Centene Corporation (NYSE: CNC) reported a fourth-quarter adjusted loss despite posting revenue above Wall Street expectations, with investor attention centered on elevated costs in the company's Commercial segment. Shares fell more than 6% intra-day on Friday following the release.

The healthcare company recorded an adjusted loss of $1.19 per share for the quarter, slightly narrower than analyst expectations for a $1.22 loss. Revenue increased 23% year over year to $49.73 billion, exceeding the consensus estimate of $48.39 billion. Despite the top-line beat, Centene's consolidated health benefits ratio (HBR) rose sharply to 94.3%, compared with 89.6% in the same quarter last year.

The Commercial segment posted an HBR of 95.4%, which was roughly 100 basis points above company expectations due to net out-of-period items. In contrast, the Medicaid segment showed improvement, with an HBR of 93.0%, reflecting a 40-basis-point sequential improvement from the third quarter.

For the full year 2025, Centene reported adjusted earnings of $2.08 per share on revenue of $194.78 billion, representing a 20% increase compared with 2024. The company issued 2026 guidance calling for adjusted earnings per share of more than $3.00, signaling confidence in its recovery efforts.