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): October 30, 2013
______________
MOLINA
HEALTHCARE, INC.
(Exact
name of registrant as specified in its charter)
Delaware |
1-31719 |
13-4204626 |
(State of incorporation) |
(Commission File Number) |
(I.R.S. Employer Identification Number) |
______________
200 Oceangate, Suite 100, Long Beach, California 90802 |
(Address of principal executive offices) |
Registrant’s 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:
⃞ Written communications 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 2.02. Results of Operations and Financial Condition.
On October 30, 2013, Molina Healthcare, Inc. issued a press release announcing its financial results for the third quarter and nine months ended September 30, 2013. The full text of the press release is included as Exhibit 99.1 to this report. The information contained in the websites cited in the press release is not part of this report.
The information in this Form 8-K and the exhibit attached hereto shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, 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, as amended, or the Securities Exchange Act of 1934, as amended, except as expressly set forth by specific reference in such a filing.
Item 9.01. Financial Statements and Exhibits.
(d) Exhibits:
Exhibit No. |
Description |
|
99.1 |
Press release of Molina Healthcare, Inc. issued October 30, 2013, as to financial results for the third quarter and nine months ended September 30, 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. |
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|
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Date: | October 30, 2013 | By: |
/s/ Jeff D. Barlow |
Jeff D. Barlow |
|||
Sr. Vice President - General Counsel and |
|||
Secretary |
EXHIBIT INDEX
Exhibit |
|
No. | Description |
99.1 |
Press release of Molina Healthcare, Inc. issued October 30, 2013, as to financial results for the third quarter and nine months ended September 30, 2013. |
Exhibit 99.1
Molina Healthcare Reports Third Quarter 2013 Results
LONG BEACH, Calif.--(BUSINESS WIRE)--October 30, 2013--Molina Healthcare, Inc. (NYSE:MOH):
Molina Healthcare, Inc. (NYSE:MOH) today reported its financial results for the third quarter and nine months ended September 30, 2013. Net income per diluted share from continuing operations was $0.16, an increase of $0.17 per diluted share from continuing operations over the third quarter of 2012. Net income for the third quarter of 2013 rose to $7.6 million, or $0.16 per diluted share, versus $3.4 million, or $0.07 per diluted share, for the third quarter of 2012.
“I am pleased with the third quarter results, particularly because medical margins increased at all but one of our health plans,” said J. Mario Molina, M.D., chief executive officer of Molina Healthcare, Inc. “We closed on our acquisitions in New Mexico and South Carolina, welcomed our first members in Illinois and launched qualified health plans for the health insurance marketplace in nine states. While our results were tempered by the cleanup of old claims in Texas and continued administrative investments associated with future growth, I remain optimistic about our future long-term prospects.”
Overview of Financial Results
Net income from continuing operations for the third quarter of 2013 increased when compared with the third quarter of 2012 as a result of higher medical margins. Those medical margins were partially offset by increased administrative expense related to the Company’s preparations for significant membership growth expected in 2014.
Premium revenue for the third quarter of 2013 increased 9% over the third quarter of 2012, due to a 5% increase in enrollment and a 4% increase in revenue per member per month (PMPM).
The Company’s consolidated medical care ratio decreased to 87.3% in the third quarter of 2013 from 91.1% in the third quarter of 2012. The decline in the consolidated medical care ratio was the result of improved operating results at all but one of the Company’s health plans. Medical care ratios decreased in eight of the Company’s nine health plans, while medical margin (measured as the excess of premium revenue over medical care costs) increased in the same eight of nine health plans.
General and administrative expenses increased to 10.4% of revenue in the third quarter of 2013 from 8.2% in the third quarter of 2012, primarily due to higher costs incurred as a result of the Company’s preparations for significant membership growth in 2014 in connection with the Affordable Care Act. Increased administrative expense related to the anticipated membership growth represented approximately 1.8% of premium revenue, or $30 million, during the third quarter of 2013.
Third Quarter of 2013 Compared with the Second Quarter of 2013
Net income from continuing operations for the third quarter of 2013 decreased from the second quarter of 2013, primarily as a result of approximately $14 million in unfavorable prior period claims development at the Texas health plan. The expense related to issues with system configuration and the adjudication of claims from a number of hospital providers extending back to 2012 and the first half of 2013. The Company believes that it has substantially resolved all of the issues.
Premium revenue increased approximately 6% between the second and third quarters of 2013, primarily due to the contract acquired in New Mexico. Absent the Texas provider settlements noted above, the consolidated medical care ratio reported in the third quarter of 2013 of 87.3% would have been 86.4%. The consolidated medical care ratio reported in the second quarter of 2013 was 86.2%. General and administrative expenses increased to 10.4% of revenue in the third quarter of 2013 from 10.1% in the second quarter of 2013, due to increased expenses incurred in anticipation of 2014 enrollment growth.
Adjusted Net Income Per Diluted Share, Continuing Operations
At its Investor Day on September 19, 2013, the Company announced that it would begin presenting “Adjusted Net Income Per Diluted Share, Continuing Operations,” a non-GAAP financial measure used by management as a supplemental metric to evaluate the Company’s performance. Adjusted net income per diluted share, continuing operations increased to $0.71 per share for the third quarter of 2013 compared with $0.37 for the third quarter of 2012. The table found below on page 7 reconciles net income (loss) per diluted share to adjusted net income per diluted share, continuing operations.
Net Income Per Share Guidance
The Company announced that it expects earnings per share from continuing operations to be approximately $1.15 per diluted share for the year ended December 31, 2013. The Company expects fourth quarter results will be at approximately break-even. The Company believes that its anticipated continued strong operating performance in the fourth quarter will be offset by the following factors:
Adjusted Net Income Per Diluted Share, Continuing Operations Guidance
The Company also announced that it expects adjusted net income per diluted share, continuing operations to be approximately $3.20 for the year ended December 31, 2013.
Conference Call
The Company’s management will host a conference call and webcast to discuss its third quarter results at 5:00 p.m. Eastern time on Wednesday, October 30, 2013. The number to call for the interactive teleconference is (212) 231-2920. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Wednesday, October 30, 2013, through 6:00 p.m. on Thursday October 31, 2013, by dialing (800) 633-8284 and entering confirmation number 21673454. A live broadcast of Molina Healthcare’s conference call will be available on the Company’s website, www.molinahealthcare.com. A 30-day online replay will be available approximately an hour following the conclusion of the live broadcast.
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 Company’s licensed health plans in California, Florida, Illinois, Michigan, New Mexico, Ohio, Texas, Utah, Washington, and Wisconsin currently serve approximately 1.9 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.
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. Those risks and uncertainties include, but are not limited to, the following:
and numerous other risk factors, including those discussed in the Company’s periodic reports and filings with the Securities and Exchange Commission. These reports can be accessed under the investor relations tab of the Company’s website or on the SEC’s website at www.sec.gov. Given these risks and uncertainties, we can give no assurances that the Company’s forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by the Company’s 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 Company’s judgment as of October 30, 2013, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in the Company’s expectations.
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS |
||||||||||||||||||
Three Months Ended
September 30, |
Nine Months Ended
September 30, |
|||||||||||||||||
2013 | 2012 | 2013 | 2012 | |||||||||||||||
(Amounts in thousands, except net income (loss) per share) | ||||||||||||||||||
Revenue: | ||||||||||||||||||
Premium revenue | $ | 1,584,656 | $ | 1,448,600 | $ | 4,583,818 | $ | 4,066,737 | ||||||||||
Premium tax receipts | 43,723 | 37,894 | 127,606 | 120,953 | ||||||||||||||
Service revenue | 51,100 | 48,422 | 150,528 | 132,351 | ||||||||||||||
Investment income | 1,740 | 1,155 | 4,884 | 3,893 | ||||||||||||||
Rental and other income | 5,860 | 4,079 | 16,476 | 12,315 | ||||||||||||||
Total revenue | 1,687,079 | 1,540,150 | 4,883,312 | 4,336,249 | ||||||||||||||
Expenses: | ||||||||||||||||||
Medical care costs | 1,383,213 | 1,319,991 | 3,965,834 | 3,715,455 | ||||||||||||||
Cost of service revenue | 40,113 | 37,004 | 119,188 | 98,111 | ||||||||||||||
General and administrative expenses | 176,233 | 127,035 | 478,990 | 365,564 | ||||||||||||||
Premium tax expenses | 43,723 | 37,894 | 127,606 | 120,953 | ||||||||||||||
Depreciation and amortization | 18,871 | 15,858 | 52,449 | 46,916 | ||||||||||||||
Total expenses | 1,662,153 | 1,537,782 | 4,744,067 | 4,346,999 | ||||||||||||||
Income (loss) from operations | 24,926 | 2,368 | 139,245 | (10,750 | ) | |||||||||||||
Other expenses: | ||||||||||||||||||
Interest expense | 13,532 | 4,315 | 38,236 | 12,421 | ||||||||||||||
Other (income) expense | (24 | ) | 184 | 3,347 | 1,270 | |||||||||||||
Total other expenses | 13,508 | 4,499 | 41,583 | 13,691 | ||||||||||||||
Income (loss) from continuing operations
before income taxes |
11,418 | (2,131 | ) | 97,662 | (24,441 | ) | ||||||||||||
Income tax expense (benefit) | 3,865 | (1,966 | ) | 43,791 | (11,113 | ) | ||||||||||||
Income (loss) from continuing operations | 7,553 | (165 | ) | 53,871 | (13,328 | ) | ||||||||||||
Income (loss) from discontinued operations (1) | 16 | 3,529 | 8,184 | (2,525 | ) | |||||||||||||
Net income (loss) | $ | 7,569 | $ | 3,364 | $ | 62,055 | $ | (15,853 | ) | |||||||||
Basic income (loss) per share: | ||||||||||||||||||
Income (loss) from continuing operations | $ | 0.17 | $ | (0.01 | ) | $ | 1.18 | $ | (0.29 | ) | ||||||||
Income (loss) from discontinued operations | – | 0.08 | 0.18 | (0.05 | ) | |||||||||||||
Basic net income (loss) per share | $ | 0.17 | $ | 0.07 | $ | 1.36 | $ | (0.34 | ) | |||||||||
Diluted income (loss) per share: | ||||||||||||||||||
Income (loss) from continuing operations | $ | 0.16 | $ | (0.01 | ) | $ | 1.15 | $ | (0.29 | ) | ||||||||
Income (loss) from discontinued operations | – | 0.08 | 0.18 | (0.05 | ) | |||||||||||||
Diluted net income (loss) per share | $ | 0.16 | $ | 0.07 | $ | 1.33 | $ | (0.34 | ) | |||||||||
Weighted average shares outstanding: | ||||||||||||||||||
Basic | 45,699 | 46,546 | 45,708 | 46,301 | ||||||||||||||
Diluted | 47,062 | 46,880 | 46,767 | 46,301 | ||||||||||||||
Operating Statistics, Continuing Operations: | ||||||||||||||||||
Medical care ratio (2) | 87.3 | % | 91.1 | % | 86.5 | % | 91.4 | % | ||||||||||
Service revenue ratio (3) | 78.5 | % | 76.4 | % | 79.2 | % | 74.1 | % | ||||||||||
General and administrative expense ratio (4) | 10.4 | % | 8.2 | % | 9.8 | % | 8.4 | % | ||||||||||
Premium tax ratio (2) | 2.7 | % | 2.5 | % | 2.7 | % | 2.9 | % | ||||||||||
Effective tax rate | 33.9 | % | (92.3 | %) | 44.8 | % | (45.5 | %) | ||||||||||
(1)Net of income tax expense (benefit) of $97, $1,474, $(10,046), and $(4,115), respectively. |
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(2) Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium taxes as a percentage of premium revenue plus premium tax receipts. |
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(3) Service revenue ratio represents cost of service revenue as a percentage of service revenue. |
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(4) Computed as a percentage of total revenue. |
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MOLINA HEALTHCARE, INC. CONSOLIDATED BALANCE SHEETS |
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(Unaudited) | |||||||||
Sept. 30, 2013 |
Dec. 31, 2012 |
||||||||
(Amounts in thousands,
except per share data) |
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ASSETS | |||||||||
Current assets: | |||||||||
Cash and cash equivalents | $ | 856,556 | $ | 795,770 | |||||
Investments | 735,151 | 342,845 | |||||||
Receivables | 293,967 | 149,682 | |||||||
Deferred income taxes | 30,480 | 32,443 | |||||||
Prepaid expenses and other current assets | 50,061 | 28,386 | |||||||
Total current assets | 1,966,215 | 1,349,126 | |||||||
Property, equipment, and capitalized software, net | 267,277 | 221,443 | |||||||
Deferred contract costs | 48,768 | 58,313 | |||||||
Intangible assets, net | 104,635 | 77,711 | |||||||
Goodwill and indefinite-lived intangible assets | 230,783 | 151,088 | |||||||
Derivative asset | 191,663 | – | |||||||
Restricted investments | 65,225 | 44,101 | |||||||
Auction rate securities | 11,674 | 13,419 | |||||||
Deferred income taxes | 3,090 | – | |||||||
Other assets | 35,736 | 19,621 | |||||||
$ | 2,925,066 | $ | 1,934,822 | ||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||||
Current liabilities: | |||||||||
Medical claims and benefits payable | $ | 632,706 | $ | 494,530 | |||||
Accounts payable and accrued liabilities | 282,727 | 184,034 | |||||||
Deferred revenue | 124,388 | 141,798 | |||||||
Income taxes payable | 5,508 | 6,520 | |||||||
Current maturities of long-term debt | 109 | 1,155 | |||||||
Total current liabilities | 1,045,438 | 828,037 | |||||||
Convertible senior notes | 591,884 | 175,468 | |||||||
Lease financing obligations | 178,188 | – | |||||||
Other long-term debt | – | 86,316 | |||||||
Derivative liability | 191,556 | 1,307 | |||||||
Deferred income taxes | – | 37,900 | |||||||
Other long-term liabilities | 25,152 | 23,480 | |||||||
Total liabilities | 2,032,218 | 1,152,508 | |||||||
Stockholders’ equity: | |||||||||
Common stock, $0.001 par value; 150,000 shares authorized; outstanding: 45,757 shares at September 30, 2013 and 46,762 shares at December 31, 2012 |
46 | 47 | |||||||
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares issued and outstanding |
– | – | |||||||
Additional paid-in capital | 331,958 | 285,524 | |||||||
Accumulated other comprehensive loss | (1,411 | ) | (457 | ) | |||||
Treasury stock, at cost; 111 shares at December 31, 2012 | – | (3,000 | ) | ||||||
Retained earnings | 562,255 | 500,200 | |||||||
Total stockholders’ equity | 892,848 | 782,314 | |||||||
$ | 2,925,066 | $ | 1,934,822 |
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
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Three Months Ended
September 30, |
Nine Months Ended
September 30, |
|||||||||||||||||
2013 | 2012 | 2013 | 2012 | |||||||||||||||
(Amounts in thousands) | ||||||||||||||||||
Operating activities: | ||||||||||||||||||
Net income (loss) | $ | 7,569 | $ | 3,364 | $ | 62,055 | $ | (15,853 | ) | |||||||||
Adjustments to reconcile net income (loss) to net cash provided by operating activities: | ||||||||||||||||||
Depreciation and amortization | 24,128 | 20,279 | 68,035 | 58,289 | ||||||||||||||
Deferred income taxes | (16,287 | ) | 1,787 | (38,442 | ) | 523 | ||||||||||||
Stock-based compensation | 8,504 | 5,636 | 20,654 | 15,448 | ||||||||||||||
Gain on sale of subsidiary | – | – | – | (1,747 | ) | |||||||||||||
Amortization of convertible senior notes and lease financing obligations | 6,440 | 1,499 | 16,128 | 4,414 | ||||||||||||||
Change in fair value of derivatives | (1 | ) | 184 | 3,383 | 1,270 | |||||||||||||
Amortization of premium/discount on investments | 3,755 | 1,551 | 8,053 | 5,166 | ||||||||||||||
Amortization of deferred financing costs | 676 | 310 | 3,042 | 825 | ||||||||||||||
Tax deficiency from employee stock compensation | (34 | ) | (109 | ) | (72 | ) | (159 | ) | ||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||
Receivables | (80,191 | ) | 4,098 | (144,285 | ) | 10,989 | ||||||||||||
Prepaid expenses and other current assets | (4,696 | ) | (222 | ) | (27,552 | ) | (10,574 | ) | ||||||||||
Medical claims and benefits payable | 167,219 | 10,925 | 138,176 | 133,987 | ||||||||||||||
Accounts payable and accrued liabilities | 37,959 | 13,952 | 20,991 | (9,030 | ) | |||||||||||||
Deferred revenue | 78,439 | (33,072 | ) | (17,410 | ) | 92,354 | ||||||||||||
Income taxes | (9,988 | ) | (2,141 | ) | (1,012 | ) | (21,878 | ) | ||||||||||
Net cash provided by operating activities | 223,492 | 28,041 | 111,744 | 264,024 | ||||||||||||||
Investing activities: | ||||||||||||||||||
Purchases of equipment | (29,197 | ) | (19,247 | ) | (64,426 | ) | (52,548 | ) | ||||||||||
Purchases of investments | (95,802 | ) | (90,117 | ) | (627,953 | ) | (234,465 | ) | ||||||||||
Sales and maturities of investments | 78,380 | 76,893 | 227,800 | 213,665 | ||||||||||||||
Proceeds from sale of subsidiary, net of cash surrendered |
– | – | – | 9,162 | ||||||||||||||
Net cash paid in business combinations | (57,684 | ) | – | (57,684 | ) | – | ||||||||||||
Change in deferred contract costs | 2,551 | 4,256 | 9,545 | (18,799 | ) | |||||||||||||
Increase in restricted investments | (8,290 | ) | (880 | ) | (21,124 | ) | (3,034 | ) | ||||||||||
Change in other noncurrent assets and liabilities |
438 | (392 | ) | (7,574 | ) | (4,775 | ) | |||||||||||
Net cash used in investing activities | (109,604 | ) | (29,487 | ) | (541,416 | ) | (90,794 | ) | ||||||||||
Financing activities: | ||||||||||||||||||
Proceeds from issuance of 1.125% Notes, net of deferred financing costs |
– | – | 537,973 | – | ||||||||||||||
Proceeds from sale-leaseback transactions | – | – | 158,694 | – | ||||||||||||||
Purchase of 1.125% Notes call option | – | – | (149,331 | ) | – | |||||||||||||
Proceeds from issuance of warrants | – | – | 75,074 | – | ||||||||||||||
Treasury stock purchases | – | – | (50,000 | ) | – | |||||||||||||
Repayment of amounts borrowed under credit facility |
– | (10,000 | ) | (40,000 | ) | (20,000 | ) | |||||||||||
Amount borrowed under credit facility | – | – | – | 60,000 | ||||||||||||||
Principal payments on term loan | – | (273 | ) | (47,471 | ) | (846 | ) | |||||||||||
Settlement of interest rate swap | – | – | (875 | ) | – | |||||||||||||
Proceeds from employee stock plans | 304 | 86 | 5,156 | 5,571 | ||||||||||||||
Excess tax benefits from employee stock compensation | (306 | ) | 21 | 1,238 | 3,698 | |||||||||||||
Net cash (used in) provided by financing activities |
(2 | ) | (10,166 | ) | 490,458 | 48,423 | ||||||||||||
Net increase (decrease) in cash and cash equivalents | 113,886 | (11,612 | ) | 60,786 | 221,653 | |||||||||||||
Cash and cash equivalents at beginning of period | 742,670 | 727,092 | 795,770 | 493,827 | ||||||||||||||
Cash and cash equivalents at end of period | $ | 856,556 | $ | 715,480 | $ | 856,556 | $ | 715,480 | ||||||||||
MOLINA HEALTHCARE, INC.
UNAUDITED NON-GAAP FINANCIAL
MEASURES
The Company uses two non-GAAP1 financial measures as supplemental metrics in evaluating its financial performance, making financing and business decisions, and forecasting and planning for future periods. Management believes such measures are useful supplemental measures to investors in evaluating the Company’s performance, and when comparing the Company’s performance with 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.
The first of these non-GAAP measures is earnings before interest, taxes, depreciation and amortization, or EBITDA. The following table reconciles net income (loss), which the Company believes to be the most comparable GAAP measure, to EBITDA.
Three Months Ended
September 30, |
Nine Months Ended
September 30, |
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2013 | 2012 | 2013 | 2012 | ||||||||||||
(In thousands) | |||||||||||||||
Net income (loss) | $ | 7,569 | $ | 3,364 | $ | 62,055 | $ | (15,853 | ) | ||||||
Adjustments: | |||||||||||||||
Depreciation and amortization reported in the consolidated statements of cash flows | 24,128 | 20,279 | 68,035 | 58,289 | |||||||||||
Interest expense | 13,532 | 4,315 | 38,236 | 12,421 | |||||||||||
Income tax expense (benefit) | 3,962 | (492 | ) | 33,745 | (15,228 | ) | |||||||||
EBITDA | $ | 49,191 | $ | 27,466 | $ | 202,071 | $ | 39,629 | |||||||
The second of these non-GAAP measures is adjusted net income per diluted share, continuing operations. The following table reconciles net income (loss) per diluted share, which the Company believes to be the most comparable GAAP measure, to adjusted net income per diluted share, continuing operations. |
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Three Months Ended
September 30, |
Nine Months Ended
September 30, |
||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||
(In thousands) | |||||||||||||||
Net income (loss) per diluted share, continuing operations |
$ | 0.16 | $ | (0.01 | ) | $ | 1.15 | $ | (0.29 | ) | |||||
Adjustments, net of tax: | |||||||||||||||
Depreciation and amortization of capitalized software | 0.25 | 0.20 | 0.71 | 0.56 | |||||||||||
Stock-based compensation | 0.15 | 0.09 | 0.36 | 0.24 | |||||||||||
Amortization of intangible assets | 0.07 | 0.07 | 0.20 | 0.22 | |||||||||||
Amortization of convertible senior notes and lease financing obligations |
0.08 | 0.02 | 0.21 | 0.06 | |||||||||||
Change in fair value of derivatives | – | – | 0.08 | 0.02 | |||||||||||
Adjusted net income per diluted share, continuing operations |
$ | 0.71 | $ | 0.37 | $ | 2.71 | $ | 0.81 | |||||||
1GAAP stands for Generally Accepted Accounting Principles. |
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MOLINA HEALTHCARE, INC.
UNAUDITED DEPRECIATION AND
AMORTIZATION DATA
Depreciation and amortization related to the Company’s Health Plans segment is all recorded in “Depreciation and amortization” in the consolidated statements of operations. Depreciation and amortization related to the Company’s Molina Medicaid Solutions segment is recorded within three different headings in the consolidated statements of operations as follows:
• Amortization of purchased intangibles relating to customer relationships is reported as amortization within the heading “Depreciation and amortization;”
• Amortization of purchased intangibles relating to contract backlog is recorded as a reduction of “Service revenue;” and
• Depreciation is recorded within the heading “Cost of service revenue.”
The following table presents all depreciation and amortization recorded in the Company’s consolidated statements of operations, regardless of whether the item appears as depreciation and amortization, a reduction of revenue, or as cost of service revenue.
Three Months Ended September 30, | ||||||||||||||
2013 | 2012 | |||||||||||||
Amount |
% of Total
Revenue |
Amount |
% of Total
Revenue |
|||||||||||
(Dollar amounts in thousands) | ||||||||||||||
Depreciation, and amortization of capitalized software, continuing operations | $ | 14,237 | 0.8 | % | $ | 11,352 | 0.7 | % | ||||||
Amortization of intangible assets, continuing operations | 4,634 | 0.3 | 4,506 | 0.3 | ||||||||||
Depreciation and amortization, continuing operations | 18,871 | 1.1 | 15,858 | 1.0 | ||||||||||
Depreciation and amortization, discontinued operations | – | – | 176 | – | ||||||||||
Amortization recorded as reduction of service revenue | 729 | – | 536 | 0.1 | ||||||||||
Amortization of capitalized software recorded as cost of service revenue | 4,528 | 0.3 | 3,709 | 0.2 | ||||||||||
Depreciation and amortization reported in the consolidated statements of cash flows | $ | 24,128 | 1.4 | % | $ | 20,279 | 1.3 | % | ||||||
Nine Months Ended September 30, | ||||||||||||||
2013 | 2012 | |||||||||||||
Amount |
% of Total
Revenue |
Amount |
% of Total
Revenue |
|||||||||||
(Dollar amounts in thousands) | ||||||||||||||
Depreciation, and amortization of capitalized software, continuing operations | $ | 39,578 | 0.8 | % | $ | 31,321 | 0.7 | % | ||||||
Amortization of intangible assets, continuing operations | 12,871 | 0.3 | 15,595 | 0.4 | ||||||||||
Depreciation and amortization, continuing operations | 52,449 | 1.1 | 46,916 | 1.1 | ||||||||||
Depreciation and amortization, discontinued operations | 2 | – | 530 | – | ||||||||||
Amortization recorded as reduction of service revenue | 2,186 | – | 842 | – | ||||||||||
Amortization of capitalized software recorded as cost of service revenue | 13,398 | 0.3 | 10,001 | 0.2 | ||||||||||
Depreciation and amortization reported in the consolidated statements of cash flows | $ | 68,035 | 1.4 | % | $ | 58,289 | 1.3 | % |
MOLINA HEALTHCARE, INC. UNAUDITED MEMBERSHIP DATA, CONTINUING OPERATIONS |
||||||||||
Sept. 30, 2013 |
June 30,
2013 |
Dec. 31, 2012 |
Sept. 30, 2012 |
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Total Ending Membership by Health Plan: | ||||||||||
California | 363,000 | 355,000 | 336,000 | 346,000 | ||||||
Florida | 84,000 | 81,000 | 73,000 | 71,000 | ||||||
Michigan | 213,000 | 215,000 | 220,000 | 219,000 | ||||||
New Mexico | 172,000 | 92,000 | 91,000 | 90,000 | ||||||
Ohio | 261,000 | 240,000 | 244,000 | 272,000 | ||||||
Texas | 258,000 | 266,000 | 282,000 | 291,000 | ||||||
Utah | 87,000 | 87,000 | 87,000 | 85,000 | ||||||
Washington | 409,000 | 413,000 | 418,000 | 411,000 | ||||||
Wisconsin | 95,000 | 98,000 | 46,000 | 41,000 | ||||||
1,942,000 | 1,847,000 | 1,797,000 | 1,826,000 | |||||||
Total Ending Membership by State for the Medicare Advantage Plans: |
||||||||||
California | 8,600 | 8,100 | 7,700 | 7,300 | ||||||
Florida | 600 | 600 | 900 | 900 | ||||||
Michigan | 10,000 | 9,500 | 9,700 | 9,300 | ||||||
New Mexico | 900 | 900 | 900 | 900 | ||||||
Ohio | 400 | 400 | 300 | 200 | ||||||
Texas | 2,500 | 2,300 | 1,500 | 1,100 | ||||||
Utah | 8,200 | 7,800 | 8,200 | 8,300 | ||||||
Washington | 6,900 | 6,600 | 6,500 | 6,100 | ||||||
38,100 | 36,200 | 35,700 | 34,100 | |||||||
|
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Total Ending Membership by State for the Aged, Blind or Disabled Population: |
||||||||||
California | 46,300 | 45,400 | 44,700 | 44,100 | ||||||
Florida | 12,200 | 11,200 | 10,300 | 10,300 | ||||||
Michigan | 45,400 | 45,000 | 41,900 | 40,700 | ||||||
New Mexico | 11,400 | 6,000 | 5,700 | 5,600 | ||||||
Ohio | 33,000 | 28,000 | 28,200 | 29,000 | ||||||
Texas | 90,800 | 92,000 | 95,900 | 101,300 | ||||||
Utah | 9,500 | 9,400 | 9,000 | 8,900 | ||||||
Washington | 33,000 | 31,700 | 30,000 | 23,400 | ||||||
Wisconsin | 1,700 | 1,600 | 1,700 | 1,600 | ||||||
283,300 | 270,300 | 267,400 | 264,900 |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN, CONTINUING OPERATIONS (Amounts in thousands, except per member per month amounts) |
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Three Months Ended September 30, 2013 | |||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs |
MCR (2) |
Medical Margin |
|||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||
California | 1,076 | $ | 184,235 | $ | 171.16 | $ | 166,774 | $ | 154.93 | 90.5 | % | $ | 17,461 | ||||||||||
Florida | 251 | 67,688 | 269.58 | 60,127 | 239.46 | 88.8 | 7,561 | ||||||||||||||||
Michigan | 641 | 174,706 | 272.65 | 143,498 | 223.95 | 82.1 | 31,208 | ||||||||||||||||
New Mexico | 435 | 130,318 | 299.19 | 111,599 | 256.21 | 85.6 | 18,719 | ||||||||||||||||
Ohio | 786 | 280,964 | 357.66 | 245,148 | 312.07 | 87.3 | 35,816 | ||||||||||||||||
Texas | 780 | 320,657 | 411.17 | 287,446 | 368.59 | 89.6 | 33,211 | ||||||||||||||||
Utah | 261 | 84,525 | 323.83 | 66,555 | 254.98 | 78.7 | 17,970 | ||||||||||||||||
Washington | 1,234 | 294,808 | 238.96 | 254,430 | 206.23 | 86.3 | 40,378 | ||||||||||||||||
Wisconsin | 287 | 39,676 | 138.36 | 27,694 | 96.58 | 69.8 | 11,982 | ||||||||||||||||
Other (3) | – | 7,079 | – | 19,942 | – | – | (12,863 | ) | |||||||||||||||
5,751 | $ | 1,584,656 | $ | 275.55 | $ | 1,383,213 | $ | 240.52 | 87.3 | % | $ | 201,443 | |||||||||||
Three Months Ended September 30, 2012 | |||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs |
MCR (2) |
Medical Margin |
|||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||
California | 1,041 | $ | 162,389 | $ | 156.00 | $ | 156,106 | $ | 149.96 | 96.1 | % | $ | 6,283 | ||||||||||
Florida | 214 | 57,433 | 268.58 | 48,250 | 225.64 | 84.0 | 9,183 | ||||||||||||||||
Michigan | 656 | 159,591 | 243.32 | 143,513 | 218.80 | 89.9 | 16,078 | ||||||||||||||||
New Mexico | 269 | 80,846 | 300.79 | 73,721 | 274.28 | 91.2 | 7,125 | ||||||||||||||||
Ohio | 805 | 282,489 | 350.63 | 253,447 | 314.58 | 89.7 | 29,042 | ||||||||||||||||
Texas | 890 | 344,522 | 387.03 | 316,716 | 355.80 | 91.9 | 27,806 | ||||||||||||||||
Utah | 256 | 73,484 | 287.21 | 62,630 | 244.79 | 85.2 | 10,854 | ||||||||||||||||
Washington | 1,217 | 269,191 | 221.28 | 236,928 | 194.76 | 88.0 | 32,263 | ||||||||||||||||
Wisconsin | 124 | 16,279 | 131.21 | 15,217 | 122.65 | 93.5 | 1,062 | ||||||||||||||||
Other (3) |
– | 2,376 | – | 13,463 | – | – | (11,087 | ) | |||||||||||||||
5,472 | $ | 1,448,600 | $ | 264.74 | $ | 1,319,991 | $ | 241.23 | 91.1 | % | $ | 128,609 | |||||||||||
(1) A member month is defined as the aggregate of each month’s ending membership for the period presented. |
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(2) “MCR” represents medical costs as a percentage of premium revenue. |
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(3) “Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
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MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN, CONTINUING OPERATIONS (Amounts in thousands, except per member per month amounts) |
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Nine Months Ended September 30, 2013 | |||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical Margin |
|||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||
California | 3,132 | $ | 552,950 | $ | 176.54 | $ | 497,314 | $ | 158.78 | 89.9 | % | $ | 55,636 | ||||||||||
Florida | 712 | 187,689 | 263.62 | 161,446 | 226.76 | 86.0 | 26,243 | ||||||||||||||||
Michigan | 1,941 | 508,748 | 262.14 | 432,105 | 222.65 | 84.9 | 76,643 | ||||||||||||||||
New Mexico | 984 | 298,767 | 303.59 | 252,001 | 256.07 | 84.3 | 46,766 | ||||||||||||||||
Ohio | 2,234 | 819,879 | 367.03 | 688,266 | 308.11 | 83.9 | 131,613 | ||||||||||||||||
Texas | 2,417 | 969,063 | 400.90 | 829,854 | 343.31 | 85.6 | 139,209 | ||||||||||||||||
Utah | 781 | 236,992 | 303.41 | 193,261 | 247.42 | 81.5 | 43,731 | ||||||||||||||||
Washington | 3,722 | 892,627 | 239.85 | 779,339 | 209.41 | 87.3 | 113,288 | ||||||||||||||||
Wisconsin | 780 | 104,540 | 134.04 | 82,543 | 105.84 | 79.0 | 21,997 | ||||||||||||||||
Other (3) | – | 12,563 | – | 49,705 | – | – | (37,142 | ) | |||||||||||||||
16,703 | $ | 4,583,818 | $ | 274.43 | $ | 3,965,834 | $ | 237.43 | 86.5 | % | $ | 617,984 | |||||||||||
Nine Months Ended September 30, 2012 | |||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical Margin |
|||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||
California | 3,156 | $ | 486,714 | $ | 154.21 | $ | 446,694 | $ | 141.53 | 91.8 | % | $ | 40,020 | ||||||||||
Florida | 632 | 170,940 | 270.50 | 146,261 | 231.44 | 85.6 | 24,679 | ||||||||||||||||
Michigan | 1,983 | 480,098 | 242.13 | 419,406 | 211.52 | 87.4 | 60,692 | ||||||||||||||||
New Mexico | 801 | 240,568 | 300.51 | 208,668 | 260.66 | 86.7 | 31,900 | ||||||||||||||||
Ohio | 2,313 | 827,219 | 357.61 | 735,432 | 317.93 | 88.9 | 91,787 | ||||||||||||||||
Texas | 2,389 | 892,377 | 373.54 | 890,042 | 372.57 | 99.7 | 2,335 | ||||||||||||||||
Utah | 767 | 225,533 | 293.93 | 183,930 | 239.71 | 81.6 | 41,603 | ||||||||||||||||
Washington | 3,352 | 684,466 | 204.22 | 592,398 | 176.75 | 86.5 | 92,068 | ||||||||||||||||
Wisconsin | 374 | 52,209 | 139.46 | 54,861 | 146.54 | 105.1 | (2,652 | ) | |||||||||||||||
Other (3) | – | 6,613 | – | 37,763 | – | – | (31,150 | ) | |||||||||||||||
15,767 | $ | 4,066,737 | $ | 257.93 | $ | 3,715,455 | $ | 235.65 | 91.4 | % | $ | 351,282 | |||||||||||
(1) A member month is defined as the aggregate of each month’s ending membership for the period presented. |
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(2) “MCR” represents medical costs as a percentage of premium revenue. |
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(3) “Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
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MOLINA HEALTHCARE, INC. | ||||||||||||||||||||
UNAUDITED SELECTED FINANCIAL DATA | ||||||||||||||||||||
(Amounts in thousands, except per member per month amounts) | ||||||||||||||||||||
The following tables provide the details of the Company’s medical care costs from continuing operations for the periods indicated: |
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Three Months Ended September 30, | ||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||
Amount | PMPM |
% of
Total |
Amount | PMPM |
% of
Total |
|||||||||||||||
Fee for service | $ | 928,165 | $ | 161.39 | 67.1 | % | $ | 913,137 | $ | 166.88 | 69.2 | % | ||||||||
Pharmacy | 237,073 | 41.22 | 17.1 | 219,823 | 40.17 | 16.7 | ||||||||||||||
Capitation | 162,554 | 28.27 | 11.8 | 142,724 | 26.08 | 10.8 | ||||||||||||||
Other | 55,421 | 9.64 | 4.0 | 44,307 | 8.10 | 3.3 | ||||||||||||||
$ | 1,383,213 | $ | 240.52 | 100.0 | % | $ | 1,319,991 | $ | 241.23 | 100.0 | % | |||||||||
Nine Months Ended September 30, | ||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||
Amount | PMPM |
% of
Total |
Amount | PMPM |
% of
Total |
|||||||||||||||
Fee for service | $ | 2,674,785 | $ | 160.14 | 67.5 | % | $ | 2,566,161 | $ | 162.76 | 69.1 | % | ||||||||
Pharmacy | 691,903 | 41.42 | 17.4 | 606,004 | 38.44 | 16.3 | ||||||||||||||
Capitation | 441,287 | 26.42 | 11.1 | 412,692 | 26.17 | 11.1 | ||||||||||||||
Other | 157,859 | 9.45 | 4.0 | 130,598 | 8.28 | 3.5 | ||||||||||||||
$ | 3,965,834 | $ | 237.43 | 100.0 | % | $ | 3,715,455 | $ | 235.65 | 100.0 | % |
The following table provides the details of the Company’s medical claims and benefits payable as of the dates indicated: |
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Sept. 30, 2013 |
Dec. 31, 2012 |
Sept. 30, 2012 |
||||||||
Fee-for-service claims incurred but not paid (IBNP) | $ | 393,318 | $ | 377,614 | $ | 414,725 | ||||
Capitation payable | 77,051 | 49,066 | 55,314 | |||||||
Pharmacy | 45,451 | 38,992 | 42,681 | |||||||
Other (1) | 116,886 | 28,858 | 23,743 | |||||||
$ | 632,706 | $ | 494,530 | $ | 536,463 | |||||
(1) “Other” medical claims and benefits payable include amounts payable to certain providers for which the Company acts as an intermediary on behalf of various state agencies without assuming financial risk. Such receipts and payments do not impact the Company’s unaudited consolidated statements of operations. As of September 30, 2013, the Company had recorded provider payables of approximately $64.1 million for new intermediary arrangements that began in the third quarter of 2013. |
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MOLINA HEALTHCARE, INC.
UNAUDITED CHANGE IN MEDICAL CLAIMS
AND BENEFITS PAYABLE
The Company’s claims liability includes an allowance for adverse claims development 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. The Company’s reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior periods” represent the amount by which the Company’s original estimate of claims and benefits payable at the beginning of the period were (more) or 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 shows the components of the change in medical claims and benefits payable from continuing and discontinued operations as of the periods indicated:
Nine Months Ended Sept. 30, |
Three Months Ended Sept. 30, |
Year Ended Dec. 31, 2012 |
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2013 | 2012 | 2013 | 2012 | |||||||||||||||||||
(Dollars in thousands, except per-member amounts) | ||||||||||||||||||||||
Balances at beginning of period | $ | 494,530 | $ | 402,476 | $ | 465,487 | $ | 525,538 | $ | 402,476 | ||||||||||||
Components of medical care costs related to: | ||||||||||||||||||||||
Current period | 4,021,461 | 3,860,825 | 1,415,670 | 1,361,539 | 5,136,055 | |||||||||||||||||
Prior periods | (54,040 | ) | (37,689 | ) | (32,575 | ) | (46,968 | ) | (39,295 | ) | ||||||||||||
Total medical care costs | 3,967,421 | 3,823,136 | 1,383,095 | 1,314,571 | 5,096,760 | |||||||||||||||||
Payments for medical care costs related to: | ||||||||||||||||||||||
Current period | 3,410,689 | 3,332,896 | 851,025 | 875,236 | 4,649,363 | |||||||||||||||||
Prior periods | 418,556 | 356,253 | 364,851 | 428,410 | 355,343 | |||||||||||||||||
Total paid | 3,829,245 | 3,689,149 | 1,215,876 | 1,303,646 | 5,004,706 | |||||||||||||||||
Balances at end of period | $ | 632,706 | $ | 536,463 | $ | 632,706 | $ | 536,463 | $ | 494,530 | ||||||||||||
Benefit from prior period as a percentage of: | ||||||||||||||||||||||
Balance at beginning of period | 10.9 | % | 9.0 | % | 7.0 | % | 8.9 | % | 9.8 | % | ||||||||||||
Premium revenue, trailing twelve months | 0.9 | % | 0.7 | % | 0.5 | % | 0.8 | % | 0.7 | % | ||||||||||||
Medical care costs, trailing twelve months | 1.0 | % | 0.8 | % | 0.6 | % | 1.0 | % | 0.8 | % | ||||||||||||
Claims Data: | ||||||||||||||||||||||
Days in claims payable, fee for service | 41 | 45 | 41 | 45 | 40 | |||||||||||||||||
Number of members at end of period | 1,942,000 | 1,826,000 | 1,942,000 | 1,826,000 | 1,797,000 | |||||||||||||||||
Number of claims in inventory
at end of period |
137,100 | 163,600 | 137,100 | 163,600 | 122,700 | |||||||||||||||||
Billed charges of claims in inventory
at end of period |
$ | 257,600 | $ | 304,600 | $ | 257,600 | $ | 304,600 | $ | 255,200 | ||||||||||||
Claims in inventory per member
at end of period |
0.07 | 0.09 | 0.07 | 0.09 | 0.07 | |||||||||||||||||
Billed charges of claims in inventory
per member at end of period |
$ | 132.65 | $ | 166.81 | $ | 132.65 | $ | 166.81 | $ | 142.01 | ||||||||||||
Number of claims received
during the period |
15,751,500 | 15,455,000 | 5,227,000 | 5,079,200 | 20,842,400 | |||||||||||||||||
Billed charges of claims received
during the period |
$ | 15,848,900 | $ | 14,339,700 | $ | 5,371,100 | $ | 4,951,000 | $ | 19,429,300 |
CONTACT:
Molina Healthcare, Inc.
Investor Relations:
Juan José
Orellana, 562-435-3666, ext. 111143