Centene will sell its Spanish and central European businesses for an undisclosed sum to French private hospital company Vivalto Santé, the company announced Monday.

The insurer agreed to divest Spanish healthcare provider Ribera Salud Group, which manages healthcare administration for Torrejón Salud in Madrid. Ribera Salud also includes Pro Diagnostics Group, a chain of clinics offering radiology and other services in Slovakia and the Czech Republic.

Centene will use the majority of the proceeds from the sale to repurchase stock and reduce debt, the company said in a news release. The insurer does not expect the transaction to change its adjusted earnings per share value over the next 12 months. The deal is expected to close by the end of this year and is subject to regulatory approval in Spain and Slovakia.

“This transaction represents another significant milestone in our value creation plan and ongoing portfolio review,” CEO Sarah London said in the news release. Centene didn’t immediately respond to an interview request.

The company unveiled the value-creation plan in November after its comparatively low profit margins attracted the attention of activist investor Politan Capital Management, which owns a $900 million stake in the insurer. Politan Capital Management has pressed Centene to overhaul its leadership and board and to sell subsidiaries.

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Last month, the company disclosed it would spend $1.65 billion to unload more than half of its domestic real estate footprint. The month before, Centene announced the sales of pharmacy companies Magellan Rx and PANTHERx Rare in separate transactions collectively valued at $2.8 billion. The insurer will also sell a majority stake in home health provider U.S. Medical Management to a group of private equity firms, the company said in November.

Centene’s most recent deal does not mark the end of its overseas presence. The majority of Centene’s $2 billion in international revenue comes from its Circle Health subsidiary in the United Kingdom, which describes itself as the largest independent hospital operator in the country with 50 facilities, according to the insurer’s investor day presentation in December.

Cigna and CVS Health subsidiary Aetna have also recently sold foreign assets.


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