-
Net income of
$3.02 per diluted share on a GAAP basis in the second quarter of 2018, compared with$1.64 per diluted share in the first quarter of 2018 -
Second quarter 2018 results include a net benefit of
$0.83 per diluted share for non-run rate items, primarily relating to the 2017 Marketplace risk adjustment -
Premium revenue increases
$191 million , or 4.4%, in the second quarter of 2018 compared with the first quarter of 2018 - Medical care ratio of 85.3% in the quarter
- General and administrative expense ratio of 6.9% in the quarter
- Net profit margin of 4.1% in the quarter and 3.2% year to date
-
2018 guidance increases by
$3.00 per diluted share at the midpoint to a range of$7.15 - $7.35 net income per diluted share on a GAAP basis -
2018 guidance includes the net benefit of
$0.96 per diluted share for the non-run rate items recorded in the first half of the year
“Our second quarter results are a strong indication that the early
stages of our margin recovery and sustainability plan are working,” said
We believe that the sequential comparison of our 2018 second quarter performance with our 2018 first quarter performance is the most useful indicator of our business progress. Significant items impacting the quarter are presented in a table later in this press release.
Second Quarter of 2018 Compared With First Quarter of 2018
Net income increased to
Overall, the medical care ratio improved to 85.3%, from 86.1% in the
first quarter of 2018. Excluding the combined benefit of the 2017
Marketplace risk adjustment and cost sharing reduction (CSR)
reimbursement, the medical care ratio would have been 87.0% in the
second quarter of 2018, compared with 87.2% in the first quarter of
2018. The sequential improvement in the overall medical care ratio was
due to a decrease in the
-
The
Medicaid medical care ratio decreased to 89.8%, from 90.8% in the first quarter of 2018. Improved performance at theWashington, California ,Texas ,New Mexico andIllinois health plans, partially offset by a decline in performance at theOhio andFlorida health plans, drove the decrease in the medical care ratio forMedicaid . - The Marketplace medical care ratio increased to 57.4%, from 50.6% in the first quarter of 2018. Excluding the combined net benefit of the 2017 risk adjustment and CSR, the Marketplace medical care ratio would have been 68.4% in the second quarter of 2018, compared with 63.5% in the first quarter of 2018.
The general and administrative (G&A) expense ratio decreased to 6.9%, from 7.6% in the first quarter of 2018, due to increased revenue and continuing G&A cost containment. Excluding the impact of Marketplace broker commissions and exchange fees in both periods, the G&A ratio decreased to 6.2%, from 6.8% in the first quarter of 2018.
Renewal of Medicaid Contracts
Year to date in 2018, we renewed
-
In
May 2018 , ourWashington health plan was selected to negotiate and enter into a managed care contract for the eight remaining regions of the state’s Apple Health Integrated Managed Care program, in addition to the two regions previously awarded to us. As ofJune 30, 2018 , we served approximately 742,000Medicaid members inWashington . -
In
June 2018 , ourFlorida health plan was awarded Medicaid Managed Care contracts in Regions 8 and 11 of the Florida Statewide Medicaid Managed Care Invitation to Negotiate, beginning in 2019. As ofJune 30, 2018 , we served approximately 96,000Medicaid members in those regions. -
In
July 2018 , ourPuerto Rico health plan was selected to be one of the organizations to administer the Commonwealth’s newMedicaid Managed Care contract. Services under the new contract, currently expected to begin onNovember 1, 2018 , would cover the entire island. As ofJune 30, 2018 , we served approximately 326,000Medicaid members in the East andSouthwest regions ofPuerto Rico .
Capital Plan Progress
In the second quarter of 2018, we repaid
Sale of Molina Medicaid Solutions Segment
In
Second Quarter of 2018 Compared With Second Quarter of 2017
Net income for the second quarter of 2018 was
2018 Revised Guidance
The following table summarizes 2018 Revised Guidance (1):
Premium revenue | ~ $17.5B | ||||||
Service revenue | ~ $475M | ||||||
Premium tax revenue | ~ $415M | ||||||
Health insurer fees reimbursed | ~ $325M | ||||||
Investment income and other revenue | ~ $125M | ||||||
Total revenue | ~ $18.8B | ||||||
Medical care costs | ~ $15.2B | ||||||
Medical care ratio (2) | ~ 87% | ||||||
Cost of service revenue | ~ $430M | ||||||
General and administrative expenses | ~ $1.4B | ||||||
G&A ratio (3) | ~ 7.4% | ||||||
Premium tax expenses | ~ $415M | ||||||
Health insurer fees | ~ $345M | ||||||
Depreciation and amortization | ~ $100M | ||||||
Restructuring and separation costs | ~ $30M | ||||||
Interest expense and other income, net | ~ $140M | ||||||
Income before income taxes | $730M - $745M | ||||||
Net income | $471M - $484M | ||||||
EBITDA (4) | $968M - $985M | ||||||
Effective tax rate | 35% - 36% | ||||||
Net profit margin (3) | 2.5% - 2.6% | ||||||
Diluted weighted average shares | ~ 65.9M | ||||||
Net income per share | $7.15 - $7.35 | ||||||
Adjusted net income per share (4) | $7.39 - $7.59 | ||||||
End-of-year Marketplace membership | 354,000 | ||||||
End-of-year Medicaid and Medicare membership | 3,569,000 |
__________________ |
||
(1) | All amounts are estimates; actual results may differ materially. See the Company’s risk factors as discussed in its 2017 Form 10-K and other filings and the statements below in this press release after the heading “Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995.” | |
(2) | Medical care ratio represents medical care costs as a percentage of premium revenue. | |
(3) | G&A ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net income as a percentage of total revenue. | |
(4) | See reconciliation of non-GAAP financial measures at the end of this release. | |
ConferenceCall
Management will host a conference call and webcast to discuss Molina
Healthcare’s second quarter 2018 results at
About
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This earnings release contains “forward-looking statements” regarding the Company’s 2018 revised guidance, as well as its plans, expectations, and anticipated future events. Actual results could differ materially due to numerous known and unknown risks and uncertainties. Those known risks and uncertainties include, but are not limited to, the following:
- the success of the Company’s profit improvement and maintenance initiatives, including the timing and amounts of the benefits realized, and administrative and medical cost savings achieved;
- the numerous political and market-based uncertainties associated with the Affordable Care Act (the “ACA”) or “Obamacare;”
- the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with risk adjustment requirements, the potential for disproportionate enrollment of higher acuity members, the discontinuation of premium tax credits, and the adequacy of agreed rates;
- subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment;
- effective management of the Company’s medical costs;
- the Company’s ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates associated with seasonal flu patterns or other newly emergent diseases;
- significant budget pressures on state governments and their potential inability to maintain current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria;
- the full reimbursement of the ACA health insurer fee, or HIF;
- the success of the Company’s efforts to retain existing or awarded
government contracts, including those in
New Mexico andTexas , and those for Regions 8 and 11 inFlorida , including the success of any protest filings or defenses; - the Company’s ability to manage its operations, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of its care management initiatives;
- the Company’s ability to consummate and realize benefits from divestitures and acquisitions, including the timely closing of the MMS divestiture;
- the Company’s receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
- the Company’s ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
- the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit sharing arrangements, and risk adjustment provisions and requirements;
- the Company’s estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;
- the
Medicaid expansion medical cost corridors inCalifornia ,New Mexico , andWashington , and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members; - the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and the Company’s ability to recognize revenue amounts associated therewith;
- cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
- the success of the Company’s health plan in
Puerto Rico , including the resolution of the debt crisis and the effect of the PROMESA law, and the impact of any future significant weather events; - the success and renewal of the Company’s duals demonstration
programs in
California ,Illinois ,Michigan ,Ohio ,South Carolina , andTexas ; - the accurate estimation of incurred but not reported or paid medical costs across the Company’s health plans;
- efforts by states to recoup previously paid and recognized premium amounts;
- complications, member confusion, or enrollment backlogs related to
the annual renewal of
Medicaid coverage; - government audits and reviews, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom;
- changes with respect to the Company’s provider contracts and the loss of providers;
- approval by state regulators of dividends and distributions by the Company’s health plan subsidiaries;
- changes in funding under the Company’s contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
- high dollar claims related to catastrophic illness;
- the favorable resolution of litigation, arbitration, or administrative proceedings, including litigation involving the ACA to which we ourselves are not a direct party;
- the relatively small number of states in which we operate health
plans, including the greater scale and revenues of the Company’s
California ,Ohio ,Texas , andWashington health plans; - the availability of adequate financing on acceptable terms to fund and capitalize the Company’s expansion and growth, repay the Company’s outstanding indebtedness at maturity and meet its liquidity needs, including the interest expense and other costs associated with such financing;
- the Company’s failure to comply with the financial or other covenants in its credit agreements or the indentures governing its outstanding notes;
- the sufficiency of the Company’s funds on hand to pay the amounts due upon conversion or maturity of its outstanding notes;
- the failure of a state in which we operate to renew its federal
Medicaid waiver; - changes generally affecting the managed care or
Medicaid management information systems industries; - increases in government surcharges, taxes, and assessments, including but not limited to the deductibility of certain compensation costs;
- newly emergent viruses or widespread epidemics, public catastrophes or terrorist attacks, and associated public alarm;
- the unexpected loss of the leadership of one or more of our senior executives;
- increasing competition and consolidation in the
Medicaid industry;
and numerous other risk factors, including those discussed in the
Company’s periodic reports and filings with the
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS |
||||||||||||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
(Dollar amounts in millions, except per-share amounts) | ||||||||||||||||||||
Revenue: | ||||||||||||||||||||
Premium revenue | $ | 4,514 | $ | 4,740 | $ | 8,837 | $ | 9,388 | ||||||||||||
Service revenue | 127 | 129 | 261 | 260 | ||||||||||||||||
Premium tax revenue | 106 | 114 | 210 | 225 | ||||||||||||||||
Health insurer fees reimbursed | 104 | — | 165 | — | ||||||||||||||||
Investment income and other revenue | 32 | 16 | 56 | 30 | ||||||||||||||||
Total revenue | 4,883 | 4,999 | 9,529 | 9,903 | ||||||||||||||||
Operating expenses: | ||||||||||||||||||||
Medical care costs | 3,850 | 4,491 | 7,572 | 8,602 | ||||||||||||||||
Cost of service revenue | 118 | 124 | 238 | 246 | ||||||||||||||||
General and administrative expenses | 335 | 405 | 687 | 844 | ||||||||||||||||
Premium tax expenses | 106 | 114 | 210 | 225 | ||||||||||||||||
Health insurer fees | 99 | — | 174 | — | ||||||||||||||||
Depreciation and amortization | 25 | 37 | 51 | 76 | ||||||||||||||||
Impairment losses | — | 72 | — | 72 | ||||||||||||||||
Restructuring and separation costs | 8 | 43 | 33 | 43 | ||||||||||||||||
Total operating expenses | 4,541 | 5,286 | 8,965 | 10,108 | ||||||||||||||||
Operating income (loss) | 342 | (287 | ) | 564 | (205 | ) | ||||||||||||||
Other expenses (income), net: | ||||||||||||||||||||
Interest expense | 32 | 27 | 65 | 53 | ||||||||||||||||
Other expense (income), net | 5 | — | 15 | (75 | ) | |||||||||||||||
Total other expenses (income), net | 37 | 27 | 80 | (22 | ) | |||||||||||||||
Income (loss) before income tax expense (benefit) | 305 | (314 | ) | 484 | (183 | ) | ||||||||||||||
Income tax expense (benefit) | 103 | (84 | ) | 175 | (30 | ) | ||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Net income (loss) per diluted share | $ | 3.02 | $ | (4.10 | ) | $ | 4.68 | $ | (2.74 | ) | ||||||||||
Diluted weighted average shares outstanding | 66.7 | 56.2 | 66.0 | 56.1 | ||||||||||||||||
Operating Statistics: | ||||||||||||||||||||
Medical care ratio | 85.3 | % | 94.8 | % | 85.7 | % | 91.6 | % | ||||||||||||
G&A ratio | 6.9 | % | 8.1 | % | 7.2 | % | 8.5 | % | ||||||||||||
Premium tax ratio | 2.3 | % | 2.4 | % | 2.3 | % | 2.3 | % | ||||||||||||
Effective income tax rate | 33.8 | % | 26.8 | % | 36.2 | % | 16.0 | % | ||||||||||||
Net profit (loss) margin | 4.1 | % | (4.6 | )% | 3.2 | % | (1.5 | )% | ||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED BALANCE SHEETS |
||||||||||
June 30, | December 31, | |||||||||
2018 | 2017 | |||||||||
(In millions, |
||||||||||
ASSETS | ||||||||||
Current assets: | ||||||||||
Cash and cash equivalents | $ | 3,392 | $ | 3,186 | ||||||
Investments | 2,176 | 2,524 | ||||||||
Restricted investments | 80 | 169 | ||||||||
Receivables | 1,148 | 871 | ||||||||
Prepaid expenses and other current assets | 344 | 239 | ||||||||
Derivative asset | 657 | 522 | ||||||||
Assets held for sale | 230 | — | ||||||||
Total current assets | 8,027 | 7,511 | ||||||||
Property, equipment, and capitalized software, net | 276 | 342 | ||||||||
Goodwill and intangible assets, net | 201 | 255 | ||||||||
Restricted investments | 117 | 119 | ||||||||
Deferred income taxes | 114 | 103 | ||||||||
Other assets | 28 | 141 | ||||||||
$ | 8,763 | $ | 8,471 | |||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||||
Current liabilities: | ||||||||||
Medical claims and benefits payable | $ | 1,920 | $ | 2,192 | ||||||
Amounts due government agencies | 1,746 | 1,542 | ||||||||
Accounts payable and accrued liabilities | 754 | 366 | ||||||||
Deferred revenue | 193 | 282 | ||||||||
Current portion of long-term debt | 484 | 653 | ||||||||
Derivative liability | 657 | 522 | ||||||||
Liabilities held for sale | 66 | — | ||||||||
Total current liabilities | 5,820 | 5,557 | ||||||||
Long-term debt | 1,019 | 1,318 | ||||||||
Lease financing obligations | 198 | 198 | ||||||||
Other long-term liabilities | 68 | 61 | ||||||||
Total liabilities | 7,105 | 7,134 | ||||||||
Stockholders’ equity: | ||||||||||
Common stock, $0.001 par value, 150 shares authorized; outstanding: 62 shares at June 30, 2018 and 60 shares at December 31, 2017 | — | — | ||||||||
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding | — | — | ||||||||
Additional paid-in capital | 1,055 | 1,044 | ||||||||
Accumulated other comprehensive loss | (11 | ) | (5 | ) | ||||||
Retained earnings | 614 | 298 | ||||||||
Total stockholders’ equity | 1,658 | 1,337 | ||||||||
$ | 8,763 | $ | 8,471 | |||||||
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
||||||||||||||||||||
Three Months Ended | Six Months Ended | |||||||||||||||||||
June 30, | June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
(In millions) | ||||||||||||||||||||
Operating activities: | ||||||||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||||||||||||||||||||
Depreciation and amortization | 36 | 47 | 73 | 96 | ||||||||||||||||
Impairment losses | — | 72 | — | 72 | ||||||||||||||||
Deferred income taxes | — | (36 | ) | (6 | ) | (41 | ) | |||||||||||||
Share-based compensation | 7 | 29 | 13 | 35 | ||||||||||||||||
Non-cash restructuring costs | — | — | 17 | — | ||||||||||||||||
Amortization of convertible senior notes and lease financing obligations | 6 | 8 | 13 | 16 | ||||||||||||||||
Loss on debt extinguishment | 5 | — | 15 | — | ||||||||||||||||
Other, net | 2 | 4 | 4 | 7 | ||||||||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||||
Receivables | (232 | ) | — | (315 | ) | (32 | ) | |||||||||||||
Prepaid expenses and other current assets | 58 | (26 | ) | (181 | ) | (38 | ) | |||||||||||||
Medical claims and benefits payable | (104 | ) | 151 | (267 | ) | 148 | ||||||||||||||
Amounts due government agencies | 33 | 269 | 205 | 642 | ||||||||||||||||
Accounts payable and accrued liabilities | 30 | (68 | ) | 349 | (18 | ) | ||||||||||||||
Deferred revenue | (172 | ) | (178 | ) | (42 | ) | (32 | ) | ||||||||||||
Income taxes | 49 | (89 | ) | 127 | (30 | ) | ||||||||||||||
Net cash (used in) provided by operating activities | (80 | ) | (47 | ) | 314 | 672 | ||||||||||||||
Investing activities: | ||||||||||||||||||||
Purchases of investments | (525 | ) | (903 | ) | (914 | ) | (1,636 | ) | ||||||||||||
Proceeds from sales and maturities of investments | 792 | 441 | 1,335 | 874 | ||||||||||||||||
Purchases of property, equipment, and capitalized software | (10 | ) | (34 | ) | (14 | ) | (60 | ) | ||||||||||||
Other, net | (4 | ) | (13 | ) | (9 | ) | (24 | ) | ||||||||||||
Net cash provided by (used in) investing activities | 253 | (509 | ) | 398 | (846 | ) | ||||||||||||||
Financing activities: | ||||||||||||||||||||
Repayment of credit facility | (300 | ) | — | (300 | ) | — | ||||||||||||||
Repayment of 1.125% Convertible Notes | (89 | ) | — | (89 | ) | — | ||||||||||||||
Cash paid for partial settlement of 1.125% Conversion Option | (134 | ) | — | (134 | ) | — | ||||||||||||||
Cash received for partial termination of 1.125% Call Option | 134 | — | 134 | — | ||||||||||||||||
Cash paid for partial termination of 1.125% Warrants | (113 | ) | — | (113 | ) | — | ||||||||||||||
Proceeds from senior notes offerings, net of issuance costs | — | 325 | — | 325 | ||||||||||||||||
Other, net | 4 | 9 | (1 | ) | 8 | |||||||||||||||
Net cash (used in) provided by financing activities | (498 | ) | 334 | (503 | ) | 333 | ||||||||||||||
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents | (325 | ) | (222 | ) | 209 | 159 | ||||||||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 3,824 | 3,293 | 3,290 | 2,912 | ||||||||||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ | 3,499 | $ | 3,071 | $ | 3,499 | $ | 3,071 | ||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP |
|||||||||||
June 30, | December 31, | June 30, | |||||||||
2018 | 2017 | 2017 | |||||||||
Ending Membership by Program: | |||||||||||
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) | 2,464,000 | 2,457,000 | 2,517,000 | ||||||||
Medicaid Expansion | 675,000 | 668,000 | 678,000 | ||||||||
Aged, Blind or Disabled (ABD) | 415,000 | 412,000 | 408,000 | ||||||||
Total Medicaid | 3,554,000 | 3,537,000 | 3,603,000 | ||||||||
Medicare-Medicaid Plan (MMP) - Integrated | 55,000 | 57,000 | 54,000 | ||||||||
Medicare Special Needs Plans | 45,000 | 44,000 | 44,000 | ||||||||
Total Medicare | 100,000 | 101,000 | 98,000 | ||||||||
Total Medicaid and Medicare | 3,654,000 | 3,638,000 | 3,701,000 | ||||||||
Marketplace | 409,000 | 815,000 | 949,000 | ||||||||
4,063,000 | 4,453,000 | 4,650,000 | |||||||||
Ending Membership by Health Plan: | |||||||||||
California | 639,000 | 746,000 | 766,000 | ||||||||
Florida | 398,000 | 625,000 | 672,000 | ||||||||
Illinois | 219,000 | 165,000 | 163,000 | ||||||||
Michigan | 397,000 | 398,000 | 414,000 | ||||||||
New Mexico | 241,000 | 253,000 | 266,000 | ||||||||
Ohio | 320,000 | 327,000 | 351,000 | ||||||||
Puerto Rico | 326,000 | 314,000 | 322,000 | ||||||||
South Carolina | 114,000 | 116,000 | 112,000 | ||||||||
Texas | 450,000 | 430,000 | 465,000 | ||||||||
Washington | 776,000 | 777,000 | 788,000 | ||||||||
Other (1) | 183,000 | 302,000 | 331,000 | ||||||||
4,063,000 | 4,453,000 | 4,650,000 |
__________________ |
||
(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 7.5 | $ | 1,393 | $ | 186.18 | $ | 1,205 | $ | 161.13 | 86.5 | % | $ | 188 | ||||||||||||||||||||
Medicaid Expansion | 2.1 | 761 | 372.04 | 676 | 330.83 | 88.9 | 85 | ||||||||||||||||||||||||||
ABD | 1.3 | 1,288 | 1,033.34 | 1,209 | 969.27 | 93.8 | 79 | ||||||||||||||||||||||||||
Total Medicaid | 10.9 | 3,442 | 319.52 | 3,090 | 286.89 | 89.8 | 352 | ||||||||||||||||||||||||||
MMP | 0.1 | 367 | 2,224.30 | 313 | 1,893.91 | 85.1 | 54 | ||||||||||||||||||||||||||
Medicare | 0.2 | 157 | 1,168.40 | 133 | 989.33 | 84.7 | 24 | ||||||||||||||||||||||||||
Total Medicare | 0.3 | 524 | 1,751.49 | 446 | 1,488.85 | 85.0 | 78 | ||||||||||||||||||||||||||
Total Medicaid and Medicare | 11.2 | 3,966 | 358.23 | 3,536 | 319.37 | 89.2 | 430 | ||||||||||||||||||||||||||
Marketplace | 1.2 | 548 | 440.93 | 314 | 253.04 | 57.4 | 234 | ||||||||||||||||||||||||||
12.4 | $ | 4,514 | $ | 366.57 | $ | 3,850 | $ | 312.68 | 85.3 | % | $ | 664 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 7.6 | $ | 1,391 | $ | 182.47 | $ | 1,315 | $ | 172.48 | 94.5 | % | $ | 76 | ||||||||||||||||||||
Medicaid Expansion | 2.1 | 786 | 383.07 | 689 | 335.26 | 87.5 | 97 | ||||||||||||||||||||||||||
ABD | 1.2 | 1,285 | 1,053.89 | 1,245 | 1,020.85 | 96.9 | 40 | ||||||||||||||||||||||||||
Total Medicaid | 10.9 | 3,462 | 317.79 | 3,249 | 298.10 | 93.8 | 213 | ||||||||||||||||||||||||||
MMP | 0.1 | 361 | 2,217.44 | 333 | 2,050.20 | 92.5 | 28 | ||||||||||||||||||||||||||
Medicare | 0.2 | 148 | 1,126.14 | 126 | 963.34 | 85.5 | 22 | ||||||||||||||||||||||||||
Total Medicare | 0.3 | 509 | 1,730.91 | 459 | 1,565.65 | 90.5 | 50 | ||||||||||||||||||||||||||
Total Medicaid and Medicare | 11.2 | 3,971 | 354.87 | 3,708 | 331.36 | 93.4 | 263 | ||||||||||||||||||||||||||
Marketplace | 2.8 | 769 | 267.37 | 783 | 272.37 | 101.9 | (14 | ) | |||||||||||||||||||||||||
14.0 | $ | 4,740 | $ | 336.98 | $ | 4,491 | $ | 319.29 | 94.8 | % | $ | 249 |
__________________ |
||
(1) | A member month is defined as the aggregate of each month’s ending membership for the period presented. | |
(2) | The MCR represents medical costs as a percentage of premium revenue. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | ||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||||||||
TANF and CHIP | 14.9 | $ | 2,766 | $ | 185.66 | $ | 2,477 | $ | 166.32 | 89.6 | % | $ | 289 | |||||||||||||||||||
Medicaid Expansion | 4.1 | 1,513 | 372.39 | 1,317 | 324.19 | 87.1 | 196 | |||||||||||||||||||||||||
ABD | 2.5 | 2,542 | 1,023.83 | 2,364 | 951.99 | 93.0 | 178 | |||||||||||||||||||||||||
Total Medicaid | 21.5 | 6,821 | 318.11 | 6,158 | 287.22 | 90.3 | 663 | |||||||||||||||||||||||||
MMP | 0.3 | 724 | 2,180.86 | 618 | 1,858.87 | 85.2 | 106 | |||||||||||||||||||||||||
Medicare | 0.3 | 314 | 1,178.58 | 264 | 992.05 | 84.2 | 50 | |||||||||||||||||||||||||
Total Medicare | 0.6 | 1,038 | 1,735.05 | 882 | 1,473.30 | 84.9 | 156 | |||||||||||||||||||||||||
Total Medicaid and Medicare | 22.1 | 7,859 | 356.59 | 7,040 | 319.43 | 89.6 | 819 | |||||||||||||||||||||||||
Marketplace | 2.6 | 978 | 373.67 | 532 | 203.34 | 54.4 | 446 | |||||||||||||||||||||||||
24.7 | $ | 8,837 | $ | 358.40 | $ | 7,572 | $ | 307.11 | 85.7 | % | $ | 1,265 | ||||||||||||||||||||
Six Months Ended June 30, 2017 | ||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||||||||
TANF and CHIP | 15.3 | $ | 2,793 | $ | 182.58 | $ | 2,619 | $ | 171.25 | 93.8 | % | $ | 174 | |||||||||||||||||||
Medicaid Expansion | 4.1 | 1,603 | 390.88 | 1,378 | 335.88 | 85.9 | 225 | |||||||||||||||||||||||||
ABD | 2.4 | 2,481 | 1,030.68 | 2,375 | 986.54 | 95.7 | 106 | |||||||||||||||||||||||||
Total Medicaid | 21.8 | 6,877 | 315.39 | 6,372 | 292.22 | 92.7 | 505 | |||||||||||||||||||||||||
MMP | 0.3 | 705 | 2,152.75 | 640 | 1,954.15 | 90.8 | 65 | |||||||||||||||||||||||||
Medicare | 0.3 | 286 | 1,097.36 | 243 | 933.20 | 85.0 | 43 | |||||||||||||||||||||||||
Total Medicare | 0.6 | 991 | 1,685.72 | 883 | 1,502.36 | 89.1 | 108 | |||||||||||||||||||||||||
Total Medicaid and Medicare | 22.4 | 7,868 | 351.35 | 7,255 | 323.98 | 92.2 | 613 | |||||||||||||||||||||||||
Marketplace | 5.7 | 1,520 | 264.77 | 1,347 | 234.62 | 88.6 | 173 | |||||||||||||||||||||||||
28.1 | $ | 9,388 | $ | 333.68 | $ | 8,602 | $ | 305.74 | 91.6 | % | $ | 786 | ||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA— MEDICAID AND MEDICARE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 1.8 | $ | 517 | $ | 289.80 | $ | 441 | $ | 247.36 | 85.4 | % | $ | 76 | ||||||||||||||||||||
Florida | 1.2 | 377 | 353.81 | 362 | 339.31 | 95.9 | 15 | ||||||||||||||||||||||||||
Illinois | 0.6 | 203 | 311.60 | 170 | 261.59 | 84.0 | 33 | ||||||||||||||||||||||||||
Michigan | 1.2 | 388 | 342.45 | 331 | 292.20 | 85.3 | 57 | ||||||||||||||||||||||||||
New Mexico | 0.7 | 313 | 469.88 | 290 | 435.36 | 92.7 | 23 | ||||||||||||||||||||||||||
Ohio | 1.0 | 535 | 571.08 | 482 | 514.57 | 90.1 | 53 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 184 | 188.26 | 165 | 168.20 | 89.3 | 19 | ||||||||||||||||||||||||||
South Carolina | 0.4 | 123 | 350.22 | 107 | 304.20 | 86.9 | 16 | ||||||||||||||||||||||||||
Texas | 0.7 | 576 | 835.66 | 510 | 740.55 | 88.6 | 66 | ||||||||||||||||||||||||||
Washington | 2.2 | 571 | 252.61 | 526 | 232.49 | 92.0 | 45 | ||||||||||||||||||||||||||
Other (1) | 0.5 | 179 | 322.99 | 152 | 274.59 | 85.0 | 27 | ||||||||||||||||||||||||||
11.2 | $ | 3,966 | $ | 358.23 | $ | 3,536 | $ | 319.37 | 89.2 | % | $ | 430 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member
|
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 1.9 | $ | 598 | $ | 318.89 | $ | 539 | $ | 287.36 | 90.1 | % | $ | 59 | ||||||||||||||||||||
Florida | 1.1 | 380 | 347.20 | 370 | 337.92 | 97.3 | 10 | ||||||||||||||||||||||||||
Illinois | 0.5 | 149 | 289.51 | 174 | 336.76 | 116.3 | (25 | ) | |||||||||||||||||||||||||
Michigan | 1.1 | 390 | 333.26 | 358 | 305.40 | 91.6 | 32 | ||||||||||||||||||||||||||
New Mexico | 0.8 | 321 | 443.13 | 311 | 428.58 | 96.7 | 10 | ||||||||||||||||||||||||||
Ohio | 1.0 | 529 | 536.90 | 489 | 496.41 | 92.5 | 40 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 179 | 184.28 | 189 | 194.42 | 105.5 | (10 | ) | |||||||||||||||||||||||||
South Carolina | 0.4 | 111 | 326.57 | 102 | 304.14 | 93.1 | 9 | ||||||||||||||||||||||||||
Texas | 0.7 | 524 | 752.01 | 473 | 679.43 | 90.3 | 51 | ||||||||||||||||||||||||||
Washington | 2.2 | 618 | 276.90 | 546 | 244.58 | 88.3 | 72 | ||||||||||||||||||||||||||
Other (1) | 0.6 | 172 | 294.15 | 157 | 268.91 | 91.4 | 15 | ||||||||||||||||||||||||||
11.2 | $ | 3,971 | $ | 354.87 | $ | 3,708 | $ | 331.36 | 93.4 | % | $ | 263 |
__________________ |
||
(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA— MEDICAID AND MEDICARE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 3.6 | $ | 1,011 | $ | 281.14 | $ | 853 | $ | 237.26 | 84.4 | % | $ | 158 | ||||||||||||||||||||
Florida | 2.2 | 759 | 352.68 | 707 | 328.26 | 93.1 | 52 | ||||||||||||||||||||||||||
Illinois | 1.1 | 344 | 305.94 | 292 | 259.87 | 84.9 | 52 | ||||||||||||||||||||||||||
Michigan | 2.3 | 764 | 339.56 | 662 | 294.19 | 86.6 | 102 | ||||||||||||||||||||||||||
New Mexico | 1.4 | 632 | 468.00 | 600 | 444.44 | 95.0 | 32 | ||||||||||||||||||||||||||
Ohio | 1.9 | 1,086 | 573.87 | 942 | 497.75 | 86.7 | 144 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 370 | 190.68 | 339 | 174.74 | 91.6 | 31 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 245 | 349.15 | 211 | 300.87 | 86.2 | 34 | ||||||||||||||||||||||||||
Texas | 1.4 | 1,138 | 822.72 | 1,029 | 744.05 | 90.4 | 109 | ||||||||||||||||||||||||||
Washington | 4.5 | 1,155 | 254.64 | 1,100 | 242.48 | 95.2 | 55 | ||||||||||||||||||||||||||
Other | 1.1 | 355 | 318.94 | 305 | 273.97 | 85.9 | 50 | ||||||||||||||||||||||||||
22.1 | $ | 7,859 | $ | 356.59 | $ | 7,040 | $ | 319.43 | 89.6 | % | $ | 819 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 3.7 | $ | 1,170 | $ | 313.76 | $ | 1,023 | $ | 274.42 | 87.5 | % | $ | 147 | ||||||||||||||||||||
Florida | 2.2 | 744 | 343.29 | 722 | 333.23 | 97.1 | 22 | ||||||||||||||||||||||||||
Illinois | 1.1 | 310 | 282.66 | 354 | 322.63 | 114.1 | (44 | ) | |||||||||||||||||||||||||
Michigan | 2.3 | 772 | 330.34 | 690 | 295.02 | 89.3 | 82 | ||||||||||||||||||||||||||
New Mexico | 1.5 | 629 | 432.98 | 610 | 419.65 | 96.9 | 19 | ||||||||||||||||||||||||||
Ohio | 2.0 | 1,049 | 532.35 | 951 | 482.73 | 90.7 | 98 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 362 | 185.40 | 354 | 181.24 | 97.8 | 8 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 216 | 321.85 | 200 | 298.79 | 92.8 | 16 | ||||||||||||||||||||||||||
Texas | 1.4 | 1,051 | 751.94 | 962 | 687.96 | 91.5 | 89 | ||||||||||||||||||||||||||
Washington | 4.4 | 1,223 | 275.05 | 1,081 | 243.18 | 88.4 | 142 | ||||||||||||||||||||||||||
Other | 1.2 | 342 | 291.93 | 308 | 262.97 | 90.1 | 34 | ||||||||||||||||||||||||||
22.4 | $ | 7,868 | $ | 351.35 | $ | 7,255 | $ | 323.98 | 92.2 | % | $ | 613 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.2 | $ | 73 | $ | 426.16 | $ | 21 | $ | 117.92 | 27.7 | % | $ | 52 | ||||||||||||||||||||
Florida | 0.1 | 100 | 698.31 | 38 | 269.86 | 38.6 | 62 | ||||||||||||||||||||||||||
Michigan | — | 15 | 288.67 | 7 | 146.97 | 50.9 | 8 | ||||||||||||||||||||||||||
New Mexico | — | 31 | 418.82 | 18 | 247.06 | 59.0 | 13 | ||||||||||||||||||||||||||
Ohio | — | 31 | 518.64 | 23 | 381.46 | 73.6 | 8 | ||||||||||||||||||||||||||
Texas | 0.7 | 222 | 330.12 | 160 | 238.72 | 72.3 | 62 | ||||||||||||||||||||||||||
Washington | 0.2 | 56 | 787.80 | 41 | 572.48 | 72.7 | 15 | ||||||||||||||||||||||||||
Other (1) | — | 20 | NM | 6 | NM | NM | 14 | ||||||||||||||||||||||||||
1.2 | $ | 548 | $ | 440.93 | $ | 314 | $ | 253.04 | 57.4 | % | $ | 234 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.5 | $ | 81 | $ | 186.90 | $ | 67 | $ | 154.23 | 82.5 | % | $ | 14 | ||||||||||||||||||||
Florida | 0.9 | 269 | 284.60 | 317 | 336.78 | 118.3 | (48 | ) | |||||||||||||||||||||||||
Michigan | 0.1 | 16 | 204.15 | 10 | 135.89 | 66.6 | 6 | ||||||||||||||||||||||||||
New Mexico | — | 31 | 367.98 | 23 | 266.91 | 72.5 | 8 | ||||||||||||||||||||||||||
Ohio | — | 24 | 377.94 | 27 | 404.20 | 106.9 | (3 | ) | |||||||||||||||||||||||||
Texas | 0.7 | 177 | 247.49 | 129 | 180.92 | 73.1 | 48 | ||||||||||||||||||||||||||
Washington | 0.2 | 44 | 317.42 | 49 | 359.87 | 113.4 | (5 | ) | |||||||||||||||||||||||||
Other (1) | 0.4 | 127 | 304.00 | 161 | 383.02 | 126.0 | (34 | ) | |||||||||||||||||||||||||
2.8 | $ | 769 | $ | 267.37 | $ | 783 | $ | 272.37 | 101.9 | % | $ | (14 | ) |
__________________ |
||
(1) | “Other” includes the Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. We terminated Marketplace operations at these plans effective January 1, 2018, so the ratios for 2018 periods are not meaningful (NM). | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.4 | $ | 122 | $ | 334.47 | $ | 52 | $ | 141.73 | 42.4 | % | $ | 70 | ||||||||||||||||||||
Florida | 0.3 | 145 | 468.36 | 22 | 73.13 | 15.6 | 123 | ||||||||||||||||||||||||||
Michigan | 0.1 | 28 | 254.69 | 16 | 145.49 | 57.1 | 12 | ||||||||||||||||||||||||||
New Mexico | 0.1 | 65 | 429.19 | 37 | 246.77 | 57.5 | 28 | ||||||||||||||||||||||||||
Ohio | 0.1 | 57 | 458.48 | 40 | 319.53 | 69.7 | 17 | ||||||||||||||||||||||||||
Texas | 1.4 | 451 | 318.93 | 306 | 216.83 | 68.0 | 145 | ||||||||||||||||||||||||||
Washington | 0.2 | 95 | 653.89 | 71 | 486.90 | 74.5 | 24 | ||||||||||||||||||||||||||
Other | — | 15 | NM | (12 | ) | NM | NM | 27 | |||||||||||||||||||||||||
2.6 | $ | 978 | $ | 373.67 | $ | 532 | $ | 203.34 | 54.4 | % | $ | 446 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.9 | $ | 153 | $ | 185.68 | $ | 93 | $ | 112.20 | 60.4 | % | $ | 60 | ||||||||||||||||||||
Florida | 1.9 | 561 | 288.81 | 523 | 269.48 | 93.3 | 38 | ||||||||||||||||||||||||||
Michigan | 0.2 | 27 | 177.12 | 17 | 116.21 | 65.6 | 10 | ||||||||||||||||||||||||||
New Mexico | 0.1 | 53 | 317.10 | 42 | 249.90 | 78.8 | 11 | ||||||||||||||||||||||||||
Ohio | 0.1 | 45 | 356.20 | 44 | 339.26 | 95.2 | 1 | ||||||||||||||||||||||||||
Texas | 1.4 | 334 | 235.07 | 242 | 171.07 | 72.8 | 92 | ||||||||||||||||||||||||||
Washington | 0.3 | 81 | 310.26 | 95 | 362.78 | 116.9 | (14 | ) | |||||||||||||||||||||||||
Other | 0.8 | 266 | 313.77 | 291 | 342.88 | 109.3 | (25 | ) | |||||||||||||||||||||||||
5.7 | $ | 1,520 | $ | 264.77 | $ | 1,347 | $ | 234.62 | 88.6 | % | $ | 173 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 2.0 | $ | 590 | $ | 301.73 | $ | 462 | $ | 236.04 | 78.2 | % | $ | 128 | ||||||||||||||||||||
Florida | 1.3 | 477 | 394.38 | 400 | 331.13 | 84.0 | 77 | ||||||||||||||||||||||||||
Illinois | 0.6 | 203 | 311.60 | 170 | 261.59 | 84.0 | 33 | ||||||||||||||||||||||||||
Michigan | 1.2 | 403 | 340.08 | 338 | 285.78 | 84.0 | 65 | ||||||||||||||||||||||||||
New Mexico | 0.7 | 344 | 464.90 | 308 | 416.99 | 89.7 | 36 | ||||||||||||||||||||||||||
Ohio | 1.0 | 566 | 567.96 | 505 | 506.66 | 89.2 | 61 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 184 | 188.26 | 165 | 168.20 | 89.3 | 19 | ||||||||||||||||||||||||||
South Carolina | 0.4 | 123 | 350.22 | 107 | 304.20 | 86.9 | 16 | ||||||||||||||||||||||||||
Texas | 1.4 | 798 | 585.50 | 670 | 492.23 | 84.1 | 128 | ||||||||||||||||||||||||||
Washington | 2.4 | 627 | 268.84 | 567 | 242.80 | 90.3 | 60 | ||||||||||||||||||||||||||
Other (1) | 0.5 | 199 | 360.90 | 158 | 285.65 | 79.1 | 41 | ||||||||||||||||||||||||||
12.4 | $ | 4,514 | $ | 366.57 | $ | 3,850 | $ | 312.68 | 85.3 | % | $ | 664 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 2.4 | $ | 679 | $ | 294.09 | $ | 606 | $ | 262.34 | 89.2 | % | $ | 73 | ||||||||||||||||||||
Florida | 2.0 | 649 | 318.21 | 687 | 337.39 | 106.0 | (38 | ) | |||||||||||||||||||||||||
Illinois | 0.5 | 149 | 289.51 | 174 | 336.76 | 116.3 | (25 | ) | |||||||||||||||||||||||||
Michigan | 1.2 | 406 | 325.38 | 368 | 295.06 | 90.7 | 38 | ||||||||||||||||||||||||||
New Mexico | 0.8 | 352 | 435.34 | 334 | 411.83 | 94.6 | 18 | ||||||||||||||||||||||||||
Ohio | 1.0 | 553 | 527.14 | 516 | 490.75 | 93.1 | 37 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 179 | 184.28 | 189 | 194.42 | 105.5 | (10 | ) | |||||||||||||||||||||||||
South Carolina | 0.4 | 111 | 326.57 | 102 | 304.14 | 93.1 | 9 | ||||||||||||||||||||||||||
Texas | 1.4 | 701 | 495.93 | 602 | 426.41 | 86.0 | 99 | ||||||||||||||||||||||||||
Washington | 2.4 | 662 | 279.21 | 595 | 251.16 | 90.0 | 67 | ||||||||||||||||||||||||||
Other (1) | 1.0 | 299 | 298.29 | 318 | 316.89 | 106.2 | (19 | ) | |||||||||||||||||||||||||
14.0 | $ | 4,740 | $ | 336.98 | $ | 4,491 | $ | 319.29 | 94.8 | % | $ | 249 |
__________________ |
||
(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 4.0 | $ | 1,133 | $ | 286.07 | $ | 905 | $ | 228.44 | 79.9 | % | $ | 228 | ||||||||||||||||||||
Florida | 2.5 | 904 | 367.18 | 729 | 296.29 | 80.7 | 175 | ||||||||||||||||||||||||||
Illinois | 1.1 | 344 | 305.94 | 292 | 259.87 | 84.9 | 52 | ||||||||||||||||||||||||||
Michigan | 2.4 | 792 | 335.59 | 678 | 287.23 | 85.6 | 114 | ||||||||||||||||||||||||||
New Mexico | 1.5 | 697 | 464.11 | 637 | 424.58 | 91.5 | 60 | ||||||||||||||||||||||||||
Ohio | 2.0 | 1,143 | 566.77 | 982 | 486.79 | 85.9 | 161 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 370 | 190.68 | 339 | 174.74 | 91.6 | 31 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 245 | 349.15 | 211 | 300.87 | 86.2 | 34 | ||||||||||||||||||||||||||
Texas | 2.8 | 1,589 | 567.95 | 1,335 | 477.43 | 84.1 | 254 | ||||||||||||||||||||||||||
Washington | 4.7 | 1,250 | 267.01 | 1,171 | 250.05 | 93.6 | 79 | ||||||||||||||||||||||||||
Other | 1.1 | 370 | 333.35 | 293 | 263.24 | 79.0 | 77 | ||||||||||||||||||||||||||
24.7 | $ | 8,837 | $ | 358.40 | $ | 7,572 | $ | 307.11 | 85.7 | % | $ | 1,265 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 4.6 | $ | 1,323 | $ | 290.56 | $ | 1,116 | $ | 245.02 | 84.3 | % | $ | 207 | ||||||||||||||||||||
Florida | 4.1 | 1,305 | 317.53 | 1,245 | 303.09 | 95.5 | 60 | ||||||||||||||||||||||||||
Illinois | 1.1 | 310 | 282.66 | 354 | 322.63 | 114.1 | (44 | ) | |||||||||||||||||||||||||
Michigan | 2.5 | 799 | 321.10 | 707 | 284.24 | 88.5 | 92 | ||||||||||||||||||||||||||
New Mexico | 1.6 | 682 | 421.11 | 652 | 402.27 | 95.5 | 30 | ||||||||||||||||||||||||||
Ohio | 2.1 | 1,094 | 521.57 | 995 | 473.95 | 90.9 | 99 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 362 | 185.40 | 354 | 181.24 | 97.8 | 8 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 216 | 321.85 | 200 | 298.79 | 92.8 | 16 | ||||||||||||||||||||||||||
Texas | 2.8 | 1,385 | 491.46 | 1,204 | 427.48 | 87.0 | 181 | ||||||||||||||||||||||||||
Washington | 4.7 | 1,304 | 276.99 | 1,176 | 249.79 | 90.2 | 128 | ||||||||||||||||||||||||||
Other | 2.0 | 608 | 301.11 | 599 | 296.58 | 98.5 | 9 | ||||||||||||||||||||||||||
28.1 | $ | 9,388 | $ | 333.68 | $ | 8,602 | $ | 305.74 | 91.6 | % | $ | 786 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. |
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The following tables provide the details of our medical care costs for the periods indicated: |
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Three Months Ended June 30, | |||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Amount | PMPM |
% of |
Amount | PMPM |
% of |
||||||||||||||||||||
Fee for service | $ | 2,861 | $ | 232.40 | 74.4 | % | $ | 3,348 | $ | 238.04 | 74.5 | % | |||||||||||||
Pharmacy | 567 | 46.05 | 14.7 | 650 | 46.23 | 14.5 | |||||||||||||||||||
Capitation | 282 | 22.89 | 7.3 | 356 | 25.29 | 7.9 | |||||||||||||||||||
Other | 140 | 11.34 | 3.6 | 137 | 9.73 | 3.1 | |||||||||||||||||||
$ | 3,850 | $ | 312.68 | 100.0 | % | $ | 4,491 | $ | 319.29 | 100.0 | % | ||||||||||||||
Six Months Ended June 30, | |||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Amount | PMPM |
% of |
Amount | PMPM |
% of |
||||||||||||||||||||
Fee for service | $ | 5,606 | $ | 227.38 | 74.1 | % | $ | 6,434 | $ | 228.68 | 74.8 | % | |||||||||||||
Pharmacy | 1,150 | 46.66 | 15.2 | 1,266 | 45.00 | 14.7 | |||||||||||||||||||
Capitation | 594 | 24.09 | 7.8 | 680 | 24.17 | 7.9 | |||||||||||||||||||
Other | 222 | 8.98 | 2.9 | 222 | 7.89 | 2.6 | |||||||||||||||||||
$ | 7,572 | $ | 307.11 | 100.0 | % | $ | 8,602 | $ | 305.74 | 100.0 | % | ||||||||||||||
The following table provides the details of our medical claims and benefits payable as of the dates indicated: |
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June 30, | December 31, | ||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Fee-for-service claims incurred but not paid (IBNP) | $ | 1,510 | $ | 1,717 | |||||||||||||||||||||
Pharmacy payable | 116 | 112 | |||||||||||||||||||||||
Capitation payable | 49 | 67 | |||||||||||||||||||||||
Other (1) | 245 | 296 | |||||||||||||||||||||||
$ | 1,920 | $ | 2,192 |
__________________ |
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(1) | “Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various state agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of operations. As of June 30, 2018 and December 31, 2017, we had recorded non-risk provider payables of approximately $158 million and $122 million, respectively. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE |
(Dollars in millions, except per-member amounts) |
Our claims liability includes a provision for adverse claims deviation based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. Our reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior period” represent the amount by which our original estimate of claims and benefits payable at the beginning of the period was (more) less than the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
Six Months Ended June 30, |
Year Ended |
||||||||||||||
2018 | 2017 | ||||||||||||||
Medical claims and benefits payable, beginning balance | $ | 2,192 | $ | 1,929 | $ | 1,929 | |||||||||
Components of medical care costs related to: | |||||||||||||||
Current period | 7,794 | 8,633 | 17,037 | ||||||||||||
Prior period (1) | (222 | ) | (31 | ) | 36 | ||||||||||
Total medical care costs | 7,572 | 8,602 | 17,073 | ||||||||||||
Change in non-risk provider payables | 56 | (114 | ) | (106 | ) | ||||||||||
Payments for medical care costs related to: | |||||||||||||||
Current period | 6,248 | 6,883 | 15,130 | ||||||||||||
Prior period | 1,652 | 1,457 | 1,574 | ||||||||||||
Total paid | 7,900 | 8,340 | 16,704 | ||||||||||||
Medical claims and benefits payable, ending balance | $ | 1,920 | $ | 2,077 | $ | 2,192 | |||||||||
Days in claims payable, fee for service (2) | 49 | 46 | 54 |
__________________ |
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(1) | Excludes the 2018 benefit of the 2017 Marketplace CSR reimbursement. | |
(2) | Claims payable includes primarily IBNP. It also includes certain fee-for-service payables reported in “Other” medical claims and benefits payable amounting to $33 million, $157 million and $99 million, as of June 30, 2018, 2017 and December 31, 2017, respectively. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED SUMMARY OF SIGNIFICANT ITEMS AFFECTING SECOND QUARTER AND |
YEAR-TO-DATE FINANCIAL RESULTS |
(In millions, except per diluted share amounts) |
The table below summarizes the impact of certain items significant to our financial performance in the periods presented. The individual items presented below increase (decrease) income before income tax expense.
Three Months Ended |
Six Months Ended |
|||||||||||||||||||
Amount |
Per |
Amount |
Per |
|||||||||||||||||
Marketplace risk adjustment, for 2017 dates of service | $ | 79 | $ | 0.92 | $ | 56 | $ | 0.66 | ||||||||||||
Marketplace CSR subsidies, for 2017 dates of service | 6 | 0.07 | 76 | 0.90 | ||||||||||||||||
Restructuring costs | (8 | ) | (0.10 | ) | (33 | ) | (0.39 | ) | ||||||||||||
Loss on debt extinguishment | (5 | ) | (0.06 | ) | (15 | ) | (0.21 | ) | ||||||||||||
$ | 72 | $ | 0.83 | $ | 84 | $ | 0.96 |
__________________ |
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(1) | Except for certain items that are not deductible for tax purposes, per diluted share amounts are generally calculated at the statutory income tax rate of 22%. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED NON-GAAP FINANCIAL MEASURES |
We use non-generally accepted accounting principles, or non-GAAP, financial measures as supplemental metrics in evaluating our financial performance, making financing and business decisions, and forecasting and planning for future periods. For these reasons, management believes such measures are useful supplemental measures to investors in comparing our performance to the performance of other public companies in the health care industry. These non-GAAP financial measures should be considered as supplements to, and not as substitutes for or superior to, GAAP measures. See further information regarding non-GAAP measures below the tables (in millions, except per diluted share amounts).
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Adjustments: | ||||||||||||||||||||
Depreciation and amortization of intangible assets and capitalized software | 33 | 44 | 67 | 90 | ||||||||||||||||
Interest expense | 32 | 27 | 65 | 53 | ||||||||||||||||
Income tax expense (benefit) | 103 | (84 | ) | 175 | (30 | ) | ||||||||||||||
EBITDA | $ | 370 | $ | (243 | ) | $ | 616 | $ | (40 | ) | ||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||||||||||||||||||||||
Amount |
Per |
Amount |
Per |
Amount |
Per |
Amount |
Per |
|||||||||||||||||||||||||||||||||
Net income (loss) | $ | 202 | $ | 3.02 | $ | (230 | ) | $ | (4.10 | ) | $ | 309 | $ | 4.68 | $ | (153 | ) | $ | (2.74 | ) | ||||||||||||||||||||
Adjustment: | ||||||||||||||||||||||||||||||||||||||||
Amortization of intangible assets | 5 | 0.08 | 8 | 0.14 | 10 | 0.16 | 17 | 0.30 | ||||||||||||||||||||||||||||||||
Income tax effect (1) | (1 | ) | (0.02 | ) | (3 | ) | (0.05 | ) | (2 | ) | (0.04 | ) | (6 | ) | (0.11 | ) | ||||||||||||||||||||||||
Amortization of intangible assets, net of tax effect | 4 | 0.06 | 5 | 0.09 | 8 | 0.12 | 11 | 0.19 | ||||||||||||||||||||||||||||||||
Adjusted net income (loss) | $ | 206 | $ | 3.08 | $ | (225 | ) | $ | (4.01 | ) | $ | 317 | $ | 4.80 | $ | (142 | ) | $ | (2.55 | ) |
__________________ |
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(1) | Income tax effect of adjustments calculated at the blended federal and state statutory tax rate of 22% and 37% for 2018 and 2017, respectively. | |
The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release:
Earnings before interest, taxes, depreciation and amortization (EBITDA): Net income (loss) (GAAP) less depreciation, and amortization of intangible assets and capitalized software, interest expense and income tax expense. We believe that EBITDA is helpful in assessing our ability to meet the cash demands of our operating units.
Adjusted net income: Net income (loss) (GAAP) less amortization of intangible assets, net of income tax effect calculated at the statutory tax rate. We believe that adjusted net income (loss) is helpful in assessing our financial performance exclusive of the non-cash impact of the amortization of purchased intangibles.
Adjusted net income per diluted share: Adjusted net income (loss) divided by weighted average common shares outstanding on a fully diluted basis.
MOLINA HEALTHCARE, INC. 2018 REVISED GUIDANCE |
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Reconciliation of Non-GAAP Financial Measures |
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(in millions, except per-share amounts) |
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Low End | High End | |||||||||||||||||||
Net income | $ | 471 | $ | 484 | ||||||||||||||||
Adjustments: | ||||||||||||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 125 | 125 | ||||||||||||||||||
Interest expense | 115 | 115 | ||||||||||||||||||
Income tax expense | 257 | 261 | ||||||||||||||||||
EBITDA | $ | 968 | $ | 985 | ||||||||||||||||
Low End | High End | |||||||||||||||||||
Amount | Per share (2) | Amount |
Per share (2) |
|||||||||||||||||
Net income | $ | 471 | $ | 7.15 | $ | 484 | $ | 7.35 | ||||||||||||
Adjustments: | ||||||||||||||||||||
Amortization of intangible assets | 21 | 0.32 | 21 | 0.32 | ||||||||||||||||
Income tax effect (1) | (5 | ) | (0.08 | ) | (5 | ) | (0.08 | ) | ||||||||||||
Amortization of intangible assets, net of tax effect | 16 | 0.24 | 16 | 0.24 | ||||||||||||||||
Adjusted net income | $ | 487 | $ | 7.39 | $ | 500 | $ | 7.59 |
__________________ |
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(1) | Income tax effect calculated at the statutory tax rate of 22%. | |
(2) |
Computation assumes 65.9 million diluted weighted average shares outstanding. |
View source version on businesswire.com: https://www.businesswire.com/news/home/20180731005924/en/
Source:
Molina Healthcare, Inc.
Ryan Kubota, 562-435-3666, ext. 119057
Investor
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