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 2, 2017
______________
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))
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company ⃞
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ⃞
Item 2.02. |
Results of Operations and Financial Condition. |
On May 2, 2017, Molina Healthcare, Inc. issued a press release announcing its financial results for the first quarter ended March 31, 2017. 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 2, 2017, as to financial results for the first quarter ended March 31, 2017. |
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: | May 2, 2017 | By: |
/s/ Jeff D. Barlow |
Jeff D. Barlow |
|||
Chief Legal Officer and Secretary |
EXHIBIT INDEX
Exhibit |
|
No. | Description |
99.1 |
Press release of Molina Healthcare, Inc. issued May 2, 2017, as to financial results for the first quarter ended March 31, 2017. |
Exhibit 99.1
Molina Healthcare Reports First Quarter 2017 Results
LONG BEACH, Calif.--(BUSINESS WIRE)--May 2, 2017--Molina Healthcare, Inc. (NYSE: MOH)
Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the first quarter of 2017.
“While we are pleased with the results we reported today, we understand that they represent only one step along the path to improving on our 2016 results,” said Joseph White, interim chief executive officer and chief financial officer of Molina Healthcare, Inc. “Our entire Company is focused on improving our profitability in 2017 and beyond.”
First Quarter 2017 Compared with First Quarter 2016
Net income per diluted share increased to $1.37 in the first quarter of 2017 compared with $0.43 reported for the first quarter of 2016. Adjusted net income per diluted share increased to $1.47 in the first quarter of 2017, compared with $0.51 in the first quarter of 2016. Income before income taxes increased $67 million to $131 million in the first quarter of 2017 from $64 million in the first quarter of 2016.
First quarter financial performance was affected by the following developments:
2017 Outlook
The Company is confirming its 2017 Outlook for earnings per diluted share and adjusted earnings per diluted share, to $2.53 and $2.90, respectively, and revising the 2017 Outlook for the impact of the $75 million acquisition termination fee received in the first quarter of 2017.
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s first quarter results at 5:00 p.m. Eastern time on Tuesday, May 2, 2017. The number to call for the interactive teleconference is (212) 231-2909. A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Tuesday, May 2, 2017, through 6:00 p.m. Eastern Time on Wednesday, May 3, 2017, by dialing (800) 633-8284 and entering confirmation number 21849898. A live audio broadcast of Molina Healthcare’s conference call will be available on our website, 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 managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces. Through our locally operated health plans in 12 states across the nation and in the Commonwealth of Puerto Rico, Molina currently serves approximately 4.8 million members. Dr. C. David Molina founded our company in 1980 as a provider organization serving low-income families in Southern California. Today, we continue his mission of providing high quality and cost-effective health care to those who need it most. For more information about Molina Healthcare, please visit our website at molinahealthcare.com.
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding our 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 our periodic reports and filings with the Securities and Exchange Commission. These reports can be accessed under the investor relations tab of our website or on the SEC’s website at sec.gov. Given these risks and uncertainties, we can give no assurances that our forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by our 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 our judgment as of May 2, 2017, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in our expectations.
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED STATEMENTS OF INCOME |
||||||||
Three Months Ended March 31, | ||||||||
2017 | 2016 | |||||||
(Dollar amounts in millions, |
||||||||
Revenue: | ||||||||
Premium revenue | $ | 4,648 | $ | 3,995 | ||||
Service revenue | 131 | 140 | ||||||
Premium tax revenue | 111 | 109 | ||||||
Health insurer fee revenue | — | 90 | ||||||
Investment income and other revenue | 14 | 9 | ||||||
Total revenue | 4,904 | 4,343 | ||||||
Operating expenses: | ||||||||
Medical care costs | 4,111 | 3,588 | ||||||
Cost of service revenue | 122 | 127 | ||||||
General and administrative expenses | 439 | 340 | ||||||
Premium tax expenses | 111 | 109 | ||||||
Health insurer fee expenses | — | 58 | ||||||
Depreciation and amortization | 39 | 32 | ||||||
Total operating expenses | 4,822 | 4,254 | ||||||
Operating income | 82 | 89 | ||||||
Other (income) expenses, net: | ||||||||
Interest expense | 26 | 25 | ||||||
Other income, net | (75 | ) | — | |||||
Total other (income) expenses, net | (49 | ) | 25 | |||||
Income before income tax expense | 131 | 64 | ||||||
Income tax expense | 54 | 40 | ||||||
Net income | $ | 77 | $ | 24 | ||||
Net income per diluted share | $ | 1.37 | $ | 0.43 | ||||
Diluted weighted average shares outstanding | 56.2 | 56.9 | ||||||
Operating Statistics: | ||||||||
Medical care ratio (1) | 88.4 | % | 89.8 | % | ||||
G&A ratio (2) | 8.9 | % | 7.8 | % | ||||
Premium tax ratio (1) | 2.3 | % | 2.6 | % | ||||
Effective tax rate | 41.6 | % | 61.7 | % | ||||
Net profit margin (2) | 1.6 | % | 0.6 | % | ||||
Net profit margin excluding acquisition termination fee (2) | 0.6 | % | 0.6 | % | ||||
(1)Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium tax expenses as a percentage of premium revenue plus premium tax revenue.
|
||||||||
(2)G&A ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net income as a percentage of total revenue. Net profit margin excluding acquisition termination fee represents net income excluding the acquisition termination fee (net of income taxes at our blended federal and state statutory tax rate of 37%), as a percentage of total revenue. |
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MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED BALANCE SHEETS |
||||||||
March 31, | December 31, | |||||||
2017 | 2016 | |||||||
(In millions, |
||||||||
ASSETS | ||||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 3,198 | $ | 2,819 | ||||
Investments | 2,056 | 1,758 | ||||||
Receivables | 1,006 | 974 | ||||||
Income taxes refundable | — | 39 | ||||||
Prepaid expenses and other current assets | 142 | 131 | ||||||
Derivative asset | — | 267 | ||||||
Total current assets | 6,402 | 5,988 | ||||||
Property, equipment, and capitalized software, net | 447 | 454 | ||||||
Deferred contract costs | 89 | 86 | ||||||
Intangible assets, net | 131 | 140 | ||||||
Goodwill | 620 | 620 | ||||||
Restricted investments | 115 | 110 | ||||||
Deferred income taxes | 10 | 10 | ||||||
Derivative asset | 181 | — | ||||||
Other assets | 43 | 41 | ||||||
$ | 8,038 | $ | 7,449 | |||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||
Current liabilities: | ||||||||
Medical claims and benefits payable | $ | 1,926 | $ | 1,929 | ||||
Amounts due government agencies | 1,575 | 1,202 | ||||||
Accounts payable and accrued liabilities | 438 | 385 | ||||||
Deferred revenue | 461 | 315 | ||||||
Income taxes payable | 21 | — | ||||||
Current portion of long-term debt | 1 | 472 | ||||||
Derivative liability | — | 267 | ||||||
Total current liabilities | 4,422 | 4,570 | ||||||
Senior notes | 1,455 | 975 | ||||||
Lease financing obligations | 198 | 198 | ||||||
Deferred income taxes | 11 | 15 | ||||||
Derivative liability | 181 | — | ||||||
Other long-term liabilities | 44 | 42 | ||||||
Total liabilities | 6,311 | 5,800 | ||||||
Stockholders’ equity: | ||||||||
Common stock, $0.001 par value; 150 shares authorized; outstanding: 57 shares at March 31, 2017 and December 31, 2016 | — | — | ||||||
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding | — | — | ||||||
Additional paid-in capital | 841 | 841 | ||||||
Accumulated other comprehensive loss | (1 | ) | (2 | ) | ||||
Retained earnings | 887 | 810 | ||||||
Total stockholders’ equity | 1,727 | 1,649 | ||||||
$ | 8,038 | $ | 7,449 | |||||
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
||||||||
Three Months Ended March 31, | ||||||||
2017 | 2016 | |||||||
(In millions) | ||||||||
Operating activities: | ||||||||
Net income | $ | 77 | $ | 24 | ||||
Adjustments to reconcile net income to net cash provided by operating activities: | ||||||||
Depreciation and amortization | 49 | 44 | ||||||
Deferred income taxes | (5 | ) | 30 | |||||
Share-based compensation | 6 | 7 | ||||||
Amortization of convertible senior notes and lease financing obligations | 8 | 8 | ||||||
Other, net | 3 | 6 | ||||||
Changes in operating assets and liabilities: | ||||||||
Receivables | (32 | ) | (266 | ) | ||||
Prepaid expenses and other assets | (12 | ) | (202 | ) | ||||
Medical claims and benefits payable | (3 | ) | 255 | |||||
Amounts due government agencies | 373 | 181 | ||||||
Accounts payable and accrued liabilities | 50 | 205 | ||||||
Deferred revenue | 146 | (129 | ) | |||||
Income taxes | 59 | (24 | ) | |||||
Net cash provided by operating activities | 719 | 139 | ||||||
Investing activities: | ||||||||
Purchases of investments | (733 | ) | (611 | ) | ||||
Proceeds from sales and maturities of investments | 433 | 348 | ||||||
Purchases of property, equipment, and capitalized software | (26 | ) | (46 | ) | ||||
Change in restricted investments | (7 | ) | (4 | ) | ||||
Net cash paid in business combinations | — | (2 | ) | |||||
Other, net | (6 | ) | 1 | |||||
Net cash used in investing activities | (339 | ) | (314 | ) | ||||
Financing activities: | ||||||||
Proceeds from employee stock plans | 1 | — | ||||||
Other, net | (2 | ) | 2 | |||||
Net cash (used in) provided by financing activities | (1 | ) | 2 | |||||
Net increase (decrease) in cash and cash equivalents | 379 | (173 | ) | |||||
Cash and cash equivalents at beginning of period | 2,819 | 2,329 | ||||||
Cash and cash equivalents at end of period | $ | 3,198 | $ | 2,156 | ||||
MOLINA HEALTHCARE, INC. UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP |
||||||||
March 31, |
December 31, |
March 31, |
||||||
Ending Membership by Program: | ||||||||
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) | 2,548,000 | 2,536,000 | 2,485,000 | |||||
Marketplace | 1,035,000 | 526,000 | 630,000 | |||||
Medicaid Expansion | 684,000 | 673,000 | 632,000 | |||||
Aged, Blind or Disabled (ABD) | 401,000 | 396,000 | 380,000 | |||||
Medicare-Medicaid Plan (MMP) - Integrated | 55,000 | 51,000 | 50,000 | |||||
Medicare Special Needs Plans | 43,000 | 45,000 | 43,000 | |||||
4,766,000 | 4,227,000 | 4,220,000 | ||||||
Ending Membership by Health Plan: | ||||||||
California | 765,000 | 683,000 | 676,000 | |||||
Florida | 711,000 | 553,000 | 576,000 | |||||
Illinois | 194,000 | 195,000 | 206,000 | |||||
Michigan | 417,000 | 391,000 | 399,000 | |||||
New Mexico | 270,000 | 254,000 | 246,000 | |||||
New York (1) | 34,000 | 35,000 | — | |||||
Ohio | 351,000 | 332,000 | 336,000 | |||||
Puerto Rico | 326,000 | 330,000 | 339,000 | |||||
South Carolina | 111,000 | 109,000 | 102,000 | |||||
Texas | 493,000 | 337,000 | 380,000 | |||||
Utah | 172,000 | 146,000 | 151,000 | |||||
Washington | 785,000 | 736,000 | 672,000 | |||||
Wisconsin | 137,000 | 126,000 | 137,000 | |||||
4,766,000 | 4,227,000 | 4,220,000 | ||||||
(1) The New York health plan was acquired on August 1, 2016. |
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MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
||||||||||||||||||||||||||
Three Months Ended March 31, 2017 | ||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||
TANF and CHIP | 7.7 | $ | 1,402 | $ | 182.69 | $ | 1,304 | $ | 170.02 | 93.1 | % | $ |
98 |
|||||||||||||
Medicaid Expansion | 2.0 | 817 | 398.70 | 689 | 336.51 | 84.4 | 128 | |||||||||||||||||||
ABD | 1.2 | 1,196 | 1,006.84 | 1,130 | 951.32 | 94.5 | 66 | |||||||||||||||||||
Total Medicaid | 10.9 | 3,415 | 312.98 | 3,123 | 286.35 | 91.5 |
292 |
|||||||||||||||||||
MMP | 0.2 | 344 | 2,088.96 | 307 | 1,859.41 | 89.0 | 37 | |||||||||||||||||||
Medicare | 0.1 | 138 | 1,068.20 | 117 | 902.67 | 84.5 | 21 | |||||||||||||||||||
Total Medicare | 0.3 | 482 | 1,640.63 | 424 | 1,439.20 | 87.7 | 58 | |||||||||||||||||||
Excluding Marketplace | 11.2 | 3,897 | 347.84 | 3,547 | 316.62 | 91.0 |
350 |
|||||||||||||||||||
Marketplace | 2.9 | 751 | 262.16 | 564 | 196.72 | 75.0 |
187 |
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14.1 | $ | 4,648 | $ | 330.39 | $ | 4,111 | $ | 292.20 | 88.4 | % | $ | 537 | ||||||||||||||
Three Months Ended March 31, 2016 | ||||||||||||||||||||||||||
Member
|
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||
TANF and CHIP | 7.4 | $ | 1,324 | $ | 178.47 | $ | 1,198 | $ | 161.46 | 90.5 | % | $ | 126 | |||||||||||||
Medicaid Expansion | 1.9 | 679 | 365.11 | 574 | 308.30 | 84.4 | 105 | |||||||||||||||||||
ABD | 1.2 | 1,112 | 961.49 | 1,041 | 899.79 | 93.6 | 71 | |||||||||||||||||||
Total Medicaid | 10.5 | 3,115 | 298.51 | 2,813 | 269.42 | 90.3 | 302 | |||||||||||||||||||
MMP | 0.1 | 340 | 2,220.68 | 317 | 2,070.23 | 93.2 | 23 | |||||||||||||||||||
Medicare | 0.1 | 131 | 1,029.10 | 124 | 980.49 | 95.3 | 7 | |||||||||||||||||||
Total Medicare | 0.2 | 471 | 1,681.57 | 441 | 1,577.21 | 93.8 | 30 | |||||||||||||||||||
Excluding Marketplace | 10.7 | 3,586 | 334.62 | 3,254 | 303.59 | 90.7 | 332 | |||||||||||||||||||
Marketplace | 1.6 | 409 | 251.85 | 334 | 205.86 | 81.7 | 75 | |||||||||||||||||||
12.3 | $ | 3,995 | $ | 323.73 | $ | 3,588 | $ | 290.74 | 89.8 | % | $ | 407 | ||||||||||||||
Twelve Months Ended December 31, 2016 | ||||||||||||||||||||||||||
Member
|
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||
TANF and CHIP | 30.2 | $ | 5,403 | $ | 179.21 | $ | 4,950 | $ | 164.18 | 91.6 | % | $ | 453 | |||||||||||||
Medicaid Expansion | 7.8 | 2,952 | 378.58 | 2,475 | 317.37 | 83.8 | 477 | |||||||||||||||||||
ABD | 4.7 | 4,666 | 991.24 | 4,277 | 908.39 | 91.6 | 389 | |||||||||||||||||||
Total Medicaid | 42.7 | 13,021 | 305.28 | 11,702 | 274.33 | 89.9 | 1,319 | |||||||||||||||||||
MMP | 0.6 | 1,303 | 2,131.97 | 1,141 | 1,866.93 | 87.6 | 162 | |||||||||||||||||||
Medicare | 0.5 | 543 | 1,033.15 | 515 | 981.36 | 95.0 | 28 | |||||||||||||||||||
Total Medicare | 1.1 | 1,846 | 1,624.15 | 1,656 | 1,457.67 | 89.7 | 190 | |||||||||||||||||||
Excluding Marketplace | 43.8 | 14,867 | 339.51 | 13,358 | 305.03 | 89.8 | 1,509 | |||||||||||||||||||
Marketplace | 6.7 | 1,525 | 228.44 | 1,416 | 212.17 | 92.9 | 109 | |||||||||||||||||||
|
50.5 | $ | 16,392 | $ | 324.82 | $ | 14,774 | $ | 292.75 | 90.1 | % | $ | 1,618 | |||||||||||||
(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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MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
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Three Months Ended March 31, 2017 | ||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||
California | 2.2 | $ | 644 | $ | 286.92 | $ | 510 | $ | 227.19 | 79.2 | % | $ | 134 | |||||||||||||
Florida | 2.1 | 656 | 316.86 | 558 | 269.33 | 85.0 | 98 | |||||||||||||||||||
Illinois | 0.6 | 161 | 276.58 | 180 | 310.08 | 112.1 | (19 | ) | ||||||||||||||||||
Michigan | 1.3 | 393 | 316.80 | 339 | 273.36 | 86.3 | 54 | |||||||||||||||||||
New Mexico | 0.8 | 330 | 406.90 | 318 | 392.72 | 96.5 | 12 | |||||||||||||||||||
New York (3) | 0.1 | 46 | 441.19 | 42 | 409.63 | 92.8 | 4 | |||||||||||||||||||
Ohio | 1.1 | 541 | 516.00 | 479 | 457.14 | 88.6 | 62 | |||||||||||||||||||
Puerto Rico | 1.0 | 183 | 186.51 | 165 | 168.18 | 90.2 | 18 | |||||||||||||||||||
South Carolina | 0.3 | 105 | 317.07 | 98 | 293.34 | 92.5 | 7 | |||||||||||||||||||
Texas | 1.4 | 684 | 486.96 | 602 | 428.55 | 88.0 | 82 | |||||||||||||||||||
Utah | 0.5 | 134 | 264.73 | 123 | 242.57 | 91.6 | 11 | |||||||||||||||||||
Washington | 2.3 | 642 | 274.74 | 581 | 248.40 | 90.4 | 61 | |||||||||||||||||||
Wisconsin | 0.4 | 127 | 311.30 | 108 | 264.53 | 85.0 | 19 | |||||||||||||||||||
Other (4) | — | 2 | — | 8 | — | — | (6 | ) | ||||||||||||||||||
14.1 | $ | 4,648 | $ | 330.39 | $ | 4,111 | $ | 292.20 | 88.4 | % | $ | 537 | ||||||||||||||
Three Months Ended March 31, 2016 | ||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
||||||||||||||||||||||
Total | PMPM | Total | PMPM | |||||||||||||||||||||||
California | 2.0 | $ | 541 | $ | 273.42 | $ | 469 | $ | 236.92 | 86.7 | % | $ | 72 | |||||||||||||
Florida | 1.6 | 489 | 295.42 | 413 | 249.45 | 84.4 | 76 | |||||||||||||||||||
Illinois | 0.6 | 149 | 267.10 | 132 | 236.76 | 88.6 | 17 | |||||||||||||||||||
Michigan | 1.2 | 387 | 320.14 | 347 | 287.34 | 89.8 | 40 | |||||||||||||||||||
New Mexico | 0.7 | 336 | 449.52 | 296 | 394.77 | 87.8 | 40 | |||||||||||||||||||
New York (3) | — | — | — | — | — | — | — | |||||||||||||||||||
Ohio | 1.0 | 488 | 489.14 | 449 | 450.11 | 92.0 | 39 | |||||||||||||||||||
Puerto Rico | 1.0 | 181 | 176.85 | 174 | 170.43 | 96.4 | 7 | |||||||||||||||||||
South Carolina | 0.3 | 84 | 275.97 | 67 | 220.78 | 80.0 | 17 | |||||||||||||||||||
Texas | 1.1 | 620 | 580.81 | 575 | 538.91 | 92.8 | 45 | |||||||||||||||||||
Utah | 0.4 | 114 | 264.62 | 102 | 235.88 | 89.1 | 12 | |||||||||||||||||||
Washington | 2.0 | 506 | 255.41 | 458 | 231.18 | 90.5 | 48 | |||||||||||||||||||
Wisconsin | 0.4 | 97 | 250.36 | 92 | 238.01 | 95.1 | 5 | |||||||||||||||||||
Other (4) | — | 3 | — | 14 | — | — | (11 | ) | ||||||||||||||||||
12.3 | $ | 3,995 | $ | 323.73 | $ | 3,588 | $ | 290.74 | 89.8 | % | $ | 407 | ||||||||||||||
(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 New York health plan was acquired on August 1, 2016. |
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(4) “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 HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts)
|
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The following tables provide the details of our medical care costs for the periods indicated: |
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Three Months Ended March 31, | ||||||||||||||||||||||
2017 | 2016 | |||||||||||||||||||||
Amount | PMPM |
% of |
Amount | PMPM |
% of |
|||||||||||||||||
Fee for service | $ | 3,086 | $ | 219.32 | 75.1 | % | $ | 2,737 | $ | 221.77 | 76.3 | % | ||||||||||
Pharmacy | 616 | 43.76 | 15.0 | 525 | 42.53 | 14.6 | ||||||||||||||||
Capitation | 324 | 23.06 | 7.9 | 295 | 23.87 | 8.2 | ||||||||||||||||
Direct delivery | 22 | 1.58 | 0.5 | 16 | 1.34 | 0.5 | ||||||||||||||||
Other | 63 | 4.48 | 1.5 | 15 | 1.23 | 0.4 | ||||||||||||||||
$ | 4,111 | $ | 292.20 | 100.0 | % | $ | 3,588 | $ | 290.74 | 100.0 | % |
The following table provides the details of our medical claims and
benefits payable as of the |
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March 31, | December 31, | ||||||
2017 | 2016 | ||||||
Fee-for-service claims incurred but not paid (IBNP) | $ | 1,425 | $ | 1,352 | |||
Pharmacy payable | 133 | 112 | |||||
Capitation payable | 36 | 37 | |||||
Other (1) | 332 | 428 | |||||
$ | 1,926 | $ | 1,929 | ||||
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(1) “Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various state agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. As of March 31, 2017 and December 31, 2016, we had recorded non-risk provider payables of approximately $131 million and $225 million, respectively.
MOLINA HEALTHCARE, INC. UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE (Dollars in millions, except per-member amounts) |
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Our claims liability includes a provision for adverse claims deviation 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. Our 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 our 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 presents the components of the change in medical claims and benefits payable for the periods indicated: |
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Three Months Ended March 31, |
Year Ended |
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2017 | 2016 | |||||||||||
Medical claims and benefits payable, beginning balance | $ | 1,929 | $ | 1,685 | $ | 1,685 | ||||||
Components of medical care costs related to: | ||||||||||||
Current period | 4,253 | 3,755 | 14,966 | |||||||||
Prior period | (142 | ) | (167 | ) | (192 | ) | ||||||
Total medical care costs | 4,111 | 3,588 | 14,774 | |||||||||
Change in non-risk provider payables | (96 | ) | 24 | 58 | ||||||||
Payments for medical care costs related to: | ||||||||||||
Current period | 2,683 | 2,241 | 13,304 | |||||||||
Prior period | 1,335 | 1,116 | 1,284 | |||||||||
Total paid | 4,018 | 3,357 | 14,588 | |||||||||
Medical claims and benefits payable, ending balance | $ | 1,926 | $ | 1,940 | $ | 1,929 | ||||||
Benefit from prior period as a percentage of: | ||||||||||||
Balance at beginning of period | 7.4 | % | 10.0 | % | 11.4 | % | ||||||
Premium revenue, trailing twelve months | 0.8 | % | 1.2 | % | 1.2 | % | ||||||
Medical care costs, trailing twelve months | 0.9 | % | 1.3 | % | 1.3 | % | ||||||
Days in claims payable, fee for service (1) | 45 | 46 | 47 | |||||||||
(1) Claims payable at March 31, 2017 and December 31, 2016 includes IBNP and $119 million and $94 million of fee-for-service payables included in “Other” medical claims and benefits payable, respectively. |
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MOLINA HEALTHCARE, INC. UNAUDITED NON-GAAP FINANCIAL MEASURES
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We use non-GAAP financial measures as supplemental metrics in evaluating our 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 our 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. See further information regarding non-GAAP measures below the tables (in millions, except per diluted share amounts). |
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Three Months Ended |
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2017 | 2016 | ||||||||||||||||||||||||||||
Net income | $ | 77 | $ | 24 | |||||||||||||||||||||||||
Adjustments: | |||||||||||||||||||||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 46 | 37 | |||||||||||||||||||||||||||
Interest expense | 26 | 25 | |||||||||||||||||||||||||||
Income tax expense | 54 | 40 | |||||||||||||||||||||||||||
EBITDA | $ | 203 | $ | 126 | |||||||||||||||||||||||||
Three Months Ended March 31, |
Projected: |
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2017 | 2016 | 2017 | |||||||||||||||||||||||||||
Amount | Per diluted share | Amount | Per diluted share | Amount | Per diluted share (2) | ||||||||||||||||||||||||
Net income | $ | 77 | $ | 1.37 | $ | 24 | $ | 0.43 | $ | 147 | $ | 2.53 | |||||||||||||||||
Adjustment: | |||||||||||||||||||||||||||||
Amortization of intangible assets | 9 | 0.16 | 7 | 0.13 | 34 | 0.58 | |||||||||||||||||||||||
Income tax effect (1) | (3 | ) | (0.06 | ) | (2 | ) | (0.05 | ) | (12 | ) | (0.21 | ) | |||||||||||||||||
Amortization of intangible assets, net of tax effect | 6 | 0.10 | 5 | 0.08 | 22 | 0.37 | |||||||||||||||||||||||
Adjusted net income | $ | 83 | $ | 1.47 | $ | 29 | $ | 0.51 | $ | 169 | $ | 2.90 | |||||||||||||||||
(1) Income tax effect of adjustment calculated at the blended federal and state statutory tax rate of 37%. |
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(2) Computation assumes 58.2 million diluted weighted average shares outstanding. |
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The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release: |
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Earnings before interest, taxes, depreciation and amortization (EBITDA): Net income (GAAP) less depreciation, and amortization of intangible assets and capitalized software, interest expense and income tax expense. We believe that EBITDA is helpful in assessing our ability to meet the cash demands of our operating units. |
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Adjusted net income: Net income (GAAP) less amortization of intangible assets, net of income tax effect calculated at the statutory tax rate of 37%. We believe that adjusted net income is helpful in assessing our financial performance exclusive of the non-cash impact of the amortization of purchased intangibles. |
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Adjusted net income per diluted share: Adjusted net income divided by weighted average common shares outstanding on a fully diluted basis. |
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CONTACT:
Molina Healthcare, Inc.
Juan José Orellana, 562-435-3666,
ext. 111143
Investor Relations