|
||||
Delaware
|
|
1-31719
|
|
13-4204626
|
(State
of incorporation)
|
|
(Commission
File Number)
|
|
(I.R.S.
Employer Identification
Number)
|
Exhibit
No.
|
Description |
99.1 | Press release of Molina Healthcare, Inc. issued August 8, 2005, as to financial results for the second quarter and six months ended June 30, 2005. |
MOLINA HEALTHCARE, INC. | ||
|
|
|
Date: August 8, 2005 | By: | /s/ Mark L. Andrews |
Mark
L. Andrews
Executive
Vice President, General Counsel
and
Corporate Secretary
|
Exhibit
No.
|
Description |
99.1 | Press release of Molina Healthcare, Inc. issued August 8, 2005, as to financial results for the second quarter and six months ended June 30, 2005. |
· |
Additional
claims expense of approximately $13.4 million for adverse out-of-period
claims development arising in the second quarter of 2005, all of
which
related to the first quarter of 2005. The effect of this item was
to
reduce second quarter earnings per diluted share by $0.30.
|
· |
Additional
claims expense of approximately $12.0 million ($0.27 per diluted
share for
the quarter and six months ended June 30) resulting from an increase
made
to the Company’s claims liability in order to mitigate the impact of any
future out-of-period claims development.
|
· |
Charges
totaling $3.1 million ($0.07 per diluted share for the quarter and
six
months ended June 30) for hospital provider settlements, a loss
contract charge unrelated to the Company’s Medicaid business, and the
expensing of costs associated with a registration statement filed
during
the quarter.
|
· |
A
benefit of $1.4 million ($0.03 per diluted share for the quarter
and six
months ended June 30) due to lowered employee bonus expense.
|
· |
Increased
hospital costs. The
Company has experienced a shift in utilization to higher cost hospitals.
|
· |
Increased
costs from catastrophic cases. The
Company has experienced increases in both the incidence and the acuity
of
catastrophic cases. The financial impact of such cases has outpaced
membership growth.
|
· |
Increased
maternity costs in Michigan and Washington.
The Company has experienced increased costs and increased utilization
of
maternity services, particularly in Western and Northeastern Michigan
and
in Washington. The cost of providing these services has grown faster
than
the revenue we receive for providing the services.
|
· |
Increased
outpatient utilization caused in part by a high incidence of flu-like
illness in Washington and a late arriving flu season in Michigan.
Flu
season in Washington appears to have been particularly severe in
2005.
Additionally, the unexpectedly delayed arrival of flu season in Michigan
led the Company to underestimate the impact of the flu season on
its
medical care ratio during the first quarter of the year.
|
· |
Partnering
with cost-effective providers.
The Company is working with its physician partners to insure that
members
requiring hospital care are referred to appropriate and cost-effective
hospitals. The Company is reassessing its hospital network needs
in
specific geographic areas and is attempting to re-contract with hospitals
as appropriate.
|
· |
Strengthening
medical
management.
The Company’s newly hired chief medical officer is leading efforts to
enhance the Company’s medical management capabilities in order to better
control medical costs. The Company is also instituting enhanced procedures
to identify catastrophic cases earlier and to better assess the potential
financial impact of such cases.
|
· |
Enhancing
utilization and cost analysis.
The Company is developing improved health informatics, thereby
strengthening its ability to derive actionable information from medical
data. This effort involves the implementation of uniform protocols,
reports and procedures and the installation of improved data analysis
software across all health plans.
|
· |
Seeking
appropriate compensation. The
Company is working with state authorities to insure that premium
rates are
adequate. This includes working to insure that the Company does not
bear a
disproportionate share of the cost of serving the seriously ill,
that
delivery case rates effectively match the costs of maternity services,
that premium rates incorporate the appropriate risk adjusters and
that
state recertification efforts do not result in adverse selection.
|
· |
Finding
the right funding for members.
The Company will also continue its efforts to insure that the appropriate
sources of funding are used in providing for member needs. In certain
circumstances, this will involve the enrollment of its members in
other
government programs.
|
· |
Improving
the payment process.
The Company has undertaken a number of initiatives to strengthen
the
linkages between medical management and the claims payment process.
Among
these initiatives are enhanced pre-authorization processes, improved
claims auditing procedures and the retention of third-party vendors
to
review claims adjudication both before and after the release of
payments.
|
· |
Operating
its own medical facilities.
The Company has operated an extensive network of primary care facilities
in California for over 20 years. It may seek to capitalize on its
experience as a direct provider of medical care in situations where
cost-effective providers are not
available.
|
· |
A
charge of $1.8 million for the settlement of certain provider
claims.
|
· |
A
loss contract charge of $0.9 million for a commercial membership
transition services agreement in New Mexico.
|
· |
The
write-off of $0.4 million of costs associated with a registration
statement filed during the second quarter of 2005.
|
June
30,
|
|
March
31,
|
|
June
30,
|
|
|||||
|
|
2005
|
|
2005
|
|
2004
|
||||
Michigan
|
152,000
|
157,000
|
90,000
|
|||||||
Washington
|
285,000
|
276,000
|
269,000
|
|||||||
California
|
339,000
|
254,000
|
245,000
|
|||||||
Utah
|
54,000
|
55,000
|
48,000
|
|||||||
New
Mexico
|
60,000
|
61,000
|
N/A
|
|||||||
Indiana
|
8,000
|
N/A
|
N/A
|
|||||||
Total
|
898,000
|
803,000
|
652,000
|
|||||||
Quarter
Ended
|
Six
Months Ended
|
|||||||||||||||
June
30,
|
|
March
31,
|
|
June
30,
|
|
June
30,
|
|
June
30,
|
|
|||||||
|
|
2005
|
|
2005
|
|
2004
|
|
2005
|
|
2004
|
||||||
Michigan
|
463,000
|
471,000
|
268,000
|
934,000
|
524,000
|
|||||||||||
Washington
|
842,000
|
823,000
|
679,000
|
1,665,000
|
1,269,000
|
|||||||||||
California
|
839,000
|
753,000
|
742,000
|
1,592,000
|
1,503,000
|
|||||||||||
Utah
|
169,000
|
159,000
|
138,000
|
328,000
|
270,000
|
|||||||||||
New
Mexico
|
183,000
|
187,000
|
N/A
|
370,000
|
N/A
|
|||||||||||
Indiana
|
20,000
|
N/A
|
N/A
|
20,000
|
N/A
|
|||||||||||
Total
|
2,516,000
|
2,393,000
|
1,827,000
|
4,909,000
|
3,566,000
|
|||||||||||
Three
Months Ended
|
Six
Months Ended
|
||||||||||||
June
30,
|
June
30,
|
||||||||||||
2005
|
2004
|
2005
|
2004
|
||||||||||
Revenue:
|
|||||||||||||
Premium
revenue
|
$
|
400,756
|
$
|
247,455
|
$
|
791,680
|
$
|
465,323
|
|||||
Other
operating revenue
|
1,159
|
691
|
2,422
|
1,986
|
|||||||||
Total
premium and other operating revenue
|
401,915
|
248,146
|
794,102
|
467,309
|
|||||||||
Investment
income
|
2,359
|
912
|
4,124
|
1,775
|
|||||||||
Total
operating revenue
|
404,274
|
249,058
|
798,226
|
469,084
|
|||||||||
Expenses:
|
|||||||||||||
Medical
care costs:
|
|||||||||||||
Medical
services
|
67,604
|
51,511
|
131,271
|
102,279
|
|||||||||
Hospital
and specialty services
|
257,266
|
132,964
|
483,798
|
242,753
|
|||||||||
Pharmacy
|
42,870
|
24,573
|
85,785
|
48,233
|
|||||||||
Provider
settlements
|
1,750
|
—
|
1,750
|
—
|
|||||||||
Total
medical care costs
|
369,490
|
209,048
|
702,604
|
393,265
|
|||||||||
Salary,
general and administrative expenses
|
37,060
|
18,842
|
70,606
|
36,300
|
|||||||||
Loss
contract charge (1)
|
939
|
—
|
939
|
—
|
|||||||||
Depreciation
and amortization
|
3,558
|
1,734
|
6,756
|
3,333
|
|||||||||
Total
expenses
|
411,047
|
229,624
|
780,905
|
432,898
|
|||||||||
Operating
income (loss)
|
(6,773
|
)
|
19,434
|
17,321
|
36,186
|
||||||||
Other
income (expense):
|
|||||||||||||
Interest
expense
|
(418
|
)
|
(258
|
)
|
(707
|
)
|
(513
|
)
|
|||||
Other,
net (2)
|
(400
|
)
|
(19
|
)
|
(400
|
)
|
1,143
|
||||||
Total
other income (expense)
|
(818
|
)
|
(277
|
)
|
(1,107
|
)
|
630
|
||||||
Income
(loss) before income taxes
|
(7,591
|
)
|
19,157
|
16,214
|
36,816
|
||||||||
Income
tax expense (benefit)
|
(2,885
|
)
|
7,207
|
6,161
|
13,768
|
||||||||
Net
income (loss)
|
$
|
(4,706
|
)
|
$
|
11,950
|
$
|
10,053
|
$
|
23,048
|
||||
Net
income (loss) per share:
|
|||||||||||||
Basic
|
$
|
(0.17
|
)
|
$
|
0.44
|
$
|
0.36
|
$
|
0.87
|
||||
Diluted
|
$
|
(0.17
|
)
|
$
|
0.43
|
$
|
0.36
|
$
|
0.86
|
||||
Weighted
average number of common shares and
|
|||||||||||||
potential
dilutive common shares outstanding
|
27,707,000
|
27,738,000
|
27,981,000
|
26,829,000
|
|||||||||
Operating
Statistics:
|
|||||||||||||
Medical
care ratio (3), excluding
provider settlements
|
91.5
|
%
|
84.2
|
%
|
88.3
|
%
|
84.2
|
%
|
|||||
Provider
settlements
|
0.4
|
%
|
—
|
0.2
|
%
|
—
|
|||||||
Total
medical care ratio
|
91.9
|
%
|
84.2
|
%
|
88.5
|
%
|
84.2
|
%
|
|||||
Salary,
general and administrative expense
|
|||||||||||||
ratio
(4)
excluding
premium taxes
|
6.7
|
%
|
5.9
|
%
|
6.2
|
%
|
6.2
|
%
|
|||||
Premium
taxes included in salary,
|
|||||||||||||
general
and administrative expenses
|
2.5
|
%
|
1.7
|
%
|
2.6
|
%
|
1.5
|
%
|
|||||
Total
salary, general and
|
|||||||||||||
administrative
expense ratio
|
9.2
|
%
|
7.6
|
%
|
8.8
|
%
|
7.7
|
%
|
|||||
Members
(5)
|
898,000
|
652,000
|
|||||||||||
Days
in claims payable
|
50
|
51
|
(1)
|
Represents
a charge related to a transition services agreement entered into
in
connection with the transfer of certain commercial members to another
health plan in August 2004.
|
(2)
|
For
the quarter ended June 30, 2005, includes a charge of $0.4 million
related
to the write-off of costs associated with a registration statement
filed
during the second quarter of 2005. For the six months ended June
30, 2004,
includes $1.162 million in income arising from the termination in
the
first quarter of 2004 of a split dollar life insurance arrangement
between
the Company and a related party.
|
(3)
|
Medical care ratio represents medical care costs as a percentage of premium and other operating revenue. |
(4)
|
Salary,
general and administrative expense ratio represents such expenses
as a
percentage of total operating revenue.
|
(5)
|
Number of members at end of period. |
June
30,
|
|
Dec.
31,
|
|
||||
|
|
2005
|
|
2004
|
|
||
|
|
(Unaudited)
|
|
||||
ASSETS
|
|||||||
Current
assets:
|
|||||||
Cash
and cash equivalents
|
$
|
202,463
|
$
|
228,071
|
|||
Investments
|
85,615
|
88,530
|
|||||
Receivables
|
68,974
|
65,430
|
|||||
Income
tax receivable
|
11,931
|
—
|
|||||
Deferred
income taxes
|
3,576
|
3,981
|
|||||
Prepaid
and other current assets
|
8,593
|
8,306
|
|||||
Total
current assets
|
381,152
|
394,318
|
|||||
Property
and equipment, net
|
29,248
|
25,826
|
|||||
Goodwill
and intangible assets, net
|
125,290
|
98,727
|
|||||
Restricted
investments
|
10,936
|
10,847
|
|||||
Other
assets
|
9,013
|
4,141
|
|||||
Total
assets
|
555,639
|
$
|
533,859
|
||||
LIABILITIES
AND STOCKHOLDERS’ EQUITY
|
|||||||
Current
liabilities:
|
|||||||
Medical
claims and benefits payable
|
$
|
179,337
|
$
|
160,210
|
|||
Accounts
payable and accrued liabilities
|
17,066
|
22,966
|
|||||
Net
liability for commercial membership sale
|
939
|
1,676
|
|||||
Income
taxes payable
|
—
|
7,110
|
|||||
Current
maturities of long-term debt
|
177
|
171
|
|||||
Total
current liabilities
|
197,519
|
192,133
|
|||||
Long-term
debt, less current maturities
|
4,735
|
1,723
|
|||||
Deferred
income taxes
|
4,899
|
5,315
|
|||||
Other
long-term liabilities
|
4,361
|
4,066
|
|||||
Total
liabilities
|
211,514
|
203,237
|
|||||
Stockholders’
equity:
|
|||||||
Common
stock, $0.001 par value; 80,000,000 shares authorized;
|
|||||||
issued
and outstanding: 27,739,843 shares at June 30, 2005,
|
|||||||
and
27,602,443 shares at December 31, 2004
|
28
|
28
|
|||||
Preferred
stock, $0.001 par value; 20,000,000 shares authorized,
|
|||||||
no
shares issued and outstanding
|
—
|
—
|
|||||
Additional
paid-in capital
|
161,239
|
157,666
|
|||||
Accumulated
other comprehensive income (loss)
|
(357
|
)
|
(234
|
)
|
|||
Retained
earnings
|
203,605
|
193,552
|
|||||
Treasury
stock (1,201,174 shares, at cost)
|
(20,390
|
)
|
(20,390
|
)
|
|||
Total
stockholders’ equity
|
344,125
|
330,622
|
|||||
Total
liabilities and stockholders’ equity
|
$
|
555,639
|
$
|
533,859
|
Six
Months Ended
|
|||||||
June
30,
|
|||||||
2005
|
2004
|
||||||
Operating
activities:
|
|||||||
Net
income
|
$
|
10,053
|
$
|
23,048
|
|||
Adjustments
to reconcile net income to net cash provided by operating
activities:
|
|||||||
Depreciation
and amortization
|
6,756
|
3,333
|
|||||
Amortization
of capitalized credit facility fees
|
338
|
314
|
|||||
Deferred
income taxes
|
68
|
516
|
|||||
Tax
benefit from exercise of employee stock options
|
|||||||
recorded
as additional paid-in capital
|
1,758
|
2,029
|
|||||
Stock-based
compensation
|
341
|
—
|
|||||
Changes
in operating assets and liabilities:
|
|||||||
Receivables
|
(3,544
|
)
|
(2,800
|
)
|
|||
Prepaid
and other current assets
|
(287
|
)
|
(573
|
)
|
|||
Medical
claims and benefits payable
|
19,127
|
(4,018
|
)
|
||||
Accounts
payable and accrued liabilities
|
(6,637
|
)
|
1,906
|
||||
Income
taxes payable (receivable)
|
(17,784
|
)
|
218
|
||||
Net
cash provided by operating activities
|
10,189
|
23,973
|
|||||
Investing
activities:
|
|||||||
Purchases
of equipment
|
(6,798
|
)
|
(2,172
|
)
|
|||
Purchases
of investments
|
(19,645
|
)
|
(401,644
|
)
|
|||
Sales
and maturities of investments
|
22,358
|
382,546
|
|||||
Net
cash paid in purchase transactions
|
(31,200
|
)
|
(18,000
|
)
|
|||
Increase
in restricted cash
|
(89
|
)
|
—
|
||||
Other
long-term liabilities
|
295
|
|
(5
|
)
|
|||
Other
assets
|
(5,210
|
)
|
2,953
|
||||
Net
cash used in investing activities
|
(40,289
|
)
|
(36,322
|
)
|
|||
Financing
activities:
|
|||||||
Issuance
of common stock
|
—
|
47,360
|
|||||
Borrowing
under credit facility
|
3,100
|
—
|
|||||
Principal
payments on capital lease obligations and mortgage note
|
(82
|
)
|
—
|
||||
Proceeds
from exercise of stock options and employee stock purchases
|
1,474
|
1,478
|
|||||
Net
cash provided by financing activities
|
4,492
|
48,838
|
|||||
Net
(decrease) increase in cash and cash equivalents
|
(25,608
|
)
|
36,489
|
||||
Cash
and cash equivalents at beginning of period
|
228,071
|
141,850
|
|||||
Cash
and cash equivalents at end of period
|
$
|
202,463
|
$
|
178,339
|
Six
Months Ended
|
|||||||
June
30,
|
|||||||
2005
|
2004
|
||||||
Balances
at beginning of period
|
$
|
160,210
|
$
|
105,540
|
|||
Components
of medical care costs related to:
|
|||||||
Current
year
|
702,454
|
398,970
|
|||||
Prior
years
|
150
|
(5,705
|
)
|
||||
Total
medical care costs
|
702,604
|
393,265
|
|||||
Payments
for medical care costs related to:
|
|||||||
Current
year
|
538,999
|
310,162
|
|||||
Prior
years
|
144,478
|
86,921
|
|||||
Total
paid
|
683,477
|
397,083
|
|||||
Balances
at end of period
|
$
|
179,337
|
$
|
101,722
|
|||