The following table presents the Company’s outlook for fiscal year 2015: (1)
| Premium Revenue | $13.4 billion | |||
| Health Insurer Fee Revenue (2) | $260 million | |||
| Premium Tax Revenue | $395 million | |||
| Service Revenue |
$185 million |
|||
| Investment and Other Income |
$15 million |
|||
| Total Revenue | $14.3 billion | |||
| Total Medical Care Costs | $12.1 billion | |||
| Medical Care Ratio (3) | 90.0% | |||
| Total Cost of Service Revenue | $150 million | |||
| General & Administrative Expenses | $1.1 billion | |||
| G&A Ratio (4) | 7.5% | |||
| Premium Tax Expense | $395 million | |||
| Health Insurer Fee Expense | $155 million | |||
| Depreciation & Amortization | $105 million | |||
| Interest and Other Expense | $60 million | |||
| Income Before Income Taxes | $275 million | |||
| Net Income | $117 million | |||
| EBITDA | $460 million | |||
| Effective Tax Rate | 57% | |||
| Diluted EPS (5) | $2.35 | |||
| Adjusted EPS (5) | $4.60 | |||
(1) All amounts are estimates; actual results may differ materially. See our risk factors as discussed in our Form 10-K and other filings.
(2) Outlook assumes full reimbursement of the Health Insurer Fee and
related tax effects in 2015, and recognition of
(3) Medical Care Ratio represents Medical Care Costs as a percentage of Premium Revenue.
(4) G&A Ratio computed as a percentage of Total Revenue.
(5) Computation assumes 50 million diluted weighted average shares outstanding; see reconciliation of non-GAAP financial measure on next page.
The following table reconciles net income per diluted share to adjusted net income per diluted share:(1) (2)
|
2015 |
|||||
| Net income per diluted share | $ | 2.35 | |||
| Adjustments, net of tax: | |||||
| Depreciation, and amortization of capitalized software | 1.33 | ||||
| Amortization of convertible senior notes and lease financing obligations | 0.37 | ||||
| Stock-based compensation | 0.35 | ||||
| Amortization of intangible assets | 0.20 | ||||
| Adjusted net income per diluted share | $ | 4.60 | |||
(1) All amounts are estimates and subject to change. Computation assumes 50 million diluted weighted average shares outstanding.
(2) Adjusted net income per diluted share is a non-GAAP financial
measure used by management as a supplemental metric in evaluating its
financial performance, its financing and business decisions, and in
forecasting and planning for future periods. This measure is not
determined in accordance with accounting principles generally accepted
in
2015 Business Outlook and Investor Meeting
The Company will host its 2015 Business Outlook and Investor Meeting
webcast and presentation on
About
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding the Company’s plans, expectations, and anticipated future events. Actual results could differ materially due to numerous known and unknown risks and uncertainties, including, without limitation, risk factors related to the following:
-
continuing uncertainties associated with the implementation of the
Affordable Care Act, including the full grossed up reimbursement by
states of the non-deductible ACA health insurer fee, the
Medicaid expansion, the insurance marketplaces, the effect of various implementing regulations, the King v. Burwell case now pending before theSupreme Court , and uncertainties regarding the Medicare-Medicaid dual eligible demonstration programs inCalifornia ,Illinois ,Michigan ,Ohio , andSouth Carolina ; - management of our medical costs, including seasonal flu patterns and rates of utilization that are consistent with our expectations, and our ability to reduce over time the high medical costs commonly associated with new patient populations;
- federal or state medical cost expenditure floors, administrative cost and profit ceilings, and profit sharing arrangements;
- the interpretation and implementation of at-risk premium revenue recognition rules regarding the achievement of certain quality measures;
- cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
-
the success of our new health plan in
Puerto Rico ; -
newly
FDA -approved specialty drugs such as Sovaldi, Olysio, Harvoni, and other specialty drugs or generic drugs that are exorbitantly priced but not factored into the calculation of our capitated rates; - 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 accurate estimation of incurred but not paid medical costs across our health plans;
-
retroactive adjustments to premium revenue or accounting estimates
which require adjustment based upon subsequent developments, including
Medicaid pharmaceutical rebates or retroactive premium rate increases; - efforts by states to recoup previously paid amounts;
-
the success of our efforts to retain existing government contracts
and to obtain new government contracts in connection with state
requests for proposals (RFPs) in both existing and new states,
including the success of the proposal of Molina Medicaid Solutions in
New Jersey ; - the continuation and renewal of the government contracts of both our health plans and Molina Medicaid Solutions and the terms under which such contracts are renewed;
-
complications, member confusion, or enrollment backlogs related to
the annual renewal of
Medicaid coverage; - government audits and reviews, and any fine, enrollment freeze, or monitoring program that may result therefrom;
- changes with respect to our provider contracts and the loss of providers;
- approval by state regulators of dividends and distributions by our health plan subsidiaries;
- changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
- high dollar claims related to catastrophic illness;
-
the favorable or unfavorable resolution of litigation, arbitration,
or administrative proceedings, including pending qui tam actions in
Florida andCalifornia , and the litigation commenced against us by the state ofLouisiana alleging that Molina Medicaid Solutions and its predecessors used an incorrect reimbursement formula for the payment of pharmaceutical claims; - the relatively small number of states in which we operate health plans;
-
our management of a portion of College Health Enterprises’ hospital
in
Long Beach, California ; - the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity and meet our liquidity needs, including the interest expense and other costs associated with such financing;
-
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;
- public alarm associated with the Ebola virus, measles, or any actual widespread epidemic;
- changes in general economic conditions, including unemployment rates;
-
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
Source:
Molina Healthcare, Inc.
Juan José Orellana, 562-435-3666, ext.
111143
Investor Relations