-
Fourth quarter 2016 net loss per diluted share decreases
$0.79 , to$0.85 -
Net income per diluted share for full year 2016 increases
$0.78 , to$0.92 -
2017 guidance of
$1.72 net income per diluted share and$2.09 adjusted net income per diluted share remains unchanged
The pre-tax impact of that retroactive contract amendment was
Income before income tax expense for the full year of 2016 after the
adjustment will be
“We want our stockholders to know that providing confidence and
transparency in our financial statements has always been a top priority
for
About
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding our expected 2017 financial performance. 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:
- the success of our profit improvement and cost-cutting initiatives;
-
the numerous political and market-based uncertainties associated
with the Affordable Care Act (the “ACA”) or “Obamacare,” including any
potential repeal and replacement of the law, amendment of the law, or
move to state block grants for
Medicaid ; - the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with risk transfer requirements, the potential for disproportionate enrollment of higher acuity members, the withdrawal of cost sharing subsidies and/or premium tax credits, the adequacy of agreed rates, and potential disruption associated with market withdrawal;
- subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment/risk transfer, risk corridors, and reinsurance;
- management of our medical costs, including our ability to reduce over time the high medical costs commonly associated with new patient populations;
- our ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates in new plans, geographies, and programs where we have less experience with patient and provider populations, and also including utilization rates associated with seasonal flu patterns or other newly emergent diseases;
-
significant budget pressures on state governments and their
potential inability to maintain current rates, to implement expected
rate increases, or to maintain existing benefit packages or membership
eligibility thresholds or criteria, including the resolution of the
Illinois budget impasse and continued payment of all amounts due to ourIllinois health plan; -
the success of our efforts to retain existing government contracts,
including those in
Illinois ,Washington ,Florida ,Texas , andNew Mexico , and to obtain new government contracts in connection with state requests for proposals (RFPs) in both existing and new states; - our ability to manage growth, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
- our ability to consummate and realize benefits from acquisitions, and to integrate acquisitions;
- our receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
- our ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
- the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit sharing arrangements, and risk adjustment provisions;
- our estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;
-
the
Medicaid expansion cost corridors inNew Mexico andWashington , and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members; - the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
- cyber-attacks or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
-
the success of our health plan in
Puerto Rico , including the resolution of thePuerto Rico debt crisis, payment of all amounts due under ourMedicaid contract, the effect of the PROMESA law, and our efforts to better manage the health care costs of ourPuerto Rico health plan; -
the success and renewal of our duals demonstration programs in
California ,Illinois ,Michigan ,Ohio ,South Carolina , andTexas ; - the accurate estimation of incurred but not reported or paid medical costs across our health plans;
- efforts by states to recoup previously paid and recognized premium amounts;
- the continuation and renewal of the government contracts of our health plans, Molina Medicaid Solutions, and Pathways, and the terms under which such contracts are renewed;
-
complications, member confusion, or enrollment backlogs related to
the annual renewal of
Medicaid coverage; - government audits and reviews, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom;
- changes with respect to our provider contracts and the loss of providers;
- approval by state regulators of dividends and distributions by our health plan subsidiaries;
- changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
- high dollar claims related to catastrophic illness;
- the favorable resolution of litigation, arbitration, or administrative proceedings;
- the relatively small number of states in which we operate health plans;
- the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity and meet our liquidity needs, including the interest expense and other costs associated with such financing;
- our failure to comply with the financial or other covenants in our credit agreement or the indentures governing our outstanding notes;
- the sufficiency of our funds on hand to pay the amounts due upon conversion of our outstanding notes;
-
the failure of a state in which we operate to renew its federal
Medicaid waiver; -
changes generally affecting the managed care or
Medicaid management information systems industries; - increases in government surcharges, taxes, and assessments, including but not limited to the deductibility of certain compensation costs;
- newly emergent viruses or widespread epidemics, public catastrophes or terrorist attacks, and associated public alarm;
-
increasing competition and consolidation in the
Medicaid industry;
and numerous other risk factors, including those discussed in our
periodic reports and filings with the
MOLINA HEALTHCARE, INC. | |||||||||||||||||||||||||
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS | |||||||||||||||||||||||||
Three Months Ended December 31, 2016 | Year Ended December 31, 2016 | ||||||||||||||||||||||||
As Previously Reported |
Adjustments | As Revised |
As Previously Reported |
Adjustments | As Revised | ||||||||||||||||||||
(Dollar amounts in millions, except per-share amounts) | |||||||||||||||||||||||||
Revenue: | |||||||||||||||||||||||||
Premium revenue | $ | 4,109 | $ | 68 | $ | 4,177 | $ | 16,324 | $ | 68 | $ | 16,392 | |||||||||||||
Service revenue | 131 | — | 131 | 539 | — | 539 | |||||||||||||||||||
Premium tax revenue | 120 | 3 | 123 | 465 | 3 | 468 | |||||||||||||||||||
Health insurer fee revenue | 94 | — | 94 | 345 | — | 345 | |||||||||||||||||||
Investment income and other revenue | 9 | — | 9 | 38 | — | 38 | |||||||||||||||||||
Total revenue | 4,463 | 71 | 4,534 | 17,711 | 71 | 17,782 | |||||||||||||||||||
Operating expenses: | |||||||||||||||||||||||||
Medical care costs | 3,844 | — | 3,844 | 14,774 | — | 14,774 | |||||||||||||||||||
Cost of service revenue | 123 | — | 123 | 485 | — | 485 | |||||||||||||||||||
General and administrative expenses | 359 | — | 359 | 1,393 | — | 1,393 | |||||||||||||||||||
Premium tax expenses | 120 | 3 | 123 | 465 | 3 | 468 | |||||||||||||||||||
Health insurer fee expenses | 54 | — | 54 | 217 | — | 217 | |||||||||||||||||||
Depreciation and amortization | 37 | — | 37 | 139 | — | 139 | |||||||||||||||||||
Total operating expenses | 4,537 | 3 | 4,540 | 17,473 | 3 | 17,476 | |||||||||||||||||||
Operating (loss) income | (74 | ) | 68 | (6 | ) | 238 | 68 | 306 | |||||||||||||||||
Interest expense | 25 | — | 25 | 101 | — | 101 | |||||||||||||||||||
(Loss) income before income tax expense | (99 | ) | 68 | (31 | ) | 137 | 68 | 205 | |||||||||||||||||
Income tax (benefit) expense | (8 | ) | 24 | 16 | 129 | 24 | 153 | ||||||||||||||||||
Net (loss) income | $ | (91 | ) | $ | 44 | $ | (47 | ) | $ | 8 | $ | 44 | $ | 52 | |||||||||||
Diluted net (loss) income per share | $ | (1.64 | ) | $ | 0.79 | $ | (0.85 | ) | $ | 0.14 | $ | 0.78 | $ | 0.92 | |||||||||||
Diluted weighted average shares outstanding | 55.6 | — | 55.6 | 56.3 | — | 56.3 | |||||||||||||||||||
Operating Statistics: | |||||||||||||||||||||||||
Medical care ratio (1) | 93.6 | % | 92.0 | % | 90.5 | % | 90.1 | % | |||||||||||||||||
General and administrative expense ratio (2) | 8.0 | % | 7.9 | % | 7.9 | % | 7.8 | % | |||||||||||||||||
Premium tax ratio (1) | 2.8 | % | 2.9 | % | 2.8 | % | 2.8 | % | |||||||||||||||||
Effective tax rate | 79.0 | % | (54.5 | )% | 94.1 | % | 74.8 | % | |||||||||||||||||
Net profit margin (2) | (2.0 | )% | (1.0 | )% | — | % | 0.3 | % | |||||||||||||||||
____________ |
|||||||||||||||||||||||||
(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) |
General and administrative expense ratio represents general and administrative expenses as a percentage of total revenue. Net profit margin represents net (loss) income as a percentage of total revenue. |
||||||||||||||||||||||||
MOLINA HEALTHCARE, INC. | ||||||||||||
UNAUDITED CONDENSED CONSOLIDATED BALANCE SHEETS | ||||||||||||
As of December 31, 2016 | ||||||||||||
As Previously Reported |
Adjustments | As Revised | ||||||||||
(In millions, except per-share data) |
||||||||||||
ASSETS | ||||||||||||
Current assets: | ||||||||||||
Cash and cash equivalents | $ | 2,819 | $ | — | $ | 2,819 | ||||||
Investments | 1,758 | — | 1,758 | |||||||||
Receivables | 974 | — | 974 | |||||||||
Income taxes refundable | 63 | (24 | ) | 39 | ||||||||
Prepaid expenses and other current assets | 131 | — | 131 | |||||||||
Derivative asset | 267 | — | 267 | |||||||||
Total current assets | 6,012 | (24 | ) | 5,988 | ||||||||
Property, equipment, and capitalized software, net | 454 | — | 454 | |||||||||
Deferred contract costs | 86 | — | 86 | |||||||||
Intangible assets, net | 140 | — | 140 | |||||||||
Goodwill | 620 | — | 620 | |||||||||
Restricted investments | 110 | — | 110 | |||||||||
Deferred income taxes | 10 | — | 10 | |||||||||
Other assets | 41 | — | 41 | |||||||||
$ | 7,473 | $ | (24 | ) | $ | 7,449 | ||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||||||
Current liabilities: | ||||||||||||
Medical claims and benefits payable | $ | 1,929 | $ | — | $ | 1,929 | ||||||
Amounts due government agencies | 1,273 | (71 | ) | 1,202 | ||||||||
Accounts payable and accrued liabilities | 382 | 3 | 385 | |||||||||
Deferred revenue | 315 | — | 315 | |||||||||
Current portion of long-term debt | 472 | — | 472 | |||||||||
Derivative liability | 267 | — | 267 | |||||||||
Total current liabilities | 4,638 | (68 | ) | 4,570 | ||||||||
Senior notes | 975 | — | 975 | |||||||||
Lease financing obligations | 198 | — | 198 | |||||||||
Deferred income taxes | 15 | — | 15 | |||||||||
Other long-term liabilities | 42 | — | 42 | |||||||||
Total liabilities | 5,868 | (68 | ) | 5,800 | ||||||||
Stockholders’ equity: | ||||||||||||
Common stock, $0.001 par value; 150 shares authorized; outstanding: 57 shares at December 31, 2016 and 56 shares at December 31, 2015 | — | — | — | |||||||||
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding | — | — | — | |||||||||
Additional paid-in capital | 841 | — | 841 | |||||||||
Accumulated other comprehensive loss | (2 | ) | — | (2 | ) | |||||||
Retained earnings | 766 | 44 | 810 | |||||||||
Total stockholders’ equity | 1,605 | 44 | 1,649 | |||||||||
$ | 7,473 | $ | (24 | ) | $ | 7,449 | ||||||
MOLINA HEALTHCARE, INC. | ||||||||||||||||||||||||
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS | ||||||||||||||||||||||||
Three Months Ended December 31, 2016 | Year Ended December 31, 2016 | |||||||||||||||||||||||
As Previously Reported |
Adjustments | As Revised |
As Previously Reported |
Adjustments | As Revised | |||||||||||||||||||
(In millions) | ||||||||||||||||||||||||
Operating activities: | ||||||||||||||||||||||||
Net (loss) income | $ | (91 | ) | $ | 44 | $ | (47 | ) | $ | 8 | $ | 44 | $ | 52 | ||||||||||
Adjustments to reconcile net (loss) income to net cash provided by operating activities: | ||||||||||||||||||||||||
Depreciation and amortization | 47 | — | 47 | 182 | — | 182 | ||||||||||||||||||
Deferred income taxes | 2 | — | 2 | 22 | — | 22 | ||||||||||||||||||
Share-based compensation | 2 | — | 2 | 26 | — | 26 | ||||||||||||||||||
Amortization of convertible senior notes and lease financing obligations | 8 | — | 8 | 31 | — | 31 | ||||||||||||||||||
Other, net | 2 | — | 2 | 16 | — | 16 | ||||||||||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||||||||
Receivables | 79 | — | 79 | (348 | ) | — | (348 | ) | ||||||||||||||||
Prepaid expenses and other assets | 47 | — | 47 | (69 | ) | — | (69 | ) | ||||||||||||||||
Medical claims and benefits payable | 58 | — | 58 | 226 | — | 226 | ||||||||||||||||||
Amounts due government agencies | 41 | (71 | ) | (30 | ) | 544 | (71 | ) | 473 | |||||||||||||||
Accounts payable and accrued liabilities | (8 | ) | 3 | (5 | ) | (7 | ) | 3 | (4 | ) | ||||||||||||||
Deferred revenue | (65 | ) | — | (65 | ) | 92 | — | 92 | ||||||||||||||||
Income taxes | (82 | ) | 24 | (58 | ) | (50 | ) | 24 | (26 | ) | ||||||||||||||
Net cash provided by operating activities | 40 | — | 40 | 673 | — | 673 | ||||||||||||||||||
Investing activities: | ||||||||||||||||||||||||
Purchases of investments | (485 | ) | — | (485 | ) | (1,929 | ) | — | (1,929 | ) | ||||||||||||||
Proceeds from sales and maturities of investments | 454 | — | 454 | 1,966 | — | 1,966 | ||||||||||||||||||
Purchases of property, equipment, and capitalized software | (33 | ) | — | (33 | ) | (176 | ) | — | (176 | ) | ||||||||||||||
Change in restricted investments | — | — | — | 4 | — | 4 | ||||||||||||||||||
Net cash paid in business combinations | — | — | — | (48 | ) | — | (48 | ) | ||||||||||||||||
Other, net | (7 | ) | — | (7 | ) | (19 | ) | — | (19 | ) | ||||||||||||||
Net cash used in investing activities | (71 | ) | — | (71 | ) | (202 | ) | — | (202 | ) | ||||||||||||||
Financing activities: | ||||||||||||||||||||||||
Proceeds from employee stock plans | 8 | — | 8 | 18 | — | 18 | ||||||||||||||||||
Other, net | — | — | — | 1 | — | 1 | ||||||||||||||||||
Net cash provided by financing activities | 8 | — | 8 | 19 | — | 19 | ||||||||||||||||||
Net (decrease) increase in cash and cash equivalents | (23 | ) | — | (23 | ) | 490 | — | 490 | ||||||||||||||||
Cash and cash equivalents at beginning of period | 2,842 | — | 2,842 | 2,329 | — | 2,329 | ||||||||||||||||||
Cash and cash equivalents at end of period | $ | 2,819 | $ | — | $ | 2,819 | $ | 2,819 | $ | — | $ | 2,819 | ||||||||||||
MOLINA HEALTHCARE, INC. | |||||||||
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES — 2017 OUTLOOK | |||||||||
Amount | Per share (2) | ||||||||
(In millions, except per-share |
|||||||||
Net income - 2017 Outlook | $ | 100 | $ | 1.72 | |||||
Adjustments: | |||||||||
Amortization of intangible assets | 34 | 0.59 | |||||||
Income tax effect (1) | (12 | ) | (0.22 | ) | |||||
Amortization of intangible assets, net of tax effect | 22 | 0.37 | |||||||
Adjusted net income - 2017 Outlook | $ | 122 | $ | 2.09 | |||||
____________ |
|||||||||
(1) |
Income tax effect calculated at the statutory tax rate of 37%. |
||||||||
(2) |
Computation assumes 58.2 million diluted weighted average shares outstanding. |
||||||||
The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release: |
|||||||||
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 very helpful in assessing our financial performance exclusive of the non-cash impact of the amortization of purchased intangibles. |
|||||||||
Adjusted net income per diluted share: Adjusted net income divided by weighted average common shares outstanding on a fully diluted basis. |
View source version on businesswire.com: http://www.businesswire.com/news/home/20170301006407/en/
Source:
Molina Healthcare, Inc.
Juan José Orellana, 562-435-3666, ext.
111143
Investor Relations