- Net income per diluted share was $2.99
in the first quarter of 2019 compared with $1.64 in the first
quarter of 2018, which included a net benefit of $0.38 per diluted
share for non-run-rate items
- After-tax margin improved to 4.8% in
the first quarter of 2019 compared with 2.3% in the first quarter
of 2018
- Medical care ratio was 85.3% in the
first quarter, an improvement from 87.7% in the first quarter of
2018, excluding non-run-rate items in the first quarter of
2018
- Premium revenue was $4.0 billion in the
first quarter of 2019, a 9% decrease compared with the first
quarter of 2018, which was in line with the Company’s
expectations
- The Company raised full year 2019
earnings guidance to $10.50 - $11.00 from $9.25 - $9.75, which does
not include any future prior-period reserve development
Molina Healthcare, Inc. (NYSE: MOH) today reported financial
results for the first quarter of 2019 and raised full year 2019
guidance.
“These results are a testament to the achievability of the
second phase of our strategy, which is to sustain the attractive
margin position we had built in 2018,” said Joe Zubretsky,
president and CEO. “While certainly not conclusive, our first
quarter results validate our position that durable financial and
operational improvement can and should allow us to sustain these
margins, all while we begin to grow the top line again.”
Consolidated Results
First Quarter of 2019 Compared with First Quarter of
2018
Net income increased to $198 million from $107 million in the
first quarter of 2018. Net income per diluted share increased to
$2.99 from $1.64 in the first quarter of 2018.
Premium revenue decreased $371 million, or 9%, in the first
quarter of 2019 compared with the first quarter of 2018, as
expected. The decrease was primarily due to the previously
announced loss of the Company’s New Mexico Medicaid contract along
with the resizing of the Company’s Florida Medicaid contract and
the related transition out of all but two regions.
The medical care ratio (MCR) was 85.3% in the first quarter of
2019, an improvement compared with 86.1% in the first quarter of
2018. Excluding the $70 million benefit of the 2017 Marketplace
cost-sharing reduction (CSR) reimbursement recognized in first
quarter of 2018, the MCR would have been 87.7% in the first quarter
of 2018. The change in the overall MCR was due to:
- The Medicaid MCR was 88.5% in the first
quarter of 2019, an improvement compared with 90.8% in the first
quarter of 2018. This was mainly due to improvements in the
Temporary Assistance for Needy Families and Aged, Blind or Disabled
programs, partially offset by an increased MCR in the Medicaid
Expansion program, primarily in California and Ohio.
- The Marketplace MCR was 62.2% in the
first quarter of 2019, compared with 50.6% in the first quarter of
2018. The prior year MCR was positively impacted by the benefit of
the CSR, without which the Marketplace MCR would have been 66.8% in
the first quarter of 2018. The year-over-year improvement primarily
reflected increased premium revenue related to rate increases and
risk scores that are more commensurate with the acuity of the
Company’s Marketplace population.
The general and administrative (G&A) expense ratio was 7.3%
in the first quarter of 2019, an improvement compared with 7.6% in
the first quarter of 2018 primarily due to lower expenses and the
timing of certain expenditures, which were partially offset by the
impact associated with lower premium revenue.
Capital Plan Progress
In the first quarter of 2019, the Company repaid $46 million
aggregate principal amount of its 1.125% Convertible Notes and
entered into privately negotiated termination agreements to
terminate the respective portion of the related 1.125% Call Option
and 1.125% Warrants.
In April 2019, the Company repaid an additional $128 million
aggregate principal amount of its 1.125% Convertible Notes and
entered into privately negotiated termination agreements to
terminate the respective portion of the related 1.125% Call Option
and 1.125% Warrants. Following these transactions, the remaining
principal amount outstanding of the Company’s 1.125% Convertible
Notes is $78 million. In addition, the Company has received a
conversion notice for $7 million principal amount that will be
settled in August 2019.
2019 Revised Guidance
The following table summarizes 2019 Revised Guidance
(1):
2019 RevisedGuidance
2019 InitialGuidance
Premium revenue ~$15.9B ~$15.8B Premium
tax revenue ~$425M ~$375M Investment income and other
revenue ~$115M ~$195M
Total revenue ~$16.4B ~$16.3B
Medical care costs ~$13.6B ~$13.7B Medical
care ratio (2) ~86% 86.7% - 87.0%
General and administrative
expenses ~$1.3B ~$1.2B G&A ratio (3) ~7.7%
7.5% - 7.7% Premium tax expenses ~$425M ~$375M Depreciation and
amortization ~$90M ~$85M Interest expense and other expenses, net
~$90M ~$100M Income before income taxes $900M - $940M $790M - $840M
Net income $680M - $710M $600M - $630M
EBITDA (4) $1,080M - $1,120M $975M -
$1,025M Effective tax rate ~24.5% 24.5% - 25.0% After-tax
margin (3) 4.1% - 4.3% 3.7% - 3.9% Diluted weighted average shares
~64.7M ~64.7M Net income per share $10.50 - $11.00 $9.25 - $9.75
End-of-year membership by government program: Medicaid and Medicare
~3.1M ~3.2M Marketplace 270K - 280K 250K - 275K
__________________
(1) All amounts are estimates and do not include
non-recurring significant items. Earnings per diluted share as
shown is calculated on a GAAP basis; actual results may differ
materially. See the Company’s risk factors as discussed in its 2018
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. After-tax 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 first quarter 2019 results at 8:30 a.m. Eastern
time on Tuesday, April 30, 2019. The number to call for the
interactive teleconference is (877) 883-0383 and the confirmation
number is 4093086. A telephonic replay of the conference call will
be available through Tuesday, May 7, 2019, by dialing (877)
344-7529 and entering confirmation number 10130214. 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 3.4
million members as of March 31, 2019. 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 revised 2019 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 risks and uncertainties are discussed in the
section entitled “Risk Factors” in the Company’s Annual Report on
Form 10-K for the year ended December 31, 2018, and the
section entitled “Forward-Looking Statements” in the Company’s
Quarterly Report on Form 10-Q for the period ended March 31,
2019.
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 April 29, 2019, and, except as otherwise
required by law, 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
INCOME
Three Months Ended March 31,
2019 2018
(In millions, except
per-shareamounts)
Revenue: Premium revenue $ 3,952 $ 4,323 Premium tax revenue 138
104 Health insurer fees reimbursed — 61 Service revenue — 134
Investment income and other revenue 29 24
Total revenue 4,119 4,646
Operating expenses: Medical care costs 3,371 3,722 General and
administrative expenses 302 352 Premium tax expenses 138 104 Health
insurer fees — 75 Depreciation and amortization 25 26 Restructuring
costs 3 25 Cost of service revenue — 120
Total operating expenses 3,839 4,424
Operating income 280 222 Other
expenses, net: Interest expense 23 33 Other (income) expenses, net
(3 ) 10 Total other expenses, net 20
43 Income before income tax expense 260 179
Income tax expense 62 72 Net income $
198 $ 107 Net income per diluted share $ 2.99
$ 1.64 Diluted weighted average shares
outstanding 66.2 65.2
Operating Statistics: Medical care ratio 85.3 % 86.1 %
G&A ratio 7.3 % 7.6 % Premium tax ratio 3.4 % 2.3 % Effective
income tax expense rate 23.8 % 40.3 % After-tax margin 4.8 % 2.3 %
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED BALANCE
SHEETS
March 31, December
31, 2019 2018
(Dollars in millions,except
per-share amounts)
ASSETS Current assets: Cash and cash equivalents $ 3,224 $
2,826 Investments 1,508 1,681 Receivables 1,359 1,330 Prepaid
expenses and other current assets 124 149 Derivative asset
516 476 Total current assets 6,731 6,462
Property, equipment, and capitalized software, net 376 241 Goodwill
and intangible assets, net 185 190 Restricted investments 100 120
Deferred income taxes 76 117 Other assets 111
24 $ 7,579 $ 7,154
LIABILITIES AND
STOCKHOLDERS’ EQUITY Current liabilities: Medical claims and
benefits payable $ 1,995 $ 1,961 Amounts due government agencies
932 967 Accounts payable and accrued liabilities 444 390 Deferred
revenue 207 211 Current portion of long-term debt 198 241
Derivative liability 516 476 Total
current liabilities 4,292 4,246 Long-term debt 1,121 1,020 Finance
lease liabilities 234 197 Other long-term liabilities 97
44 Total liabilities 5,744
5,507 Stockholders’ equity: Common stock, $0.001 par
value, 150 million shares authorized; outstanding: 63 million
shares at March 31, 2019 and 62 million shares at December 31, 2018
— — Preferred stock, $0.001 par value; 20 million shares
authorized, no shares issued and outstanding — — Additional paid-in
capital 543 643 Accumulated other comprehensive loss (3 ) (8 )
Retained earnings 1,295 1,012 Total
stockholders’ equity 1,835 1,647 $
7,579 $ 7,154
MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED
STATEMENTS OF CASH FLOWS
Three Months Ended March 31,
2019 2018 (In millions)
Operating activities: Net income $ 198 $ 107 Adjustments to
reconcile net income to net cash provided by operating activities:
Depreciation and amortization 25 37 Deferred income taxes 15 (6 )
Share-based compensation 9 6 Amortization of convertible senior
notes and finance lease liabilities 3 7 (Gain) loss on debt
extinguishment (3 ) 10 Non-cash restructuring costs — 17 Other, net
3 2 Changes in operating assets and liabilities: Receivables (29 )
(83 ) Prepaid expenses and other current assets 20 (239 ) Medical
claims and benefits payable 34 (163 ) Amounts due government
agencies (35 ) 172 Accounts payable and accrued liabilities (30 )
319 Deferred revenue (4 ) 130 Income taxes 43
78 Net cash provided by operating activities 249
394 Investing activities: Purchases of
investments (185 ) (389 ) Proceeds from sales and maturities of
investments 366 543 Purchases of property, equipment, and
capitalized software (6 ) (4 ) Other, net (4 ) (5 )
Net cash provided by investing activities 171
145 Financing activities: Repayment of principal amount of
1.125% Convertible Notes (46 ) — Cash paid for partial settlement
of 1.125% Conversion Option (115 ) — Cash received for partial
termination of 1.125% Call Option 115 — Cash paid for partial
termination of 1.125% Warrants (103 ) — Proceeds from borrowings
under Term Loan 100 — Other, net 1 (5 ) Net
cash used in financing activities (48 ) (5 ) Net
increase in cash, cash equivalents, and restricted cash and cash
equivalents 372 534 Cash, cash equivalents, and restricted cash and
cash equivalents at beginning of period 2,926
3,290 Cash, cash equivalents, and restricted cash and cash
equivalents at end of period $ 3,298 $ 3,824
MOLINA HEALTHCARE, INC.
UNAUDITED HEALTH PLANS SEGMENT
MEMBERSHIP
March 31,2019
December 31,2018
March 31,2018
Ending Membership by Government Program: Temporary
Assistance for Needy Families (“TANF”) and Children’s Health
Insurance Program (“CHIP”) 2,016,000 2,295,000 2,435,000 Medicaid
Expansion 596,000 660,000 662,000 Aged, Blind or Disabled (“ABD”)
352,000 406,000 411,000 Total Medicaid 2,964,000 3,361,000
3,508,000 Medicare-Medicaid Plan (“MMP”) - Integrated 56,000 54,000
56,000 Medicare Special Needs Plans 41,000 44,000 44,000 Total
Medicare 97,000 98,000 100,000 Total Medicaid and Medicare
3,061,000 3,459,000 3,608,000 Marketplace 332,000 362,000 453,000
3,393,000 3,821,000 4,061,000
Ending Membership by Health
Plan: California 600,000 608,000 656,000 Florida (1) 144,000
313,000 414,000 Illinois 219,000 224,000 151,000 Michigan 369,000
383,000 388,000 New Mexico (1) 27,000 222,000 250,000 Ohio 295,000
302,000 328,000 Puerto Rico 207,000 252,000 316,000 South Carolina
126,000 120,000 117,000 Texas 377,000 423,000 476,000 Washington
815,000 781,000 779,000 Other (2) 214,000 193,000 186,000 3,393,000
3,821,000 4,061,000 __________________ (1) As reported
throughout 2018, the Company’s Medicaid contracts in New Mexico and
in all but two regions in Florida terminated in late 2018 and early
2019. During 2019, the Company continues to serve Medicare and
Marketplace members in both Florida and New Mexico, as well as
Medicaid members in two regions in Florida. (2) “Other” includes
the Idaho, Mississippi, New York, Utah and Wisconsin health plans,
which are not individually significant to the Company’s
consolidated operating results.
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT
FINANCIAL DATA—
BY GOVERNMENT PROGRAM
(In millions, except percentages and
per-member per-month amounts)
Three Months Ended March 31, 2019
MemberMonths (1)
Premium Revenue Medical Care
Costs MCR (2)
MedicalMargin
Total PMPM Total
PMPM TANF and CHIP 6.2 $ 1,173 $ 189.36 $ 1,022 $ 165.05
87.2 % $ 151 Medicaid Expansion 1.8 664 369.62 594 330.45 89.4 70
ABD 1.1 1,167 1,068.43 1,042 953.48 89.2 125
Total Medicaid 9.1 3,004 330.75 2,658 292.60 88.5
346 MMP 0.2 388 2,355.29 333 2,026.83 86.1 55 Medicare 0.1
163 1,284.70 133 1,047.78 81.6 30 Total
Medicare 0.3 551 1,889.47 466 1,600.84 84.7 85
Total Medicaid and Medicare 9.4 3,555 379.19 3,124
333.26 87.9 431 Marketplace 1.0 397 393.53 247
244.61 62.2 150 10.4 $ 3,952 $ 380.59 $ 3,371 $ 324.65 85.3
% $ 581
Three Months Ended March 31, 2018
MemberMonths
Premium Revenue Medical Care Costs MCR
MedicalMargin
Total PMPM Total PMPM TANF and CHIP 7.4
$ 1,373 $ 185.14 $ 1,272 $ 171.56 92.7 % $ 101 Medicaid Expansion
2.0 752 372.75 641 317.46 85.2 111 ABD 1.2 1,254 1,014.23
1,155 934.55 92.1 99 Total Medicaid 10.6 3,379
316.69 3,068 287.56 90.8 311 MMP 0.2 357 2,137.88 305
1,824.21 85.3 52 Medicare 0.1 157 1,188.97 131 994.81
83.7 26 Total Medicare 0.3 514 1,718.61 436
1,457.75 84.8 78 Total Medicaid and Medicare 10.9
3,893 354.94 3,504 319.48 90.0 389 Marketplace 1.4
430 312.87 218 158.40 50.6 212 12.3 $ 4,323 $
350.25 $ 3,722 $ 301.55 86.1 % $ 601 __________________ (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—
MEDICAID AND MEDICARE BY HEALTH
PLAN
(In millions, except percentages and
per-member per-month amounts)
Three Months Ended March 31, 2019
MemberMonths
Premium Revenue Medical Care
Costs MCR
MedicalMargin
Total PMPM Total
PMPM California 1.7 $ 499 $ 299.83 $ 448 $ 269.33 89.8 % $
51 Florida 0.4 162 387.48 127 303.05 78.2 35 Illinois 0.7 227
348.04 185 282.70 81.2 42 Michigan 1.1 395 363.04 326 299.99 82.6
69 Ohio 0.9 590 659.09 537 600.07 91.0 53 Puerto Rico 0.6 102
165.02 90 145.38 88.1 12 South Carolina 0.4 136 363.14 115 308.87
85.1 21 Texas 0.6 599 902.56 532 801.53 88.8 67 Washington 2.4 614
258.41 586 246.69 95.5 28 Other (1) (2) 0.6 231 370.26
178 285.13 77.0 53 9.4 $ 3,555 $ 379.19 $ 3,124 $
333.26 87.9 % $ 431
Three Months Ended March 31,
2018
MemberMonths
Premium Revenue Medical Care Costs MCR
MedicalMargin
Total PMPM Total PMPM California 1.8 $
494 $ 272.61 $ 412 $ 227.31 83.4 % $ 82 Florida 1.0 382 351.58 345
317.41 90.3 37 Illinois 0.5 141 298.17 122 257.50 86.4 19 Michigan
1.1 376 336.64 331 296.19 88.0 45 New Mexico (2) 0.7 319 466.17 310
453.30 97.2 9 Ohio 0.9 551 576.60 460 481.26 83.5 91 Puerto Rico
1.0 186 193.13 174 181.39 93.9 12 South Carolina 0.3 122 348.08 104
297.52 85.5 18 Texas 0.7 562 809.90 519 747.53 92.3 43 Washington
2.3 584 256.66 574 252.41 98.3 10 Other (1) 0.6 176 314.93
153 273.36 86.8 23 10.9 $ 3,893 $ 354.94 $ 3,504 $
319.48 90.0 % $ 389 __________________ (1) “Other” includes
the Idaho, Mississippi, New York, Utah and Wisconsin health plans,
which are not individually significant to the Company’s
consolidated operating results. (2) In 2019, “Other” includes the
New Mexico health plan. The New Mexico health plan’s Medicaid
contract terminated on December 31, 2018, and therefore its 2019
results are not individually significant to the Company’s
consolidated operating results.
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT
FINANCIAL DATA—
MARKETPLACE BY HEALTH PLAN
(In millions, except percentages and
per-member per-month amounts)
Three Months Ended March 31, 2019
MemberMonths
Premium Revenue Medical Care
Costs MCR
MedicalMargin
Total PMPM Total
PMPM California 0.1 $ 56 $ 342.00 $ 33 $ 201.46 58.9 % $ 23
Florida 0.2 61 421.17 26 177.31 42.1 35 Michigan — 10 467.25 5
211.50 45.3 5 Ohio — 30 853.87 15 448.51 52.5 15 Texas 0.6 148
306.36 109 226.36 73.9 39 Washington — 47 711.60 29 435.90 61.3 18
Other (1) 0.1 45 476.11 30 314.70 66.1
15 1.0 $ 397 $ 393.53 $ 247 $ 244.61 62.2 % $
150
Three Months Ended March 31, 2018
MemberMonths
Premium Revenue Medical Care Costs MCR
MedicalMargin
Total PMPM Total PMPM California 0.2 $
49 $ 253.93 $ 31 $ 162.64 64.0 % $ 18 Florida 0.2 45 271.12 (16 )
(95.60 ) (35.3 ) 61 Michigan 0.1 13 224.11 9 144.16 64.3 4 New
Mexico 0.1 34 438.67 19 246.50 56.2 15 Ohio 0.1 26 403.44 17 262.87
65.2 9 Texas 0.7 229 308.74 146 196.89 63.8 83 Washington — 39
526.36 30 405.40 77.0 9 Other (2) — (5 ) NM (18 ) NM
NM 13 1.4 $ 430 $ 312.87 $ 218 $ 158.40 50.6 %
$ 212 __________________ (1) “Other” includes the New
Mexico, Utah and Wisconsin health plans, which are not individually
significant to the Company’s consolidated operating results in
2019. (2) “Other” includes the Utah and Wisconsin health plans,
where the Company did not participate in the Marketplace in 2018.
Therefore, the ratios for 2018 periods are not meaningful (NM).
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT
FINANCIAL DATA—
TOTAL BY HEALTH PLAN
(In millions, except percentages and
per-member per-month amounts)
Three Months Ended March 31, 2019
MemberMonths
Premium Revenue Medical Care
Costs MCR
MedicalMargin
Total PMPM Total
PMPM California 1.8 $ 555 $ 303.64 $ 481 $ 263.20 86.7 % $
74 Florida 0.6 223 396.13 153 270.76 68.4 70 Illinois 0.7 227
348.04 185 282.70 81.2 42 Michigan 1.1 405 365.09 331 298.25 81.7
74 Ohio 0.9 620 666.41 552 594.38 89.2 68 Puerto Rico 0.6 102
165.02 90 145.38 88.1 12 South Carolina 0.4 136 363.14 115 308.87
85.1 21 Texas 1.2 747 651.67 641 559.49 85.9 106 Washington 2.4 661
270.72 615 251.83 93.0 46 Other (1) (2) 0.7 276 384.08
208 288.99 75.2 68 10.4 $ 3,952 $ 380.59 $ 3,371 $
324.65 85.3 % $ 581
Three Months Ended March 31,
2018
MemberMonths
Premium Revenue Medical Care Costs MCR
MedicalMargin
Total PMPM Total PMPM California 2.0 $
543 $ 270.80 $ 443 $ 221.03 81.6 % $ 100 Florida 1.2 427 340.91 329
262.65 77.0 98 Illinois 0.5 141 298.17 122 257.50 86.4 19 Michigan
1.2 389 331.08 340 288.68 87.2 49 New Mexico (2) 0.8 353 463.33 329
431.94 93.2 24 Ohio 1.0 577 565.62 477 467.41 82.6 100 Puerto Rico
1.0 186 193.13 174 181.39 93.9 12 South Carolina 0.3 122 348.08 104
297.52 85.5 18 Texas 1.4 791 551.28 665 463.37 84.1 126 Washington
2.3 623 265.20 604 257.25 97.0 19 Other (1) 0.6 171 305.94
135 240.95 78.8 36 12.3 $ 4,323 $ 350.25 $ 3,722 $
301.55 86.1 % $ 601 __________________ (1) “Other” includes
the Idaho, Mississippi, New York, Utah and Wisconsin health plans,
which are not individually significant to the Company’s
consolidated operating results. (2) In 2019, “Other” includes the
New Mexico health plan. The New Mexico health plan’s Medicaid
contract terminated on December 31, 2018, and therefore its 2019
results are not individually significant to the Company’s
consolidated operating results.
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL
DATA
(In millions, except percentages and
per-member per-month amounts)
The following table provides details of
the Company’s medical care costs for the periods indicated:
Three Months Ended March 31,
2019 2018 Amount
PMPM
% ofTotal
Amount PMPM
% ofTotal
Fee for service $ 2,514 $ 242.12 74.6 % $ 2,745 $ 222.38 73.8 %
Pharmacy 413 39.73 12.2 583 47.25 15.6 Capitation 285 27.46 8.5 312
25.28 8.4 Other 159 15.34 4.7 82
6.64 2.2 $ 3,371 $ 324.65 100.0 % $ 3,722 $ 301.55
100.0 %
The following table provides details of
the Company’s medical claims and benefits payable as of the dates
indicated:
March 31, December 31, 2019 2018
Fee-for-service claims incurred but not paid (IBNP) $ 1,411 $ 1,562
Pharmacy payable 114 115 Capitation payable 59 52 Other (1)
411 232 $ 1,995 $ 1,961 __________________ (1)
“Other” medical claims and benefits payable include amounts
payable to certain providers for which the Company acts as an
intermediary on behalf of various state agencies without assuming
financial risk. Such receipts and payments do not impact the
Company’s consolidated statements of income. As of March 31, 2019
and December 31, 2018, the Company had recorded non-risk provider
payables of approximately $278 million and $107 million,
respectively.
MOLINA HEALTHCARE, INC.UNAUDITED
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE(Dollars in
millions)
The Company’s 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. The Company’s reserving methodology
is consistently applied across all periods presented. The amounts
displayed for “Components of medical care costs related to: Prior
period” represent the amount by which its original estimate of
claims and benefits payable at the beginning of the period was more
than the actual amount of the liability based on information
(principally the payment of claims) developed since that liability
was first reported. The following table presents the components of
the change in medical claims and benefits payable for the periods
indicated:
Three Months Ended March 31,
Year EndedDecember
31,2018
2019 2018 Medical claims and benefits
payable, beginning balance $ 1,961 $ 2,192 $ 2,192 Components of
medical care costs related to: Current period 3,560 4,033 15,478
Prior period (1) (189 ) (311 ) (341 ) Total
medical care costs 3,371 3,722
15,137 Change in non-risk provider payables
171 45 13 Payments for medical
care costs related to: Current period 2,197 2,498 13,671 Prior
period 1,311 1,438 1,710
Total paid 3,508 3,936 15,381
Medical claims and benefits payable, ending balance $ 1,995
$ 2,023 $ 1,961 Days in claims payable,
fee for service (2) 52 53 53 __________________ (1) March
31, 2018, includes the 2018 benefit of the 2017 Marketplace CSR
reimbursement of $70 million. December 31, 2018, includes the 2018
benefit of the 2017 Marketplace CSR reimbursement of $81 million.
(2) Claims payable includes primarily IBNP. It also includes
certain fee-for-service payables reported in “Other” medical claims
and benefits payable amounting to $51 million, $22 million and $43
million, as of March 31, 2019, March 31, 2018, and December 31,
2018, respectively.
MOLINA HEALTHCARE, INC.UNAUDITED
SUMMARY OF SIGNIFICANT ITEMS AFFECTING CURRENT QUARTER
ANDYEAR-TO-DATE FINANCIAL RESULTS(In millions, except
per diluted share amounts)
The table below summarizes the impact of certain items
significant to the Company’s financial performance in the periods
presented. The individual items presented below increase (decrease)
income before income tax expense.
Three Months Ended March 31, 2019
2018 Amount
Per DilutedShare
(1)
Amount
Per DilutedShare
(1)
Marketplace CSR subsidies, for 2017 dates of service $ — $ —
$ 70 $ 0.83 Restructuring costs (3 ) (0.03 ) (25 ) (0.30 ) Gain
(loss) on debt extinguishment 3 0.03
(10 ) (0.15 ) $ — $ — $ 35 $
0.38 __________________ (1) Except for
permanent differences between GAAP and tax (such as certain
expenses that are not deductible for tax purposes), per diluted
share amounts are generally calculated at the statutory income tax
rate of 22.6% and 22% for the first quarter of 2019 and 2018,
respectively.
MOLINA HEALTHCARE, INC.UNAUDITED
NON-GAAP FINANCIAL MEASURES(In millions, except per diluted
share amounts)
The Company uses non-generally accepted accounting principles,
or non-GAAP, financial measures as supplemental metrics in
evaluating the Company’s financial performance, making financing
and business decisions, and forecasting and planning for future
periods. For these reasons, management believes such measures are
useful supplemental measures to investors in comparing the
Company’s performance to the performance of other public companies
in the health care industry. These non-GAAP financial measures
should be considered as supplements to, and not as substitutes for
or superior to, GAAP measures. See further information regarding
non-GAAP measures below the tables.
Three Months Ended March 31, 2019
2018 Net income $ 198 $ 107
Adjustments: Depreciation, and amortization of intangible assets
and capitalized software 25 34 Interest expense 23 33 Income tax
expense 62 72 EBITDA $ 308 $ 246
Three Months Ended March 31,
2019 2018 Amount
Per DilutedShare
Amount
Per DilutedShare
Net income $ 198 $ 2.99 $ 107 $ 1.64 Adjustment: Amortization of
intangible assets 5 0.07 5 0.08 Income tax effect (1) (1 )
(0.02 ) (1 ) (0.01 ) Amortization of
intangible assets, net of tax effect 4 0.05
4 0.07 Adjusted net income $ 202
$ 3.04 $ 111 $ 1.71
__________________ (1) Income tax effect of adjustments
calculated at the blended federal and state statutory tax rate of
22.6% and 22% for 2019 and 2018, 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 on a GAAP basis less
depreciation, and amortization of intangible assets and capitalized
software, interest expense and income tax expense. The Company
believes that EBITDA is helpful in assessing the Company’s ability
to meet the cash demands of its operating units.
Adjusted net income: Net income on a GAAP basis less
amortization of intangible assets, net of income tax effect
calculated at the statutory tax rate. The Company believes that
adjusted net income is helpful in assessing the Company’s 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.
MOLINA HEALTHCARE, INC.
2019 REVISED GUIDANCE
Reconciliation of
Non-GAAP Financial Measures
Low End High End
(In millions) Net income $ 680 $ 710 Adjustments:
Depreciation, and amortization of intangible assets and capitalized
software 90 90 Interest expense 90 90 Income tax expense 220
230 EBITDA $ 1,080 $ 1,120
View source
version on businesswire.com: https://www.businesswire.com/news/home/20190429005776/en/
Ryan KubotaInvestor Relations562-435-3666, ext. 119057
Molina Healthcare (NYSE:MOH)
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