UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-K
Current Report
Pursuant to Section 13 or 15(d) of
the Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): February 20, 2013
MOLINA HEALTHCARE, INC.
(Exact name of registrant as specified in its charter)
Delaware | 1-31719 | 13-4204626 | ||
(State of Incorporation) | (Commission File Number) | (IRS Employer Identification No.) |
200 Oceangate, Suite 100, Long Beach, California 90802
(Address of principal executive offices)
Registrants telephone number, including area code: (562) 435-3666
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):
¨ | Written communication pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |
¨ | Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) |
¨ | Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) |
¨ | Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Item 7.01 Regulation FD Disclosure.
On February 20, 2013, Molina Healthcare, Inc. (the Company) issued a press release updating its 2013 guidance provided on February 7, 2013, to include the impact of the issuance of $550 million aggregate principal amount of cash convertible senior notes on February 15, 2013, and certain projected increases to its health care revenue. The full text of the press release is attached as Exhibit 99.1 to this report. The information contained in the websites cited in the press release is not part of this report.
In addition, on February 21, 2013, the Company presented and webcast certain slides as part of the Companys presentation at its Investor Day Conference held in New York City. A copy of the Companys complete slide presentation is included as Exhibit 99.2 to this report. An audio and slide replay of the live webcast of the Companys Investor Day presentation will be available for 30 days from the date of the presentation at the Companys website, www.molinahealthcare.com, or at www.earnings.com. The information contained in such websites is not part of this current report.
The information in this Form 8-K and the exhibits attached hereto shall not be deemed to be filed for purposes of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934, except as expressly set forth by specific reference in such a filing.
Item 9.01 Financial Statements and Exhibits
(d) Exhibits
Exhibit |
Description | |
99.1 | Press release of Molina Healthcare, Inc. issued February 20, 2013. | |
99.2 | Slide presentation given at the Investor Day Conference of Molina Healthcare, Inc. on February 21, 2013. |
SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
MOLINA HEALTHCARE, INC. | ||||||
Date: February 21, 2013 | By | /s/ Jeff D. Barlow | ||||
Jeff D. Barlow | ||||||
Sr. Vice PresidentGeneral Counsel and Secretary |
EXHIBIT INDEX
Exhibit No. |
Description | |
99.1 | Press release of Molina Healthcare, Inc. issued February 20, 2013. | |
99.2 | Slide presentation given at the Investor Day Conference of Molina Healthcare, Inc. on February 21, 2013. |
Exhibit 99.1
News Release
Contact:
Juan José Orellana
Investor Relations
562-435-3666, ext. 111143
MOLINA HEALTHCARE UPDATES FISCAL YEAR 2013 GUIDANCE
TO INCLUDE IMPACT OF ISSUANCE OF CASH CONVERTIBLE SENIOR NOTES
AND PROJECTED HIGHER PREMIUM REVENUE
Long Beach, California (February 20, 2013) Molina Healthcare, Inc. (NYSE: MOH) announced today that it is updating its 2013 guidance provided on February 7, 2013, to include the impact of the issuance of $550 million aggregate principal amount of cash convertible senior notes on February 15, 2013, and certain projected increases to its premium revenue. The Company is also expanding its guidance to include line items in addition to those provided on February 7, 2013. Updated 2013 guidance includes:
| Operating income expected to increase $10 million ($0.13 per diluted share) compared with previously issued guidance due to newly expected increases in premium revenue. |
| EBITDA expected to increase $10 million compared with previously issued guidance. |
| Issuance of convertible notes expected to reduce earnings per diluted share by $0.23 compared with previously issued guidance. Updated guidance includes an incremental $17 million ($0.21 per diluted share) of non-cash interest expense. |
| Earnings per diluted share projected at $1.45 for 2013. |
The issuance of the $550 million of cash convertible senior notes is expected to reduce earnings per diluted share by approximately $0.23 as follows:
| Non-cash interest expense is expected to reduce earnings per diluted share by approximately $0.21; |
| Cash interest expense is expected to reduce earnings per diluted share by approximately $0.07; and |
| Higher interest expense is expected to be offset by higher investment income and the reductions in share count resulting from the share buyback that accompanied the note issuance, the combination of which is expected to increase earnings per diluted share by approximately $0.05. |
The upsizing of the Companys convertible note offering from the $375 million anticipated at launch to the ultimate amount of $550 million resulted in incremental interest costs of approximately $0.10 per diluted share for all of 2013.
-MORE-
MOH Updates Fiscal Year 2013 Guidance
Page 2
February 20, 2013
The following is the Companys updated guidance for fiscal year 2013 (all amounts are approximate):
Premium Revenue |
$ | 6.7 billion | ||
Premium Tax Revenue |
$ | 160 million | ||
Service Revenue |
$ | 200 million | ||
Investment and Other Income |
$ | 13 million | ||
Total Revenue |
$ | 7.0 billion | ||
Medical Care Costs |
$ | 5.9 billion | ||
Medical Care Ratio |
88% | |||
Service Costs |
$ | 170 million | ||
G&A Expense |
$ | 600 million | ||
G&A Ratio |
8.6% | |||
Premium Tax Expense |
$ | 160 million | ||
Depreciation & Amortization |
$ | 78 million | ||
Operating Income |
$ | 157 million | ||
Interest Expense Excluding Non-Cash |
$ | 18 million | ||
Interest Expense Non-Cash |
$ | 24 million | ||
Income Before Tax |
$ | 115 million | ||
Income Tax |
$ | 48 million | ||
Effective Tax Rate |
42.0% | |||
Net Income |
$ | 67 million | ||
Weighted Average Diluted Shares Outstanding |
46.1 million | |||
Diluted EPS |
$ | 1.45 | ||
EBITDA |
$ | 255 million |
The Company will host an Investor Day meeting at the Le Parker Meridien Hotel in New York City on Thursday, February 21, 2013, from 12:30 p.m. to 4:30 p.m. Eastern Time. The Company will webcast the presentations offered by its management team, which will be followed by question-and-answer sessions. A 30-day online replay of the Investor Day meeting will be available approximately one hour following the conclusion of the live webcast. A link to this webcast can be found on the Companys website at www.molinahealthcare.com.
About Molina Healthcare
Molina Healthcare, Inc., a FORTUNE 500 company, provides quality and cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals and to assist state agencies in their administration of the Medicaid program. The Companys licensed health plans in California, Florida, Michigan, New Mexico, Ohio, Texas, Utah, Washington, and Wisconsin currently serve approximately 1.8 million members, and its subsidiary, Molina Medicaid Solutions, provides business processing and information technology administrative services to Medicaid agencies in Idaho, Louisiana, Maine, New Jersey, and West Virginia, and drug rebate administration services in Florida. More information about Molina Healthcare is available at www.molinahealthcare.com.
-MORE-
MOH Updates Fiscal Year 2013 Guidance
Page 3
February 20, 2013
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains forward-looking statements regarding the Companys 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:
| uncertainties associated with the implementation of the Affordable Care Act, including the impact of the health insurance industry excise tax, the expansion of Medicaid eligibility in the states that participate to previously uninsured populations unfamiliar with managed care, the implementation of state insurance exchanges currently expected to become operational by October 1, 2013, the effect of various implementing regulations, and uncertainties regarding the impact of other federal or state health care and insurance reform measures, including the duals demonstration programs in California, Illinois, Michigan, Ohio, Texas and Washington; |
| the success of our medical cost containment initiatives in Texas, and other risks associated with the expansion of our Texas health plans service areas in 2012; |
| 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; |
| management of our medical costs, including seasonal flu patterns and rates of utilization that are consistent with our expectations and our incurred but not reported accruals; |
| 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, and our ability to increase our revenues consistent with our expectations; |
| accurate estimation of incurred but not reported medical costs across our health plans; |
| risks associated with the continued growth in new Medicaid and Medicare enrollees, and the development of actuarially sound rates with respect to such new enrollees, including dual enrollees, or duals; |
| retroactive adjustments to premium revenue or accounting estimates which require adjustment based upon subsequent developments, including Medicaid pharmaceutical rebates or retroactive premium rate increases; |
| 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; |
| government audits and reviews, and any enrollment freeze or monitoring program that may result therefrom; |
| changes with respect to our provider contracts and the loss of providers; |
| the establishment of a federal or state medical cost expenditure floor as a percentage of the premiums we receive, and the interpretation and implementation of medical cost expenditure floors, administrative cost and profit ceilings, and profit sharing arrangements; |
| interpretation and implementation of at-risk premium rules regarding the achievement of certain quality measures; |
| 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 our pending litigation against the state of California related to rates paid to our California plan in earlier years that were not actuarially sound; |
| the relatively small number of states in which we operate health plans; |
| 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; |
| a states failure to renew its federal Medicaid waiver; |
| inadvertent unauthorized disclosure of protected health information; |
| changes generally affecting the managed care or Medicaid management information systems industries; |
| increases in government surcharges, taxes, and assessments; |
| changes in general economic conditions, including unemployment rates; increasing consolidation in the Medicaid industry; and |
numerous other risk factors, including those discussed in the Companys periodic reports and filings with the Securities and Exchange Commission. These reports can be accessed under the investor relations tab of the Companys website or on the SECs website at www.sec.gov. Given these risks and uncertainties, we can give no assurances that the Companys forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by the Companys forward-looking statements will in fact occur, and we caution investors not to place undue reliance on these statements. All forward-looking statements in this release represent the Companys judgment as of February 20, 2013, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in the Companys expectations.
-END-
Investor Day 2013A
February 21, 2013
New York, New York
Exhibit 99.2 |
Cautionary Statement
Safe
Harbor
Statement under the Private Securities Litigation Reform Act of 1995:
presentation and
our
accompanying
oral
remarks
contain
numerous
forward
looking
statements
regarding,
without
limitation:
our
short-term
and
long-term
revenue,
membership,
and
profitability
growth
projections;
market opportunities across all of our health plans related to dually eligible
members, to the Affordable Care Act
Medicaid
expansion,
and
to
the
insurance
exchanges
or
marketplaces; the
New
Mexico
Centennial
Care
program
and
the
Florida
Long
Term
Care
program; duals
and
ABD
opportunities
in
Illinois;
our
capital
requirements and potential financing sources; benefit expansions
in California and Utah; rate changes
expected in
2013; our
2013
financial
guidance; and
various
other
matters. All
of
our
forward-looking
statements are subject to numerous risks, uncertainties, and other factors that
could cause our actual results to
differ
materially. Anyone
viewing
or
listening
to
this
presentation
is
urged
to
read
the
risk
factors
and
cautionary
statements
found
under
Item
1A
in
our
annual
report
on
Form
10-K,
as
well
as
the
risk
factors
and
cautionary
statements
in
our
quarterly
reports
and
in
our
other
reports
and
filings
with
the
Securities
and
Exchange
Commission
and
available
for
viewing
on
its
website
at
www.sec.gov.
Except to
the
extent
otherwise
required by
federal
securities
laws,
we
do
not
undertake
to
address or update forward-looking
statements
in
future
filings
or
communications
regarding
our
business
or
operating
results.
©
2013 Molina Healthcare, Inc.
This slide
2 |
3
©
2013 Molina Healthcare, Inc.
Today
Approx. Time
Topic
Speaker
3
©
2013 Molina Healthcare, Inc.
Juan José
Orellana, VP Investor Relations
Opening Remarks
12:30pm-12:35pm
1:45pm-2:00pm
12:35pm-1:10pm
1:10pm-1:45pm
2:00pm-2:15pm
2:15pm-2:45pm
2:45pm-3:05pm
3:05pm-3:50pm
3:50pm-4:30pm
4:30pm
Business Overview
Operations Review
Q&A
Break
Financial Discussion
Q&A
Financial Discussion
Q&A
End of Program
Dr. J. Mario Molina, Chief Executive Officer
Terry Bayer, Chief Operating Officer
Joseph White, Chief Accounting Officer
John Molina, Chief Financial Officer |
Business Overview
J. Mario Molina, M.D.
President & Chief Executive Officer
February 21, 2013
New York, New York |
Our
Mission To provide quality health services to financially
vulnerable families and individuals covered by
government programs.
5
©
2013 Molina Healthcare, Inc. |
Strategic Intent
Our goal over the next three years is to increase the
annual revenue of the company from $6 billion to
$12 billion, while increasing profitability and
establishing a reputation as the premier health care
organization serving low-income persons served by
government programs.
6
©
2013 Molina Healthcare, Inc. |
Non-risk fee based fiscal agent
services, business process
outsourcing, and care and
utilization management.
What Makes Us Unique
Risk-based health plan
outsourcing for Medicaid and
other government programs.
We are a multistate healthcare organization with broad capabilities focused
exclusively on government-sponsored
healthcare
programs
for
low
income
individuals
and
families.
Company owned or company
operated primary care
community clinics.
Managed Care
Health Plans
Medicaid Health
Information Mgmt.
Healthcare
Direct
7
©
2013 Molina Healthcare, Inc.
No other company in the Medicaid space can do all three
|
1.8
million members Our Markets (4Q2012)
Business Snapshot
Californ
ia
336
k
(18
clinics)
New
Mexico
91k
(2
clinics)
Wiscons
in
46k
Michiga
n
220
k
Florida
73k
(2
clinics)
Idaho
MMI
S
Utah
87k
Washing
ton
418
k
(2
clinics)
Texas
282
k
W Virginia
MMIS
Ohio
244
k
Louisiana
MMIS
Maine
MMI
S
New Jersey
MMIS
Virgini
a
Direct
Delive
ry
(3
clinics)
75% TANF
15% ABD
8% CHIP
2% Medicare
Membership Profile
8
©
2013 Molina Healthcare, Inc. |
Strategic decision to focus exclusively on government
programs
Capabilities in managed care, fiscal agent and direct
delivery
Diversification: balance between mature and
expanding markets
Market presence in key Medicaid markets
Management continuity
Main Elements of our Business Model
9
©
2013 Molina Healthcare, Inc. |
Managed through difficult operating environment in
California, Texas, and Wisconsin
Revenues grew by $1.3 billion
Enrollment grew by an additional 100,000
Successful in Medicaid contract bids in Ohio and
Washington
Selected for Medicare Medicaid Plan (duals) contracts
in California, Ohio, and Illinois
Earned CMS certification for MMIS system in Idaho
2012 Performance Summary
10
©
2013 Molina Healthcare, Inc. |
State finances in fiscal 2013 are
modestly recovering in step with
the slowly improving national
economy.
MCOs are becoming
increasingly focused on vertical
integration with providers.
Robust pipeline as States expand
service areas, increase eligibility
groups, and increasingly turn
over the most costly members to
managed care.
Medicaid and government
focused businesses are highly
valued for their growth potential.
Bad for investment income, good
for borrowing.
Affordable Care
Act
Expansion of Medicaid in several
states represents a strong
tailwind for pure-play Medicaid
competitors.
Growth in the Medicaid addressable market and greater adoption of
Medicaid managed care
Business Environment & State of the Industry
Direct Delivery
Competition
Low Interest
Rates
State Fiscal
Conditions
Medicaid & Dual
Eligible RFPs
photo: sacbee.com
photo: cnn.com
11
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2013 Molina Healthcare, Inc. |
12
©
2013 Molina Healthcare, Inc.
1.
Mature Markets: high
managed care
penetration,
TANF
Examples:
California
Michigan
Management Priorities:
Actively manage margins
Efficiently gain market
share
Administrative cost
efficiency
2. Expanding Markets:
new regions, for
existing products
Examples:
Texas
Washington
Management Priorities:
Gain profitable market
share
Network re-contracting
Leverage existing
infrastructure
3. New Market/New
Products: duals,
marketplaces, carve-
ins
Examples:
California
Illinois
New Mexico
Management Priorities:
Invest in support
infrastructure
Build/Buy domain
experience
Three environmental factors have converged, each requiring different management
priorities. Business Environment and State of the Industry
|
13
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2013 Molina Healthcare, Inc.
States are exhibiting new programmatic purchasing trends
State Customer Purchasing Trends
Inclusion or exclusion of separate specific
services from a general Medicaid contract
Carve-Ins & Carve Outs
Care Management
Required care management programs
based on nationally recognized and
accepted evidence-based clinical protocols
Complex Patients
Financial Measures
Focus on Quality
Migration of higher cost patients such as
the duals into managed care
Increasing the use of financial measures
such as MCR floors, profit limits, P4P
programs
Greater focus on quality measured by
NCQA accreditation, Star ratings, HEDIS,
CAPHS |
14
©
2013 Molina Healthcare, Inc.
Listening to Our State Customers
TX
CA
OH
OH
IL
NM
FL
RFP Award Date
8/2011
4/2012
6/2012
8/2012
11/2012
2/2013
2/2013
Program Type
Star
Star+
PLUS
CHIP
Duals
TANF
ABD
Duals
Duals
ABD
TANF
ABD
LTC
LTC
Total Covered
Population
3.4M
122K
1.6M
48K
38K
735K
35K
Effective Date
3/2012
6/2013
7/2013
9/2013
Summer 2013
(ABD)
Winter 2013
(Duals)
1/2014
12/2013
State contract wins (trailing 18 months) |
15
©
2013 Molina Healthcare, Inc.
Estimated potential
revenue run-rate by 2015 as a result of duals and Medicaid expansion
Please refer to the Companys cautionary statements.
Long Term Incremental Growth Drivers
Duals
1
Current
Health Plan
Business
~$6B
~$4B
ACA
2
~$12B
Total
1.
Duals denotes revenue potential for dual eligibles in CA, MI, OH, IL, WA and
TX. 2.
ACA denotes revenue potential as a result of Medicaid expansion in CA, MI, OH, NM,
UT, WA, WI; and exchanges in CA, FL, MI, NM, OH, TX, UT, WA, WI. ~$2B
2012
2015 |
©
2013 Molina Healthcare, Inc.
Medicaid
& CHIP
Marketplaces
Employer
Non-group
& Other
Uninsured
Estimated Changes in Insurance Coverage by 2022*
1
2
March 2012 Baseline
July 2012 Estimate Incorporating
SCOTUS Decision on ACA
February 2013 Estimate Update
U.S. Medicaid Coverage Estimates
17M
22M
(3M)
(3M)(3M)
(33M)
11M
25M
(4M)
(30M)
12M
26M
(7M)
(4M)
(27M)
16
* Source: Congressional Budget Office, Estimates for the Insurance Coverage Provisions of
the Affordable Care Act Updated for the Recent Supreme Court Decision. July 2012.
1. The change in employment-based coverage is the net result of increases in cost and
losses of offers of health insurance from employers and changes in enrollment by workers and their families.
2. Other includes Medicare; the effects of the ACA are almost entirely on non-group
coverage . |
©
2013 Molina Healthcare, Inc.
Medicaid Expansion
Where
States
Stand
on
Medicaid
Expansion
as
of
February
2013
2
Participating
Leaning Toward Participating
Undecided/No Comment
Leaning Toward Not Participating
CA
OR
WA
ID
NV
UT
CO
NM
AR
MT
WY
ND
SD
NE
KS
OK
TX
MN
WI
IA
IL
MO
MI
LA
AR
MS
AL
GA
FL
TN
KY
IN
OH
PA
NY
ME
SC
NC
VA
WV
DE
MD
DC
VT
NH
MA
RI
CT
Not Participating
HI
AK
Federal Government Will
Bear Nearly All Medicaid
Expansion
Costs Over 2014-2022
1
States
Share
$73 billion
(7%)
Source(s):
1. Center on Budget and Policy Priorities analysis of the Congressional
Budget
Office
March
2012
baseline.
www.Cbpp.org
2.
http://www.advisory.com/Daily-Briefing/2012/11/09/MedicaidMap
17
NJ
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2013 Molina Healthcare, Inc.
Federal
Share
$931
billion
(93%) |
18
©
2013 Molina Healthcare, Inc.
Molina Healthcare will pursue entry into the health insurance
marketplaces in states where it currently has Medicaid
managed
care
contracts.
Requirement: State offers government-
subsidized products for low-income
persons(<250% of FPL) consistent with our
mission.
Be a partner with our state customers as they
manage the impact of the transition point
Extend our services to the lowincome
uninsured who share many characteristics with
our low income population
134%
-
250%
(Health Insurance
Marketplace)
0
133% FPL
(Medicaid/CHIP)
Molinas Participation in Health Insurance Marketplaces
|
19
©
2013 Molina Healthcare, Inc.
Membership by Product
2012
TANF/CHIP
83%
ABD &
Medicare
17%
Membership by Product
2008
TANF/CHIP
92%
ABD &
Medicare
8%
1.3 Million Members
1.8 Million Members
Molina Has Experience With Complex Patients
Molina has added 173,000 Aged, Blind or Disabled members since 2008
|
Molina Market
Infrastructure
CA
OH
MI
TX
WA
Mature Provider
Network
State Government
Program
TANF,
ABD,
CHIP
TANF,
ABD
TANF,
ABD,
CHIP
TANF,
ABD,
CHIP
TANF,
ABD,
CHIP
Federal Program
(Medicare SNP)
Direct Delivery
Presence
-
-
-
Existing Infrastructure Will Support Dual Eligible Patients
20
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2013 Molina Healthcare, Inc. |
21
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2013 Molina Healthcare, Inc.
Pricing & Savings Targets for Duals
CMS Rate Setting Process
Guidance
Sample Aggregate Savings Targets
Under the Demonstrations
1.
CMS Joint Rate Setting Process Under the Capitated Financial Alignment
Initiative 2.
Memorandum of Understanding (MOU) between CMS and the State of Ohio
3.
Memorandum of Understanding (MOU) between CMS and the State of Massachusetts
Massachusetts
Not
a Molina State
MOU released August 2012
Ohio
Molina Selected for 3 Regions
MOU released December 2012
Savings targets may differ among
States with low historic Medicare
spending, low utilization of institutional
long-term care services, or a high
penetration of Medicaid managed care.
Savings percentages will be applied equally to the Medicaid and Medicare A/B
components. Rate updates will take place on January 1st of each calendar
year. 2,
3
3
2
1 |
Tailwinds & Headwinds
Medicaid expansion
Tailwinds
Footprint includes 4 out 5 largest
Medicaid Markets
Uniquely positioned to capture dual
eligible enrollment
Delayed State implementations
Headwinds
Industry tax
Medical cost pressure associated with
new contracts/populations
©
2013 Molina Healthcare, Inc.
22 |
23
©
2013 Molina Healthcare, Inc.
Mission
Priorities
Manage our growth
Organic growth
Medicaid expansion
Dual eligible population
RFPs
Leverage our business portfolio
Health plan business
MMS
Direct delivery
Strive for operational excellence
Quality Care
Star Ratings
Our Strategic Priorities
Our mission is to provide quality health
services to financially vulnerable
families and individuals covered by
government programs.
Margin Expansion |
Operations Review
Terry Bayer
Chief Operations Officer
February 21, 2013
New York, New York |
25
©
2013 Molina Healthcare, Inc.
Historical Revenue
2008-2012
Percent represents year over year increase
(decrease) Revenue
Total revenue up 26% over 2011 |
26
©
2013 Molina Healthcare, Inc.
+16%
+11%
+5%
+6%
Historical EOY Membership
2008-2012
Percent represents year over year increase
(decrease) Membership
Aggregate membership up 6% over 2011
1,256K
1,455K
1,613K
1,697K
1,797K
2008
2009
2010
2011
2012 |
27
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2013 Molina Healthcare, Inc.
Quarterly MCR* 2011-2012
(2012 YE MCR 89.9%)
* Figures reflect medical care ratio net of premium tax
Quarterly Medical Care Ratio 2011-2012
Second Half 2012 improvement in MCR |
28
California
Premium rate increase for
the ABD population
Approximately 2% rate
increase
retroactive to
July 1, 2011
Decrease in inpatient
utilization
California MCR* FY2012
* MCR net of premium tax
©
2013 Molina Healthcare, Inc. |
29
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2013 Molina Healthcare, Inc.
Texas
Effective March 1, 2012, Molina added three new service areas in
Texas. Medical care costs particularly among ABD patients in
Hidalgo and El Paso service area increased dramatically.
Remediation activities:
New President &
Management Team
Provider contract changes
Re-contracted at lower unit costs
Implementation of state required
fee schedules
Utilization management
Blended rate increase of
4% effective 9/1/2012
Molina Healthcare of Texas
Adjusted
Quarterly Medical Care Ratio 2012
1. Adjusted medical care ratio is estimated based upon retroactive adjustments
to revenue and medical cost for all quarters in 2012
Added new service
areas 3/1/2012
Molina Healthcare of Texas
Historical Enrollment Growth
2008-2012
29
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1 |
30
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2013 Molina Healthcare, Inc.
Molina Selected To Expand Statewide in Ohio
In Q3 2013 Molina Healthcare will expand into 38 new counties.
* OH Molina members as of December 31, 2012
Ohio MCR 2008-2009
* MCR net of premium tax
2013 Expansion counties
Current service area
96%
92%
86%
84%
89%
New Molina Statewide Service
Area
1.6M eligibles (TANF+ABD)
2008
2009
2010
2011
2012
Source: Ohio Department of Job and Family Services
http://jfs.ohio.gov/rfp/JFSR1213078019/JFSR1213078019.stm
http://jfs.ohio.gov/ohp/bmhc/documents/reports/December2011
_CFC_Penetration-Enrollment.pdf |
31
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2013 Molina Healthcare, Inc.
Dayton
Columbus
Molina Selected To Serve Dual Eligibles in Ohio
Molina Healthcare will also participate in the 3-year dual eligibles
demonstration program in the Southwest, West Central, and
Central regions. Implementation is expected late 2013.
New Molina Integrated Care
Coordination Program Regions
45K Dual Eligible beneficiaries
West Central
Region
12k
Eligibles
Central
Region
16k
Eligibles
South West
Region
17k
Eligibles
Cincinnati
Source: Ohio Department of Job and Family Services
http://jfs.ohio.gov/rfp/JFSR1213078019/JFSR1213078019.stm
http://jfs.ohio.gov/ohp/bmhc/documents/reports/December2011_CFC_Penetration-
Enrollment.pdf |
32
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2013 Molina Healthcare, Inc.
Molina Selected for Centennial Care Contract in New Mexico
Molina will expand arranging for services beyond physical
and acute care by including behavioral health and long
term care, which were previously procured as separate
contracts
Approximately 735,000 beneficiaries
¹
560,000 current Medicaid beneficiaries
Up to 175,000 individuals starting in 2014 (ACA)
Number of health plans reduced from 6 to 4
Effective January 1, 2014
In 2012, Molinas contract in
New Mexico covered 90,000
New Mexicans and generated
$331 Million in premium
revenues.
Molina Healthcare of New Mexico selected
to participate in the
States Centennial Care plan (February 8, 2013)
1. Centennial Care: Ensuring Care for New Mexicans for the Next 100 Years and Beyond;
New Mexico Human Services Department; February 21, 2012 |
33
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2013 Molina Healthcare, Inc.
New Opportunities in Florida
Long Term Care Program
Molina will provide services to patients through the Florida
Statewide
Medicaid
Managed
Care
Long-Term
Care
(SMMC LTC) program
Regions awarded include Regions 5, 6 and 11
No change to price submission
Approximately 35,000 eligible members
Effective December 1, 2013
Molina Healthcare of Florida selected to provide health care
services to Long-Term Care patients (February 14, 2013)
1
1. Regions encompass Pasco, Pinellas, Hillsborough, Polk, Manatee, Hardee, Highland,
Miami-Dade, and Monroe counties
|
34
Historical IL Medicaid Enrollees
FY2006-2010
Illinois
ranks
as
the
4
th
largest
Medicaid
market
by
number
of
eligibles
Managed care penetration is less than 10%, at least 50% of
eligibles will be transitioned to managed care by 2015.
$ figures represent yearly Medicaid payments
©
2013 Molina Healthcare, Inc.
Why the Illinois Market?
Source:
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/illinois.html
|
35
The Illinois Duals Opportunity
The Illinois Medicare-Medicaid Alignment Initiative (MMAI) is
expected to begin passive enrollment on 10/2013, with an
effective date of 1/2014.
©
2013 Molina Healthcare, Inc. |
36
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2013 Molina Healthcare, Inc.
The Illinois ABD Opportunity
Springfield
Decatur
Bloomington
Peoria
Central Illinois
15 Counties
13k
Eligibles
East St. Louis
3 Counties
7k
Eligibles
Chicago
Illinois ABD for Central Illinois is expected to begin 6/2013 and
East St. Louis in 7/2013.
36
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2013 Molina Healthcare, Inc. |
37
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2013 Molina Healthcare, Inc.
Duals
What Are We Doing to Get Ready?
Dual Eligible
Readiness Review
Areas of Focus
Staffing capacity
and organizational
structure
Provider and
pharmacy
networks
Systems:
Claims,
Enrollment,
Payment, etc.
Person-first
services:
UM/Care
Coordination
Performance
and Quality
Improvement
Member
Protections
37
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2013 Molina Healthcare, Inc. |
38
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2013 Molina Healthcare, Inc.
Duals
Model of Care
Integrated
LTSS/Acute
And Rx
Care
Transition
Programs
Measuring
Improvements
Individualized
Care Plans
Medication
Reviews and
Medication
Therapy
Mgmt.
Interdisciplinary
Care Teams
Health Risk
Assessments
Care
Management
38
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2013 Molina Healthcare, Inc. |
39
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2013 Molina Healthcare, Inc.
Q&A |
2012 Results
John
Molina,
Chief
Financial
Officer
February 21, 2013
New York, New York |
©
2013 Molina Healthcare, Inc.
Quarterly Results
Premium Revenue
Premium Tax Revenue
Service Revenue
Investment and Rental Income
Medical Care Costs
Medical Care Ratio
2
Service Costs
G&A Expense
G&A Ratio
3
Premium Tax Expense
Depreciation & Amortization
Operating Income
Interest Expense
Income Tax
Net Income
Diluted EPS
Weighted Average Diluted
Shares Outstanding
$1.5B
$38.0M
$55.4M
$5.2M
$1.3B
85.9 %
$43.1M
$153.4M
9.7 %
$38.0M
$16.3M
$54.1M
$4.3M
$24.5M
$25.6M
$0.54
47.1M
$1.2B
$44.0M
$49.2M
$2.2M
$1.0B
85.7 %
$39.0M
$125.0M
9.6 %
$44.0M
$12.1M
($16.1M)
$3.9M
$13.0M
($33.0M)
($0.72)
45.7M
Q4 2012
Q4 2011
1
41
1.
Results for the quarter ended December 31, 2011 were affected by an impairment charge of $64.6 million
related to the Companys Missouri health plan.
2.
Medical care ratio represents medical care costs as a percentage of premium revenue, net of premium
taxes. 3.
Computed as a percentage of total revenue.
|
©
2013 Molina Healthcare, Inc.
Year End Results
Premium Revenue
Premium Tax Revenue
Service Revenue
Investment and Rental Income
Medical Care Costs
Medical Care Ratio
2
Service Costs
G&A Expense
G&A Ratio
3
Premium Tax Expense
Depreciation & Amortization
Operating Income
Interest Expense
Income Tax
Net Income
Diluted EPS
Weighted Average Diluted
Shares Outstanding
$5.7B
$159.0M
$187.7M
$14.6M
$5.1B
89.9 %
$141.2M
$532.6M
8.8 %
$159.0M
$63.7M
$35.5M
$16.8M
$9.3M
$9.8M
$0.21
47.0M
$4.4B
$154.6M
$160.4M
$6.0M
$3.9B
86.8 %
$144.0M
$415.9M
8.7 %
$154.6M
$50.7M
$80.2M
$15.5M
$43.8M
$20.8
$0.45
46.4M
2012
2011
1
42
1.
Results for the year ended December 31, 2011 were affected by an impairment charge of $64.6
million related to the Companys Missouri health plan.
2.
Medical care ratio represents medical care costs as a percentage of premium revenue, net of premium
taxes. 3.
Computed as a percentage of total revenue.
|
Earnings Margin 2006-2012
EBITDA Margin
H1N1 Flu
Excluding
Texas and
Missouri
After Tax Margin
Excluding
Missouri
write-down
TX & OH
Startup
H1N1 Flu
Excluding
Texas and
Missouri
Excluding
Missouri
write-down
TX & OH
Startup
1. P denotes results excluding Missouri write-down in 2011, and Texas and
Missouri operations in 2012 43
©
2013 Molina Healthcare, Inc. |
Long-Term Growth Update
John
Molina,
Chief
Financial
Officer
February 21, 2013
New York, New York |
©
2013 Molina Healthcare, Inc.
Estimated potential
revenue run-rate by 2015 as a result of duals and Medicaid expansion
Please refer to the Companys cautionary statements.
Long Term Incremental Growth Drivers
Duals
¹
Current
Health Plan
Business
~$6B
~$4B
ACA
~$12B
Total
1.
Duals denotes revenue potential for dual eligibles in CA, MI, OH, IL, WA and
TX. 2.
ACA denotes revenue potential as a result of Medicaid expansion in CA, MI, OH, NM,
UT, WA, WI; and exchanges in CA, FL, MI, NM, OH, TX, UT, WA, WI. ~$2B
2012
2015
2
45 |
46
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2013 Molina Healthcare, Inc.
Dual Eligibles Market Opportunity
State
Dual
Eligibles
Statewide
Estimated
Potential
Enrollment
1
Estimated
PMPM
Revenue
Annualized
Potential
Revenue
2
California
527K
392K
61K
$2,600
$1.9B
Ohio
115K
48K
24K
$2,600
$0.7B
Illinois
156K
18K
9K
$2,600
$0.3B
Michigan
4
199K
62K
31K
$2,600
$1.0B
Washington
4
115K
40K
20K
$2,600
$0.6B
Texas
4
214K
160K
80K
$2,600
$2.5B
Total
1.3M
720K
225K
$2,600
$7.0B
Potential impact of delays in implementation, reduced Molina market share
or reductions in covered individuals
Estimated Total Revenue
$4.0B
Please refer to the Companys cautionary statements.
3
3
Dual Eligibles
in Molina
Service Areas
($3.0B)
Source: Company estimates, figures may not add due to rounding.
1)
Based on 50% market share in Molina Service areas and counties in Ohio, Illinois, Michigan, Texas and
Washington. In California assumes 50% market share in San Diego, Riverside and San Bernardino markets. Membership projections exclude LA county
2)
Assumes a $2,600 premium based on Ohio Medicaid dual eligibles premiums, estimated Medicare premiums
and assumes 40% opt out of Medicare.
3)
2013 start date
4)
2014 Start date
3 |
47
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2013 Molina Healthcare, Inc.
Medicaid Expansion Opportunity
State
Expansion
Eligibles in
Medicaid
Managed Care
Molinas
Estimated
Enrollment
Estimated
Premium
1
PMPM
Annualized
Potential
Revenue
California
1M
100K
$155
$185M
Florida
not included
not included
not included
not included
Michigan
500K
100K
$215
$260M
New Mexico
100K
30K
$310
$110M
Ohio
500K
145K
$375
$650M
Texas
not included
not included
not included
not included
Utah
125K
40K
$240
$115M
Washington
250K
125K
$230
$345M
Wisconsin
125K
15K
$130
$20M
Total
2.6M
555K
-
$ 1.7B
Please refer to the Companys cautionary statements.
Source: Company estimates, figures may not add due to rounding.
1.
Based on Molinas current TANF and ABD premium |
48
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2013 Molina Healthcare, Inc.
State
Number of
Marketplace
Members in
Molina Markets
Molinas
Estimated
Marketplace
Enrollment
Estimated
Premium
PMPM
Annualized
Potential
Revenue
California
1.4M
28K
$136M
Florida
546K
26K
$400
$122M
Michigan
246K
35K
$400
$87M
New Mexico
63K
4K
$400
$19M
Ohio
264K
22K
$400
$106M
Texas
693K
66K
$400
$319M
Utah
87K
5K
$400
$22M
Washington
266K
30K
$400
$14M
Wisconsin
76K
20K
$400
$54M
Illinois
not included
not included
not included
not included
Total
3.6M
236K
$0.9B
Potential impact of delays in implementation, reduced Molina market
share or reductions in covered individuals
($0.3B)
Estimated Total Revenue
$0.6B
Marketplace Opportunity
Source: Company estimates, figures may not add due to rounding.
Please refer to the Companys cautionary statements.
$400 |
Convertible Debt
Joseph
White,
Chief
Accounting
Officer
February 21, 2013
New York, New York |
©
2013 Molina Healthcare, Inc.
$550M Convertible Debt Offering
Please refer to the Companys cautionary statements.
Convertible Debt
$550M
Pay Down Revolver
($40M)
Pay Down Existing Notes
($187M)
Share Repurchase
($50M)
Call Spread
($74M)
Fees
($17M)
Balance from Proceeds
$182M
Sources and Uses
$550M Convertible Debt
Underlying shares (13.5 million)
1.125% coupon ($ 0.07 2013
EPS)
32.5% conversion ($40.77 per
share)
75.0% high call ($53.85 per
share)
Cash Settle
Maturity 1/15/2020
GAAP interest rate 6% ($0.21
2013 EPS related to non cash
interest expense)
$550,000,000
February 2013
1.125% Convertible Senior Notes due 2020
Interest payable January 15 and July 15
50 |
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2013 Molina Healthcare, Inc.
Why a Convert?
Financing
Considerations
High Yield
Debt
Convertible
Debt
Equity
Coupon
High
Low
None
Dilution
None
Limited
High
Speed of execution
Slow
Fast
Moderate
$550,000,000
February 2013
1.125% Convertible Senior Notes due 2020
Interest payable January 15 and July 15
51 |
52
©
2013 Molina Healthcare, Inc.
MOH Convertible Note
A.
We have issued debt with a 1.125%
coupon
B.
We will pay additional cash if our
share price exceeds $40.77
(on 13.5
million shares)
C.
We have bought a bond hedge
requiring counter parties to pay us the
amount we pay to the note holders in B
above
D.
We must issue shares to the bond
hedge counter parties to make them
whole above a share price of $53.85
What Have We Done?
Convert
Key Share Prices
Share Price
Close
2/11/2013
Convertible
Price/Low Strike
Convertible
Price/High Strike
$30.77
$40.77
$53.85
32.5%
75% |
53
©
2013 Molina Healthcare, Inc.
MOH Convertible Note Settlement
Note
Holders
53
©
2013 Molina Healthcare, Inc.
Underlying
Shares
-
13.5
million
Conversion
price
(low
strike)
-
$40.77
High Strike -
$53.85
Example : Share Price < $40.77
At Maturity
Share Price
Conversion Price
$550M
Principal Payment |
MOH
Convertible Note Settlement Note
Holders
Bond Hedge
Counter
Parties
* 13.5 million underlying shares x $5 per
share ($45.77 market price less $40.77
conversion/low strike)
At Maturity
Share
Price
Conversion
Price
but
High
Strike
Example
:
Share
Price
$45.77
($5
above
low
strike)
Underlying
Shares
-
13.5
million
Conversion
price
(low
strike)
-
$40.77
High
Strike
-
$53.85
$550M
Principal Payment
$67.5M*
+
Conversion Premium
$67.5M*
Bond Hedge
(Cash Settlement)
Settlement
©
2013 Molina Healthcare, Inc.
54 |
55
©
2013 Molina Healthcare, Inc.
MOH Convertible Note Settlement
Note
Holders
Bond Hedge
Counter
Parties
*13.5 million underlying shares x $18.08 per share
($58.85 market price less $40.77 conversion/low
strike)
** $67.5 million (13.5 million underlying shares x $5 per
share( $58.85 market price less $53.75 high strike
price) divided by market price ($58.85)
55
©
2013 Molina Healthcare, Inc.
Underlying
Shares
-
13.5
million
Conversion price (low strike) -
$40.77
High Strike -
$53.85
Example : Share Price $58.85 ($5 above
high strike)
At Maturity
$550M
Principal Payment
+
$244M*
Conversion Premium
(Cash Settlement)
$244M*
Bond Hedge
Settlement
1.15M
Shares
MOH Common Stock**
Share Price
High Strike |
56
©
2013 Molina Healthcare, Inc.
<$40.77
>$53.85
MOH Convertible Note Settlement
MOH share price $40.77
$40.77 MOH Share Price
$53.85
MOH Share Price
$53.85
Pay Principal
+ Cash Value of Shares
greater than $40.77
Settle hedge; receive cash
value of share price in
excess of $40.77
Issue shares at $53.85
Pay Principal +
+ Cash Value of Shares
greater than $40.77
Settle hedge; receive
cash value of share
price in excess of
$40.77
No Action
Pay principal
Note
Bond
Hedge
Warrant
No Action
No Action |
57
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2013 Molina Healthcare, Inc.
Value of convertible
debt at date of
issuance (with both
debt and option
components)
-
Value of debt component
at date of issuance, based
on present value of cash
flows
=
Value of option
component at date of
issuance
GAAP requires that convertible debt be bifurcated into:
A vanilla
debt component; and a
Derivative option component representing the value of the conversion feature.
For cash settled convertible debt the derivative is classified as a liability.
Accounting For Convertible Debt
Why 6% of interest expense for a 1.125% coupon sold at par?
|
©
2013 Molina Healthcare, Inc.
Accounting For Convertible Debt
Why 6 % of interest expense for a 1.125% coupon sold at par?
Value of convertible
debt at date of
issuance (with both
debt and option
components)
-
Value of debt component
at date of issuance, based
on present value of cash
flows
=
Value of option
component at date of
issuance
Value of the debt component is based on NPV of cash flows (principal plus
interest) Interest rate is estimate of what Molina would pay on similar
non-convertible debt The
debt
component
is
recoded
on
the
balance
sheet
net
of
a
debt
discount.
That discount is written off (the amount of the debt component is increased) over
time by the recognition of non-cash interest expense.
Non-cash interest expense will reduce EPS by an estimated $0.21 in 2013.
Value of the option based derivative liability is determined by subtracting the
value of the debt component from the value of the convertible at date of
issuance. The derivative liability will be matched by an asset derivative
representing Molinas right to collect on the bond hedge.
Both derivatives (asset + liability) will be marked to market quarterly.
58 |
Funding Our Growth
John Molina,
Chief Financial Officer
February 21, 2013
New York, New York |
©
2013 Molina Healthcare, Inc.
Capital Needs
Current regulatory
requirements
Future (anticipated) regulatory
requirements in currents
and new states
Capital demands on health plans in the event of losses
Costs of acquisitions and other expansions
Costs of MMS implementations in new and existing states
Costs of infrastructure
$6B
Revenues are
estimated to reach
$12B by 2015 as a
result of duals and
Medicaid expansion
2012
2015
Please refer to the Companys cautionary statements.
60
$12B |
©
2013 Molina Healthcare, Inc.
Sources of Capital
Current excess net worth
Issuance of securities
debt
equity
convertible
Future earnings
Alternative Financing
sale and lease back
capital leases
structured co-insurance or structured quota share
Please refer to the Companys cautionary statements.
61 |
©
2013 Molina Healthcare, Inc.
Estimated regulatory capital at 12/31/12
approximately $0.5B; compared to a
requirement of approximately $0.3B.
1. Denotes estimated required regulatory capital for 12/31/12
2. Excess assumes actual regulatory capital as of 12/31/12
Regulatory Capital and Requirements
$0.3B
$0.2B
Excess
Regulatory
Capital
Capital
1
$0.5B
Surplus regulatory capital will support
$2.8B
of
incremental
revenue
$5.7B
$2.8B
Growth Capacity
with Existing
Regulatory
Capital
Current
Revenue
$8.5B
Required minimum net worth on average is 7% of revenue
Please refer to the Companys cautionary statements.
62
2
Regulatory Capital
Growth Capacity
Required
Regulatory |
©
2013 Molina Healthcare, Inc.
Issuance of securities
Convertible Debt
$550M
Pay Down Revolver
.
($40M)
Pay Down Existing Notes
....
($187M)
Share Repurchase.
..
($50M)
Call Spread
..
($74M)
Fees
.
($17M)
Balance from Proceeds
...
$182M
On February 11, 2013, we issued $550M convertible notes
Please refer to the Companys cautionary statements.
63
Net proceeds from convertible debt issuance supports $2.6 billion of revenue
Required minimum net worth on average is 7% of revenue |
©
2013 Molina Healthcare, Inc.
Summary of Growth Capacity
Current required capital
$0.3B
$0.2B
$0.2B
$0.8 -
$1.1B
$5.7B
$2.8B
$2.6B
$13B -
$17B
Required minimum net worth on average is 7% of revenue
Current excess capital
Proceeds from convertible
Retained earnings @ 0.5%*
Retained earnings @ 1.0%*
Retained earnings @ 1.5%*
$0.1B
$0.1B
$0.1B
* Retained earnings @ % of net income margin, each 0.5% equates to $0.1B
Capital
$2.0B
$2.0B
$2.0B
Current Revenue
Capacity
Revenue capacity dependent
on profitability
Please refer to the Companys cautionary statements.
64
Revenue Growth Capacity |
65
©
2013 Molina Healthcare, Inc.
Alternative Financing
Sale and lease back
Capital leases
Structured co-insurance or structured quota
share
Please refer to the Companys cautionary statements. |
66
©
2013 Molina Healthcare, Inc.
Why We Might Want To Raise More Capital?
Acquisitions
Capital expenditures
Variability in profitability
Timing
New benefits
Growth above expectations
Desire for capital cushion (e.g. debt covenant and rating
agencies)
Regulatory capital in excess of minimum requirements
Regulatory requirements in advance of premium receipts
Please refer to the Companys cautionary statements. |
©
2013 Molina Healthcare, Inc.
Q&A
67 |
Guidance
John Molina,
Chief Financial Officer
February 21, 2013
New York, New York |
©
2013 Molina Healthcare, Inc.
2013 Guidance
Premium Revenue
Premium Tax Revenue
Service Revenue
Investment and Other Income
Total Revenue
Medical Care Costs
Medical Care Ratio
Service Costs
G&A Expense
G&A Ratio
Premium Tax Expense
Depreciation & Amortization
Operating Income
Interest Expense Excluding Non-Cash
Interest Expense Non-Cash
Income Before Tax
Income Tax
Net Income
Weighted Average Diluted Shares Outstanding
Diluted EPS
EBITDA
2
$6.7B
$160M
$200M
$13M
$7B
$5.9B
88%
$170M
$600M
8.6%
$160M
$78M
$157M
$18M
$24M
$115M
$48M
$67M
46.1M
$1.45
$255M
Please refer to the Companys cautionary statements.
1
69
Note(s):
1. Denotes guidance. Amounts are estimates and subject to change. Actual
results may differ materially. See cautionary statement. 2. EBITDA includes approximately $20 million in depreciation and amortization
recoded in service revenue and service costs related to our Molina Medical Solutions segment.
|
70
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2013 Molina Healthcare, Inc.
2013 Guidance
Includes
Convertible Notes
Convertible Non-Cash Interest ($0.21) EPS
Product and Market Expansions
California & Ohio Dual Integration start up second half of year
Illinois ABD and California ABD expansion start up second half of year
Negligible rate increases
Additional administrative costs required to prepare for growth:
Ramp up for New Mexico Expansion (Implementation & Operations)
Illinois ABDs (Implementation & Operations)
California & Ohio Dual Integration programs (Implementation &
Operations) Implementation
costs for Florida LTC, Market Place, Medicaid Expansion and Duals
Integration in states other than California & Ohio
42% Effective Tax Rate
Anticipated Resolution of California AB 97 rate cuts
Excludes
Acquisitions
Operational ramp up
costs for Florida LTC, Market Place, Medicaid Expansion, and
Duals Integration in states other than California & Ohio
Rate impact of PCP parity rules
Anticipated Settlement for California rate disputes
Please refer to the Companys cautionary statements. |
71
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2013 Molina Healthcare, Inc.
2013 Guidance: Issued 2/7/13 and 2/21/13
1
Premium Revenue
Premium Tax Revenue
Service Revenue
Investment and Other Income
Total Revenue
Medical Care Costs
Medical Care Ratio
Service Costs
G&A Expense
G&A Ratio
Premium Tax Expense
Depreciation and Amortization
Operating Income
Interest Expense Excluding Non-Cash
Interest Expense Non-Cash
Income Before Tax
Income Tax
Effective Tax Rate
Net Income
Weighted Average Diluted Shares Outstanding
Diluted EPS
EBITDA
Issued
2/7/13
$6.7B
$160M
$200M
$13M
$7B
$5.9B
88%
$170M
$600M
8.6%
$160M
$78M
$146M
$11M
$6M
$128M
$54M
42%
$74M
47.7M
$1.55
$245M
Please refer to the Companys cautionary statements.
Issued
2/21/13
$6.7B
$160M
$200M
$13M
$7B
$5.9B
88%
$170M
$600M
8.6%
$160M
$78M
$157M
$18M
$24M
$115M
$48M
42%
$67M
46.1M
$1.45
$255M
Note(s):
1.
Denotes
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement.
1
2
2. EBITDA includes approximately $20 million in depreciation and amortization
recoded in service revenue and service costs related to our Molina Medical Solutions segment.
|
72
©
2013 Molina Healthcare, Inc.
Note(s):
Denotes
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement.
The
upsizing
of
the
Companys
convertible
note
offering
from
the
$375
million
anticipated
at
launch
to
the
ultimate
amount
of
$550
million
resulted
The
upsizing
of
the
Companys
convertible
note
offering
from
the
$375
million
anticipated
at
launch
to
the
ultimate
amount
of
$550
million
resulted
Increase in Revenue
Convertible Debt Issuance:
Convertible Coupon Interest
2
Convertible Non-Cash Interest
3
Incremental Interest Income (assumes 40bps investment income
) Other Fees and Costs
Impact of Share Buy Back
Subtotal -
Impact of Convertible Debt Issuance
2013 Guidance Issued 2/7/13
Revised 2013 Guidance
Pretax
1
EPS
1
$10.4M
($5.4M)
($17.0M)
$1.2M
($1.6M)
-
($22.8M)
$128M
$115M
$1.55
$1.45
$0.13
($0.07)
($0.21)
$0.02
($0.02)
$0.06
($0.23)
Total Change
($12.4M)
($0.10)
Add: Non-Cash Interest Expense related to New Convertible Debt
$17M
$0.21
Guidance excluding New Convertible Debt Non Cash Interest
$132M
$1.66
Please refer to the Companys cautionary statements.
Guidance Bridge*
1.
2.
3.
in incremental coupon interest of approximately $0.03 per diluted share
for all of 2013. in incremental non cash interest costs of approximately
$0.07 per diluted share for all of 2013. |
©
2013 Molina Healthcare, Inc.
Membership Growth
By year end we expect 2.0 million
members as a result both organic
growth and expansion into new
products and markets
Membership
2012
YE
1.8M
members
New
Products &
Markets
Organic
Expansion
4%
Organic
Growth
3%
2013
YE
2.0M
members
CA ABDs,
MI & OH
ABD Kids,
WI regions
CA & OH Duals,
IL ABDs
Please refer to the Companys cautionary statements.
73
1
2%
Note(s):
1. Denotes
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement. |
©
2013 Molina Healthcare, Inc.
2013 Benefit Expansions
Please refer to the Companys cautionary statements.
California
carved
in
Long
Term
Care
(LTC)
and
in
Home
Support
Services
(IHSS)
starting
9/1/13
Utah carved in the Pharmacy
Benefit
effective 1/1/13
Note(s):
1. Denotes
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement
2. Members will be rolled in the LTC and IHSS programs on
their birth date. .
UT Rx Carve In
CA LTC & IHSS Carve In
2013 Estimated Revenue
2013 Estimated Revenue
2
$30M
$70M
74
1
1 |
©
2013 Molina Healthcare, Inc.
Rate changes included in 2013 Guidance
Please refer to the Companys cautionary statements.
State
2013
Rate Change
1, 2, 3
California
various
(3%)
Florida
n/a
None
Michigan
n/a
None
New Mexico
Jan-13
2%
Ohio
Jan-13
4%
Texas
various
1%
Utah
Jan-13
(16%)
Washington
n/a
None
Wisconsin
Jan-13
3%
75
1.
2.
3.
Denotes
estimated
rate
changes
included
in
2013
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement.
2013 rates do not reflect potential rate changes as a result of PCP parity rules. Does not include impact of risk
adjustments. Note(s):
|
©
2013 Molina Healthcare, Inc.
Admin Spend Investment is required to prepare for growth
Our FY 2013 guidance assumes
administrative costs are expected to be
600M or 8.6%
of total revenues
Administrative Costs
2013
Operational Costs
(CA, OH Duals, IL
ABD, NM)
Implementation
Costs
Current
Business
Implementation
Operational
Timing:
Up to a year before
membership
Timing:
Approx. 1-3 months
before membership
Functions:
Program & Benefit
Design
IT & Systems
Development
Functions:
Member Care
Activities
Claims
Call Center
Fixed
Variable
Guidance includes
implementation costs
for all
growth products
Guidance includes
operational costs for
only CA, OH Duals, IL
ABDs & NM build out
Market Place,
Medicaid Expansion,
Other Duals, FL LTC
0.4%
In 2013 guidance implementation &
operational costs related to growth are
approximately 0.7%
of total revenue or
$0.60 EPS
Excluded
Please refer to the Companys cautionary statements.
Note(s):
1. Denotes
guidance.
Amounts
are
estimates
and
subject
to
change.
Actual
results
may
differ
materially.
See
cautionary
statement.
1
1
76
$22M
$29M
$550M
7.9%
0.3% |
©
2013 Molina Healthcare, Inc.
Flu Trends
Please refer to the Companys cautionary statements.
2.0
4.0
6.0
8.0
10.0
12.0
2,000
4,000
6,000
8,000
10,000
Google Flu Trends
CDC % ILI
-
-
77
Google Flu Trends vs. CDC % ILI |
78
©
2013 Molina Healthcare, Inc.
Investment Highlights
Attractive sector growth prospects driven by government
policies and economic conditions
Focus on government-sponsored health care programs
Proven flexible health care services portfolio (risk-based,
fee-based and direct delivery)
Diversified geographic exposure in 15 states with
significant presence in high growth regions
Scalable administrative efficiencies stemming from
centralized and standardized functions
Seasoned management team with strong track record of
delivering earnings growth
Over 30 years of experience
Please refer to the Companys cautionary statements. |
©
2013 Molina Healthcare, Inc.
Q&A
79 |