare services company, and assets of ScriptAssist, a medication medication /med·i·ca·tion/ (med?i-ka´shun) 1. medicine (1). 2. impregnation with a medicine. 3. administration of a medicine or other remedy. compliance company. -- Health benefits ratio of 83.4%, within the Company's target range of 82.0% to 83.5% and at forecasted levels for New Jersey. Michael Michael, archangel Michael (mī`kəl) [Heb.,=who is like God?], archangel prominent in Christian, Jewish, and Muslim traditions. In the Bible and early Jewish literature, Michael is one of the angels of God's presence. F. Neidorff, Centene's president and chief executive officer, said, "This is our first quarter reflecting the implementation of our long-stated strategy of developing a Medicaid Medicaid, national health insurance program in the United States for low-income persons; established in 1965 with passage of the Social Security Amendments and now run by the Centers for Medicare and Medicaid Services. focused, multi-line company. We are pleased to again deliver results that are consistent and in-line In-line Used in the context of general equities. (1) An order or market in a specific security within the inside market; 2) any announcement (earnings) that adheres closely to Wall Street analysts' expectations. with our internal expectations and the diversity of our growing business. These results reflect our first at-risk at-risk adj. Being endangered, as from exposure to disease or from a lack of parental or familial guidance and proper health care: efforts to make the vaccine available to at-risk groups of children. SSI (1) See server-side include and single-system image. (2) (Small-Scale Integration) Less than 100 transistors on a chip. See MSI, LSI, VLSI and ULSI. 1. (electronics) SSI - small scale integration. 2. membership, two new specialty A contract under seal. A specialty is a written document that has been sealed and delivered and is given as security for the payment of a specifically indicated debt. companies, solid margins in our state health plans, and ongoing tight controls over corporate expenses. Our results confirm the premise under which we operate, to work with the states on their budget issues while improving the quality of care and health outcomes of our recipients and diversifying into fee-for-service fee-for-ser·vice adj. Charging a fee for each service performed. business." Neidorff continued, "Consistent with our strategy to diversify diversify To acquire a variety of assets that do not tend to change in value at the same time. To diversify a securities portfolio is to purchase different types of securities in different companies in unrelated industries. our business into areas that affect our managed Medicaid population, we entered into a joint venture with Group Practice Affiliates, a behavioral healthcare company. This investment provides the opportunity to be proactive in an area that is often overlooked by healthcare providers. We are pleased with their progress to date in establishing a presence in Wisconsin Wisconsin, state, United States Wisconsin (wĭskŏn`sən, –sĭn), upper midwestern state of the United States. It is bounded by Lake Superior and the Upper Peninsula of Michigan, from which it is divided by the Menominee , which will support our health plan, starting in the third quarter, and are developing additional outside fee-for-service business. Concurrently con·cur·rent adj. 1. Happening at the same time as something else. See Synonyms at contemporary. 2. Operating or acting in conjunction with another. 3. Meeting or tending to meet at the same point; convergent. , we purchased the assets of ScriptAssist, which promotes adherence adherence /ad·her·ence/ (ad-her´ens) the act or condition of sticking to something. immune adherence to prescription drugs prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, , and integrated them into our NurseWise subsidiary. We will continue to develop opportunities to increase our revenue in this area and work toward our longer-term goal of becoming a multi-line government services provider." "While the fiscal landscape remains challenging for many states, it is clearer than ever that the states are working with us as we help them find constructive (mathematics) constructive - A proof that something exists is "constructive" if it provides a method for actually constructing it. Cantor's proof that the real numbers are uncountable can be thought of as a *non-constructive* proof that irrational numbers exist. solutions to their budget issues. We remain confident that there are significant opportunities to continue to grow our revenue base, expand membership, and complete strategic acquisitions," concluded Neidorff. Membership totaled 419,300 at March 31, 2003, a 68.2% increase from 249,300 at March 31, 2002. The Company experienced solid growth in its Wisconsin and Texas markets during the quarter, while membership in its Indiana Indiana, state, United States Indiana, midwestern state in the N central United States. It is bordered by Lake Michigan and the state of Michigan (N), Ohio (E), Kentucky, across the Ohio R. (S), and Illinois (W). and New Jersey markets was stable. The state of Indiana altered its enrollment process to begin requiring in-person adj. 1. undertaken by an individual in person; as, an in-person appearance s>. Adj. 1. in-person - an appearance carried out personally in someone else's physical presence; "he carried out the negotiations in person"; "a eligibility verification See verify. verification - The process of determining whether or not the products of a given phase in the life-cycle fulfil a set of established requirements. for Medicaid recipients who also receive food stamp food stamp n. A stamp or coupon, issued by the government to persons with low incomes, that can be redeemed for food at stores. Noun 1. benefits. This change temporarily reduced the Company's membership in this category. Centene adopted new procedures to preempt pre·empt or pre-empt v. pre·empt·ed, pre·empt·ing, pre·empts v.tr. 1. To appropriate, seize, or take for oneself before others. See Synonyms at appropriate. 2. a. this issue in the future; however, the unusually inclement in·clem·ent adj. 1. Stormy: inclement weather. 2. Showing no clemency; unmerciful. in·clem weather in Indiana during the first quarter further stalled stall 1 n. 1. A compartment for one domestic animal in a barn or shed. 2. a. A booth, cubicle, or stand used by a vendor, as at a market. b. the implementation measures. New Jersey membership will continue to be consistent, as planned, through the second quarter as the Company builds a solid base in this market. This initial experience is consistent with the Company's past acquisitions in Wisconsin and Texas. The following table depicts membership in Centene's managed care organizations by state at March 31, 2003 and 2002:
2003 2002
--------- ---------
Wisconsin 139,100 114,600
Texas 122,700 57,100
Indiana 104,800 77,600
New Jersey 52,700 -
--------- ---------
TOTAL 419,300 249,300
========= =========
The following table depicts membership in Centene's managed care organizations by member category at March 31, 2003 and 2002:
2003 2002
--------- ---------
Medicaid 344,700 224,900
SCHIP 66,600 21,900
SSI 8,000(a) 2,500(b)
--------- ---------
TOTAL 419,300 249,300
========= =========
(a) 4,200 at-risk; 3,800 ASO
(b) All ASO
The Company is also expanding its disclosure as it relates to claims information to include both period-end claims inventory as well as average claims inventory. While the period-end inventory count has declined over sequential One after the other in some consecutive order such as by name or number. quarters reflecting faster claims payment, the average inventory levels increased with the integration of both University Health Plans and the Texas Universities Health Plan SCHIP SCHIP State Children's Health Insurance Program contracts, which added approximately ap·prox·i·mate adj. 1. Almost exact or correct: the approximate time of the accident. 2. 76,000 members. By example, the University Health Plans transaction closed December December: see month. 1, 2002 and as such, a complete cycle of physician billings Billings, city (1990 pop. 81,151), seat of Yellowstone co., S Mont., on the Yellowstone River, in a valley surrounded by seven mountain ranges; inc. as a city 1885. was not reflected due to a lag in provider claims submission Submission Elliott, Anne reluctantly gives up her fiancé on her family’s advice. [Br. Lit.: Jane Austen Persuasion in Magill I, 734] . Statement of Earnings Highlights -- For the first quarter of 2003, revenues increased 85.3% to $177.4 million from $95.8 million in the first quarter of 2002. Net of acquisitions, revenue growth was $45.6 million, or 47.7%, over the same prior year period. -- The health benefits ratio, which reflects medical services costs as a percent of premium revenues, was 83.4%, with the Medicaid component at 82.4% and compared to 82.5% for the same period in 2002. Both ratios were within the Company's targeted range of 82.0% to 83.5%. The Company experienced an increase in this ratio due to the addition of SSI risk members from its acquisition of 80% of University Health Plans in December 2002. The health benefits ratio for SSI is influenced by a small membership base and is therefore more volatile With regard to computer memory, it means "temporary" and not "highly changeable," which is the usual meaning of the word. See volatile memory. 1. (programming) volatile - volatile variable. 2. (storage) volatile - See non-volatile storage. . As the SSI population reaches critical mass, the ratio for this SSI population is expected to normalize normalize to convert a set of data by, for example, converting them to logarithms or reciprocals so that their previous non-normal distribution is converted to a normal one. in a range of 83.0% to 86.0% percent. -- General and administrative expenses as a percent of revenues on the Company's Medicaid business consistently decreased to 10.5% from 10.7% in the first quarter of 2002. Including the effects of the Company's specialty business, which has a higher level of general and administrative expenses, the consolidated con·sol·i·date v. con·sol·i·dat·ed, con·sol·i·dat·ing, con·sol·i·dates v.tr. 1. To unite into one system or whole; combine: general and administrative expense ratio remained constant at 10.9% quarter over quarter. -- Earnings from operations increased 62.0% to $10.1 million from $6.3 million in 2002. Net earnings improved to $7.2 million, or $0.60 per diluted share, compared to $4.3 million, or $0.38 per diluted share, for the first quarter of 2002. Balance Sheet Highlights At March 31, 2003, the Company had cash and investments of $172.4 million, a portion of which is restricted due to state regulatory requirements Regulatory requirements are part of the process of drug discovery and drug development. Regulatory requirements describe what is necessary for a new drug to be approved for marketing in any particular country. . Medical claims liabilities totaled $94.8 million, representing 58.1 days in claims payable. A full reconciliation of the Company's change in days in claims payable from the immediately preceding quarter is highlighted below:
Full Quarter of New Jersey Medical Expense (7.3)
Physician Quality Bonus (3.3)
Pharmacy Accrual Changes 0.4
Faster Payment Turn-Around (3.1)
Lower Ending Inventory (0.4)
-----------
Total (13.7) days
===========
Outlook Karey L. Witty wit·ty adj. wit·ti·er, wit·ti·est 1. Possessing or demonstrating wit in speech or writing; very clever and humorous. 2. , Centene's chief financial officer, commented, "We anticipate 2003 revenue in the range of $720 million to $730 million and net earnings of $2.59 to $2.64 per share. This does not include the potential impact of any additional acquisitions we may undertake during 2003." Conference Call As previously announced, the Company will host a conference call tomorrow, May 1, 2003, at 8:30 a.m. (Eastern Time) to review the financial results for the first quarter ended March 31, 2003, and to discuss its business outlook. Michael F. Neidorff and Karey L. Witty will host the conference call. Investors are invited to participate in the conference call by dialing (800) 273-1254 in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. and Canada Canada (kăn`ədə), independent nation (2001 pop. 30,007,094), 3,851,787 sq mi (9,976,128 sq km), N North America. Canada occupies all of North America N of the United States (and E of Alaska) except for Greenland and the French islands of , and (706) 679-8592 for international participants, or via a live Internet Internet Publicly accessible computer network connecting many smaller networks from around the world. It grew out of a U.S. Defense Department program called ARPANET (Advanced Research Projects Agency Network), established in 1969 with connections between computers at the broadcast at the Company's website, www.centene.com. A replay of the call will be available from May 1, 2003, shortly after completion of the call and ending on May 14, 2003, at 11:59 p.m. Investors may dial (800) 642-1687 in the United States and (706) 645-9291 from abroad and enter access number 9309238. Additionally, the webcast will be archived for the same period at www.centene.com. About Centene Corporation Centene Corporation provides managed care programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income Supplemental Security Income A Social Security program established to help the blind, disabled, and poor. (SSI), and the State Children's Health Children's Health Definition Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. Insurance Program (SCHIP). The Company operates health plans in Wisconsin, Texas, Indiana and New Jersey. In addition, the Company contracts with other healthcare organizations to provide specialty services including behavioral health Behavioral health was first used in the 1980's to name the combination of the fields mental health and substance abuse. As an example, an organization serving both mental health and substance abuse clients might refer to its practice as behavioral health or , nurse triage triage Division of patients for priority of care, usually into three categories: those who will not survive even with treatment; those who will survive without treatment; and those whose survival depends on treatment. and pharmacy pharmacy, art of compounding and dispensing drugs and medication. The term is also applied to an establishment used for such purposes. Until modern times medication was prepared and dispensed by the physician himself. In the 18th cent. compliance. The information provided in the second, third and fourth paragraphs following the bullet listing under "First Quarter Highlights," the second bullet under "Statement of Earnings Highlights" and the paragraph under "Outlook" above contain forward-looking statements forward-looking statement A projected financial statement based on management expectations. A forward-looking statement involves risks with regard to the accuracy of assumptions underlying the projections. that relate to future events and future financial performance of Centene. These forward-looking statements represent the Company's estimates as of April 30, 2003. Subsequent events and developments may cause the Company's estimates to change. The Company disclaims any obligation to update this forward-looking for·ward-look·ing adj. Concerned with or making provision for the future: forward-looking educators; a forward-looking corporate plan. Adj. 1. financial information in the future. Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory reg·u·late tr.v. reg·u·lat·ed, reg·u·lat·ing, reg·u·lates 1. To control or direct according to rule, principle, or law. 2. , competitive and other factors that may cause Centene's or its industry's actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied Inferred from circumstances; known indirectly. In its legal application, the term implied is used in contrast with express, where the intention regarding the subject matter is explicitly and directly indicated. by these forward-looking statements. Actual results may differ from projections or estimates due to a variety of important factors, including Centene's ability to accurately predict and effectively manage health benefits and other operating expenses Operating expenses The amount paid for asset maintenance or the cost of doing business, excluding depreciation. Earnings are distributed after operating expenses are deducted. , competition, changes in healthcare practices, changes in federal or state laws or regulations, inflation, provider contract changes, new technologies, reduction in provider payments by governmental payors, major epidemics This article is a list of major epidemics. Worldwide Pandemics
2. In general, the expiration of a contract puts an end to all the engagements of the parties, except to those which arise from the non- fulfillment of obligations created , cancellation cancellation (See: cancel) CANCELLATION. Its general acceptation, is the act of crossing a writing; it is used sometimes to signify the manual operation of tearing or destroying the instrument itself. Hyde v. Hyde, 1 Eq. Cas. Abr. 409; Rob. or suspension suspension, in vehicles suspension, in automobiles, system of springs used to suspend the frame, body, engine, and power train above the wheels. Its principal purpose is to lessen the jarring of the automobile that is caused by irregularities in the roads of Centene's Medicaid managed care contracts by state governments would also negatively affect Centene.
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In thousands, except share data)
MARCH 31, DECEMBER 31,
2003 2002
----------- -------------
(Unaudited)
ASSETS
CURRENT ASSETS:
Cash and cash equivalents $59,970 $59,656
Premium and related receivables, net of
allowances of $215 and $219, respectively 19,925 16,773
Short-term investments, at fair value
(amortized cost $8,724 and $9,687,
respectively) 8,719 9,571
Deferred income taxes 1,853 2,846
Other current assets 5,335 4,243
----------- -------------
Total current assets 95,802 93,089
LONG-TERM INVESTMENTS, at fair value
(amortized cost $85,580 and $78,025,
respectively) 87,187 79,666
RESTRICTED DEPOSITS, at fair value
(amortized cost $16,322 and $15,561,
respectively) 16,533 15,762
PROPERTY AND EQUIPMENT, net 6,998 6,295
INTANGIBLE ASSETS, net 13,308 10,695
DEFERRED INCOME TAXES 630 472
OTHER ASSETS 4,289 4,348
----------- -------------
Total assets $224,747 $210,327
=========== =============
LIABILITIES AND STOCKHOLDERS' EQUITY
CURRENT LIABILITIES:
Medical claims liabilities $94,767 $91,181
Accounts payable and accrued expenses 13,041 10,748
Other current liabilities 370 --
----------- -------------
Total current liabilities 108,178 101,929
OTHER LIABILITIES 6,319 5,334
----------- -------------
Total liabilities 114,497 107,263
MINORITY INTEREST 589 881
STOCKHOLDERS' EQUITY:
Common stock, $.001 par value; authorized
40,000,000 shares; 10,943,142 and
10,829,099 shares issued and outstanding,
respectively 11 11
Additional paid-in capital 72,640 72,377
Accumulated other comprehensive income:
Net unrealized gain on investments, net of
tax 1,141 1,087
Retained earnings 35,869 28,708
----------- -------------
Total stockholders' equity 109,661 102,183
----------- -------------
Total liabilities and stockholders'
equity $224,747 $210,327
=========== =============
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF EARNINGS
(In thousands, except share data)
THREE MONTHS ENDED
MARCH 31,
2003 2002
----------- -----------
(Unaudited)
REVENUES:
Premiums $176,212 $95,650
Services 1,222 103
----------- -----------
Total revenues 177,434 95,753
----------- -----------
EXPENSES:
Medical costs 146,907 78,944
Cost of services(a) 975 82
General and administrative expenses 19,405 10,465
----------- -----------
Total operating expenses 167,287 89,491
----------- -----------
Earnings from operations 10,147 6,262
OTHER INCOME (EXPENSE):
Investment and other income, net 974 915
Interest expense (27) --
----------- -----------
Earnings before income taxes 11,094 7,177
INCOME TAX EXPENSE 4,233 2,877
MINORITY INTEREST 300 --
----------- -----------
Net earnings $7,161 $4,300
=========== ===========
EARNINGS PER COMMON SHARE, BASIC:
Net earnings per common share $0.66 $0.43
EARNINGS PER COMMON SHARE, DILUTED:
Net earnings per common share $0.60 $0.38
SHARES USED IN COMPUTING PER SHARE AMOUNTS:
Basic 10,898,849 10,091,348
Diluted 11,838,177 11,317,634
(a) Cost of services includes salaries and wages of physicians,
clinicians, therapists and teachers who provide specialty
services.
CENTENE CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
THREE MONTHS ENDED
MARCH 31,
2003 2002
--------- ---------
(Unaudited)
CASH FLOWS FROM OPERATING ACTIVITIES:
Net earnings $7,161 $4,300
Adjustments to reconcile net earnings to net cash
provided by operating activities --
Depreciation and amortization 1,379 476
Stock compensation expense 5 4
Minority interest (300) --
Gain on sale of investments (293) (205)
Changes in assets and liabilities --
Increase in premium and related receivables (1,982) (2,640)
Increase in other current assets (626) (2,413)
Decrease in deferred income taxes 803 288
Decrease in other assets 58 --
Increase in medical claims liabilities 3,586 5,363
Decrease in accounts payable and accrued
expenses (187) (2,869)
Increase in unearned revenues 19 --
Increase in other liabilities 236 --
--------- ---------
Net cash provided by operating activities 9,859 2,304
--------- ---------
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchase of property and equipment (684) (1,338)
Purchase of investments (42,055) (6,673)
Sales and maturities of investments 35,218 11,751
Contract acquisitions (561) --
Investment in subsidiary (1,722) (3,188)
--------- ---------
Net cash (used in) provided by investing
activities (9,804) 552
--------- ---------
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from exercise of stock options 259 15
--------- ---------
Net cash provided by financing activities 259 15
--------- ---------
Net increase in cash and cash equivalents 314 2,871
--------- ---------
CASH AND CASH EQUIVALENTS, beginning of period 59,656 88,867
--------- ---------
CASH AND CASH EQUIVALENTS, end of period $59,970 $91,738
========= =========
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:
Interest paid $18 $--
Income taxes paid $1,230 $4,330
CENTENE CORPORATION
SUPPLEMENTAL FINANCIAL DATA
Q1 Q4 Q3 Q2
2003 2002 2002 2002
----------- ----------- ---------- ----------
MEMBERSHIP
Wisconsin 139,100 133,000 126,800 123,900
Texas 122,700(a) 118,000(a) 67,800 61,900
Indiana 104,800 105,700 101,500 92,800
New Jersey 52,700 52,900 -- --
----------- ----------- ---------- ----------
Total 419,300 409,600 296,100 278,600
=========== =========== ========== ==========
(a) Includes 12,000 members managed on an interim basis.
Medicaid 344,700 336,100 264,100 252,100
SCHIP 66,600 65,900 29,400 23,900
SSI 8,000 7,600 2,600 2,600
----------- ----------- ---------- ----------
Total 419,300 409,600 296,100 278,600
=========== =========== ========== ==========
REVENUE PER MEMBER $142.06 $134.08 $133.20 $132.33
CLAIMS
Period-end Inventory 144,465 150,717 140,432 169,969
Average Inventory 131,382 73,800 51,700 79,000
Period-end Inventory
per Member 0.34 0.37 0.47 0.61
DAYS IN CLAIMS PAYABLE(b) 58.1 71.8 62.7 65.6
(b) Days in Claims Payable is a calculation of Medical Claims
Liabilities at the end of the period divided by average
medical costs per calendar day for such period.
ANNUALIZED RETURN ON EQUITY(c) 27.0% 27.7% 27.5% 26.0%
(c) Annualized Return on Equity is calculated as follows:
(net income for quarter x 4) divided by ((beginning of
period equity + end of period equity) divided by 2).
HEALTH BENEFITS RATIO BY CATEGORY:
THREE MONTHS ENDED
MARCH 31,
2003 2002
---------- -----------
Medicaid (excluding SSI) 82.4% 82.5%
SSI 104.2% ---
Total 83.4% 82.5%
GENERAL AND ADMINISTRATIVE EXPENSE RATIO BY BUSINESS SEGMENT:
THREE MONTHS ENDED
MARCH 31,
2003 2002
----------- -----------
Medicaid Managed Care 10.5% 10.7%
Specialty Services 18.6% 20.1%
Total 10.9% 10.9%
MEDICAL CLAIMS LIABILITIES
(in thousands)
Four rolling quarters of the changes in medical claims liabilities
are summarized as follows:
Balance, March 31, 2002 $64,928
Acquisitions 16,230(d)
Incurred related to:
Current period 468,829
Prior period (21,398)
-----------------
Total incurred 447,431
-----------------
Paid related to:
Current period 393,662
Prior period 40,160
-----------------
Total paid 433,822
-----------------
Balance, March 31, 2003 $94,767
=================
(d) Includes reserves acquired in connection with the acquisition
of 80% of the outstanding capital stock of University Health
Plans, Inc.
Our claims reserving process utilizes a consistent actuarial
methodology to estimate our ultimate liability. Any reduction in
the "Incurred related to: Prior period" claims may be offset as we
actuarially determine "Incurred related to: Current period." As such,
only in the absence of a consistent reserving methodology would
favorable development of prior period claims liability estimates
reduce medical costs. We believe we have consistently applied our
claims reserving methodology in each of the periods presented.
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