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UPDATE 2-Centene profit hit by higher medical costs, shares fall 5%

(Recasts lead, adds share movement, analyst comment)

Feb 4 (Reuters) - U.S. health insurer Centene Corp posted a 13% fall in fourth-quarter profit on Tuesday, hurt by higher medical costs in its Obamacare business and a rise in flu-related claims, sending its shares down about 5% in trading before the bell.

Centene's health benefits ratio, the amount it spends on medical claims compared with its income from premiums, worsened to 88.4% from 86.8% a year earlier. Analysts on average had expected a ratio of 87.60%, according to Refinitiv IBES data.

Medical cost dynamics in Centene's fourth quarter were identical to those of Anthem, Stephens analyst Scott Fidel said.

Rival Anthem blamed a sooner-than-expected onset of the flu season for higher medical costs in the latest quarter, although industry bellwether UnitedHealth downplayed the impact, saying there was some increase in outpatient care but hospitalizations were not high.

Centene, which closed its acquisition of smaller rival WellCare Health Plans last month, said it continues to expect mid-to-higher single-digit growth in 2021 profit from the deal.

Net earnings attributable to Centene fell to $209 million, or 49 cents per share, in the quarter ended Dec. 31 from $241 million, or 57 cents per share, a year earlier.

The company said it added 1.07 million members to its health insurance plans in 2019, taking the total to 15.24 million.

The membership growth and higher revenue from premiums helped the insurer report a 14% rise in total revenue to $18.86 billion, above estimates of $18.43 billion.

Excluding some items, Centene reported earnings per share of 73 cents, in line with estimates.

The insurer said it expects to update its forecast for the year to reflect the WellCare deal on March 3.

(Reporting by Manojna Maddipatla and Tamara Mathias in Bengaluru; Editing by Maju Samuel and Anil D'Silva)