Molina Healthcare, Inc. (NYSE: MOH):
Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the second quarter of 2018.
“Our second quarter results are a strong indication that the early stages of our margin recovery and sustainability plan are working,” said Joe Zubretsky, President and Chief Executive Officer. “Our focus on managed care fundamentals and a more rigorous performance management process is reflected in our improved earnings.”
We believe that the sequential comparison of our 2018 second quarter performance with our 2018 first quarter performance is the most useful indicator of our business progress. Significant items impacting the quarter are presented in a table later in this press release.
Second Quarter of 2018 Compared With First Quarter of 2018
Net income increased to $202 million, from $107 million in the first quarter of 2018. Net income per diluted share increased to $3.02, from $1.64 in the first quarter of 2018.
Overall, the medical care ratio improved to 85.3%, from 86.1% in the first quarter of 2018. Excluding the combined benefit of the 2017 Marketplace risk adjustment and cost sharing reduction (CSR) reimbursement, the medical care ratio would have been 87.0% in the second quarter of 2018, compared with 87.2% in the first quarter of 2018. The sequential improvement in the overall medical care ratio was due to a decrease in the Medicaid medical care ratio partially offset by a seasonally higher Marketplace medical care ratio.
The general and administrative (G&A) expense ratio decreased to 6.9%, from 7.6% in the first quarter of 2018, due to increased revenue and continuing G&A cost containment. Excluding the impact of Marketplace broker commissions and exchange fees in both periods, the G&A ratio decreased to 6.2%, from 6.8% in the first quarter of 2018.
Renewal of Medicaid Contracts
Year to date in 2018, we renewed Medicaid contracts in Washington, Florida and Puerto Rico as follows:
Capital Plan Progress
In the second quarter of 2018, we repaid $300 million outstanding under the revolving credit facility. In addition, we repaid $96 million aggregate principal amount of our 1.125% cash convertible senior notes due 2020 and entered into privately negotiated termination agreements to terminate the respective portions of the call options and warrants. Year to date, we have reduced the principal amount of outstanding debt by $493 million.
Sale of Molina Medicaid Solutions Segment
In June 2018, we entered into a definitive agreement to sell Molina Medicaid Solutions (MMS) to DXC Technology Company. The divestiture, expected to close in the third quarter of 2018, is subject to the satisfaction of customary closing conditions and the receipt of certain third party consents and regulatory approvals. We expect the net cash selling price for the equity interests of MMS to approximate $220 million after certain adjustments.
Second Quarter of 2018 Compared With Second Quarter of 2017
Net income for the second quarter of 2018 was $202 million, compared with a net loss of $230 million for the second quarter of 2017. Net income per diluted share was $3.02 for the second quarter of 2018 compared with net loss per diluted share of $4.10 reported for the second quarter of 2017. In the second quarter of 2017, we recorded significant medical care costs relating to prior year dates of service in excess of historical expectations, and Marketplace-related premium deficiency reserves and changes in estimates relating to prior year dates of service. In addition, we recorded significant impairment and restructuring charges.
2018 Revised Guidance
The following table summarizes 2018 Revised Guidance (1):
Premium revenue | ~ $17.5B | ||||||
Service revenue | ~ $475M | ||||||
Premium tax revenue | ~ $415M | ||||||
Health insurer fees reimbursed | ~ $325M | ||||||
Investment income and other revenue | ~ $125M | ||||||
Total revenue | ~ $18.8B | ||||||
Medical care costs | ~ $15.2B | ||||||
Medical care ratio (2) | ~ 87% | ||||||
Cost of service revenue | ~ $430M | ||||||
General and administrative expenses | ~ $1.4B | ||||||
G&A ratio (3) | ~ 7.4% | ||||||
Premium tax expenses | ~ $415M | ||||||
Health insurer fees | ~ $345M | ||||||
Depreciation and amortization | ~ $100M | ||||||
Restructuring and separation costs | ~ $30M | ||||||
Interest expense and other income, net | ~ $140M | ||||||
Income before income taxes | $730M - $745M | ||||||
Net income | $471M - $484M | ||||||
EBITDA (4) | $968M - $985M | ||||||
Effective tax rate | 35% - 36% | ||||||
Net profit margin (3) | 2.5% - 2.6% | ||||||
Diluted weighted average shares | ~ 65.9M | ||||||
Net income per share | $7.15 - $7.35 | ||||||
Adjusted net income per share (4) | $7.39 - $7.59 | ||||||
End-of-year Marketplace membership | 354,000 | ||||||
End-of-year Medicaid and Medicare membership | 3,569,000 |
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(1) | All amounts are estimates; actual results may differ materially. See the Company’s risk factors as discussed in its 2017 Form 10-K and other filings and the statements below in this press release after the heading “Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995.” | |
(2) | Medical care ratio represents medical care costs as a percentage of premium revenue. | |
(3) | 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. | |
(4) | See reconciliation of non-GAAP financial measures at the end of this release. | |
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s second quarter 2018 results at 8:00 a.m. Eastern time on Wednesday, August 1, 2018. The number to call for the interactive teleconference is (877) 883-0383 and entering confirmation number 7567890. A telephonic replay of the conference call will be available through Wednesday, August 8, 2018, by dialing (877) 344-7529 and entering confirmation number 10121865. A live audio broadcast of this conference call will be available on Molina Healthcare’s 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 its locally operated health plans, Molina Healthcare served approximately 4.1 million members as of June 30, 2018. For more information about Molina Healthcare, please visit molinahealthcare.com.
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This earnings release contains “forward-looking statements” regarding the Company’s 2018 revised guidance, as well as its 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 sec.gov. Given these risks and uncertainties, the Company can give no assurances that its forward-looking statements will prove to be accurate, or that any other results or events projected or contemplated by its forward-looking statements will in fact occur, and the Company cautions investors not to place undue reliance on these statements. All forward-looking statements in this release represent the Company’s judgment as of July 31, 2018, and the Company disclaims any obligation to update any forward-looking statements to conform the statement to actual results or changes in its expectations.
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS |
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Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
(Dollar amounts in millions, except per-share amounts) | ||||||||||||||||||||
Revenue: | ||||||||||||||||||||
Premium revenue | $ | 4,514 | $ | 4,740 | $ | 8,837 | $ | 9,388 | ||||||||||||
Service revenue | 127 | 129 | 261 | 260 | ||||||||||||||||
Premium tax revenue | 106 | 114 | 210 | 225 | ||||||||||||||||
Health insurer fees reimbursed | 104 | — | 165 | — | ||||||||||||||||
Investment income and other revenue | 32 | 16 | 56 | 30 | ||||||||||||||||
Total revenue | 4,883 | 4,999 | 9,529 | 9,903 | ||||||||||||||||
Operating expenses: | ||||||||||||||||||||
Medical care costs | 3,850 | 4,491 | 7,572 | 8,602 | ||||||||||||||||
Cost of service revenue | 118 | 124 | 238 | 246 | ||||||||||||||||
General and administrative expenses | 335 | 405 | 687 | 844 | ||||||||||||||||
Premium tax expenses | 106 | 114 | 210 | 225 | ||||||||||||||||
Health insurer fees | 99 | — | 174 | — | ||||||||||||||||
Depreciation and amortization | 25 | 37 | 51 | 76 | ||||||||||||||||
Impairment losses | — | 72 | — | 72 | ||||||||||||||||
Restructuring and separation costs | 8 | 43 | 33 | 43 | ||||||||||||||||
Total operating expenses | 4,541 | 5,286 | 8,965 | 10,108 | ||||||||||||||||
Operating income (loss) | 342 | (287 | ) | 564 | (205 | ) | ||||||||||||||
Other expenses (income), net: | ||||||||||||||||||||
Interest expense | 32 | 27 | 65 | 53 | ||||||||||||||||
Other expense (income), net | 5 | — | 15 | (75 | ) | |||||||||||||||
Total other expenses (income), net | 37 | 27 | 80 | (22 | ) | |||||||||||||||
Income (loss) before income tax expense (benefit) | 305 | (314 | ) | 484 | (183 | ) | ||||||||||||||
Income tax expense (benefit) | 103 | (84 | ) | 175 | (30 | ) | ||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Net income (loss) per diluted share | $ | 3.02 | $ | (4.10 | ) | $ | 4.68 | $ | (2.74 | ) | ||||||||||
Diluted weighted average shares outstanding | 66.7 | 56.2 | 66.0 | 56.1 | ||||||||||||||||
Operating Statistics: | ||||||||||||||||||||
Medical care ratio | 85.3 | % | 94.8 | % | 85.7 | % | 91.6 | % | ||||||||||||
G&A ratio | 6.9 | % | 8.1 | % | 7.2 | % | 8.5 | % | ||||||||||||
Premium tax ratio | 2.3 | % | 2.4 | % | 2.3 | % | 2.3 | % | ||||||||||||
Effective income tax rate | 33.8 | % | 26.8 | % | 36.2 | % | 16.0 | % | ||||||||||||
Net profit (loss) margin | 4.1 | % | (4.6 | )% | 3.2 | % | (1.5 | )% | ||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED CONSOLIDATED BALANCE SHEETS |
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June 30, | December 31, | |||||||||
2018 | 2017 | |||||||||
(In millions, |
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ASSETS | ||||||||||
Current assets: | ||||||||||
Cash and cash equivalents | $ | 3,392 | $ | 3,186 | ||||||
Investments | 2,176 | 2,524 | ||||||||
Restricted investments | 80 | 169 | ||||||||
Receivables | 1,148 | 871 | ||||||||
Prepaid expenses and other current assets | 344 | 239 | ||||||||
Derivative asset | 657 | 522 | ||||||||
Assets held for sale | 230 | — | ||||||||
Total current assets | 8,027 | 7,511 | ||||||||
Property, equipment, and capitalized software, net | 276 | 342 | ||||||||
Goodwill and intangible assets, net | 201 | 255 | ||||||||
Restricted investments | 117 | 119 | ||||||||
Deferred income taxes | 114 | 103 | ||||||||
Other assets | 28 | 141 | ||||||||
$ | 8,763 | $ | 8,471 | |||||||
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||||||
Current liabilities: | ||||||||||
Medical claims and benefits payable | $ | 1,920 | $ | 2,192 | ||||||
Amounts due government agencies | 1,746 | 1,542 | ||||||||
Accounts payable and accrued liabilities | 754 | 366 | ||||||||
Deferred revenue | 193 | 282 | ||||||||
Current portion of long-term debt | 484 | 653 | ||||||||
Derivative liability | 657 | 522 | ||||||||
Liabilities held for sale | 66 | — | ||||||||
Total current liabilities | 5,820 | 5,557 | ||||||||
Long-term debt | 1,019 | 1,318 | ||||||||
Lease financing obligations | 198 | 198 | ||||||||
Other long-term liabilities | 68 | 61 | ||||||||
Total liabilities | 7,105 | 7,134 | ||||||||
Stockholders’ equity: | ||||||||||
Common stock, $0.001 par value, 150 shares authorized; outstanding: 62 shares at June 30, 2018 and 60 shares at December 31, 2017 | — | — | ||||||||
Preferred stock, $0.001 par value; 20 shares authorized, no shares issued and outstanding | — | — | ||||||||
Additional paid-in capital | 1,055 | 1,044 | ||||||||
Accumulated other comprehensive loss | (11 | ) | (5 | ) | ||||||
Retained earnings | 614 | 298 | ||||||||
Total stockholders’ equity | 1,658 | 1,337 | ||||||||
$ | 8,763 | $ | 8,471 | |||||||
MOLINA HEALTHCARE, INC. UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
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Three Months Ended | Six Months Ended | |||||||||||||||||||
June 30, | June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
(In millions) | ||||||||||||||||||||
Operating activities: | ||||||||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities: | ||||||||||||||||||||
Depreciation and amortization | 36 | 47 | 73 | 96 | ||||||||||||||||
Impairment losses | — | 72 | — | 72 | ||||||||||||||||
Deferred income taxes | — | (36 | ) | (6 | ) | (41 | ) | |||||||||||||
Share-based compensation | 7 | 29 | 13 | 35 | ||||||||||||||||
Non-cash restructuring costs | — | — | 17 | — | ||||||||||||||||
Amortization of convertible senior notes and lease financing obligations | 6 | 8 | 13 | 16 | ||||||||||||||||
Loss on debt extinguishment | 5 | — | 15 | — | ||||||||||||||||
Other, net | 2 | 4 | 4 | 7 | ||||||||||||||||
Changes in operating assets and liabilities: | ||||||||||||||||||||
Receivables | (232 | ) | — | (315 | ) | (32 | ) | |||||||||||||
Prepaid expenses and other current assets | 58 | (26 | ) | (181 | ) | (38 | ) | |||||||||||||
Medical claims and benefits payable | (104 | ) | 151 | (267 | ) | 148 | ||||||||||||||
Amounts due government agencies | 33 | 269 | 205 | 642 | ||||||||||||||||
Accounts payable and accrued liabilities | 30 | (68 | ) | 349 | (18 | ) | ||||||||||||||
Deferred revenue | (172 | ) | (178 | ) | (42 | ) | (32 | ) | ||||||||||||
Income taxes | 49 | (89 | ) | 127 | (30 | ) | ||||||||||||||
Net cash (used in) provided by operating activities | (80 | ) | (47 | ) | 314 | 672 | ||||||||||||||
Investing activities: | ||||||||||||||||||||
Purchases of investments | (525 | ) | (903 | ) | (914 | ) | (1,636 | ) | ||||||||||||
Proceeds from sales and maturities of investments | 792 | 441 | 1,335 | 874 | ||||||||||||||||
Purchases of property, equipment, and capitalized software | (10 | ) | (34 | ) | (14 | ) | (60 | ) | ||||||||||||
Other, net | (4 | ) | (13 | ) | (9 | ) | (24 | ) | ||||||||||||
Net cash provided by (used in) investing activities | 253 | (509 | ) | 398 | (846 | ) | ||||||||||||||
Financing activities: | ||||||||||||||||||||
Repayment of credit facility | (300 | ) | — | (300 | ) | — | ||||||||||||||
Repayment of 1.125% Convertible Notes | (89 | ) | — | (89 | ) | — | ||||||||||||||
Cash paid for partial settlement of 1.125% Conversion Option | (134 | ) | — | (134 | ) | — | ||||||||||||||
Cash received for partial termination of 1.125% Call Option | 134 | — | 134 | — | ||||||||||||||||
Cash paid for partial termination of 1.125% Warrants | (113 | ) | — | (113 | ) | — | ||||||||||||||
Proceeds from senior notes offerings, net of issuance costs | — | 325 | — | 325 | ||||||||||||||||
Other, net | 4 | 9 | (1 | ) | 8 | |||||||||||||||
Net cash (used in) provided by financing activities | (498 | ) | 334 | (503 | ) | 333 | ||||||||||||||
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents | (325 | ) | (222 | ) | 209 | 159 | ||||||||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 3,824 | 3,293 | 3,290 | 2,912 | ||||||||||||||||
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ | 3,499 | $ | 3,071 | $ | 3,499 | $ | 3,071 | ||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP |
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June 30, | December 31, | June 30, | |||||||||
2018 | 2017 | 2017 | |||||||||
Ending Membership by Program: | |||||||||||
Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) | 2,464,000 | 2,457,000 | 2,517,000 | ||||||||
Medicaid Expansion | 675,000 | 668,000 | 678,000 | ||||||||
Aged, Blind or Disabled (ABD) | 415,000 | 412,000 | 408,000 | ||||||||
Total Medicaid | 3,554,000 | 3,537,000 | 3,603,000 | ||||||||
Medicare-Medicaid Plan (MMP) - Integrated | 55,000 | 57,000 | 54,000 | ||||||||
Medicare Special Needs Plans | 45,000 | 44,000 | 44,000 | ||||||||
Total Medicare | 100,000 | 101,000 | 98,000 | ||||||||
Total Medicaid and Medicare | 3,654,000 | 3,638,000 | 3,701,000 | ||||||||
Marketplace | 409,000 | 815,000 | 949,000 | ||||||||
4,063,000 | 4,453,000 | 4,650,000 | |||||||||
Ending Membership by Health Plan: | |||||||||||
California | 639,000 | 746,000 | 766,000 | ||||||||
Florida | 398,000 | 625,000 | 672,000 | ||||||||
Illinois | 219,000 | 165,000 | 163,000 | ||||||||
Michigan | 397,000 | 398,000 | 414,000 | ||||||||
New Mexico | 241,000 | 253,000 | 266,000 | ||||||||
Ohio | 320,000 | 327,000 | 351,000 | ||||||||
Puerto Rico | 326,000 | 314,000 | 322,000 | ||||||||
South Carolina | 114,000 | 116,000 | 112,000 | ||||||||
Texas | 450,000 | 430,000 | 465,000 | ||||||||
Washington | 776,000 | 777,000 | 788,000 | ||||||||
Other (1) | 183,000 | 302,000 | 331,000 | ||||||||
4,063,000 | 4,453,000 | 4,650,000 |
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(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
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 June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
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Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 7.5 | $ | 1,393 | $ | 186.18 | $ | 1,205 | $ | 161.13 | 86.5 | % | $ | 188 | ||||||||||||||||||||
Medicaid Expansion | 2.1 | 761 | 372.04 | 676 | 330.83 | 88.9 | 85 | ||||||||||||||||||||||||||
ABD | 1.3 | 1,288 | 1,033.34 | 1,209 | 969.27 | 93.8 | 79 | ||||||||||||||||||||||||||
Total Medicaid | 10.9 | 3,442 | 319.52 | 3,090 | 286.89 | 89.8 | 352 | ||||||||||||||||||||||||||
MMP | 0.1 | 367 | 2,224.30 | 313 | 1,893.91 | 85.1 | 54 | ||||||||||||||||||||||||||
Medicare | 0.2 | 157 | 1,168.40 | 133 | 989.33 | 84.7 | 24 | ||||||||||||||||||||||||||
Total Medicare | 0.3 | 524 | 1,751.49 | 446 | 1,488.85 | 85.0 | 78 | ||||||||||||||||||||||||||
Total Medicaid and Medicare | 11.2 | 3,966 | 358.23 | 3,536 | 319.37 | 89.2 | 430 | ||||||||||||||||||||||||||
Marketplace | 1.2 | 548 | 440.93 | 314 | 253.04 | 57.4 | 234 | ||||||||||||||||||||||||||
12.4 | $ | 4,514 | $ | 366.57 | $ | 3,850 | $ | 312.68 | 85.3 | % | $ | 664 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR (2) |
Medical |
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Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
TANF and CHIP | 7.6 | $ | 1,391 | $ | 182.47 | $ | 1,315 | $ | 172.48 | 94.5 | % | $ | 76 | ||||||||||||||||||||
Medicaid Expansion | 2.1 | 786 | 383.07 | 689 | 335.26 | 87.5 | 97 | ||||||||||||||||||||||||||
ABD | 1.2 | 1,285 | 1,053.89 | 1,245 | 1,020.85 | 96.9 | 40 | ||||||||||||||||||||||||||
Total Medicaid | 10.9 | 3,462 | 317.79 | 3,249 | 298.10 | 93.8 | 213 | ||||||||||||||||||||||||||
MMP | 0.1 | 361 | 2,217.44 | 333 | 2,050.20 | 92.5 | 28 | ||||||||||||||||||||||||||
Medicare | 0.2 | 148 | 1,126.14 | 126 | 963.34 | 85.5 | 22 | ||||||||||||||||||||||||||
Total Medicare | 0.3 | 509 | 1,730.91 | 459 | 1,565.65 | 90.5 | 50 | ||||||||||||||||||||||||||
Total Medicaid and Medicare | 11.2 | 3,971 | 354.87 | 3,708 | 331.36 | 93.4 | 263 | ||||||||||||||||||||||||||
Marketplace | 2.8 | 769 | 267.37 | 783 | 272.37 | 101.9 | (14 | ) | |||||||||||||||||||||||||
14.0 | $ | 4,740 | $ | 336.98 | $ | 4,491 | $ | 319.29 | 94.8 | % | $ | 249 |
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(1) | A member month is defined as the aggregate of each month’s ending membership for the period presented. | |
(2) | The MCR represents medical costs as a percentage of premium revenue. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA (In millions, except percentages and per-member per-month amounts) |
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Six Months Ended June 30, 2018 | ||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
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Total | PMPM | Total | PMPM | |||||||||||||||||||||||||||||
TANF and CHIP | 14.9 | $ | 2,766 | $ | 185.66 | $ | 2,477 | $ | 166.32 | 89.6 | % | $ | 289 | |||||||||||||||||||
Medicaid Expansion | 4.1 | 1,513 | 372.39 | 1,317 | 324.19 | 87.1 | 196 | |||||||||||||||||||||||||
ABD | 2.5 | 2,542 | 1,023.83 | 2,364 | 951.99 | 93.0 | 178 | |||||||||||||||||||||||||
Total Medicaid | 21.5 | 6,821 | 318.11 | 6,158 | 287.22 | 90.3 | 663 | |||||||||||||||||||||||||
MMP | 0.3 | 724 | 2,180.86 | 618 | 1,858.87 | 85.2 | 106 | |||||||||||||||||||||||||
Medicare | 0.3 | 314 | 1,178.58 | 264 | 992.05 | 84.2 | 50 | |||||||||||||||||||||||||
Total Medicare | 0.6 | 1,038 | 1,735.05 | 882 | 1,473.30 | 84.9 | 156 | |||||||||||||||||||||||||
Total Medicaid and Medicare | 22.1 | 7,859 | 356.59 | 7,040 | 319.43 | 89.6 | 819 | |||||||||||||||||||||||||
Marketplace | 2.6 | 978 | 373.67 | 532 | 203.34 | 54.4 | 446 | |||||||||||||||||||||||||
24.7 | $ | 8,837 | $ | 358.40 | $ | 7,572 | $ | 307.11 | 85.7 | % | $ | 1,265 | ||||||||||||||||||||
Six Months Ended June 30, 2017 | ||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
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Total | PMPM | Total | PMPM | |||||||||||||||||||||||||||||
TANF and CHIP | 15.3 | $ | 2,793 | $ | 182.58 | $ | 2,619 | $ | 171.25 | 93.8 | % | $ | 174 | |||||||||||||||||||
Medicaid Expansion | 4.1 | 1,603 | 390.88 | 1,378 | 335.88 | 85.9 | 225 | |||||||||||||||||||||||||
ABD | 2.4 | 2,481 | 1,030.68 | 2,375 | 986.54 | 95.7 | 106 | |||||||||||||||||||||||||
Total Medicaid | 21.8 | 6,877 | 315.39 | 6,372 | 292.22 | 92.7 | 505 | |||||||||||||||||||||||||
MMP | 0.3 | 705 | 2,152.75 | 640 | 1,954.15 | 90.8 | 65 | |||||||||||||||||||||||||
Medicare | 0.3 | 286 | 1,097.36 | 243 | 933.20 | 85.0 | 43 | |||||||||||||||||||||||||
Total Medicare | 0.6 | 991 | 1,685.72 | 883 | 1,502.36 | 89.1 | 108 | |||||||||||||||||||||||||
Total Medicaid and Medicare | 22.4 | 7,868 | 351.35 | 7,255 | 323.98 | 92.2 | 613 | |||||||||||||||||||||||||
Marketplace | 5.7 | 1,520 | 264.77 | 1,347 | 234.62 | 88.6 | 173 | |||||||||||||||||||||||||
28.1 | $ | 9,388 | $ | 333.68 | $ | 8,602 | $ | 305.74 | 91.6 | % | $ | 786 | ||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA— MEDICAID AND MEDICARE (In millions, except percentages and per-member per-month amounts) |
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Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 1.8 | $ | 517 | $ | 289.80 | $ | 441 | $ | 247.36 | 85.4 | % | $ | 76 | ||||||||||||||||||||
Florida | 1.2 | 377 | 353.81 | 362 | 339.31 | 95.9 | 15 | ||||||||||||||||||||||||||
Illinois | 0.6 | 203 | 311.60 | 170 | 261.59 | 84.0 | 33 | ||||||||||||||||||||||||||
Michigan | 1.2 | 388 | 342.45 | 331 | 292.20 | 85.3 | 57 | ||||||||||||||||||||||||||
New Mexico | 0.7 | 313 | 469.88 | 290 | 435.36 | 92.7 | 23 | ||||||||||||||||||||||||||
Ohio | 1.0 | 535 | 571.08 | 482 | 514.57 | 90.1 | 53 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 184 | 188.26 | 165 | 168.20 | 89.3 | 19 | ||||||||||||||||||||||||||
South Carolina | 0.4 | 123 | 350.22 | 107 | 304.20 | 86.9 | 16 | ||||||||||||||||||||||||||
Texas | 0.7 | 576 | 835.66 | 510 | 740.55 | 88.6 | 66 | ||||||||||||||||||||||||||
Washington | 2.2 | 571 | 252.61 | 526 | 232.49 | 92.0 | 45 | ||||||||||||||||||||||||||
Other (1) | 0.5 | 179 | 322.99 | 152 | 274.59 | 85.0 | 27 | ||||||||||||||||||||||||||
11.2 | $ | 3,966 | $ | 358.23 | $ | 3,536 | $ | 319.37 | 89.2 | % | $ | 430 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member
|
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 1.9 | $ | 598 | $ | 318.89 | $ | 539 | $ | 287.36 | 90.1 | % | $ | 59 | ||||||||||||||||||||
Florida | 1.1 | 380 | 347.20 | 370 | 337.92 | 97.3 | 10 | ||||||||||||||||||||||||||
Illinois | 0.5 | 149 | 289.51 | 174 | 336.76 | 116.3 | (25 | ) | |||||||||||||||||||||||||
Michigan | 1.1 | 390 | 333.26 | 358 | 305.40 | 91.6 | 32 | ||||||||||||||||||||||||||
New Mexico | 0.8 | 321 | 443.13 | 311 | 428.58 | 96.7 | 10 | ||||||||||||||||||||||||||
Ohio | 1.0 | 529 | 536.90 | 489 | 496.41 | 92.5 | 40 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 179 | 184.28 | 189 | 194.42 | 105.5 | (10 | ) | |||||||||||||||||||||||||
South Carolina | 0.4 | 111 | 326.57 | 102 | 304.14 | 93.1 | 9 | ||||||||||||||||||||||||||
Texas | 0.7 | 524 | 752.01 | 473 | 679.43 | 90.3 | 51 | ||||||||||||||||||||||||||
Washington | 2.2 | 618 | 276.90 | 546 | 244.58 | 88.3 | 72 | ||||||||||||||||||||||||||
Other (1) | 0.6 | 172 | 294.15 | 157 | 268.91 | 91.4 | 15 | ||||||||||||||||||||||||||
11.2 | $ | 3,971 | $ | 354.87 | $ | 3,708 | $ | 331.36 | 93.4 | % | $ | 263 |
__________________ |
||
(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA— MEDICAID AND MEDICARE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 3.6 | $ | 1,011 | $ | 281.14 | $ | 853 | $ | 237.26 | 84.4 | % | $ | 158 | ||||||||||||||||||||
Florida | 2.2 | 759 | 352.68 | 707 | 328.26 | 93.1 | 52 | ||||||||||||||||||||||||||
Illinois | 1.1 | 344 | 305.94 | 292 | 259.87 | 84.9 | 52 | ||||||||||||||||||||||||||
Michigan | 2.3 | 764 | 339.56 | 662 | 294.19 | 86.6 | 102 | ||||||||||||||||||||||||||
New Mexico | 1.4 | 632 | 468.00 | 600 | 444.44 | 95.0 | 32 | ||||||||||||||||||||||||||
Ohio | 1.9 | 1,086 | 573.87 | 942 | 497.75 | 86.7 | 144 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 370 | 190.68 | 339 | 174.74 | 91.6 | 31 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 245 | 349.15 | 211 | 300.87 | 86.2 | 34 | ||||||||||||||||||||||||||
Texas | 1.4 | 1,138 | 822.72 | 1,029 | 744.05 | 90.4 | 109 | ||||||||||||||||||||||||||
Washington | 4.5 | 1,155 | 254.64 | 1,100 | 242.48 | 95.2 | 55 | ||||||||||||||||||||||||||
Other | 1.1 | 355 | 318.94 | 305 | 273.97 | 85.9 | 50 | ||||||||||||||||||||||||||
22.1 | $ | 7,859 | $ | 356.59 | $ | 7,040 | $ | 319.43 | 89.6 | % | $ | 819 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 3.7 | $ | 1,170 | $ | 313.76 | $ | 1,023 | $ | 274.42 | 87.5 | % | $ | 147 | ||||||||||||||||||||
Florida | 2.2 | 744 | 343.29 | 722 | 333.23 | 97.1 | 22 | ||||||||||||||||||||||||||
Illinois | 1.1 | 310 | 282.66 | 354 | 322.63 | 114.1 | (44 | ) | |||||||||||||||||||||||||
Michigan | 2.3 | 772 | 330.34 | 690 | 295.02 | 89.3 | 82 | ||||||||||||||||||||||||||
New Mexico | 1.5 | 629 | 432.98 | 610 | 419.65 | 96.9 | 19 | ||||||||||||||||||||||||||
Ohio | 2.0 | 1,049 | 532.35 | 951 | 482.73 | 90.7 | 98 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 362 | 185.40 | 354 | 181.24 | 97.8 | 8 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 216 | 321.85 | 200 | 298.79 | 92.8 | 16 | ||||||||||||||||||||||||||
Texas | 1.4 | 1,051 | 751.94 | 962 | 687.96 | 91.5 | 89 | ||||||||||||||||||||||||||
Washington | 4.4 | 1,223 | 275.05 | 1,081 | 243.18 | 88.4 | 142 | ||||||||||||||||||||||||||
Other | 1.2 | 342 | 291.93 | 308 | 262.97 | 90.1 | 34 | ||||||||||||||||||||||||||
22.4 | $ | 7,868 | $ | 351.35 | $ | 7,255 | $ | 323.98 | 92.2 | % | $ | 613 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.2 | $ | 73 | $ | 426.16 | $ | 21 | $ | 117.92 | 27.7 | % | $ | 52 | ||||||||||||||||||||
Florida | 0.1 | 100 | 698.31 | 38 | 269.86 | 38.6 | 62 | ||||||||||||||||||||||||||
Michigan | — | 15 | 288.67 | 7 | 146.97 | 50.9 | 8 | ||||||||||||||||||||||||||
New Mexico | — | 31 | 418.82 | 18 | 247.06 | 59.0 | 13 | ||||||||||||||||||||||||||
Ohio | — | 31 | 518.64 | 23 | 381.46 | 73.6 | 8 | ||||||||||||||||||||||||||
Texas | 0.7 | 222 | 330.12 | 160 | 238.72 | 72.3 | 62 | ||||||||||||||||||||||||||
Washington | 0.2 | 56 | 787.80 | 41 | 572.48 | 72.7 | 15 | ||||||||||||||||||||||||||
Other (1) | — | 20 | NM | 6 | NM | NM | 14 | ||||||||||||||||||||||||||
1.2 | $ | 548 | $ | 440.93 | $ | 314 | $ | 253.04 | 57.4 | % | $ | 234 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.5 | $ | 81 | $ | 186.90 | $ | 67 | $ | 154.23 | 82.5 | % | $ | 14 | ||||||||||||||||||||
Florida | 0.9 | 269 | 284.60 | 317 | 336.78 | 118.3 | (48 | ) | |||||||||||||||||||||||||
Michigan | 0.1 | 16 | 204.15 | 10 | 135.89 | 66.6 | 6 | ||||||||||||||||||||||||||
New Mexico | — | 31 | 367.98 | 23 | 266.91 | 72.5 | 8 | ||||||||||||||||||||||||||
Ohio | — | 24 | 377.94 | 27 | 404.20 | 106.9 | (3 | ) | |||||||||||||||||||||||||
Texas | 0.7 | 177 | 247.49 | 129 | 180.92 | 73.1 | 48 | ||||||||||||||||||||||||||
Washington | 0.2 | 44 | 317.42 | 49 | 359.87 | 113.4 | (5 | ) | |||||||||||||||||||||||||
Other (1) | 0.4 | 127 | 304.00 | 161 | 383.02 | 126.0 | (34 | ) | |||||||||||||||||||||||||
2.8 | $ | 769 | $ | 267.37 | $ | 783 | $ | 272.37 | 101.9 | % | $ | (14 | ) |
__________________ |
||
(1) | “Other” includes the Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. We terminated Marketplace operations at these plans effective January 1, 2018, so the ratios for 2018 periods are not meaningful (NM). | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—MARKETPLACE (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.4 | $ | 122 | $ | 334.47 | $ | 52 | $ | 141.73 | 42.4 | % | $ | 70 | ||||||||||||||||||||
Florida | 0.3 | 145 | 468.36 | 22 | 73.13 | 15.6 | 123 | ||||||||||||||||||||||||||
Michigan | 0.1 | 28 | 254.69 | 16 | 145.49 | 57.1 | 12 | ||||||||||||||||||||||||||
New Mexico | 0.1 | 65 | 429.19 | 37 | 246.77 | 57.5 | 28 | ||||||||||||||||||||||||||
Ohio | 0.1 | 57 | 458.48 | 40 | 319.53 | 69.7 | 17 | ||||||||||||||||||||||||||
Texas | 1.4 | 451 | 318.93 | 306 | 216.83 | 68.0 | 145 | ||||||||||||||||||||||||||
Washington | 0.2 | 95 | 653.89 | 71 | 486.90 | 74.5 | 24 | ||||||||||||||||||||||||||
Other | — | 15 | NM | (12 | ) | NM | NM | 27 | |||||||||||||||||||||||||
2.6 | $ | 978 | $ | 373.67 | $ | 532 | $ | 203.34 | 54.4 | % | $ | 446 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 0.9 | $ | 153 | $ | 185.68 | $ | 93 | $ | 112.20 | 60.4 | % | $ | 60 | ||||||||||||||||||||
Florida | 1.9 | 561 | 288.81 | 523 | 269.48 | 93.3 | 38 | ||||||||||||||||||||||||||
Michigan | 0.2 | 27 | 177.12 | 17 | 116.21 | 65.6 | 10 | ||||||||||||||||||||||||||
New Mexico | 0.1 | 53 | 317.10 | 42 | 249.90 | 78.8 | 11 | ||||||||||||||||||||||||||
Ohio | 0.1 | 45 | 356.20 | 44 | 339.26 | 95.2 | 1 | ||||||||||||||||||||||||||
Texas | 1.4 | 334 | 235.07 | 242 | 171.07 | 72.8 | 92 | ||||||||||||||||||||||||||
Washington | 0.3 | 81 | 310.26 | 95 | 362.78 | 116.9 | (14 | ) | |||||||||||||||||||||||||
Other | 0.8 | 266 | 313.77 | 291 | 342.88 | 109.3 | (25 | ) | |||||||||||||||||||||||||
5.7 | $ | 1,520 | $ | 264.77 | $ | 1,347 | $ | 234.62 | 88.6 | % | $ | 173 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL (In millions, except percentages and per-member per-month amounts) |
|||||||||||||||||||||||||||||||||
Three Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 2.0 | $ | 590 | $ | 301.73 | $ | 462 | $ | 236.04 | 78.2 | % | $ | 128 | ||||||||||||||||||||
Florida | 1.3 | 477 | 394.38 | 400 | 331.13 | 84.0 | 77 | ||||||||||||||||||||||||||
Illinois | 0.6 | 203 | 311.60 | 170 | 261.59 | 84.0 | 33 | ||||||||||||||||||||||||||
Michigan | 1.2 | 403 | 340.08 | 338 | 285.78 | 84.0 | 65 | ||||||||||||||||||||||||||
New Mexico | 0.7 | 344 | 464.90 | 308 | 416.99 | 89.7 | 36 | ||||||||||||||||||||||||||
Ohio | 1.0 | 566 | 567.96 | 505 | 506.66 | 89.2 | 61 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 184 | 188.26 | 165 | 168.20 | 89.3 | 19 | ||||||||||||||||||||||||||
South Carolina | 0.4 | 123 | 350.22 | 107 | 304.20 | 86.9 | 16 | ||||||||||||||||||||||||||
Texas | 1.4 | 798 | 585.50 | 670 | 492.23 | 84.1 | 128 | ||||||||||||||||||||||||||
Washington | 2.4 | 627 | 268.84 | 567 | 242.80 | 90.3 | 60 | ||||||||||||||||||||||||||
Other (1) | 0.5 | 199 | 360.90 | 158 | 285.65 | 79.1 | 41 | ||||||||||||||||||||||||||
12.4 | $ | 4,514 | $ | 366.57 | $ | 3,850 | $ | 312.68 | 85.3 | % | $ | 664 | |||||||||||||||||||||
Three Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 2.4 | $ | 679 | $ | 294.09 | $ | 606 | $ | 262.34 | 89.2 | % | $ | 73 | ||||||||||||||||||||
Florida | 2.0 | 649 | 318.21 | 687 | 337.39 | 106.0 | (38 | ) | |||||||||||||||||||||||||
Illinois | 0.5 | 149 | 289.51 | 174 | 336.76 | 116.3 | (25 | ) | |||||||||||||||||||||||||
Michigan | 1.2 | 406 | 325.38 | 368 | 295.06 | 90.7 | 38 | ||||||||||||||||||||||||||
New Mexico | 0.8 | 352 | 435.34 | 334 | 411.83 | 94.6 | 18 | ||||||||||||||||||||||||||
Ohio | 1.0 | 553 | 527.14 | 516 | 490.75 | 93.1 | 37 | ||||||||||||||||||||||||||
Puerto Rico | 0.9 | 179 | 184.28 | 189 | 194.42 | 105.5 | (10 | ) | |||||||||||||||||||||||||
South Carolina | 0.4 | 111 | 326.57 | 102 | 304.14 | 93.1 | 9 | ||||||||||||||||||||||||||
Texas | 1.4 | 701 | 495.93 | 602 | 426.41 | 86.0 | 99 | ||||||||||||||||||||||||||
Washington | 2.4 | 662 | 279.21 | 595 | 251.16 | 90.0 | 67 | ||||||||||||||||||||||||||
Other (1) | 1.0 | 299 | 298.29 | 318 | 316.89 | 106.2 | (19 | ) | |||||||||||||||||||||||||
14.0 | $ | 4,740 | $ | 336.98 | $ | 4,491 | $ | 319.29 | 94.8 | % | $ | 249 |
__________________ |
||
(1) | “Other” includes the Idaho, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results. | |
MOLINA HEALTHCARE, INC. UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA—TOTAL (In millions, except percentages and per-member per-month amounts) |
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Six Months Ended June 30, 2018 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 4.0 | $ | 1,133 | $ | 286.07 | $ | 905 | $ | 228.44 | 79.9 | % | $ | 228 | ||||||||||||||||||||
Florida | 2.5 | 904 | 367.18 | 729 | 296.29 | 80.7 | 175 | ||||||||||||||||||||||||||
Illinois | 1.1 | 344 | 305.94 | 292 | 259.87 | 84.9 | 52 | ||||||||||||||||||||||||||
Michigan | 2.4 | 792 | 335.59 | 678 | 287.23 | 85.6 | 114 | ||||||||||||||||||||||||||
New Mexico | 1.5 | 697 | 464.11 | 637 | 424.58 | 91.5 | 60 | ||||||||||||||||||||||||||
Ohio | 2.0 | 1,143 | 566.77 | 982 | 486.79 | 85.9 | 161 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 370 | 190.68 | 339 | 174.74 | 91.6 | 31 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 245 | 349.15 | 211 | 300.87 | 86.2 | 34 | ||||||||||||||||||||||||||
Texas | 2.8 | 1,589 | 567.95 | 1,335 | 477.43 | 84.1 | 254 | ||||||||||||||||||||||||||
Washington | 4.7 | 1,250 | 267.01 | 1,171 | 250.05 | 93.6 | 79 | ||||||||||||||||||||||||||
Other | 1.1 | 370 | 333.35 | 293 | 263.24 | 79.0 | 77 | ||||||||||||||||||||||||||
24.7 | $ | 8,837 | $ | 358.40 | $ | 7,572 | $ | 307.11 | 85.7 | % | $ | 1,265 | |||||||||||||||||||||
Six Months Ended June 30, 2017 | |||||||||||||||||||||||||||||||||
Member |
Premium Revenue | Medical Care Costs | MCR |
Medical |
|||||||||||||||||||||||||||||
Total | PMPM | Total | PMPM | ||||||||||||||||||||||||||||||
California | 4.6 | $ | 1,323 | $ | 290.56 | $ | 1,116 | $ | 245.02 | 84.3 | % | $ | 207 | ||||||||||||||||||||
Florida | 4.1 | 1,305 | 317.53 | 1,245 | 303.09 | 95.5 | 60 | ||||||||||||||||||||||||||
Illinois | 1.1 | 310 | 282.66 | 354 | 322.63 | 114.1 | (44 | ) | |||||||||||||||||||||||||
Michigan | 2.5 | 799 | 321.10 | 707 | 284.24 | 88.5 | 92 | ||||||||||||||||||||||||||
New Mexico | 1.6 | 682 | 421.11 | 652 | 402.27 | 95.5 | 30 | ||||||||||||||||||||||||||
Ohio | 2.1 | 1,094 | 521.57 | 995 | 473.95 | 90.9 | 99 | ||||||||||||||||||||||||||
Puerto Rico | 1.9 | 362 | 185.40 | 354 | 181.24 | 97.8 | 8 | ||||||||||||||||||||||||||
South Carolina | 0.7 | 216 | 321.85 | 200 | 298.79 | 92.8 | 16 | ||||||||||||||||||||||||||
Texas | 2.8 | 1,385 | 491.46 | 1,204 | 427.48 | 87.0 | 181 | ||||||||||||||||||||||||||
Washington | 4.7 | 1,304 | 276.99 | 1,176 | 249.79 | 90.2 | 128 | ||||||||||||||||||||||||||
Other | 2.0 | 608 | 301.11 | 599 | 296.58 | 98.5 | 9 | ||||||||||||||||||||||||||
28.1 | $ | 9,388 | $ | 333.68 | $ | 8,602 | $ | 305.74 | 91.6 | % | $ | 786 | |||||||||||||||||||||
MOLINA HEALTHCARE, INC. |
|||||||||||||||||||||||||
The following tables provide the details of our medical care costs for the periods indicated: |
|||||||||||||||||||||||||
Three Months Ended June 30, | |||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Amount | PMPM |
% of |
Amount | PMPM |
% of |
||||||||||||||||||||
Fee for service | $ | 2,861 | $ | 232.40 | 74.4 | % | $ | 3,348 | $ | 238.04 | 74.5 | % | |||||||||||||
Pharmacy | 567 | 46.05 | 14.7 | 650 | 46.23 | 14.5 | |||||||||||||||||||
Capitation | 282 | 22.89 | 7.3 | 356 | 25.29 | 7.9 | |||||||||||||||||||
Other | 140 | 11.34 | 3.6 | 137 | 9.73 | 3.1 | |||||||||||||||||||
$ | 3,850 | $ | 312.68 | 100.0 | % | $ | 4,491 | $ | 319.29 | 100.0 | % | ||||||||||||||
Six Months Ended June 30, | |||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Amount | PMPM |
% of |
Amount | PMPM |
% of |
||||||||||||||||||||
Fee for service | $ | 5,606 | $ | 227.38 | 74.1 | % | $ | 6,434 | $ | 228.68 | 74.8 | % | |||||||||||||
Pharmacy | 1,150 | 46.66 | 15.2 | 1,266 | 45.00 | 14.7 | |||||||||||||||||||
Capitation | 594 | 24.09 | 7.8 | 680 | 24.17 | 7.9 | |||||||||||||||||||
Other | 222 | 8.98 | 2.9 | 222 | 7.89 | 2.6 | |||||||||||||||||||
$ | 7,572 | $ | 307.11 | 100.0 | % | $ | 8,602 | $ | 305.74 | 100.0 | % | ||||||||||||||
The following table provides the details of our medical claims and benefits payable as of the dates indicated: |
|||||||||||||||||||||||||
June 30, | December 31, | ||||||||||||||||||||||||
2018 | 2017 | ||||||||||||||||||||||||
Fee-for-service claims incurred but not paid (IBNP) | $ | 1,510 | $ | 1,717 | |||||||||||||||||||||
Pharmacy payable | 116 | 112 | |||||||||||||||||||||||
Capitation payable | 49 | 67 | |||||||||||||||||||||||
Other (1) | 245 | 296 | |||||||||||||||||||||||
$ | 1,920 | $ | 2,192 |
__________________ |
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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 operations. As of June 30, 2018 and December 31, 2017, we had recorded non-risk provider payables of approximately $158 million and $122 million, respectively. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE |
(Dollars in millions, except per-member amounts) |
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 was (more) less than the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
Six Months Ended June 30, |
Year Ended |
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2018 | 2017 | ||||||||||||||
Medical claims and benefits payable, beginning balance | $ | 2,192 | $ | 1,929 | $ | 1,929 | |||||||||
Components of medical care costs related to: | |||||||||||||||
Current period | 7,794 | 8,633 | 17,037 | ||||||||||||
Prior period (1) | (222 | ) | (31 | ) | 36 | ||||||||||
Total medical care costs | 7,572 | 8,602 | 17,073 | ||||||||||||
Change in non-risk provider payables | 56 | (114 | ) | (106 | ) | ||||||||||
Payments for medical care costs related to: | |||||||||||||||
Current period | 6,248 | 6,883 | 15,130 | ||||||||||||
Prior period | 1,652 | 1,457 | 1,574 | ||||||||||||
Total paid | 7,900 | 8,340 | 16,704 | ||||||||||||
Medical claims and benefits payable, ending balance | $ | 1,920 | $ | 2,077 | $ | 2,192 | |||||||||
Days in claims payable, fee for service (2) | 49 | 46 | 54 |
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(1) | Excludes the 2018 benefit of the 2017 Marketplace CSR reimbursement. | |
(2) | Claims payable includes primarily IBNP. It also includes certain fee-for-service payables reported in “Other” medical claims and benefits payable amounting to $33 million, $157 million and $99 million, as of June 30, 2018, 2017 and December 31, 2017, respectively. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED SUMMARY OF SIGNIFICANT ITEMS AFFECTING SECOND QUARTER AND |
YEAR-TO-DATE FINANCIAL RESULTS |
(In millions, except per diluted share amounts) |
The table below summarizes the impact of certain items significant to our financial performance in the periods presented. The individual items presented below increase (decrease) income before income tax expense.
Three Months Ended |
Six Months Ended |
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Amount |
Per |
Amount |
Per |
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Marketplace risk adjustment, for 2017 dates of service | $ | 79 | $ | 0.92 | $ | 56 | $ | 0.66 | ||||||||||||
Marketplace CSR subsidies, for 2017 dates of service | 6 | 0.07 | 76 | 0.90 | ||||||||||||||||
Restructuring costs | (8 | ) | (0.10 | ) | (33 | ) | (0.39 | ) | ||||||||||||
Loss on debt extinguishment | (5 | ) | (0.06 | ) | (15 | ) | (0.21 | ) | ||||||||||||
$ | 72 | $ | 0.83 | $ | 84 | $ | 0.96 |
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(1) | Except for certain items that are not deductible for tax purposes, per diluted share amounts are generally calculated at the statutory income tax rate of 22%. | |
MOLINA HEALTHCARE, INC. |
UNAUDITED NON-GAAP FINANCIAL MEASURES |
We use non-generally accepted accounting principles, or 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).
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||
Net income (loss) | $ | 202 | $ | (230 | ) | $ | 309 | $ | (153 | ) | ||||||||||
Adjustments: | ||||||||||||||||||||
Depreciation and amortization of intangible assets and capitalized software | 33 | 44 | 67 | 90 | ||||||||||||||||
Interest expense | 32 | 27 | 65 | 53 | ||||||||||||||||
Income tax expense (benefit) | 103 | (84 | ) | 175 | (30 | ) | ||||||||||||||
EBITDA | $ | 370 | $ | (243 | ) | $ | 616 | $ | (40 | ) | ||||||||||
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||||||||||||||||||||
2018 | 2017 | 2018 | 2017 | |||||||||||||||||||||||||||||||||||||
Amount |
Per |
Amount |
Per |
Amount |
Per |
Amount |
Per |
|||||||||||||||||||||||||||||||||
Net income (loss) | $ | 202 | $ | 3.02 | $ | (230 | ) | $ | (4.10 | ) | $ | 309 | $ | 4.68 | $ | (153 | ) | $ | (2.74 | ) | ||||||||||||||||||||
Adjustment: | ||||||||||||||||||||||||||||||||||||||||
Amortization of intangible assets | 5 | 0.08 | 8 | 0.14 | 10 | 0.16 | 17 | 0.30 | ||||||||||||||||||||||||||||||||
Income tax effect (1) | (1 | ) | (0.02 | ) | (3 | ) | (0.05 | ) | (2 | ) | (0.04 | ) | (6 | ) | (0.11 | ) | ||||||||||||||||||||||||
Amortization of intangible assets, net of tax effect | 4 | 0.06 | 5 | 0.09 | 8 | 0.12 | 11 | 0.19 | ||||||||||||||||||||||||||||||||
Adjusted net income (loss) | $ | 206 | $ | 3.08 | $ | (225 | ) | $ | (4.01 | ) | $ | 317 | $ | 4.80 | $ | (142 | ) | $ | (2.55 | ) |
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(1) | Income tax effect of adjustments calculated at the blended federal and state statutory tax rate of 22% and 37% for 2018 and 2017, respectively. | |
The following are descriptions of the adjustments made to GAAP measures used to calculate the non-GAAP measures used in this news release:
Earnings before interest, taxes, depreciation and amortization (EBITDA): Net income (loss) (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.
Adjusted net income: Net income (loss) (GAAP) less amortization of intangible assets, net of income tax effect calculated at the statutory tax rate. We believe that adjusted net income (loss) is 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 (loss) divided by weighted average common shares outstanding on a fully diluted basis.
MOLINA HEALTHCARE, INC. 2018 REVISED GUIDANCE |
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Reconciliation of Non-GAAP Financial Measures |
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(in millions, except per-share amounts) |
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Low End | High End | |||||||||||||||||||
Net income | $ | 471 | $ | 484 | ||||||||||||||||
Adjustments: | ||||||||||||||||||||
Depreciation, and amortization of intangible assets and capitalized software | 125 | 125 | ||||||||||||||||||
Interest expense | 115 | 115 | ||||||||||||||||||
Income tax expense | 257 | 261 | ||||||||||||||||||
EBITDA | $ | 968 | $ | 985 | ||||||||||||||||
Low End | High End | |||||||||||||||||||
Amount | Per share (2) | Amount |
Per share (2) |
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Net income | $ | 471 | $ | 7.15 | $ | 484 | $ | 7.35 | ||||||||||||
Adjustments: | ||||||||||||||||||||
Amortization of intangible assets | 21 | 0.32 | 21 | 0.32 | ||||||||||||||||
Income tax effect (1) | (5 | ) | (0.08 | ) | (5 | ) | (0.08 | ) | ||||||||||||
Amortization of intangible assets, net of tax effect | 16 | 0.24 | 16 | 0.24 | ||||||||||||||||
Adjusted net income | $ | 487 | $ | 7.39 | $ | 500 | $ | 7.59 |
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(1) | Income tax effect calculated at the statutory tax rate of 22%. | |
(2) |
Computation assumes 65.9 million diluted weighted average shares outstanding. |
View source version on businesswire.com: https://www.businesswire.com/news/home/20180731005924/en/
Molina Healthcare, Inc.
Ryan Kubota, 562-435-3666, ext. 119057
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