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 10, 2014
______________
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 February 10, 2014, Molina Healthcare, Inc. issued a press release announcing its financial results for the fourth quarter and year ended December 31, 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 February 10, 2014, as to financial results for the fourth quarter and year ended December 31, 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: | February 10, 2014 | 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 February 10, 2014, as to financial results for the fourth quarter and year ended December 31, 2013. |
Exhibit 99.1
Molina Healthcare Reports Fourth Quarter and Year-End 2013 Results
LONG BEACH, Calif.--(BUSINESS WIRE)--February 10, 2014--Molina Healthcare, Inc. (NYSE: MOH):
Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the fourth quarter and year ended December 31, 2013. Net income from continuing operations for the year ended December 31, 2013, was $44.8 million, or $0.96 per diluted share, compared with net income from continuing operations of $12.9 million, or $0.27 per diluted share, for the year ended December 31, 2012. Net loss from continuing operations for the fourth quarter was $9.0 million, or $0.20 per diluted share, compared with net income from continuing operations of $26.2 million, or $0.55 per diluted share, for the quarter ended December 31, 2012.
“For Molina Healthcare, 2013 was a year of both opportunity and challenge,” said J. Mario Molina, M.D., chief executive officer of Molina Healthcare, Inc. “We laid the foundation for success in 2014 and beyond by increasing medical margins, securing Duals Demonstration contracts in five states, expanding our footprint into South Carolina, and building the robust administrative infrastructure we will need going forward.”
2014 Business Outlook
The Company will discuss its 2014 guidance, corporate strategy and business outlook at its Investor Day Conference webcast and presentation to be held on February 13, 2014, at the Le Parker Meridien Hotel in New York City.
Overview of Financial Results
Year Ended December 31, 2013, Compared with Year Ended December 31, 2012
Net income from continuing operations increased to $44.8 million in 2013, from $12.9 million in 2012 as a result of higher medical margin (measured as the excess of premium revenue over medical care costs). Higher medical margin was partially offset by increased administrative expenses related to the Company’s preparations for significant membership growth expected in 2014.
Premium revenue in 2013 increased 11% over 2012, due to a 6% increase in member months and a 5% increase in revenue per member per month (PMPM).
Excluding the Company’s Illinois health plan, which was not operational until 2013, eight of the Company’s nine other health plans reported higher medical margins in 2013 than in 2012. Consolidated medical margin increased by approximately 45% year over year. The Company’s consolidated medical care ratio (measured as medical care costs as a percentage of premium revenue) decreased to 87.1% in 2013 from 90.0% in 2012.
As the Company has previously discussed, general and administrative expenses increased to 10.1% of revenue in 2013 from 8.8% in 2012. Increased administrative expenses related to the anticipated membership growth represented approximately 2% of premium revenue, or $135 million during 2013.
Conference Call
The Company’s management will host a conference call and webcast to discuss its fourth quarter and year-end results at 5:00 p.m. Eastern time on Monday, February 10, 2014. The number to call for the interactive teleconference is (212) 231-2919. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Monday, February 10, 2014, through 6:00 p.m. on Tuesday, February 11, 2014, by dialing (800) 633-8284 and entering confirmation number 21703882. 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, South Carolina, Texas, Utah, Washington, and Wisconsin currently serve approximately 2.1 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.
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 provide 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 February 10, 2014, 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 |
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Three Months Ended |
Year Ended |
||||||||||||||||||||
2013 | 2012 | 2013 | 2012 | ||||||||||||||||||
(Amounts in thousands, except net (loss) income per share) | |||||||||||||||||||||
Revenue: | |||||||||||||||||||||
Premium revenue | $ | 1,595,352 | $ | 1,477,384 | $ | 6,179,170 | $ | 5,544,121 | |||||||||||||
Premium tax revenue | 44,411 | 38,038 | 172,017 | 158,991 | |||||||||||||||||
Service revenue | 54,007 | 55,359 | 204,535 | 187,710 | |||||||||||||||||
Investment income | 2,006 | 1,182 | 6,890 | 5,075 | |||||||||||||||||
Rental and other income | 9,846 | 5,997 | 26,322 | 18,312 | |||||||||||||||||
Total revenue | 1,705,622 | 1,577,960 | 6,588,934 | 5,914,209 | |||||||||||||||||
Operating expenses: | |||||||||||||||||||||
Medical care costs | 1,414,290 | 1,275,733 | 5,380,124 | 4,991,188 | |||||||||||||||||
Cost of service revenue | 42,306 | 43,097 | 161,494 | 141,208 | |||||||||||||||||
General and administrative expenses | 187,006 | 153,051 | 665,996 | 518,615 | |||||||||||||||||
Premium tax expenses | 44,411 | 38,038 | 172,017 | 158,991 | |||||||||||||||||
Depreciation and amortization | 20,294 | 16,198 | 72,743 | 63,114 | |||||||||||||||||
Total operating expenses | 1,708,307 | 1,526,117 | 6,452,374 | 5,873,116 | |||||||||||||||||
Operating (loss) income | (2,685 | ) | 51,843 | 136,560 | 41,093 | ||||||||||||||||
Other expenses (income): | |||||||||||||||||||||
Interest expense | 13,835 | 4,348 | 52,071 | 16,769 | |||||||||||||||||
Other (income) expense | (4 | ) | (325 | ) | 3,343 | 945 | |||||||||||||||
Total other expenses (income) | 13,831 | 4,023 | 55,414 | 17,714 | |||||||||||||||||
(Loss) income from continuing operations
before income taxes |
(16,516 | ) | 47,820 | 81,146 | 23,379 | ||||||||||||||||
Income tax (benefit) expense | (7,475 | ) | 21,626 | 36,316 | 10,513 | ||||||||||||||||
(Loss) income from continuing operations | (9,041 | ) | 26,194 | 44,830 | 12,866 | ||||||||||||||||
(Loss) income from discontinued operations (1) | (85 | ) | (551 | ) | 8,099 | (3,076 | ) | ||||||||||||||
Net (loss) income | $ | (9,126 | ) | $ | 25,643 | $ | 52,929 | $ | 9,790 | ||||||||||||
Basic (loss) income per share: | |||||||||||||||||||||
(Loss) income from continuing operations | $ | (0.20 | ) | $ | 0.56 | $ | 0.98 | $ | 0.28 | ||||||||||||
(Loss) income from discontinued operations | – | (0.01 | ) | 0.18 | (0.07 | ) | |||||||||||||||
Basic net (loss) income per share | $ | (0.20 | ) | $ | 0.55 | $ | 1.16 | $ | 0.21 | ||||||||||||
Diluted (loss) income per share: | |||||||||||||||||||||
(Loss) income from continuing operations | $ | (0.20 | ) | $ | 0.55 | $ | 0.96 | $ | 0.27 | ||||||||||||
(Loss) income from discontinued operations | – | (0.01 | ) | 0.17 | (0.06 | ) | |||||||||||||||
Diluted net (loss) income per share | $ | (0.20 | ) | $ | 0.54 | $ | 1.13 | $ | 0.21 | ||||||||||||
Weighted average shares outstanding: | |||||||||||||||||||||
Basic | 45,725 | 46,617 | 45,717 | 46,380 | |||||||||||||||||
Diluted | 45,725 | 47,143 | 46,862 | 46,999 | |||||||||||||||||
Operating Statistics, Continuing Operations: | |||||||||||||||||||||
Medical care ratio (2) | 88.7 | % | 86.4 | % | 87.1 | % | 90.0 | % | |||||||||||||
Service revenue ratio (3) | 78.3 | % | 77.9 | % | 79.0 | % | 75.2 | % | |||||||||||||
General and administrative expense ratio (4) | 11.0 | % | 9.7 | % | 10.1 | % | 8.8 | % | |||||||||||||
Premium tax ratio (2) | 2.7 | % | 2.5 | % | 2.7 | % | 2.8 | % | |||||||||||||
Effective tax rate |
45.3 |
% |
45.2 | % | 44.8 | % | 45.0 | % | |||||||||||||
__________ |
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(1) |
(Loss) income from discontinued operations is net of income tax expense (benefit) of $134, $2,877, $(9,912), and $(1,238), 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 revenue. |
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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. |
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED BALANCE SHEETS |
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December 31, | ||||||||||
2013 | 2012 | |||||||||
(Amounts in thousands, |
||||||||||
ASSETS | ||||||||||
Current assets: | ||||||||||
Cash and cash equivalents | $ | 935,895 | $ | 795,770 | ||||||
Investments | 703,052 | 342,845 | ||||||||
Receivables | 298,935 | 149,682 | ||||||||
Income tax refundable | 32,742 | – | ||||||||
Deferred income taxes | 26,556 | 32,443 | ||||||||
Prepaid expenses and other current assets | 42,484 | 28,386 | ||||||||
Total current assets | 2,039,664 | 1,349,126 | ||||||||
Property, equipment, and capitalized software, net | 292,083 | 221,443 | ||||||||
Deferred contract costs | 45,675 | 58,313 | ||||||||
Intangible assets, net | 98,871 | 77,711 | ||||||||
Goodwill | 230,738 | 151,088 | ||||||||
Restricted investments | 63,093 | 44,101 | ||||||||
Auction rate securities | 10,898 | 13,419 | ||||||||
Derivative asset | 186,351 | – | ||||||||
Other assets | 35,564 | 19,621 | ||||||||
$ | 3,002,937 | $ | 1,934,822 | |||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||||
Current liabilities: | ||||||||||
Medical claims and benefits payable | $ | 669,787 | $ | 494,530 | ||||||
Accounts payable and accrued liabilities | 319,965 | 184,034 | ||||||||
Deferred revenue | 122,216 | 141,798 | ||||||||
Income taxes payable | – | 6,520 | ||||||||
Current maturities of long-term debt | 182,008 | 1,155 | ||||||||
Total current liabilities | 1,293,976 | 828,037 | ||||||||
Convertible senior notes | 416,368 | 175,468 | ||||||||
Lease financing obligations | 159,394 | – | ||||||||
Lease financing obligations - related party | 27,092 | – | ||||||||
Other long-term debt | – | 86,316 | ||||||||
Deferred income taxes | 580 | 37,900 | ||||||||
Derivative liability | 186,239 | 1,307 | ||||||||
Other long-term liabilities | 26,351 | 23,480 | ||||||||
Total liabilities | 2,110,000 | 1,152,508 | ||||||||
Stockholders’ equity: | ||||||||||
Common stock, $0.001 par value; 150,000 shares authorized; outstanding: 45,871 shares at December 31, 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 | 340,848 | 285,524 | ||||||||
Accumulated other comprehensive loss | (1,086 | ) | (457 | ) | ||||||
Treasury stock, at cost; outstanding: 111 shares at December 31, 2012 | – | (3,000 | ) | |||||||
Retained earnings | 553,129 | 500,200 | ||||||||
Total stockholders’ equity | 892,937 | 782,314 | ||||||||
$ | 3,002,937 | $ | 1,934,822 |
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS FOR CONTINUING AND DISCONTINUED OPERATIONS |
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Three Months Ended |
Year Ended |
|||||||||||||||||||
2013 | 2012 | 2013 | 2012 | |||||||||||||||||
(Amounts in thousands) | ||||||||||||||||||||
Operating activities: | ||||||||||||||||||||
Net (loss) income | $ | (9,126 | ) | $ | 25,643 | $ | 52,929 | $ | 9,790 | |||||||||||
Adjustments to reconcile net (loss) income to net cash provided by operating activities: | ||||||||||||||||||||
Depreciation and amortization | 25,831 | 20,475 | 93,866 | 78,764 | ||||||||||||||||
Deferred income taxes | 7,395 | (10,410 | ) | (31,047 | ) | (9,887 | ) | |||||||||||||
Stock-based compensation | 8,040 | 4,570 | 28,694 | 20,018 | ||||||||||||||||
Amortization of convertible senior notes and lease financing obligations |
6,692 | 1,528 | 22,820 | 5,942 | ||||||||||||||||
Amortization of premium/discount on investments | 3,734 | 1,580 | 11,787 | 6,746 | ||||||||||||||||
Amortization of deferred financing costs | 650 | 264 | 3,692 | 1,089 | ||||||||||||||||
Change in fair value of derivatives | (5 | ) | 37 | 3,378 | 1,307 | |||||||||||||||
Change in fair value of contingent consideration liabilities |
(2,400 | ) | – | (2,400 | ) | – | ||||||||||||||
Loss on disposal of property and equipment | 1,345 | 2,608 | 1,345 | 2,608 | ||||||||||||||||
Tax deficiency from employee stock compensation | (1 | ) | (367 | ) | (73 | ) | (526 | ) | ||||||||||||
Gain on sale of subsidiary | – | – | – | (1,747 | ) | |||||||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||||
Medical claims and benefits payable | 37,081 | (41,933 | ) | 175,257 | 92,054 | |||||||||||||||
Receivables | (4,968 | ) | 7,227 | (149,253 | ) | 18,216 | ||||||||||||||
Accounts payable and accrued liabilities |
40,880 |
32,375 |
60,996 |
23,345 | ||||||||||||||||
Income taxes | (38,250 | ) | 40,050 | (39,262 | ) | 18,172 | ||||||||||||||
Prepaid expenses and other current assets | 4,488 | 1,616 | (23,064 | ) | (8,958 | ) | ||||||||||||||
Deferred revenue | (2,172 | ) | (1,503 | ) | (19,582 | ) | 90,851 | |||||||||||||
Net cash provided by operating activities | 79,214 | 83,760 |
190,083 |
347,784 | ||||||||||||||||
Investing activities: | ||||||||||||||||||||
Purchases of investments | (142,130 | ) | (71,972 | ) | (770,083 | ) | (306,437 | ) | ||||||||||||
Sales and maturities of investments | 171,795 | 84,341 | 399,595 | 298,006 | ||||||||||||||||
Purchases of equipment | (33,623 | ) | (25,597 | ) | (98,049 | ) | (78,145 | ) | ||||||||||||
Net cash paid in business combinations | (3,837 | ) | – | (61,521 | ) | – | ||||||||||||||
(Increase) decrease in restricted investments | 2,132 | 387 | (18,992 | ) | (2,647 | ) | ||||||||||||||
(Increase) decrease in deferred contract costs | 3,093 | 7,189 | 12,638 | (11,610 | ) | |||||||||||||||
Proceeds from sale of subsidiary, net of cash surrendered | – | – | – | 9,162 | ||||||||||||||||
Change in other noncurrent assets and liabilities | 675 | 2,862 | (6,899 | ) | (1,913 | ) | ||||||||||||||
Net cash used in investing activities | (1,895 | ) | (2,790 | ) | (543,311 | ) | (93,584 | ) | ||||||||||||
Financing activities: | ||||||||||||||||||||
Proceeds from issuance of 1.125% Notes, net of deferred issuance 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 | (2,662 | ) | (3,000 | ) | (52,662 | ) | (3,000 | ) | ||||||||||||
Principal payments on term loan | – | (283 | ) | (47,471 | ) | (1,129 | ) | |||||||||||||
Repayment of amounts borrowed under credit facility | – | – | (40,000 | ) | (20,000 | ) | ||||||||||||||
Proceeds from employee stock plans | 4,246 | 2,634 | 9,402 | 8,205 | ||||||||||||||||
Excess tax benefits from employee stock compensation | 436 | (31 | ) | 1,674 | 3,667 | |||||||||||||||
Amount borrowed under credit facility | – | – | – | 60,000 | ||||||||||||||||
Net cash provided by (used in) financing activities | 2,020 | (680 | ) |
493,353 |
47,743 | |||||||||||||||
Net increase in cash and cash equivalents | 79,339 | 80,290 | 140,125 | 301,943 | ||||||||||||||||
Cash and cash equivalents at beginning of period | 856,556 | 715,480 | 795,770 | 493,827 | ||||||||||||||||
Cash and cash equivalents at end of period | $ | 935,895 | $ | 795,770 | $ | 935,895 | $ | 795,770 |
MOLINA HEALTHCARE, INC. UNAUDITED NON-GAAP FINANCIAL MEASURES |
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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. |
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The first of these non-GAAP measures is earnings before interest, taxes, depreciation and amortization (EBITDA). The following table reconciles net income, which we believe to be the most comparable GAAP measure, to EBITDA. |
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Three Months Ended |
Year Ended |
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2013 | 2012 | 2013 | 2012 | ||||||||||||||
(Amounts in thousands) | |||||||||||||||||
Net (loss) income | $ | (9,126 | ) | $ | 25,643 | $ | 52,929 | $ | 9,790 | ||||||||
Adjustments: | |||||||||||||||||
Depreciation and amortization reported in the consolidated statements of cash flows | 25,831 | 20,475 | 93,866 | 78,764 | |||||||||||||
Interest expense | 13,835 | 4,348 | 52,071 | 16,769 | |||||||||||||
Income tax (benefit) expense | (7,341 | ) | 24,503 | 26,404 | 9,275 | ||||||||||||
EBITDA | $ | 23,199 | $ | 74,969 | $ | 225,270 | $ | 114,598 | |||||||||
The second of these non-GAAP measures is adjusted net income per 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. |
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Three Months Ended |
Year Ended |
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2013 | 2012 | 2013 | 2012 | ||||||||||||||
Net (loss) income per diluted share, continuing operations |
$ | (0.20 | ) | $ | 0.55 | $ | 0.96 | $ | 0.27 | ||||||||
Adjustments, net of tax: | |||||||||||||||||
Depreciation, and amortization of capitalized software | 0.28 | 0.20 | 0.98 | 0.75 | |||||||||||||
Stock-based compensation | 0.19 | 0.07 | 0.52 | 0.31 | |||||||||||||
Amortization of convertible senior notes
and lease financing obligations |
0.09 | 0.02 | 0.31 | 0.08 | |||||||||||||
Amortization of intangible assets | 0.08 | 0.08 | 0.28 | 0.29 | |||||||||||||
Change in fair value of derivatives | – | – | 0.08 | 0.02 | |||||||||||||
Adjusted net income per diluted share, continuing operations |
$ | 0.44 | $ | 0.92 | $ | 3.13 | $ | 1.72 | |||||||||
1 GAAP stands for Generally Accepted Accounting Principles. |
MOLINA HEALTHCARE, INC. UNAUDITED MEMBERSHIP DATA, CONTINUING OPERATIONS |
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As of December 31, | |||||||||
2013 | 2012 | 2011 | |||||||
Total Ending Membership by Health Plan: | |||||||||
California | 368,000 | 336,000 | 355,000 | ||||||
Florida | 89,000 | 73,000 | 69,000 | ||||||
Illinois | 4,000 | – | – | ||||||
Michigan | 213,000 | 220,000 | 222,000 | ||||||
New Mexico | 168,000 | 91,000 | 88,000 | ||||||
Ohio | 255,000 | 244,000 | 248,000 | ||||||
Texas | 252,000 | 282,000 | 155,000 | ||||||
Utah | 86,000 | 87,000 | 84,000 | ||||||
Washington | 403,000 | 418,000 | 355,000 | ||||||
Wisconsin | 93,000 | 46,000 | 42,000 | ||||||
1,931,000 | 1,797,000 | 1,618,000 | |||||||
Total Ending Membership by State for the
Medicare Advantage Plans: |
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California | 8,800 | 7,700 | 6,900 | ||||||
Florida | 600 | 900 | 800 | ||||||
Michigan | 10,400 | 9,700 | 8,200 | ||||||
New Mexico | 900 | 900 | 800 | ||||||
Ohio | 500 | 300 | 200 | ||||||
Texas | 2,800 | 1,500 | 700 | ||||||
Utah | 8,300 | 8,200 | 8,400 | ||||||
Washington | 7,100 | 6,500 | 5,000 | ||||||
39,400 | 35,700 | 31,000 | |||||||
Total Ending Membership by State for the
Aged, Blind or Disabled Population: |
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California | 46,700 | 44,700 | 31,500 | ||||||
Florida | 14,700 | 10,300 | 10,400 | ||||||
Illinois | 4,000 | – | – | ||||||
Michigan | 45,300 | 41,900 | 37,500 | ||||||
New Mexico | 11,300 | 5,700 | 5,600 | ||||||
Ohio | 32,000 | 28,200 | 29,100 | ||||||
Texas | 90,200 | 95,900 | 63,700 | ||||||
Utah | 9,700 | 9,000 | 8,500 | ||||||
Washington | 33,000 | 30,000 | 4,800 | ||||||
Wisconsin | 1,700 | 1,700 | 1,700 | ||||||
288,600 | 267,400 | 192,800 |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN, CONTINUING OPERATIONS (In thousands except percentages and per-member per-month amounts) |
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Three Months Ended December 31, 2013 | |||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) | Medical Margin | |||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||
California | 1,101 | $ | 196,805 | $ | 178.70 | $ | 169,278 | $ | 153.71 | 86.0 | % | $ | 27,527 | ||||||||||||||||
Florida | 261 | 77,309 | 295.65 | 69,815 | 266.99 | 90.3 | 7,494 | ||||||||||||||||||||||
Illinois (3) | 7 | 8,121 | 1,201.34 | 7,869 | 1,164.10 | 96.9 | 252 | ||||||||||||||||||||||
Michigan | 640 | 167,252 | 261.23 | 138,539 | 216.38 | 82.8 | 28,713 | ||||||||||||||||||||||
New Mexico | 508 | 147,991 | 291.16 | 132,465 | 260.62 | 89.5 | 15,526 | ||||||||||||||||||||||
Ohio | 773 | 278,916 | 360.85 | 236,409 | 305.86 | 84.8 | 42,507 | ||||||||||||||||||||||
Texas | 761 | 321,938 | 423.35 | 284,998 | 374.77 | 88.5 | 36,940 | ||||||||||||||||||||||
Utah | 259 | 73,903 | 285.88 | 66,136 | 255.84 | 89.5 | 7,767 | ||||||||||||||||||||||
Washington | 1,219 | 275,778 | 226.15 | 248,871 | 204.09 | 90.2 | 26,907 | ||||||||||||||||||||||
Wisconsin | 280 | 38,925 | 139.19 | 31,797 | 113.70 | 81.7 | 7,128 | ||||||||||||||||||||||
Other (4) | – | 8,414 | – | 28,113 | – | – | (19,699 | ) | |||||||||||||||||||||
5,809 | $ | 1,595,352 | $ | 274.63 | $ | 1,414,290 | $ | 243.46 | 88.7 | % | $ | 181,062 | |||||||||||||||||
Three Months Ended December 31, 2012 | |||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) | Medical Margin | |||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||
California | 1,021 | $ | 178,886 | $ |
175.25 |
$ | 159,800 | $ |
156.55 |
89.3 | % | $ | 19,086 | ||||||||||||||||
Florida | 218 | 57,892 | 266.06 | 48,965 | 225.04 | 84.6 | 8,927 | ||||||||||||||||||||||
Michigan | 656 | 166,453 | 253.54 | 151,230 | 230.35 | 90.9 | 15,223 | ||||||||||||||||||||||
New Mexico | 268 | 81,285 | 302.77 | 71,440 | 266.10 | 87.9 | 9,845 | ||||||||||||||||||||||
Ohio | 752 | 267,918 | 356.60 | 235,072 | 312.88 | 87.7 | 32,846 | ||||||||||||||||||||||
Texas | 856 | 341,244 | 398.69 | 265,391 | 310.07 | 77.8 | 75,853 | ||||||||||||||||||||||
Utah | 259 | 72,859 | 281.46 | 61,741 | 238.51 | 84.7 | 11,118 | ||||||||||||||||||||||
Washington | 1,248 | 290,246 | 232.56 | 253,335 | 202.99 | 87.3 | 36,911 | ||||||||||||||||||||||
Wisconsin | 134 | 18,469 | 138.66 | 13,107 | 98.41 | 71.0 | 5,362 | ||||||||||||||||||||||
Other (3)(4) | – | 2,132 | – | 15,652 | – | – | (13,520 | ) | |||||||||||||||||||||
5,412 | $ | 1,477,384 | $ | 273.05 | $ | 1,275,733 | $ | 235.79 | 86.4 | % | $ | 201,651 | |||||||||||||||||
__________ |
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(1) |
A member month is defined as the aggregate of each month’s ending membership for the period presented. |
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(2) |
The MCR represents medical costs as a percentage of premium revenue. |
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(3) |
The Illinois health plan’s results prior to October 1, 2013, were insignificant and reported in “Other.” |
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(4) |
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN, CONTINUING OPERATIONS (In thousands except percentages and per-member per-month amounts) |
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Year Ended December 31, 2013 | |||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) | Medical Margin | |||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||
California | 4,233 | $ | 749,755 | $ | 177.10 | $ | 666,592 | $ | 157.46 | 88.9 | % | $ | 83,163 | ||||||||||||||||
Florida | 973 | 264,998 | 272.23 | 231,261 | 237.57 | 87.3 | 33,737 | ||||||||||||||||||||||
Illinois (3) | 7 | 8,121 | 1,201.34 | 7,869 | 1,164.10 | 96.9 | 252 | ||||||||||||||||||||||
Michigan | 2,581 | 676,000 | 261.91 | 570,644 | 221.09 | 84.4 | 105,356 | ||||||||||||||||||||||
New Mexico | 1,492 | 446,758 | 299.36 | 384,466 | 257.62 | 86.1 | 62,292 | ||||||||||||||||||||||
Ohio | 3,007 | 1,098,795 | 365.44 | 924,675 | 307.53 | 84.2 | 174,120 | ||||||||||||||||||||||
Texas | 3,178 | 1,291,001 | 406.27 | 1,114,852 | 350.84 | 86.4 | 176,149 | ||||||||||||||||||||||
Utah | 1,040 | 310,895 | 299.05 | 259,397 | 249.51 | 83.4 | 51,498 | ||||||||||||||||||||||
Washington | 4,941 | 1,168,405 | 236.47 | 1,028,210 | 208.10 | 88.0 | 140,195 | ||||||||||||||||||||||
Wisconsin | 1,060 | 143,465 | 135.40 | 114,340 | 107.91 | 79.7 | 29,125 | ||||||||||||||||||||||
Other (4) | – | 20,977 | – | 77,818 | – | – | (56,841 | ) | |||||||||||||||||||||
22,512 | $ | 6,179,170 | $ | 274.48 | $ | 5,380,124 | $ | 238.99 | 87.1 | % | $ | 799,046 | |||||||||||||||||
Year Ended December 31, 2012 | |||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) | Medical Margin | |||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||
California | 4,177 | $ | 665,600 | $ |
159.36 |
$ | 606,494 | $ | 145.20 | 91.1 | % | $ | 59,106 | ||||||||||||||||
Florida | 850 | 228,832 | 269.36 | 195,226 | 229.80 | 85.3 | 33,606 | ||||||||||||||||||||||
Michigan | 2,639 | 646,551 | 244.97 | 570,636 | 216.20 | 88.3 | 75,915 | ||||||||||||||||||||||
New Mexico | 1,069 | 321,853 | 301.08 | 280,108 | 262.03 | 87.0 | 41,745 | ||||||||||||||||||||||
Ohio | 3,065 | 1,095,137 | 357.36 | 970,504 | 316.69 | 88.6 | 124,633 | ||||||||||||||||||||||
Texas | 3,245 | 1,233,621 | 380.18 | 1,155,433 | 356.08 | 93.7 | 78,188 | ||||||||||||||||||||||
Utah | 1,026 | 298,392 | 290.78 | 245,671 | 239.41 | 82.3 | 52,721 | ||||||||||||||||||||||
Washington | 4,600 | 974,712 | 211.91 | 845,733 | 183.87 | 86.8 | 128,979 | ||||||||||||||||||||||
Wisconsin | 508 | 70,678 | 139.25 | 67,968 | 133.91 | 96.2 | 2,710 | ||||||||||||||||||||||
Other (3)(4) | – | 8,745 | – | 53,415 | – | – | (44,670 | ) | |||||||||||||||||||||
21,179 | $ | 5,544,121 | $ | 261.79 | $ | 4,991,188 | $ | 235.68 | 90.0 | % | $ | 552,933 | |||||||||||||||||
__________ |
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(1) |
A member month is defined as the aggregate of each month’s ending membership for the period presented. |
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(2) |
The MCR represents medical costs as a percentage of premium revenue. |
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(3) |
The Illinois health plan’s results prior to October 1, 2013, were insignificant and reported in “Other.” |
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(4) |
“Other” medical care costs include primarily medically related administrative costs at the parent company, and direct delivery costs. |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA (Dollars in thousands, except per-member-per-month amounts) |
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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 December 31, | ||||||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||||
Amount | PMPM |
% of Total |
Amount | PMPM |
% of
Total |
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Fee for service | $ | 936,744 | $ | 161.26 | 66.2 | % | $ | 857,590 | $ | 158.50 | 67.2 | % | ||||||||||||
Pharmacy | 243,301 | 41.88 | 17.2 | 229,826 | 42.48 | 18.0 | ||||||||||||||||||
Capitation | 162,651 | 28.00 | 11.5 | 139,444 | 25.77 | 10.9 | ||||||||||||||||||
Direct delivery | 20,549 | 3.54 | 1.5 | 8,694 | 1.61 | 0.7 | ||||||||||||||||||
Other | 51,045 | 8.78 | 3.6 | 40,179 | 7.43 | 3.2 | ||||||||||||||||||
$ | 1,414,290 | $ | 243.46 | 100.0 | % | $ | 1,275,733 | $ | 235.79 | 100.0 | % | |||||||||||||
Year Ended December 31, | ||||||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||||
Amount | PMPM |
% of
Total |
Amount | PMPM |
% of
Total |
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Fee for service | $ | 3,611,529 | $ | 160.43 | 67.1 | % | $ | 3,423,751 | $ | 161.67 | 68.6 | % | ||||||||||||
Pharmacy | 935,204 | 41.54 | 17.4 | 835,830 | 39.47 | 16.7 | ||||||||||||||||||
Capitation | 603,938 | 26.83 | 11.2 | 552,136 | 26.07 | 11.1 | ||||||||||||||||||
Direct delivery | 48,288 | 2.14 | 0.9 | 33,920 | 1.60 | 0.7 | ||||||||||||||||||
Other | 181,165 | 8.05 | 3.4 | 145,551 | 6.87 | 2.9 | ||||||||||||||||||
$ | 5,380,124 | $ | 238.99 | 100.0 | % | $ | 4,991,188 | $ | 235.68 | 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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December 31, 2013 |
December 31, |
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Fee-for-service claims incurred but not paid (IBNP) | $ | 424,173 | $ | 377,614 | |||||
Pharmacy payable | 45,037 | 38,992 | |||||||
Capitation payable | 20,267 | 49,066 | |||||||
Other (1) | 180,310 | 28,858 | |||||||
$ | 669,787 | $ | 494,530 | ||||||
__________ |
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(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 December 31, 2013, the Company had recorded non-risk provider payables of approximately $151.3 million. |
MOLINA HEALTHCARE, INC. UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE |
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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 presents the components of the change in medical claims and benefits payable from continuing and discontinued operations combined for the periods indicated: |
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Three Months Ended |
Year Ended
December 31, |
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2013 | 2012 | 2013 | 2012 | ||||||||||||||
(Dollars in thousands, except per-member amounts) | |||||||||||||||||
Balances at beginning of period | $ | 632,706 | $ | 536,463 | $ | 494,530 | $ | 402,476 | |||||||||
Components of medical care costs related to: | |||||||||||||||||
Current period | 1,455,385 | 1,350,043 | 5,434,443 | 5,136,055 | |||||||||||||
Prior period | (41,142 | ) | (76,419 | ) | (52,779 | ) | (39,295 | ) | |||||||||
Total medical care costs | 1,414,243 | 1,273,624 | 5,381,664 | 5,096,760 | |||||||||||||
Change in non-risk provider payables | 27,596 | (5,691 | ) | 111,267 | (7,004 | ) | |||||||||||
Payments for medical care costs related to: | |||||||||||||||||
Current period | 1,017,300 | 979,963 | 4,932,195 | 4,689,395 | |||||||||||||
Prior period | 387,458 | 329,903 | 385,479 | 308,307 | |||||||||||||
Total paid | 1,404,758 | 1,309,866 | 5,317,674 | 4,997,702 | |||||||||||||
Balances at end of period | $ | 669,787 | $ | 494,530 | $ | 669,787 | $ | 494,530 | |||||||||
Benefit from prior period as a percentage of: | |||||||||||||||||
Balance at beginning of period | 6.5 | % | 14.2 | % | 10.7 | % | 9.8 | % | |||||||||
Premium revenue, trailing twelve months | 0.7 | % | 1.3 | % | 0.9 | % | 0.7 | % | |||||||||
Medical care costs, trailing twelve months | 0.8 | % | 1.5 | % | 1.0 | % | 0.8 | % | |||||||||
Claims Data: | |||||||||||||||||
Days in claims payable, fee for service | 43 | 40 | 43 | 40 | |||||||||||||
Number of members at end of year | 1,931,000 | 1,797,000 | 1,931,000 | 1,797,000 | |||||||||||||
Number of claims in inventory at end of year | 145,800 | 122,700 | 145,800 | 122,700 | |||||||||||||
Billed charges of claims in inventory at end of year | $ | 276,500 | $ | 255,200 | $ | 276,500 | $ | 255,200 | |||||||||
Claims in inventory per member at end of year | 0.08 | 0.07 | 0.08 | 0.07 | |||||||||||||
Billed charges of claims in inventory per member
at end of year |
$ | 143.19 | $ | 142.01 | $ | 143.19 | $ | 142.01 | |||||||||
Number of claims received during the year | 5,566,000 | 5,378,400 | 21,317,500 | 20,842,400 | |||||||||||||
Billed charges of claims received during the year | $ | 5,565,600 | $ | 5,089,600 | $ | 21,414,600 | $ | 19,429,300 |
CONTACT:
Molina Healthcare, Inc.
Juan José Orellana, 562-435-3666,
ext. 111143
Investor Relations