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): May 1, 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 May 1, 2014, Molina Healthcare, Inc. issued a press release announcing its financial results for the first quarter ended March 31, 2014. 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 May 1, 2014, as to financial results for the first quarter ended March 31, 2014. |
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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Date: | May 1, 2014 | By: |
/s/ Jeff D. Barlow |
Jeff D. Barlow |
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Chief Legal Officer and Secretary |
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EXHIBIT INDEX
Exhibit |
|
No. | Description |
99.1 |
Press release of Molina Healthcare, Inc. issued May 1, 2014, as to financial results for the first quarter ended March 31, 2014. |
Exhibit 99.1
Molina Healthcare Reports First Quarter 2014 Results
LONG BEACH, Calif.--(BUSINESS WIRE)--May 1, 2014--Molina Healthcare, Inc. (NYSE: MOH):
Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the first quarter of 2014.
“First quarter operating results were strong,” said J. Mario Molina, M.D., chief executive officer of Molina Healthcare, Inc. “These results demonstrate the progress we are making towards managing our growth. While we have been investing in the infrastructure – staffing, training, technology – to be ready to accommodate the growth associated with the dual eligible programs and the Affordable Care Act, we have continued to improve the administrative efficiency of our existing business.”
Overview of Financial Results
At its Investor Day on February 13, 2014, the Company stated that its first quarter results could be adversely affected by three factors: (A) general and administrative expenses incurred before related revenue is realized; (B) delays in securing agreements for the reimbursement (including reimbursement for tax impacts) of the Affordable Care Act’s Health Insurer Fee (HIF); and (C) delays in the recognition of quality or at risk performance related revenue.
Results reported for the first quarter of 2014 would have been higher except for: | ||
(A) | General and administrative expenses for which no related revenue was recognized reduced first quarter earnings by approximately $20 million, or $0.19 per diluted share (GAAP and adjusted basis). The Company’s full year guidance for 2014 anticipates an administrative expense ratio of 7.5% for the fourth quarter of 2014. | |
(B) | The absence of full reimbursement for the HIF reduced first quarter earnings by approximately $16 million, or $0.15 per diluted share (GAAP and adjusted basis). The Company had not secured agreements with the states of California, Michigan, New Mexico, Texas, Utah and South Carolina at the close of the first quarter of 2014 for the reimbursement (including income tax effect) of the HIF. The Company remains guardedly optimistic that it will secure such agreements with all of its state partners prior to the close of 2014. | |
(C) | The failure to recognize a portion of the Texas health plan’s quality incentive revenue reduced first quarter earnings by approximately $6 million, or $0.06 per diluted share (GAAP and adjusted basis). Changes to the metrics associated with the achievement of that quality incentive revenue make it difficult to recognize revenue as of March 31, 2014. The Company remains guardedly optimistic that it will be able to recognize most of its quality revenue in Texas prior to the close of 2014. |
First Quarter of 2014 Compared with the First Quarter of 2013
Financial results for the first quarter of 2014 are difficult to compare with the first quarter of 2013 for the following reasons:
Sequential Comparison of Financial Results
First quarter 2014 financial results improved when compared with fourth quarter 2013 due to:
Net Income Per Share Guidance
The Company reaffirms its guidance for fiscal year 2014 as follows:
Low End | High End | ||||||||||
Net income per diluted share, continuing operations | $1.65 | $2.15 | |||||||||
Adjusted net income per diluted share, continuing operations | $4.00 | $4.50 | |||||||||
Conference Call
The Company’s management will host a conference call and webcast to discuss its first quarter results at 5:00 p.m. Eastern time on Thursday, May 1, 2014. The number to call for the interactive teleconference is (212) 231-2939. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Thursday, May 1, 2014, through 6:00 p.m. on Friday, May 2, 2014, by dialing (800) 633-8284 and entering confirmation number 21711622. 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 2.2 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.
Notes: |
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1. | Adjusted net income per diluted share, continuing operations, is a non-GAAP financial measure used by management as a supplemental metric in evaluating its financial performance, its financing and business decisions, and in forecasting and planning for future periods. This measure is not determined in accordance with accounting principles generally accepted in the United States of America (GAAP) and should not be viewed as a substitute for the most directly comparable GAAP measure, which is diluted net income per share, continuing operations. See below for reconciliations of the Company’s non-GAAP measures to the most directly comparable GAAP measures. |
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 known 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 May 1, 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 INCOME |
|||||||||||||||
Three Months Ended
March 31, |
|||||||||||||||
2014 | 2013 | ||||||||||||||
(Amounts in thousands,
except net income per share) |
|||||||||||||||
Revenue: | |||||||||||||||
Premium revenue | $ | 1,940,337 | $ | 1,497,433 | |||||||||||
Service revenue | 53,630 | 49,756 | |||||||||||||
Premium tax revenue | 51,693 | 37,000 | |||||||||||||
Health insurer fee revenue (1) | 18,696 | – | |||||||||||||
Investment income | 1,629 | 1,516 | |||||||||||||
Other revenue | 3,258 | 4,694 | |||||||||||||
Total revenue | 2,069,243 | 1,590,399 | |||||||||||||
Operating expenses: | |||||||||||||||
Medical care costs | 1,721,658 | 1,287,915 | |||||||||||||
Cost of service revenue | 40,657 | 39,770 | |||||||||||||
General and administrative expenses | 188,087 | 141,278 | |||||||||||||
Premium tax expenses | 51,693 | 37,000 | |||||||||||||
Health insurer fee expenses (1) | 22,190 | – | |||||||||||||
Depreciation and amortization | 20,691 | 16,563 | |||||||||||||
Total operating expenses | 2,044,976 | 1,522,526 | |||||||||||||
Operating income | 24,267 | 67,873 | |||||||||||||
Other expenses, net: | |||||||||||||||
Interest expense | 13,822 | 13,037 | |||||||||||||
Other income, net | (44 | ) | (131 | ) | |||||||||||
Total other expenses, net | 13,778 | 12,906 | |||||||||||||
Income from continuing operations before income tax expense | 10,489 | 54,967 | |||||||||||||
Income tax expense | 5,655 | 24,445 | |||||||||||||
Income from continuing operations | 4,834 | 30,522 | |||||||||||||
Loss from discontinued operations, net of tax | (336 | ) | (607 | ) | |||||||||||
Net income | $ | 4,498 | $ | 29,915 | |||||||||||
Diluted net income (loss) per share: | |||||||||||||||
Continuing operations | $ | 0.10 | $ | 0.65 | |||||||||||
Discontinued operations | (0.01 | ) | (0.01 | ) | |||||||||||
Diluted net income per share | $ | 0.09 | $ | 0.64 | |||||||||||
Diluted weighted average shares outstanding | 47,520 | 46,443 | |||||||||||||
Operating Statistics, Continuing Operations: | |||||||||||||||
Medical care ratio (2) | 88.7 | % | 86.0 | % | |||||||||||
Service revenue ratio (3) | 75.8 | % | 79.9 | % | |||||||||||
General and administrative expense ratio (4) | 9.1 | % | 8.9 | % | |||||||||||
Premium tax ratio (2) | 2.6 | % | 2.4 | % | |||||||||||
Effective tax rate | 53.9 | % | 44.5 | % | |||||||||||
____________ | |||||||||||||||
(1) Health insurer fee expenses represent insurer fees levied by the federal government under the Affordable Care Act, which are not tax deductible. Associated revenues represent state and federal reimbursement of such fees (including the related income tax effect) for Medicaid and Medicare insurers. |
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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. |
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MOLINA HEALTHCARE, INC. CONSOLIDATED BALANCE SHEETS |
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(Unaudited) | |||||||||||||||
March 31, 2014 |
Dec. 31, 2013 |
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(Amounts in thousands,
except per-share data) |
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ASSETS | |||||||||||||||
Current assets: | |||||||||||||||
Cash and cash equivalents | $ | 1,083,369 | $ | 935,895 | |||||||||||
Investments | 696,200 | 703,052 | |||||||||||||
Receivables | 338,232 | 298,935 | |||||||||||||
Income taxes refundable | 28,100 | 32,742 | |||||||||||||
Deferred income taxes | 22,414 | 26,556 | |||||||||||||
Prepaid expenses and other current assets | 112,916 | 42,484 | |||||||||||||
Total current assets | 2,281,231 | 2,039,664 | |||||||||||||
Property, equipment, and capitalized software, net | 310,364 | 292,083 | |||||||||||||
Deferred contract costs | 44,740 | 45,675 | |||||||||||||
Intangible assets, net | 93,587 | 98,871 | |||||||||||||
Goodwill | 230,738 | 230,738 | |||||||||||||
Restricted investments | 82,036 | 63,093 | |||||||||||||
Auction rate securities | 10,928 | 10,898 | |||||||||||||
Deferred income taxes | 3,510 | – | |||||||||||||
Derivative asset | 196,617 | 186,351 | |||||||||||||
Other assets | 39,730 | 35,564 | |||||||||||||
$ | 3,293,481 | $ | 3,002,937 | ||||||||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | |||||||||||||||
Current liabilities: | |||||||||||||||
Medical claims and benefits payable | $ | 819,541 | $ | 669,787 | |||||||||||
Accounts payable and accrued liabilities | 406,414 | 319,965 | |||||||||||||
Deferred revenue | 146,276 | 122,216 | |||||||||||||
Current maturities of long-term debt | 183,713 | 182,008 | |||||||||||||
Total current liabilities | 1,555,944 | 1,293,976 | |||||||||||||
Convertible senior notes | 421,004 | 416,368 | |||||||||||||
Lease financing obligations | 159,754 | 159,394 | |||||||||||||
Lease financing obligations – related party | 34,820 | 27,092 | |||||||||||||
Deferred income taxes | – | 580 | |||||||||||||
Derivative liability | 196,503 | 186,239 | |||||||||||||
Other long-term liabilities | 27,736 | 26,351 | |||||||||||||
Total liabilities | 2,395,761 | 2,110,000 | |||||||||||||
Stockholders’ equity: | |||||||||||||||
Common stock, $0.001 par value; 150,000 shares authorized; outstanding: 46,263 shares at March 31, 2014 and 45,871 shares at December 31, 2013 |
46 | 46 | |||||||||||||
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares issued and outstanding |
– | – | |||||||||||||
Additional paid-in capital | 340,429 | 340,848 | |||||||||||||
Accumulated other comprehensive loss | (382 | ) | (1,086 | ) | |||||||||||
Retained earnings | 557,627 | 553,129 | |||||||||||||
Total stockholders’ equity | 897,720 | 892,937 | |||||||||||||
$ | 3,293,481 | $ | 3,002,937 |
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS, CONTINUING AND DISCONTINUED OPERATIONS |
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Three Months Ended
March 31, |
|||||||||||||||
2014 | 2013 | ||||||||||||||
(Amounts in thousands) | |||||||||||||||
Operating activities: | |||||||||||||||
Net income | $ | 4,498 | $ | 29,915 | |||||||||||
Adjustments to reconcile net income to net cash provided by operating activities: | |||||||||||||||
Depreciation and amortization | 32,994 | 21,799 | |||||||||||||
Deferred income taxes | (670 | ) | (16 | ) | |||||||||||
Stock-based compensation | 5,596 | 4,421 | |||||||||||||
Amortization of convertible senior notes and lease financing obligations | 6,674 | 3,723 | |||||||||||||
Amortization of premium/discount on investments | 3,023 | 1,502 | |||||||||||||
Amortization of deferred financing costs | 651 | 1,248 | |||||||||||||
Gain on derivatives, net | (2 | ) | (119 | ) | |||||||||||
Change in fair value of contingent consideration liabilities | (4,265 | ) | – | ||||||||||||
Gain on disposal of property and equipment, net | (950 | ) | – | ||||||||||||
Tax deficiency from employee stock compensation | (5 | ) | (42 | ) | |||||||||||
Changes in operating assets and liabilities: | |||||||||||||||
Receivables | (39,297 | ) | (569 | ) | |||||||||||
Prepaid expenses and other assets | (78,023 | ) | (8,956 | ) | |||||||||||
Medical claims and benefits payable | 149,754 | (3,385 | ) | ||||||||||||
Accounts payable and accrued liabilities | 102,217 | (31,847 | ) | ||||||||||||
Deferred revenue | 24,060 | (5,994 | ) | ||||||||||||
Income taxes | 4,642 | 8,424 | |||||||||||||
Net cash provided by operating activities | 210,897 | 20,104 | |||||||||||||
Investing activities: | |||||||||||||||
Purchases of investments | (142,145 | ) | (76,012 | ) | |||||||||||
Sales and maturities of investments | 147,370 | 75,647 | |||||||||||||
Purchases of equipment | (17,788 | ) | (11,167 | ) | |||||||||||
Increase in restricted investments | (14,381 | ) | (11,016 | ) | |||||||||||
Sale of property and equipment | 5,715 | – | |||||||||||||
Change in deferred contract costs | (6,145 | ) | 1,756 | ||||||||||||
Change in other noncurrent assets and liabilities | (117 | ) | (408 | ) | |||||||||||
Net cash used in investing activities | (27,491 | ) | (21,200 | ) | |||||||||||
Financing activities: | |||||||||||||||
Proceeds from issuance of 1.125% Notes, net of deferred financing costs | – | 537,973 | |||||||||||||
Purchase of 1.125% Notes call option | – | (149,331 | ) | ||||||||||||
Proceeds from issuance of warrants | – | 75,074 | |||||||||||||
Treasury stock purchases | – | (50,000 | ) | ||||||||||||
Principal payments on term loan | – | (291 | ) | ||||||||||||
Repayment of amounts borrowed under credit facility | – | (40,000 | ) | ||||||||||||
Contingent consideration liabilities settled | (38,119 | ) | – | ||||||||||||
Proceeds from employee stock plans | 1,330 | 235 | |||||||||||||
Excess tax benefits from employee stock compensation | 877 | 1,177 | |||||||||||||
Principal payments on lease financing obligations | (20 | ) | – | ||||||||||||
Net cash (used in) provided by financing activities | (35,932 | ) | 374,837 | ||||||||||||
Net increase in cash and cash equivalents | 147,474 | 373,741 | |||||||||||||
Cash and cash equivalents at beginning of period | 935,895 | 795,770 | |||||||||||||
Cash and cash equivalents at end of period | $ | 1,083,369 | $ | 1,169,511 | |||||||||||
MOLINA HEALTHCARE, INC. |
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The Company uses two non-GAAP financial measures as supplemental metrics in evaluating its financial performance, making financing and business decisions, and forecasting and planning for future periods. For these reasons, management believes such measures are useful supplemental measures to investors in comparing the Company’s performance to 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 the Company believes to be the most comparable GAAP measure, to EBITDA. |
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Three Months Ended
March 31, |
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2014 | 2013 | ||||||||||||
(Amounts in thousands) | |||||||||||||
Net income | $ | 4,498 | $ | 29,915 | |||||||||
Adjustments: | |||||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 25,914 | 21,799 | |||||||||||
Interest expense | 13,822 | 13,037 | |||||||||||
Income tax expense | 5,237 | 24,270 | |||||||||||
EBITDA | $ | 49,471 | $ | 89,021 | |||||||||
The second of these non-GAAP measures is adjusted net income, continuing operations (including adjusted net income per diluted share). The following table reconciles net income from continuing operations, which the Company believes to be the most comparable GAAP measure, to adjusted net income, continuing operations. |
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Three Months Ended March 31, | |||||||||||||||||||||||||
2014 | 2013 | ||||||||||||||||||||||||
(In thousands, except per diluted share amounts) | |||||||||||||||||||||||||
Net income, continuing operations | $ | 4,834 | $ | 0.10 | $ | 30,522 | $ | 0.65 | |||||||||||||||||
Adjustments, net of tax: | |||||||||||||||||||||||||
Depreciation, and amortization of capitalized software | 12,998 | 0.27 | 10,679 | 0.23 | |||||||||||||||||||||
Stock-based compensation | 4,899 | 0.10 | 3,600 | 0.08 | |||||||||||||||||||||
Amortization of convertible senior notes and lease financing obligations | 4,205 | 0.10 | 2,345 | 0.05 | |||||||||||||||||||||
Amortization of intangible assets | 3,329 | 0.07 | 3,054 | 0.07 | |||||||||||||||||||||
Change in fair value of derivatives | (1 | ) | – | (75 | ) | – | |||||||||||||||||||
Adjusted net income, continuing operations | $ | 30,264 | $ | 0.64 | $ | 50,125 | $ | 1.08 | |||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP DATA, CONTINUING OPERATIONS |
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March 31, 2014 |
Dec. 31, 2013 |
March 31, 2013 |
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Ending Membership by Health Plan: | ||||||||||||||
California | 418,000 | 368,000 | 332,000 | |||||||||||
Florida | 91,000 | 89,000 | 75,000 | |||||||||||
Illinois | 5,000 | 4,000 | – | |||||||||||
Michigan | 218,000 | 213,000 | 217,000 | |||||||||||
New Mexico | 183,000 | 168,000 | 91,000 | |||||||||||
Ohio | 260,000 | 255,000 | 242,000 | |||||||||||
South Carolina (1) | 126,000 | – | – | |||||||||||
Texas | 246,000 | 252,000 | 274,000 | |||||||||||
Utah | 80,000 | 86,000 | 87,000 | |||||||||||
Washington | 434,000 | 403,000 | 416,000 | |||||||||||
Wisconsin | 90,000 | 93,000 | 86,000 | |||||||||||
2,151,000 | 1,931,000 | 1,820,000 | ||||||||||||
Ending Membership by Program: | ||||||||||||||
Temporary Assistance for Needy Families (TANF) | 1,575,300 | 1,503,800 | 1,402,000 | |||||||||||
Aged, Blind or Disabled (ABD) | 309,900 | 288,600 | 269,300 | |||||||||||
Medicaid Expansion (2) | 133,000 | – | – | |||||||||||
Children’s Health Insurance Program (CHIP) | 83,700 | 99,200 | 114,400 | |||||||||||
Medicare Special Needs Plans | 41,400 | 39,400 | 34,300 | |||||||||||
Health Insurance Marketplaces (3) | 7,700 | – | – | |||||||||||
2,151,000 | 1,931,000 | 1,820,000 | ||||||||||||
____________ | ||||||||||||||
(1) The South Carolina health plan began serving members under the state of South Carolina’s new full-risk Medicaid managed care program effective January 1, 2014. |
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(2) Medicaid Expansion membership phased in effective January 1, 2014. |
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(3) Health Insurance Marketplaces became available for consumers to access coverage beginning January 1, 2014. |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA, CONTINUING OPERATIONS (In thousands, except percentages and per-member-per-month amounts) |
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Three Months Ended March 31, 2014 | |||||||||||||||||||||||||||||||
Member Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical Margin |
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Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||
California | 1,254 | $ 277,642 | $ 221.42 | $ 237,344 | $ 189.28 | 85.5 | % | $ | 40,298 | ||||||||||||||||||||||
Florida | 270 | 105,166 | 389.67 | 93,461 | 346.30 | 88.9 | 11,705 | ||||||||||||||||||||||||
Illinois (3) | 14 | 15,171 | 1,078.41 | 14,494 | 1,030.28 | 95.5 | 677 | ||||||||||||||||||||||||
Michigan | 648 | 173,496 | 267.58 | 135,320 | 208.70 | 78.0 | 38,176 | ||||||||||||||||||||||||
New Mexico | 549 | 225,068 | 410.00 | 196,409 | 357.79 | 87.3 | 28,659 | ||||||||||||||||||||||||
Ohio | 772 | 278,295 | 360.62 | 237,328 | 307.53 | 85.3 | 40,967 | ||||||||||||||||||||||||
South Carolina | 394 | 96,020 | 243.41 | 90,262 | 228.82 | 94.0 | 5,758 | ||||||||||||||||||||||||
Texas | 749 | 320,096 | 427.27 | 292,958 | 391.05 | 91.5 | 27,138 | ||||||||||||||||||||||||
Utah | 246 | 78,654 | 319.96 | 67,200 | 273.37 | 85.4 | 11,454 | ||||||||||||||||||||||||
Washington | 1,276 | 323,461 | 253.48 | 298,107 | 233.61 | 92.2 | 25,354 | ||||||||||||||||||||||||
Wisconsin | 274 | 38,528 | 140.67 | 28,809 | 105.19 | 74.8 | 9,719 | ||||||||||||||||||||||||
Other (4) | – | 8,740 | – | 29,966 | – | – | (21,226 | ) | |||||||||||||||||||||||
6,446 | $ 1,940,337 | $ 301.00 | $ 1,721,658 | $ 267.08 | 88.7 | % | $ | 218,679 | |||||||||||||||||||||||
Three Months Ended March 31, 2013 | |||||||||||||||||||||||||||||||
Member
Months (1) |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical Margin |
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Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||
California | 1,001 | $ 187,788 | $ 187.55 | $ 159,763 | $ 159.56 | 85.1 | % | $ | 28,025 | ||||||||||||||||||||||
Florida | 223 | 58,164 | 260.13 | 49,404 | 220.95 | 84.9 | 8,760 | ||||||||||||||||||||||||
Michigan | 652 | 166,557 | 255.52 | 146,748 | 225.13 | 88.1 | 19,809 | ||||||||||||||||||||||||
New Mexico | 274 | 84,000 | 306.97 | 72,149 | 263.66 | 85.9 | 11,851 | ||||||||||||||||||||||||
Ohio | 726 | 268,808 | 370.44 | 227,454 | 313.45 | 84.6 | 41,354 | ||||||||||||||||||||||||
Texas | 832 | 329,451 | 395.96 | 266,449 | 320.24 | 80.9 | 63,002 | ||||||||||||||||||||||||
Utah | 259 | 74,956 | 289.59 | 65,029 | 251.24 | 86.8 | 9,927 | ||||||||||||||||||||||||
Washington | 1,250 | 298,286 | 238.70 | 261,397 | 209.18 | 87.6 | 36,889 | ||||||||||||||||||||||||
Wisconsin | 200 | 27,124 | 135.53 | 23,664 | 118.24 | 87.2 | 3,460 | ||||||||||||||||||||||||
Other (3)(4) | – | 2,299 | – | 15,858 | – | – | (13,559 | ) | |||||||||||||||||||||||
5,417 | $ 1,497,433 | $ 276.45 | $ 1,287,915 | $ 237.77 | 86.0 | % | $ | 209,518 | |||||||||||||||||||||||
____________ | |||||||||||||||||||||||||||||||
(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) | ||||||||||||||||||||||||||||||||
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 March 31, | ||||||||||||||||||||||||||||||||
2014 | 2013 | |||||||||||||||||||||||||||||||
Amount | PMPM |
% of
Total |
Amount | PMPM |
% of
Total |
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Fee for service | $ | 1,181,061 | $ | 183.21 | 68.6 | % | $ | 866,755 | $ | 160.02 | 67.3 | % | ||||||||||||||||||||
Pharmacy | 286,628 | 44.46 | 16.7 | 231,838 | 42.80 | 18.0 | ||||||||||||||||||||||||||
Capitation | 169,439 | 26.28 | 9.8 | 140,324 | 25.91 | 10.9 | ||||||||||||||||||||||||||
Direct delivery | 22,021 | 3.42 | 1.3 | 8,684 | 1.60 | 0.7 | ||||||||||||||||||||||||||
Other | 62,509 | 9.71 | 3.6 | 40,314 | 7.44 | 3.1 | ||||||||||||||||||||||||||
$ | 1,721,658 | $ | 267.08 | 100.0 | % | $ | 1,287,915 | $ | 237.77 | 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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March 31,
2014 |
Dec. 31, 2013 |
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Fee-for-service claims incurred but not paid (IBNP) | $ | 592,403 | $ | 424,173 | |||||||||
Pharmacy payable | 51,743 | 45,037 | |||||||||||
Capitation payable | 23,583 | 20,267 | |||||||||||
Other | 151,812 | 180,310 | |||||||||||
$ | 819,541 | $ | 669,787 | ||||||||||
MOLINA HEALTHCARE, INC. |
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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 period” represent the amount by which the Company’s original estimate of claims and benefits payable at the beginning of the period were more 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: |
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Three Months Ended
March 31, |
Year Ended December 31, 2013 |
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2014 | 2013 | |||||||||||||||||||
(Dollars in thousands,
except per-member amounts) |
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Balances at beginning of period | $ | 669,787 | $ | 494,530 | $ | 494,530 | ||||||||||||||
Components of medical care costs related to: | ||||||||||||||||||||
Current period | 1,773,332 | 1,347,181 | 5,434,443 | |||||||||||||||||
Prior period | (50,904 | ) | (58,427 | ) | (52,779 | ) | ||||||||||||||
Total medical care costs | 1,722,428 | 1,288,754 | 5,381,664 | |||||||||||||||||
Change in non-risk provider payables | (28,560 | ) | (7,638 | ) | 111,267 | |||||||||||||||
Payments for medical care costs related to: | ||||||||||||||||||||
Current period | 1,172,672 | 948,820 | 4,932,195 | |||||||||||||||||
Prior period | 371,442 | 335,681 | 385,479 | |||||||||||||||||
Total paid | 1,544,114 | 1,284,501 | 5,317,674 | |||||||||||||||||
Balances at end of period | $ | 819,541 | $ | 491,145 | $ | 669,787 | ||||||||||||||
Benefit from prior period as a percentage of: | ||||||||||||||||||||
Balance at beginning of period | 7.6 | % | 11.8 | % | 10.7 | % | ||||||||||||||
Premium revenue, trailing twelve months | 0.8 | % | 1.0 | % | 0.9 | % | ||||||||||||||
Medical care costs, trailing twelve months | 0.9 | % | 1.1 | % | 1.0 | % | ||||||||||||||
Claims Data: | ||||||||||||||||||||
Days in claims payable, fee for service | 46 | 38 | 43 | |||||||||||||||||
Number of members at end of period | 2,151,000 | 1,820,000 | 1,931,000 | |||||||||||||||||
Number of claims in inventory at end of period | 287,300 | 135,400 | 145,800 | |||||||||||||||||
Billed charges of claims in inventory at end of period | $ | 517,300 | $ | 236,700 | $ | 276,500 | ||||||||||||||
Claims in inventory per member at end of period | 0.13 | 0.07 | 0.08 | |||||||||||||||||
Billed charges of claims in inventory per member
at end of period |
$ | 240.49 | $ | 130.05 | $ | 143.19 | ||||||||||||||
Number of claims received during the period | 5,986,000 | 5,271,000 | 21,317,500 | |||||||||||||||||
Billed charges of claims received during the period | $ | 6,354,000 | $ | 5,170,700 | $ | 21,414,600 |
CONTACT:
Molina Healthcare, Inc.
Investor Relations:
Juan José
Orellana, 562-435-3666, ext. 111143