- Net income for the quarter comparable to prior year;
-
Cash flows from operations up
$90 million ; -
Quarterly premium revenues of
$857 million , up 18%; -
Medical margin (premium revenue minus medical care costs) of
$120 million , up 16%; - Aggregate membership up 10% over first quarter of 2008;
-
Results reflect
$3.9 million year-over-year decrease in investment income ($0.09 per diluted share); -
Repurchase authorized for up to
$25 million in the aggregate of either common stock or convertible debt; and -
2009 guidance confirmed at range of
$2.20 to $2.40 per diluted share.
In commenting on the results,
Earnings Per Share Guidance
The Company confirms its guidance issued on
Adoption of New Convertible Debt Accounting
The Company’s 2008 results have been recast to reflect the adoption of
FASB Staff Position (FSP) APB 14-1, Accounting for Convertible Debt
Instruments That May be Settled in Cash upon Conversion (Including
Partial Cash Settlement). This adjustment resulted in additional
interest expense of
Overview of Financial Results
First Quarter 2009 Compared with First Quarter 2008
First quarter 2009 net income of
First Quarter 2009 Compared with Fourth Quarter 2008
Net income for the first quarter of 2009 was approximately
Financial Results – Quarter Ended
Premium revenue for the first quarter of 2009 was
Consolidated membership increased 10% between the quarter ended
Increased membership contributed approximately 67% of the growth in premium revenue between the first quarter of 2009 and the first quarter of 2008, and increases in per member per month revenue, as a result of both rate changes and shifts in member mix, contributed the other 33%. Similarly, increased membership contributed approximately 65% of the growth in premium revenue, sequentially, and increases in per member per month revenue contributed the other 35%.
Significant contributors to the
-
A
$62.6 million increase inMedicaid premium revenue at theOhio health plan. Approximately$49 million of the increase in revenue was due to higher enrollment, and the remainder of$13 million was due to the increase in per member per month revenue as a result of both rate changes and shifts in member mix. -
A
$19.7 million increase inMedicaid premium revenue as a result of the start-up ofFlorida health plan operations inDecember 2008 . -
A
$10.4 million increase inMedicaid premium revenue at theUtah health plan, primarily due to the increase in revenue associated with higher medical expenses incurred under theUtah health plan’s cost-plus contract with the state.
Significant contributors to the
The
Investment income for the first quarter of 2009 decreased
Medical care costs as a percentage of premium revenue (the
medical care ratio, or MCR) increased to 86.1% in the first quarter of
2009, from 85.8% in the first quarter of 2008, and 84.7% for the fourth
quarter ended
-
Rising fee-for-service costs combined with flat per member per month
revenue (compared with both the first quarter of 2008 and the fourth
quarter of 2008) drove the medical care ratio of the
California health plan up to 94.5% for the quarter. TheCalifornia health plan’s medical care ratio was 88.2% in the first quarter of 2008 and 86.7% in the fourth quarter of 2008. The year-over-year and sequential increases in the plan’s medical care ratio were caused primarily by higher fee-for-service costs. -
The medical care ratio of the
Florida health plan was 90.2% for its first full quarter of operations. -
The medical care ratio of the
Michigan health plan was 82.9% for the quarter, up slightly from 82.5% in the first quarter of 2008. TheMichigan health plan’s medical care ratio was 76.4% in the fourth quarter of 2008. The increase in the medical care ratio between the fourth quarter of 2008 and the first quarter of 2009 reflected a combination of normal seasonal cost patterns combined with a return to more typical per member per month medical costs. -
The medical care ratio of the
Missouri health plan was 80.0% for the quarter, down from 89.7% in the first quarter of 2008 and up from 75.0% in the fourth quarter of 2008. The increase in the medical care ratio between the fourth quarter of 2008 and the first quarter of 2009 reflected a combination of normal seasonal cost patterns combined with a return to more typical per member per month medical costs. -
The medical care ratio of the
New Mexico health plan was 88.0% for the quarter, up from 81.1% in the first quarter of 2008 and 82.0% in the fourth quarter of 2008. During the first quarter of 2008, theNew Mexico health plan had recognized$6.7 million of premium revenue due to the reversal of amounts previously recorded as payable to the state ofNew Mexico . Absent this revenue adjustment, theNew Mexico health plan’s medical care ratio would have been 87.8% in the first quarter of 2008.
The sequential increase was due to a modest decrease in per member per month premium revenue (due to a change in member mix) between the fourth quarter of 2008 and the first quarter of 2009, coupled with increased medical costs associated with normal seasonality.
-
The medical care ratio of the
Ohio health plan, by line of business, was as follows:
| Three Months Ended | |||||||||
| March 31, 2009 | Dec. 31, 2008 | March 31, 2008 | |||||||
| Covered Families and Children (CFC) | 83.4 | % | 89.2 | % | 88.9 | % | |||
| Aged, Blind or Disabled (ABD) | 85.9 | 95.1 | 92.7 | ||||||
| Aggregate | 84.3 | % | 91.5 | % | 90.3 | % | |||
The reduction in the medical care ratio in
-
The medical care ratio of the
Texas health plan was 83.0% for the quarter, up from 76.1% in the first quarter of 2008 and 73.6% in the fourth quarter of 2008. The year-over-year and sequential increases in the plan’s medical care ratio were primarily due to increases in per member per month fee-for-service costs. -
The medical care ratio of the
Utah health plan was 87.5% for the quarter, down from 88.3% in the first quarter of 2008 and 92.0% in the fourth quarter of 2008. The sequential and year-over-year decreases were primarily due to higher per member per month premiums from the plan’sMedicare and Children’s Health Insurance Program (CHIP) lines of business. These increases more than offset the decrease in theUtah plan’s cost-plus reimbursement rate effectiveJanuary 1, 2009 , to 8% from 9%, for itsMedicaid line of business. -
The medical care ratio of the
Washington health plan was 82.8% for the quarter, up slightly from 82.5% in the first quarter of 2008 and down slightly from 83.0% in the fourth quarter of 2008.
Days in medical claims and benefits payable were 42 days
at
General and administrative expenses were
Core G&A expenses (defined as G&A expenses less premium taxes) were 7.6% of revenue in the first quarter of 2009, compared with 7.8% in the first quarter of 2008 and 8.1% in the fourth quarter of 2008. The decrease in core G&A compared with the first quarter of 2008 was primarily due to lower administrative payroll as a percentage of revenue, as indicated in the table below.
| Three Months Ended March 31, | ||||||||||||
| (in thousands) | 2009 | 2008 | ||||||||||
| Amount |
% of Total
Revenue |
Amount |
% of Total
Revenue |
|||||||||
| Medicare-related administrative costs | $ | 4,968 | 0.6 | % | $ | 5,292 | 0.7 | % | ||||
| Non Medicare-related administrative costs: | ||||||||||||
|
Administrative payroll, including employee incentive compensation
|
49,000 | 5.7 | 43,946 | 6.0 | ||||||||
| All other administrative expense | 11,439 | 1.3 | 8,502 | 1.1 | ||||||||
| Core G&A expenses | $ | 65,407 | 7.6 | % | $ | 57,740 | 7.8 | % | ||||
Interest expense for both periods presented includes
non-cash interest expense relating to the Company’s convertible senior
notes, as a result of the adoption of FSP APB 14-1. The amounts recorded
for this additional interest expense totaled approximately
Income taxes were recorded at an effective rate of 41.0% in the first quarter of 2009, consistent with 40.8% recorded in the first quarter of 2008.
Cash Flow
Cash provided by operating activities for the quarter ended
Significant contributors to this increase included the following:
-
Increased deferred revenue of approximately
$91 million , primarily due to the timing of theOhio health plan’s receipt of premium payments from the state ofOhio ; and -
Increased medical claims and benefits payable of approximately
$19 million .
These increases were offset by increased receivables of approximately
At
EBITDA (1)
| (in thousands) | Three Months Ended March 31, | |||||
| 2009 | 2008 | |||||
| Operating income | $ | 24,115 | $ | 24,451 | ||
| Add back: | ||||||
| Depreciation and amortization expense | 9,052 | 8,152 | ||||
| EBITDA | $ | 33,167 | $ | 32,603 | ||
(1) The Company calculates EBITDA by adding back depreciation and amortization expense to operating income. EBITDA is not prepared in conformity with GAAP since it excludes depreciation and amortization expense, as well as interest expense, and the provision for income taxes. This non-GAAP financial measure should not be considered as an alternative to net income, operating income, operating margin, or cash provided by operating activities. Management uses EBITDA as a metric in evaluating the Company’s financial performance, in evaluating financing and business development decisions, and in forecasting and analyzing future periods. For these reasons, management believes that EBITDA is a useful supplemental measure to investors in evaluating the Company’s performance and the performance of other companies in our industry.
Securities Repurchase Program
Under the
The Company’s Board of Directors has now authorized the repurchase of up
to an additional
Conference Call
The Company’s management will host a conference call and webcast to
discuss its first quarter results at
Safe Harbor Statement under the Private Securities Litigation
Reform Act of 1995: This press release contains “forward-looking
statements” identified by words such as “will,” “should,” “believes,”
“expects” or ”expectations,” “anticipates,” “plans,” “projects,”
“estimates,” “intends,” and similar words and expressions. In
addition, any statements that explicitly or implicitly refer to 2009
earnings guidance, expectations, projections, or their underlying
assumptions, or other characterizations of future events or
circumstances, are forward-looking statements. All of our
forward-looking statements are based on our current expectations and
assumptions which are subject to numerous known and unknown risks,
uncertainties, and other factors that could cause actual results to
differ materially. Such factors include, without limitation,
risks related to: budgetary pressures on the federal and state
governments and their resulting inability to fully fund
|
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF INCOME (Amounts in thousands, except share and per-share data) |
||||||
|
Three Months Ended
March 31, |
||||||
| 2009 |
2008 (1) |
|
||||
| Revenue: | ||||||
| Premium revenue | $ | 857,484 | $ | 729,638 | ||
| Investment income | 3,547 | 7,404 | ||||
| Total operating revenue | 861,031 | 737,042 | ||||
| Expenses: | ||||||
| Medical care costs | 737,888 | 626,347 | ||||
| General and administrative expenses | 91,508 | 78,092 | ||||
| Depreciation and amortization | 9,052 | 8,152 | ||||
| Total expenses | 838,448 | 712,591 | ||||
| Gain on retirement of convertible senior notes | 1,532 | − | ||||
| Operating income | 24,115 | 24,451 | ||||
| Interest expense (1) | (3,415 | ) | (3,368 | ) | ||
| Income before income taxes (1) | 20,700 | 21,083 | ||||
| Income tax expense (1) | 8,489 | 8,608 | ||||
| Net income (1) | $ | 12,211 | $ | 12,475 | ||
| Net income per share (1): | ||||||
| Basic | $ | 0.46 | $ | 0.44 | ||
| Diluted | $ | 0.46 | $ | 0.44 | ||
| Weighted average number of common shares and potentially dilutive common shares outstanding | 26,561,000 | 28,576,000 | ||||
| Operating Statistics: | ||||||
| Ratio of medical care costs paid directly to providers to premium revenue | 84.0 | % | 83.1 | % | ||
|
Ratio of medical care costs not paid directly to providers to premium revenue
|
2.1 | 2.7 | ||||
| Medical care ratio (2) | 86.1 | % | 85.8 | % | ||
|
General and administrative expense ratio, excluding premium taxes
(core G&A ratio) (3) |
7.6 | % | 7.8 | % | ||
| Premium taxes included in general and administrative expenses (3) | 3.0 | 2.8 | ||||
| Total general and administrative expense ratio (3) | 10.6 | % | 10.6 | % | ||
| Depreciation and amortization expense ratio (3) | 1.1 | % | 1.1 | % | ||
| Effective tax rate (1) | 41.0 | % | 40.8 | % | ||
|
(1) The Company’s 2008 results have been recast to reflect the adoption of FSP APB 14-1. This resulted in additional interest expense of $1.1 million ($0.02 per diluted share) for the three months ended March 31, 2008.
|
||||||
|
(2) Medical care ratio represents medical care costs as a percentage of premium revenue.
|
||||||
|
(3) Computed as a percentage of total operating revenue. |
||||||
|
MOLINA HEALTHCARE, INC. CONDENSED CONSOLIDATED BALANCE SHEETS (Amounts in thousands, except per-share data) |
||||||
|
March 31,
2009 |
Dec. 31,
2008 (1) |
|||||
| (Unaudited) | ||||||
| ASSETS | ||||||
| Current assets: | ||||||
| Cash and cash equivalents | $ | 405,187 | $ | 387,162 | ||
| Investments | 202,194 | 189,870 | ||||
| Receivables | 158,175 | 128,562 | ||||
| Income taxes refundable | 265 | 4,019 | ||||
| Deferred income taxes (1) | 3,884 | 9,071 | ||||
| Prepaid expenses and other current assets | 17,678 | 14,766 | ||||
| Total current assets | 787,383 | 733,450 | ||||
| Property and equipment, net | 70,116 | 65,058 | ||||
| Goodwill and intangible assets, net | 201,706 | 192,599 | ||||
| Investments | 61,828 | 58,169 | ||||
| Restricted investments | 37,757 | 38,202 | ||||
| Receivable for ceded life and annuity contracts | 26,714 | 27,367 | ||||
| Other assets (1) | 21,450 | 33,223 | ||||
| Total assets | $ | 1,206,954 | $ | 1,148,068 | ||
| LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||
| Current liabilities: | ||||||
| Medical claims and benefits payable | $ | 311,627 | $ | 292,442 | ||
| Accounts payable and accrued liabilities | 67,006 | 66,247 | ||||
| Deferred revenue | 82,506 | 29,538 | ||||
| Total current liabilities | 461,139 | 388,227 | ||||
| Long-term debt (1) | 155,312 | 164,873 | ||||
| Deferred income taxes (1) | 12,297 | 12,911 | ||||
| Liability for ceded life and annuity contracts | 26,714 | 27,367 | ||||
| Other long-term liabilities | 22,797 | 22,928 | ||||
| Total liabilities | 678,259 | 616,306 | ||||
| Stockholders’ equity: | ||||||
| Common stock, $0.001 par value; 80,000 shares authorized, outstanding 25,991 shares at March 31, 2009, and 26,725 shares at December 31, 2008 | 27 | 27 | ||||
|
Preferred stock, $0.001 par value; 20,000 shares authorized, no shares outstanding
|
− | − | ||||
| Additional paid-in capital (1) | 170,411 | 170,681 | ||||
| Accumulated other comprehensive loss | (2,342 | ) | (2,310 | ) | ||
| Retained earnings (1) | 395,965 | 383,754 | ||||
|
Treasury stock, at cost; 2,009 shares at March 31, 2009 and 1,201
shares at
December 31, 2008 |
(35,366 | ) | (20,390 | ) | ||
| Total stockholders’ equity | 528,695 | 531,762 | ||||
| Total liabilities and stockholders’ equity | $ | 1,206,954 | $ | 1,148,068 | ||
|
(1) The Company’s financial position as of December 31, 2008, has been recast to reflect adoption of FSP APB 14-1. The cumulative adjustments to reduce retained earnings were $3.4 million as of January 1, 2009, and $604,000 as of January 1, 2008. |
||||||
|
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (In thousands) |
||||||
|
Three Months Ended
March 31, |
||||||
| 2009 |
2008 (1) |
|
||||
| Operating activities: | ||||||
| Net income (1) | $ | 12,211 | $ | 12,475 | ||
|
Adjustments to reconcile net income to net cash provided by
operating activities: |
||||||
| Depreciation and amortization | 9,052 | 8,152 | ||||
| Unrealized gain on trading securities | (3,639 | ) | − | |||
| Loss on rights agreement | 3,323 | − | ||||
| Gain on retirement of convertible senior notes | (1,532 | ) | − | |||
| Deferred income taxes (1) | 4,988 | (4,774 | ) | |||
| Stock-based compensation | 1,434 | 1,511 | ||||
| Amortization of deferred financing costs (1) | 352 | 358 | ||||
| Non-cash interest expense on convertible senior notes (1) | 1,194 | 1,144 | ||||
|
Tax deficiency from employee stock compensation recorded as
additional
paid-in capital |
(533 | ) |
(14 |
) |
||
| Changes in operating assets and liabilities: | ||||||
| Receivables | (29,613 | ) | (6,016 | ) | ||
| Prepaid expenses and other current assets | (2,912 | ) | (1,257 | ) | ||
| Medical claims and benefits payable | 19,185 | 170 | ||||
| Accounts payable and accrued liabilities | (2,922 | ) | (4,277 | ) | ||
| Deferred revenue | 52,968 | (38,062 | ) | |||
| Income taxes | 3,359 | 7,134 | ||||
| Net cash provided by (used in) operating activities | 66,915 | (23,456 | ) | |||
| Investing activities: | ||||||
| Purchases of property and equipment | (10,367 | ) | (8,177 | ) | ||
| Purchases of investments | (48,127 | ) | (95,817 | ) | ||
| Sales and maturities of investments | 35,627 | 82,353 | ||||
| (Increase) decrease in restricted investments | 445 | (787 | ) | |||
| Increase in other assets (1) | (1,708 | ) | (1,562 | ) | ||
| Increase (decrease) in other long-term liabilities | (131 | ) | 363 | |||
| Net cash used in investing activities | (24,261 | ) | (23,627 | ) | ||
| Financing activities: | ||||||
| Treasury stock purchases | (14,976 | ) | − | |||
| Retirement of convertible senior notes | (9,653 | ) | − | |||
| Proceeds from exercise of stock options and employee stock purchases | − | 172 | ||||
| Net cash (used in) provided by financing activities | (24,629 | ) | 172 | |||
| Net increase (decrease) in cash and cash equivalents | 18,025 | (46,911 | ) | |||
| Cash and cash equivalents at beginning of period | 387,162 | 459,064 | ||||
| Cash and cash equivalents at end of period | $ | 405,187 | $ | 412,153 | ||
|
(1) The Company’s 2008 cash flows have been recast to reflect the adoption of FSP APB 14-1. |
||||||
|
MOLINA HEALTHCARE, INC. UNAUDITED MEMBERSHIP DATA |
|||||
| Total Ending Membership By Health Plan: | March 31, 2009 | Dec. 31, 2008 | March 31, 2008 | ||
| California | 327,000 | 322,000 | 303,000 | ||
| Florida (1) | 17,000 | – | – | ||
| Michigan | 207,000 | 206,000 | 216,000 | ||
| Missouri | 77,000 | 77,000 | 76,000 | ||
| Nevada (2) | – | – | – | ||
| New Mexico | 83,000 | 84,000 | 78,000 | ||
| Ohio | 190,000 | 176,000 | 140,000 | ||
| Texas | 33,000 | 31,000 | 28,000 | ||
| Utah | 60,000 | 61,000 | 55,000 | ||
| Washington | 309,000 | 299,000 | 289,000 | ||
| Total | 1,303,000 | 1,256,000 | 1,185,000 | ||
|
Total Ending Membership By State
for the Medicare Advantage Plans: |
|||||
| California | 1,500 | 1,500 | 1,200 | ||
| Michigan | 2,000 | 1,700 | 1,400 | ||
| Nevada | 400 | 700 | 500 | ||
| New Mexico | 400 | 300 | – | ||
| Texas | 400 | 400 | 400 | ||
| Utah | 2,800 | 2,400 | 2,000 | ||
| Washington | 1,000 | 1,000 | 800 | ||
| Total | 8,500 | 8,000 | 6,300 | ||
|
Total Ending Membership By State
for the Aged, Blind or Disabled Population: |
|||||
| California | 12,600 | 12,700 | 11,700 | ||
| Florida (1) | 4,200 | – | – | ||
| Michigan | 30,100 | 30,300 | 31,800 | ||
| New Mexico | 6,200 | 6,300 | 6,800 | ||
| Ohio | 19,700 | 19,000 | 14,700 | ||
| Texas | 16,700 | 16,200 | 16,100 | ||
| Utah | 7,500 | 7,300 | 6,800 | ||
| Washington | 3,000 | 3,000 | 3,000 | ||
| Total | 100,000 | 94,800 | 90,900 | ||
| Total Member Months (3) by Health Plan: | |||||
| California | 980,000 | 956,000 | 908,000 | ||
| Florida (1) | 61,000 | – | – | ||
| Michigan | 620,000 | 622,000 | 638,000 | ||
| Missouri | 231,000 | 232,000 | 223,000 | ||
| Nevada | 1,000 | 1,000 | 2,000 | ||
| New Mexico | 248,000 | 254,000 | 228,000 | ||
| Ohio | 560,000 | 533,000 | 413,000 | ||
| Texas | 98,000 | 91,000 | 85,000 | ||
| Utah | 184,000 | 177,000 | 157,000 | ||
| Washington | 919,000 | 892,000 | 859,000 | ||
| Total | 3,902,000 | 3,758,000 | 3,513,000 | ||
|
(1) The Florida health plan began serving members in late December 2008.
|
|||||
|
(2) Less than 1,000 members.
|
|||||
|
(3) A total member month is defined as the aggregate of each month’s ending membership for the period presented. |
|||||
|
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN (Dollars in thousands except per member per month amounts) |
|||||||||||||||||||
| Three Months Ended March 31, 2009 | |||||||||||||||||||
| Premium Revenue | Medical Care Costs | Medical Care Ratio | Premium Tax Expense | ||||||||||||||||
| Total | PMPM | Total | PMPM | ||||||||||||||||
| California | $ | 110,035 | $ | 112.29 | $ | 103,973 | $ | 106.10 | 94.5 | % | $ | 3,316 | |||||||
| Florida (1) | 19,691 | 323.89 | 17,768 | 292.25 | 90.2 | – | |||||||||||||
| Michigan | 132,765 | 213.98 | 109,995 | 177.28 | 82.9 | 6,884 | |||||||||||||
| Missouri | 58,707 | 254.00 | 46,974 | 203.24 | 80.0 | – | |||||||||||||
| Nevada | 1,230 | 1,094.70 | 434 | 386.51 | 35.3 | – | |||||||||||||
| New Mexico | 81,818 | 329.68 | 72,021 | 290.20 | 88.0 | 2,093 | |||||||||||||
| Ohio | 187,222 | 334.13 | 157,780 | 281.58 | 84.3 | 10,192 | |||||||||||||
| Texas | 33,011 | 338.14 | 27,406 | 280.73 | 83.0 | 684 | |||||||||||||
| Utah | 50,618 | 275.11 | 44,263 | 240.57 | 87.5 | – | |||||||||||||
| Washington | 180,704 | 196.66 | 149,545 | 162.75 | 82.8 | 2,947 | |||||||||||||
| Other (2) | 1,683 | – | 7,729 | – | – | (15 | ) | ||||||||||||
| Consolidated | $ | 857,484 | $ | 219.73 | $ | 737,888 | $ | 189.09 | 86.1 | % | $ | 26,101 | |||||||
| Three Months Ended March 31, 2008 | |||||||||||||||||||
| Premium Revenue | Medical Care Costs | Medical Care Ratio | Premium Tax Expense | ||||||||||||||||
| Total | PMPM | Total | PMPM | ||||||||||||||||
| California | $ | 101,621 | $ | 111.97 | $ | 89,654 | $ | 98.79 | 88.2 | % | $ | 2,958 | |||||||
| Florida (1) | – | – | – | – | – | – | |||||||||||||
| Michigan | 124,753 | 195.42 | 102,900 | 161.19 | 82.5 | 6,939 | |||||||||||||
| Missouri | 52,036 | 233.69 | 46,681 | 209.64 | 89.7 | – | |||||||||||||
| Nevada | 1,944 | 1,228.10 | 1,626 | 1,027.36 | 83.7 | – | |||||||||||||
| New Mexico | 88,649 | 388.63 | 71,925 | 315.31 | 81.1 | 1,502 | |||||||||||||
| Ohio | 124,605 | 301.68 | 112,538 | 272.46 | 90.3 | 5,605 | |||||||||||||
| Texas | 23,432 | 274.60 | 17,830 | 208.95 | 76.1 | 476 | |||||||||||||
| Utah | 37,346 | 238.51 | 32,991 | 210.69 | 88.3 | – | |||||||||||||
| Washington | 175,199 | 203.84 | 144,513 | 168.14 | 82.5 | 2,845 | |||||||||||||
| Other (2) | 53 | – | 5,689 | – | – | 27 | |||||||||||||
| Consolidated | $ | 729,638 | $ | 207.71 | $ | 626,347 | $ | 178.31 | 85.8 | % | $ | 20,352 | |||||||
|
(1) The Florida health plan began serving members in late December 2008. |
|||||||||||||||||||
|
(2) “Other” medical care costs represent primarily medically related administrative costs at the parent company. |
|||||||||||||||||||
|
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 for the periods indicated: |
||||||||||||||||||
|
Three Months Ended
March 31, 2009 |
Three Months Ended
March 31, 2008 |
|||||||||||||||||
| Amount | PMPM | % of Total Medical Care Costs | Amount | PMPM | % of Total Medical Care Costs | |||||||||||||
| Fee-for-service | $ | 489,141 | $ | 125.35 | 66.3 | % | $ | 412,009 | $ | 117.29 | 65.8 | % | ||||||
| Capitation | 118,414 | 30.34 | 16.1 | 103,791 | 29.55 | 16.6 | ||||||||||||
| Pharmacy | 102,638 | 26.30 | 13.9 | 86,282 | 24.56 | 13.8 | ||||||||||||
| Other | 27,695 | 7.10 | 3.7 | 24,265 | 6.91 | 3.8 | ||||||||||||
| Total | $ | 737,888 | $ | 189.09 | 100.0 | % | $ | 626,347 | $ | 178.31 | 100.0 | % | ||||||
The following table provides the details of the Company’s medical claims and benefits payable as of the dates indicated:
| March 31, 2009 | Dec. 31, 2008 | March 31, 2008 | |||||||
| Fee-for-service claims incurred but not paid (IBNP) | $ | 247,111 | $ | 236,492 | $ | 261,462 | |||
| Capitation payable | 31,815 | 28,111 | 30,002 | ||||||
| Pharmacy payable | 24,047 | 18,837 | 15,997 | ||||||
| Other | 8,654 | 9,002 | 4,315 | ||||||
| Total medical claims and benefits payable | $ | 311,627 | $ | 292,442 | $ | 311,776 | |||
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in thousands, except per-member amounts)
(Unaudited)
The Company’s claims liability includes an allowance for adverse claims development based on historical experience and other factors including, but not limited to, variation 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 negative amounts displayed for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of claims and benefits payable at the beginning of the period exceeded the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The benefit of this prior period development may be offset by the addition of a reserve for adverse claims development when estimating the liability at the end of the period (captured in “Components of medical care costs related to: Current year”). The following table shows the components of the change in medical claims and benefits payable as of the periods indicated:
|
Three Months Ended
March 31, |
Year Ended Dec. 31 | |||||||||||
| 2009 | 2008 | 2008 | ||||||||||
| Balances at beginning of period | $ | 292,442 | $ 311,606 | $ | 311,606 | |||||||
| Components of medical care costs related to: | ||||||||||||
| Current year | 780,112 | 668,968 | 2,683,399 | |||||||||
| Prior years | (42,224 | ) | (42,621 | ) | (62,087 | ) | ||||||
| Total medical care costs | 737,888 | 626,347 | 2,621,312 | |||||||||
| Payments for medical care costs related to: | ||||||||||||
| Current year | 510,075 | 423,107 | 2,413,128 | |||||||||
| Prior years | 208,628 | 203,070 | 227,348 | |||||||||
| Total paid | 718,703 | 626,177 | 2,640,476 | |||||||||
| Balances at end of period | $ | 311,627 | $ 311,776 | $ | 292,442 | |||||||
| Benefit from prior period as a percentage of: | ||||||||||||
| Balance at beginning of year | 14.4 | % | 13.7 | % | 19.9 | % | ||||||
| Premium revenue | 4.9 | % | 5.8 | % | 2.0 | % | ||||||
| Total medical care costs | 5.7 | % | 6.8 | % | 2.4 | % | ||||||
| Days in claims payable | 42 | 50 | 41 | |||||||||
| Number of members at end of period | 1,303,000 | 1,185,000 | 1,256,000 | |||||||||
| Number of claims in inventory at end of period | 158,900 | 186,500 | 87,300 | |||||||||
| Billed charges of claims in inventory at end of period | $ | 208,900 | $ 217,800 | $ | 115,400 | |||||||
| Claims in inventory per member at end of period | 0.12 | 0.16 | 0.07 | |||||||||
|
Billed charges of claims in inventory per member
at end of period |
$ | 160.32 | $ 183.80 | $ | 91.88 | |||||||
| Number of claims received during the period | 3,051,600 | 2,731,600 | 11,095,100 | |||||||||
| Billed charges of claims received during the period | $ | 2,280,100 | $ 1,856,100 | $ | 7,794,900 | |||||||
Source:
Molina Healthcare, Inc.
Investor Relations:
Juan José
Orellana, 562-435-3666, ext. 111143