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In 1981, Toan moved to Missouri, where he was named director of that state's department of social service.
The Employee Assistance Program, a department of CommunityCare HMO, Inc., has been providing quality EAP services since 1982.
In 1983, two employees of McDonnell Douglas, then one of Missouri's largest employers, left that company to start up their own HMO, called Sanus Corp.
In 1984, the EAP moved to St John's for-profit side, Utica Services, becoming a freestanding department serving seven client companies.
1984: Founded as Family Hospital Physician Associates, the company is established by hospital bookkeeper Elizabeth “Betty” Brinn in Wisconsin.
Toan left public service in 1985, joining GenCare as its executive director, and GenCare, with additional investments from New York Life, expanded into the New York, New Jersey, and Maryland markets.
1986: Express Scripts Inc.(ESI) is formed as a joint venture between GenCare Health Systems and Medicare-Glaser.
By 1987, New York Life had begun to increase its investment in Sanus Health Systems, investing more than $50 million in the company and increasing its investment to as much as $75 million in the following year.
New York Life was also an early investor in ESI. In 1988, Medicare-Glaser began to stumble as Walgreen's moved to expand aggressively in the former company's core St Louis market.
By early 1989, with losses mounting, Medicare-Glaser announced it was merging with SupeRx of Arizona, Georgia and Alabama Corp., moving its headquarters to Arizona.
In 1991, a joint venture corporation CORPHEALTH OF MID-AMERICA was formed combining both EAP and Managed Behavioral Health Care Services.
Toan remained with GenCare through 1991, when he took the company public.
Toan left GenCare in 1992 to turn his full attention to ESI.
1992: The company goes public; membership grows to two million customers.
In 1993, Merck & Co. paid $6.6 billion for Medco.
The company's growth also fueled its stock price, which reached $50.50 per share in April 1994.
Caremark, a division of J.C. Penney with roughly 15 percent of the PBM market, instituted alliances with Pfizer, Bristol-Myers, Rhone-Poulenc, and Lilly in 1994.
The company also made a deeper investment in information technology by launching its Practice Patterns Science (PPS) subsidiary in 1994.
In May 1995, this relationship was dissolved and now our EAP/Managed Behavioral Health Care organization is owned by CommunityCare HMO, Inc.
The last of the large PBMs, Value Health, announced its joint venture with Pfizer in 1995.
ESI's purchase of Canadian PBM Eclipse Claims Services allowed it to move into that market in 1995.
1997: The company is renamed Centene Corporation, and its corporate office is established in St Louis, Missouri.
1997: Health Management Services is created and operates as a new division of ESI.
Toan commented on the two purchases in a 1999 company press release, stating, "These acquisitions have not only provided critical mass, but also competitive strength in key markets and scope of capability that translate into value for our customers."
These trends complemented ESI's bottom line handsomely as revenue for 1999 reached $4.2 billion and net income exceeded $150 million, more than a 250 percent increase over the previous year.
The company's sales reached $6.8 billion in 2000 and it secured earnings growth for the 36th consecutive quarter.
While the company posted a $9.1 million loss for 2000, management downplayed the deal-gone-bad, claiming it had provided cash for new technology ventures.
2001: With three health plans, $327 million in revenue and 235,000 members, Centene becomes a publicly traded company.
2003: Adds Cenpatico, a behavioral health services company; Centene debuts on the New York Stock Exchange.
2004: Centene reports $1 billion in revenue; expands in Ohio as Buckeye Health Plan.
2006: Acquires additional nurse triage services; Opticare, a vision management services company; US Script, a pharmacy benefit management services company; and Cardium, a disease management services company.
2008: Acquires Celtic Group, Inc., a commercial insurance product company.
2009: Expands into Florida and Massachusetts.
2010: Joins the FORTUNE 500 list of largest United States corporations by revenue; adds NovaSys Health in Arkansas.
2012: Operations for correctional healthcare services begin.
2013: Grows to $10 billion in revenue and 2.7 million members.
2014: Ambetter brand introduced for Health Insurance Marketplace products; enters two international markets, Spain and the United Kingdom; adds United States Medical Management (USMM), an in-home health services company.
2015: Acquires health plans in Michigan and Oregon.
2016: Acquires Health Net and launches the Envolve brand for specialty whole-health solution companies.
2017: Expands operational footprint in Nebraska, Nevada, Maryland and New York.
2018: Adds Pennsylvania and New York health plans; launches the Allwell Medicare Advantage brand.
2019: Continued growth and innovation leads to being listed No.
2020: Combines with WellCare to create a premier healthcare enterprise serving more than 23 million members across all 50 states in the United States
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