[July 27, 2016] |
|
Molina Healthcare Reports Second Quarter 2016 Results
Molina Healthcare, Inc. (NYSE: MOH):
-
Net income per diluted share for the quarter of $0.58.
-
Adjusted net income per diluted share for the quarter of $0.67.
-
Net income per diluted share for the quarter up 35% over first quarter
2016.
-
Adjusted net income per diluted share for the quarter up 31% over
first quarter 2016.
-
Total revenue for the quarter of $4.4 billion, up 24% over second
quarter 2015.
-
Aggregate membership up 26% over second quarter 2015.
Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results
for the second quarter of 2016.
"The results we have reported today reflect meaningful progress from the
first quarter of 2016," said J. Mario Molina, M.D., chief executive
officer of Molina Healthcare, Inc. "Last quarter, we identified specific
improvements that we needed to make to our operations. Today's
announcement demonstrates that we are making good headway with this
work. The issues we identified in Ohio and Texas in the first quarter
are substantially resolved, and work in Puerto Rico is well under way."
Update on Financial Performance
Second Quarter 2016 Compared With First Quarter 2016
Second quarter 2016 financial performance improved significantly when
compared with the first quarter of 2016. Earnings per diluted share
increased to $0.58 in the second quarter of 2016 from $0.43 in the first
quarter. Adjusted earnings per diluted share increased to $0.67 in the
second quarter of 2016 from $0.51 in the first quarter.
Higher profitability in the second quarter was primarily the result of
improvements at the Ohio and Texas health plans. The medical care ratio
of the Ohio health plan decreased to 89.7% in the second quarter of 2016
from 92.0% in the first quarter. The medical care ratio of the Texas
health plan decreased to 78.5% in the second quarter of 2016 from 92.8%
in the first quarter. Even without the benefit of out-of-period quality
revenue adjustments discussed below, the medical care ratio of the Texas
health plan would have been approximately 85.3% in the second quarter,
still well under the 92.8% medical care ratio reported in the first
quarter.
In total, out-of-period adjustments related to 2015 dates of service
were not significant to second quarter performance. Out-of-period
adjustments were significant, however, on a geographic and program
basis. Out-of-period adjustments were the result of changes in
accounting estimates made as new information became available to the
Company. The table below will help the reader to understand the
discussion that follows.
|
Summary of Significant Out-of-Period
Adjustments Affecting 2016 Financial Results
|
|
|
|
Three Months Ended
|
|
|
Six Months Ended
|
|
|
|
June 30, 2016
|
|
|
June 30, 2016
|
|
|
|
(In millions, except per diluted share amounts)
|
|
|
|
Amount
|
|
|
Per Diluted
Share
|
|
|
Amount
|
|
|
Per Diluted
Share
|
Marketplace adjustments for 2015 dates of service
|
|
|
$
|
(37
|
)
|
|
|
$
|
(0.42
|
)
|
|
|
$
|
(68
|
)
|
|
|
$
|
(0.76
|
)
|
Texas quality revenue adjustment for 2014/2015 dates of service
|
|
|
44
|
|
|
|
0.50
|
|
|
|
44
|
|
|
|
0.49
|
|
Texas quality revenue adjustment for 1Q 2016 dates of service
|
|
|
7
|
|
|
|
0.08
|
|
|
|
N/A
|
|
|
N/A
|
Puerto Rico premium revenue adjustment for 2015 dates of service
|
|
|
(11
|
)
|
|
|
(0.12
|
)
|
|
|
(11
|
)
|
|
|
(0.12
|
)
|
Florida premium revenue adjustment for 2014/2015 dates of service
|
|
|
-
|
|
|
|
-
|
|
|
|
18
|
|
|
|
0.20
|
|
Total out-of-period adjustments, net
|
|
|
$
|
3
|
|
|
|
$
|
0.04
|
|
|
|
$
|
(17
|
)
|
|
|
$
|
(0.19
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Out-of-period adjustments increased pretax income by approximately $3
million (or approximately $0.04 per diluted share) in the second quarter
of 2016. Specifically:
-
Adjustments related to 2015 dates of service reduced Marketplace
pretax income by approximately $37 million (or approximately $0.42 per
diluted share) in the second quarter. On June 30, 2016, the Centers
for Medicare and Medicaid Services released the final update on risk
adjustment and reinsurance payments for the 2015 benefit year, and we
adjusted our accruals accordingly.
-
During the second quarter, we were informed by the Texas Department of
Health and Human Services that it will not recoup any quality revenue
for calendar years 2014, 2015, and 2016. Therefore, we recognized
previously deferred quality revenue amounting to approximately $51
million (or approximately $0.58 per diluted share) in the second
quarter of 2016. Of the $51 million adjustment, $44 million related to
2015 and 2014 dates of service, and $7 million related to the first
quarter of 2016.
-
Reductions to revenue previously recorded for 2015 dates of service in
Puerto Rico decreased pretax income by approximately $11 million (or
approximately $0.12 per diluted share) in the second quarter.
Understanding the First Half of 2016
We reported pretax income of $144 million for the first half of 2016.
These results were affected by several out-of-period adjustments related
to dates of service in 2015 and 2014. In total, these adjustments
reduced pretax income in the first half of 2016 by approximately $17
million (or approximately $0.19 per diluted share). Specifically:
-
Adjustments related to 2015 dates of service reduced Marketplace
pretax income by approximately $68 million (or approximately $0.76 per
diluted share) in the first half of 2016. We now estimate that the
medical care ratio for our Marketplace program for all of 2015 was
approximately 80%. Through June 30, 2016, the medical care ratio of
our Marketplace program for months of service in the first half of
2016 alone (exclusive of out-of-period adjustments) was approximately
78%.
-
As described above, the recognition of Texas quality revenue
associated with calendar years 2014 and 2015 increased pretax income
in the first half of 2016 by approximately $44 million (or
approximately $0.49 per diluted share).
-
Also as noted above, reductions to 2015 premium revenue in Puerto Rico
reduced pretax income by approximately $11 million (or approximately
$0.12 per diluted share) in the first half of 2016.
-
Retroactive adjustments to premium revenue in Florida for dates of
service in 2014 and 2015 increased pretax income by approximately $18
million (or approximately $0.20 per diluted share) in the first half
of 2016. Prior to reporting first quarter 2016 results, we were
informed by the Florida Agency for Health Care Administration that we
were due a retroactive increase to Medicaid premium revenue relating
to dates of service prior to 2016. We reported this development in our
first quarter 2016 results.
Net Income per Share Guidance
Our net income per share guidance for fiscal year 2016 remains
unchanged. We expect the following factors, among others, to affect our
financial performance in the second half of 2016:
-
The ultimate savings to be realized from various cost savings
initiatives and the speed at which such savings will be realized.
-
Medicaid rate increases (excluding Medicaid Expansion) of
approximately 3.0% in California (effective July 1, 2016);
approximately 2.5% in Puerto Rico (effective July 1, 2016); and
approximately 3.0% in Texas (effective September 1, 2016). All rate
changes are consistent with our previous expectations.
-
Medicaid Expansion rate decreases of approximately 11.0% in California
(effective July 1, 2016) and approximately 2.0% in Ohio (effective
July 1, 2016). All rate changes are consistent with our previous
expectations.
-
The implementation of a medical care ratio floor of 86.0% for the
South Carolina Medicaid program effective July 1, 2016.
-
Declining margins for our Marketplace business during the second half
of 2016 due to normal membership attrition; the addition of higher
cost members through the special enrollment process; higher costs as
members reach the limits of the cost-sharing provisions of their
insurance coverage; and increasing utilization as members become more
engaged with our care networks. This is consistent with our previous
expectations.
Conference Call
Management will host a conference call and webcast to discuss Molina
Healthcare's second quarter results at 5:00 p.m. Eastern time on
Wednesday, July 27, 2016. The number to call for the interactive
teleconference is (212) 271-4651. A telephonic replay of the conference
call will be available from 7:00 p.m. Eastern time on Wednesday, July
27, 2016, through 6:00 p.m. Eastern Time on Thursday, July 28, 2016, by
dialing (800) 633-8284 and entering confirmation number 21812476. A live
audio broadcast of Molina Healthcare's conference call will be available
on our website, molinahealthcare.com.
A 30-day online replay will be available approximately an hour following
the conclusion of the live broadcast.
About Molina Healthcare
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed health
care services under the Medicaid and Medicare programs and through the
state insurance marketplaces. Through our locally operated health plans
in 11 states across the nation and in the Commonwealth of Puerto Rico,
Molina currently serves approximately 4.2 million members. Dr. C. David
Molina founded our company in 1980 as a provider organization serving
low-income families in Southern California. Today, we continue his
mission of providing high quality and cost-effective health care to
those who need it most. For more information about Molina Healthcare,
please visit our website at molinahealthcare.com.
Safe Harbor Statement under the Private Securities Litigation
Reform Act of 1995: This earnings release contains "forward-looking
statements" regarding our plans, expectations, and anticipated future
events. Actual results could differ materially due to numerous known and
unknown risks and uncertainties. Those known risks and uncertainties
include, but are not limited to, the following:
-
the success of our profit improvement and cost-cutting initiatives;
-
uncertainties and evolving market and provider economics associated
with the implementation of the Affordable Care Act (the "ACA"), the
Medicaid expansion, the insurance marketplaces, the effect of various
implementing regulations, and uncertainties regarding the
Medicare-Medicaid dual eligible demonstration programs in California,
Illinois, Michigan, Ohio, South Carolina, and Texas;
-
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;
-
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 designed to control costs;
-
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;
-
the interpretation and implementation of at-risk premium rules
regarding the achievement of certain quality measures, and our ability
to recognize revenue amounts associated therewith;
-
the interpretation and implementation of state contract performance
requirements regarding the achievement of certain quality measures,
and our ability to avoid liquidated damages 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 the Puerto Rico debt crisis, payment of all amounts due
under our Medicaid contract, the effect of the newly enacted PROMESA
law, and our efforts to better manage the health care costs of our
Puerto Rico health plan;
-
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
our Illinois health plan;
-
the accurate estimation of incurred but not reported or paid
medical costs across our health plans;
-
subsequent adjustments to reported premium revenue based upon
subsequent developments or new information, including changes to
estimated amounts due to or receivable from CMS under the ACA's "three
R's" marketplace premium stabilization programs;
-
efforts by states to recoup previously paid amounts, including our
dispute with the state of New Mexico related to reimbursement for
retroactively enrolled members in 2014;
-
the success of our efforts to retain existing government contracts
and to obtain new government contracts in connection with state
requests for proposals (RFPs) in both existing and new states;
-
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, and any fine, enrollment freeze, or
monitoring program 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 effect on our Los Angeles County subcontract of Centene
Corporation's acquisition of Health Net Inc.;
-
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;
-
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, including the Zika
virus, public catastrophes or terrorist attacks, and associated public
alarm;
-
changes in general economic conditions, including unemployment
rates;
-
the sufficiency of our funds on hand to pay the amounts due upon
conversion of our outstanding notes;
-
increasing competition and consolidation in the Medicaid industry;
and numerous other risk factors, including those discussed in our
periodic reports and filings with the Securities and Exchange
Commission. These reports can be accessed under the investor relations
tab of our website or on the SEC's website at sec.gov.
Given these risks and uncertainties, we can give no assurances that our
forward-looking statements will prove to be accurate, or that any other
results or events projected or contemplated by our forward-looking
statements will in fact occur, and we caution investors not to place
undue reliance on these statements. All forward-looking statements in
this release represent our judgment as of July 27, 2016, and we disclaim
any obligation to update any forward-looking statements to conform the
statement to actual results or changes in our expectations.
|
|
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30,
|
|
|
Six Months Ended June 30,
|
|
|
|
2016
|
|
|
2015
|
|
|
2016
|
|
|
2015
|
|
|
|
(Dollar amounts in millions, except net income per share)
|
Revenue:
|
|
|
|
|
|
|
|
|
|
|
|
|
Premium revenue
|
|
|
$
|
4,029
|
|
|
|
$
|
3,304
|
|
|
|
$
|
8,024
|
|
|
|
$
|
6,275
|
|
Service revenue
|
|
|
135
|
|
|
|
47
|
|
|
|
275
|
|
|
|
99
|
|
Premium tax revenue
|
|
|
109
|
|
|
|
95
|
|
|
|
218
|
|
|
|
190
|
|
Health insurer fee revenue
|
|
|
76
|
|
|
|
74
|
|
|
|
166
|
|
|
|
122
|
|
Investment income
|
|
|
8
|
|
|
|
4
|
|
|
|
16
|
|
|
|
7
|
|
Other revenue
|
|
|
2
|
|
|
|
1
|
|
|
|
3
|
|
|
|
3
|
|
Total revenue
|
|
|
4,359
|
|
|
|
3,525
|
|
|
|
8,702
|
|
|
|
6,696
|
|
Operating expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical care costs
|
|
|
3,594
|
|
|
|
2,929
|
|
|
|
7,182
|
|
|
|
5,565
|
|
Cost of service revenue
|
|
|
116
|
|
|
|
33
|
|
|
|
243
|
|
|
|
69
|
|
General and administrative expenses
|
|
|
351
|
|
|
|
287
|
|
|
|
691
|
|
|
|
543
|
|
Premium tax expenses
|
|
|
109
|
|
|
|
95
|
|
|
|
218
|
|
|
|
190
|
|
Health insurer fee expenses
|
|
|
50
|
|
|
|
40
|
|
|
|
108
|
|
|
|
81
|
|
Depreciation and amortization
|
|
|
34
|
|
|
|
25
|
|
|
|
66
|
|
|
|
50
|
|
Total operating expenses
|
|
|
4,254
|
|
|
|
3,409
|
|
|
|
8,508
|
|
|
|
6,498
|
|
Operating income
|
|
|
105
|
|
|
|
116
|
|
|
|
194
|
|
|
|
198
|
|
Interest expense
|
|
|
25
|
|
|
|
15
|
|
|
|
50
|
|
|
|
30
|
|
Income before income tax expense
|
|
|
80
|
|
|
|
101
|
|
|
|
144
|
|
|
|
168
|
|
Income tax expense
|
|
|
47
|
|
|
|
62
|
|
|
|
87
|
|
|
|
101
|
|
Net income
|
|
|
$
|
33
|
|
|
|
$
|
39
|
|
|
|
$
|
57
|
|
|
|
$
|
67
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted net income per share
|
|
|
$
|
0.58
|
|
|
|
$
|
0.72
|
|
|
|
$
|
1.01
|
|
|
|
$
|
1.29
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted weighted average shares outstanding
|
|
|
55.5
|
|
|
|
53.9
|
|
|
|
56.3
|
|
|
|
52.0
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Operating Statistics:
|
|
|
|
|
|
|
|
|
|
|
|
|
Medical care ratio (1)
|
|
|
89.2
|
%
|
|
|
88.7
|
%
|
|
|
89.5
|
%
|
|
|
88.7
|
%
|
General and administrative expense ratio (2)
|
|
|
8.1
|
%
|
|
|
8.1
|
%
|
|
|
7.9
|
%
|
|
|
8.1
|
%
|
Premium tax ratio (1)
|
|
|
2.6
|
%
|
|
|
2.8
|
%
|
|
|
2.6
|
%
|
|
|
2.9
|
%
|
Effective tax rate
|
|
|
59.8
|
%
|
|
|
61.3
|
%
|
|
|
60.7
|
%
|
|
|
60.1
|
%
|
Net profit margin (2)
|
|
|
0.7
|
%
|
|
|
1.1
|
%
|
|
|
0.7
|
%
|
|
|
1.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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) Computed as a percentage of total revenue.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED BALANCE SHEETS
|
|
|
|
|
|
|
|
|
|
|
June 30,
|
|
|
December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
(Unaudited)
|
|
|
|
|
|
|
(Amounts in millions, except per-share data)
|
ASSETS
|
Current assets:
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
|
$
|
2,345
|
|
|
|
$
|
2,329
|
|
Investments
|
|
|
1,968
|
|
|
|
1,801
|
|
Receivables
|
|
|
1,012
|
|
|
|
597
|
|
Income taxes refundable
|
|
|
23
|
|
|
|
13
|
|
Prepaid expenses and other current assets
|
|
|
197
|
|
|
|
192
|
|
Derivative asset
|
|
|
-
|
|
|
|
374
|
|
Total current assets
|
|
|
5,545
|
|
|
|
5,306
|
|
Property, equipment, and capitalized software, net
|
|
|
448
|
|
|
|
393
|
|
Deferred contract costs
|
|
|
80
|
|
|
|
81
|
|
Intangible assets, net
|
|
|
146
|
|
|
|
122
|
|
Goodwill
|
|
|
611
|
|
|
|
519
|
|
Restricted investments
|
|
|
107
|
|
|
|
109
|
|
Deferred income taxes
|
|
|
-
|
|
|
|
18
|
|
Derivative asset
|
|
|
226
|
|
|
|
-
|
|
Other assets
|
|
|
39
|
|
|
|
28
|
|
|
|
|
$
|
7,202
|
|
|
|
$
|
6,576
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS' EQUITY
|
Current liabilities:
|
|
|
|
|
|
|
Medical claims and benefits payable
|
|
|
$
|
1,766
|
|
|
|
$
|
1,685
|
|
Amounts due government agencies
|
|
|
1,238
|
|
|
|
729
|
|
Accounts payable and accrued liabilities
|
|
|
537
|
|
|
|
362
|
|
Deferred revenue
|
|
|
104
|
|
|
|
223
|
|
Current portion of long-term debt
|
|
|
1
|
|
|
|
449
|
|
Derivative liability
|
|
|
-
|
|
|
|
374
|
|
Total current liabilities
|
|
|
3,646
|
|
|
|
3,822
|
|
Senior notes
|
|
|
1,428
|
|
|
|
962
|
|
Lease financing obligations
|
|
|
198
|
|
|
|
198
|
|
Deferred income taxes
|
|
|
25
|
|
|
|
-
|
|
Derivative liability
|
|
|
226
|
|
|
|
-
|
|
Other long-term liabilities
|
|
|
38
|
|
|
|
37
|
|
Total liabilities
|
|
|
5,561
|
|
|
|
5,019
|
|
Stockholders' equity:
|
|
|
|
|
|
|
Common stock, $0.001 par value; 150 shares authorized; outstanding:
57 shares at June 30, 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
|
|
|
822
|
|
|
|
803
|
|
Accumulated other comprehensive gain (loss)
|
|
|
4
|
|
|
|
(4
|
)
|
Retained earnings
|
|
|
815
|
|
|
|
758
|
|
Total stockholders' equity
|
|
|
1,641
|
|
|
|
1,557
|
|
|
|
|
$
|
7,202
|
|
|
|
$
|
6,576
|
|
|
|
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30,
|
|
|
Six Months Ended June 30,
|
|
|
|
2016
|
|
|
2015
|
|
|
2016
|
|
|
2015
|
|
|
|
(Amounts in millions)
|
Operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
|
$
|
33
|
|
|
|
$
|
39
|
|
|
|
$
|
57
|
|
|
|
$
|
67
|
|
Adjustments to reconcile net income to net cash provided by
operating activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation and amortization
|
|
|
45
|
|
|
|
29
|
|
|
|
89
|
|
|
|
62
|
|
Deferred income taxes
|
|
|
9
|
|
|
|
6
|
|
|
|
39
|
|
|
|
7
|
|
Share-based compensation
|
|
|
9
|
|
|
|
3
|
|
|
|
16
|
|
|
|
9
|
|
Amortization of convertible senior notes and lease financing
obligations
|
|
|
7
|
|
|
|
8
|
|
|
|
15
|
|
|
|
15
|
|
Other, net
|
|
|
5
|
|
|
|
6
|
|
|
|
11
|
|
|
|
9
|
|
Changes in operating assets and liabilities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Receivables
|
|
|
(149
|
)
|
|
|
(140
|
)
|
|
|
(415
|
)
|
|
|
(35
|
)
|
Prepaid expenses and other assets
|
|
|
59
|
|
|
|
40
|
|
|
|
(143
|
)
|
|
|
(97
|
)
|
Medical claims and benefits payable
|
|
|
(173
|
)
|
|
|
44
|
|
|
|
82
|
|
|
|
292
|
|
Amounts due government agencies
|
|
|
328
|
|
|
|
203
|
|
|
|
509
|
|
|
|
298
|
|
Accounts payable and accrued liabilities
|
|
|
(58
|
)
|
|
|
(31
|
)
|
|
|
147
|
|
|
|
158
|
|
Deferred revenue
|
|
|
10
|
|
|
|
(112
|
)
|
|
|
(119
|
)
|
|
|
(138
|
)
|
Income taxes
|
|
|
14
|
|
|
|
(1
|
)
|
|
|
(10
|
)
|
|
|
1
|
|
Net cash provided by operating activities
|
|
|
139
|
|
|
|
94
|
|
|
|
278
|
|
|
|
648
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Investing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Purchases of investments
|
|
|
(363
|
)
|
|
|
(555
|
)
|
|
|
(974
|
)
|
|
|
(993
|
)
|
Proceeds from sales and maturities of investments
|
|
|
464
|
|
|
|
286
|
|
|
|
812
|
|
|
|
541
|
|
Purchases of property, equipment, and capitalized software
|
|
|
(56
|
)
|
|
|
(41
|
)
|
|
|
(102
|
)
|
|
|
(66
|
)
|
Change in restricted investments
|
|
|
9
|
|
|
|
(9
|
)
|
|
|
5
|
|
|
|
(14
|
)
|
Net cash paid in business combinations
|
|
|
(6
|
)
|
|
|
-
|
|
|
|
(8
|
)
|
|
|
(8
|
)
|
Other, net
|
|
|
(7
|
)
|
|
|
(10
|
)
|
|
|
(6
|
)
|
|
|
(17
|
)
|
Net cash provided by (used in) investing activities
|
|
|
41
|
|
|
|
(329
|
)
|
|
|
(273
|
)
|
|
|
(557
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Financing activities:
|
|
|
|
|
|
|
|
|
|
|
|
|
Proceeds from common stock offering, net of issuance costs
|
|
|
-
|
|
|
|
373
|
|
|
|
-
|
|
|
|
373
|
|
Proceeds from employee stock plans
|
|
|
10
|
|
|
|
7
|
|
|
|
10
|
|
|
|
8
|
|
Other, net
|
|
|
(1
|
)
|
|
|
(1
|
)
|
|
|
1
|
|
|
|
3
|
|
Net cash provided by financing activities
|
|
|
9
|
|
|
|
379
|
|
|
|
11
|
|
|
|
384
|
|
Net increase in cash and cash equivalents
|
|
|
189
|
|
|
|
144
|
|
|
|
16
|
|
|
|
475
|
|
Cash and cash equivalents at beginning of period
|
|
|
2,156
|
|
|
|
1,870
|
|
|
|
2,329
|
|
|
|
1,539
|
|
Cash and cash equivalents at end of period
|
|
|
$
|
2,345
|
|
|
|
$
|
2,014
|
|
|
|
$
|
2,345
|
|
|
|
$
|
2,014
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MOLINA HEALTHCARE, INC. UNAUDITED NON-GAAP FINANCIAL
MEASURES
We use two 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.
The first of these non-GAAP measures is earnings before interest, taxes,
depreciation and amortization (EBITDA). We believe that EBITDA is
particularly helpful in assessing our ability to meet the cash demands
of our operating units. The following table reconciles net income, which
we believe to be the most comparable GAAP measure, to EBITDA.
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30,
|
|
|
Six Months Ended June 30,
|
|
|
|
2016
|
|
|
2015
|
|
|
2016
|
|
|
2015
|
|
|
|
(Amounts in millions)
|
Net income
|
|
|
$
|
33
|
|
|
|
$
|
39
|
|
|
|
$
|
57
|
|
|
|
$
|
67
|
Adjustments:
|
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation, and amortization of intangible assets and capitalized
software
|
|
|
39
|
|
|
|
29
|
|
|
|
76
|
|
|
|
58
|
Interest expense
|
|
|
25
|
|
|
|
15
|
|
|
|
50
|
|
|
|
30
|
Income tax expense
|
|
|
47
|
|
|
|
62
|
|
|
|
87
|
|
|
|
101
|
EBITDA
|
|
|
$
|
144
|
|
|
|
$
|
145
|
|
|
|
$
|
270
|
|
|
|
$
|
256
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The second of these non-GAAP measures is adjusted net income (including
adjusted net income per diluted share). We believe that adjusted net
income per diluted share is very helpful in assessing our financial
performance exclusive of the non-cash impact of the amortization of
purchased intangibles. The following table reconciles net income, which
we believe to be the most comparable GAAP measure, to adjusted net
income.
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30,
|
|
|
Six Months Ended June 30,
|
|
|
2016
|
|
|
2015
|
|
|
2016
|
|
|
2015
|
|
|
|
(In millions, except per diluted share amounts)
|
|
|
|
Amount
|
|
|
Per share
|
|
|
Amount
|
|
|
Per share
|
|
|
Amount
|
|
|
Per share
|
|
|
Amount
|
|
|
Per share
|
Net income
|
|
|
$
|
33
|
|
|
|
$
|
0.58
|
|
|
|
$
|
39
|
|
|
|
$
|
0.72
|
|
|
|
$
|
57
|
|
|
|
$
|
1.01
|
|
|
|
$
|
67
|
|
|
|
$
|
1.29
|
Adjustment, net of tax:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Amortization of intangible assets
|
|
|
5
|
|
|
|
0.09
|
|
|
|
3
|
|
|
|
0.05
|
|
|
|
10
|
|
|
|
0.17
|
|
|
|
6
|
|
|
|
0.10
|
Adjusted net income
|
|
|
$
|
38
|
|
|
|
$
|
0.67
|
|
|
|
$
|
42
|
|
|
|
$
|
0.77
|
|
|
|
$
|
67
|
|
|
|
$
|
1.18
|
|
|
|
$
|
73
|
|
|
|
$
|
1.39
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED HEALTH PLANS SEGMENT MEMBERSHIP
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
June 30,
|
|
|
March 31,
|
|
|
December 31,
|
|
|
June 30,
|
|
|
|
2016
|
|
|
2016
|
|
|
2015
|
|
|
2015
|
Ending Membership by Health Plan:
|
|
|
|
|
|
|
|
|
|
|
|
|
California
|
|
|
680,000
|
|
|
|
676,000
|
|
|
|
620,000
|
|
|
|
593,000
|
Florida
|
|
|
565,000
|
|
|
|
576,000
|
|
|
|
440,000
|
|
|
|
348,000
|
Illinois
|
|
|
201,000
|
|
|
|
206,000
|
|
|
|
98,000
|
|
|
|
101,000
|
Michigan
|
|
|
393,000
|
|
|
|
399,000
|
|
|
|
328,000
|
|
|
|
260,000
|
New Mexico
|
|
|
251,000
|
|
|
|
246,000
|
|
|
|
231,000
|
|
|
|
225,000
|
Ohio
|
|
|
341,000
|
|
|
|
336,000
|
|
|
|
327,000
|
|
|
|
332,000
|
Puerto Rico
|
|
|
336,000
|
|
|
|
339,000
|
|
|
|
348,000
|
|
|
|
361,000
|
South Carolina
|
|
|
105,000
|
|
|
|
102,000
|
|
|
|
99,000
|
|
|
|
114,000
|
Texas
|
|
|
367,000
|
|
|
|
380,000
|
|
|
|
260,000
|
|
|
|
266,000
|
Utah
|
|
|
151,000
|
|
|
|
151,000
|
|
|
|
102,000
|
|
|
|
92,000
|
Washington
|
|
|
709,000
|
|
|
|
672,000
|
|
|
|
582,000
|
|
|
|
553,000
|
Wisconsin
|
|
|
134,000
|
|
|
|
137,000
|
|
|
|
98,000
|
|
|
|
107,000
|
|
|
|
4,233,000
|
|
|
|
4,220,000
|
|
|
|
3,533,000
|
|
|
|
3,352,000
|
Ending Membership by Program:
|
|
|
|
|
|
|
|
|
|
|
|
|
Temporary Assistance for Needy Families (TANF), CHIP(1)
|
|
|
2,500,000
|
|
|
|
2,485,000
|
|
|
|
2,312,000
|
|
|
|
2,180,000
|
Medicaid Expansion
|
|
|
654,000
|
|
|
|
632,000
|
|
|
|
557,000
|
|
|
|
475,000
|
Marketplace
|
|
|
597,000
|
|
|
|
630,000
|
|
|
|
205,000
|
|
|
|
261,000
|
Aged, Blind or Disabled (ABD)
|
|
|
387,000
|
|
|
|
380,000
|
|
|
|
366,000
|
|
|
|
353,000
|
Medicare-Medicaid Plan (MMP) - Integrated
|
|
|
51,000
|
|
|
|
50,000
|
|
|
|
51,000
|
|
|
|
39,000
|
Medicare Special Needs Plans
|
|
|
44,000
|
|
|
|
43,000
|
|
|
|
42,000
|
|
|
|
44,000
|
|
|
|
4,233,000
|
|
|
|
4,220,000
|
|
|
|
3,533,000
|
|
|
|
3,352,000
|
|
|
(1) CHIP stands for Children's Health Insurance Program.
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month
amounts)
|
|
|
|
|
|
|
|
Three Months Ended June 30, 2016
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
California
|
|
|
2.0
|
|
|
|
$
|
554
|
|
|
|
$
|
268.95
|
|
|
|
$
|
493
|
|
|
|
$
|
239.63
|
|
|
|
89.1
|
%
|
|
|
$
|
61
|
|
Florida
|
|
|
1.8
|
|
|
|
464
|
|
|
|
273.90
|
|
|
|
426
|
|
|
|
251.69
|
|
|
|
91.9
|
|
|
|
38
|
|
Illinois
|
|
|
0.6
|
|
|
|
154
|
|
|
|
256.17
|
|
|
|
137
|
|
|
|
227.71
|
|
|
|
88.9
|
|
|
|
17
|
|
Michigan
|
|
|
1.2
|
|
|
|
369
|
|
|
|
312.18
|
|
|
|
334
|
|
|
|
282.86
|
|
|
|
90.6
|
|
|
|
35
|
|
New Mexico
|
|
|
0.8
|
|
|
|
342
|
|
|
|
451.72
|
|
|
|
305
|
|
|
|
403.52
|
|
|
|
89.3
|
|
|
|
37
|
|
Ohio
|
|
|
1.0
|
|
|
|
483
|
|
|
|
473.91
|
|
|
|
433
|
|
|
|
424.87
|
|
|
|
89.7
|
|
|
|
50
|
|
Puerto Rico
|
|
|
1.0
|
|
|
|
170
|
|
|
|
169.04
|
|
|
|
175
|
|
|
|
173.49
|
|
|
|
102.6
|
|
|
|
(5
|
)
|
South Carolina
|
|
|
0.3
|
|
|
|
87
|
|
|
|
277.22
|
|
|
|
71
|
|
|
|
226.27
|
|
|
|
81.6
|
|
|
|
16
|
|
Texas
|
|
|
1.1
|
|
|
|
635
|
|
|
|
571.14
|
|
|
|
499
|
|
|
|
448.23
|
|
|
|
78.5
|
|
|
|
136
|
|
Utah
|
|
|
0.5
|
|
|
|
110
|
|
|
|
240.26
|
|
|
|
106
|
|
|
|
233.12
|
|
|
|
97.0
|
|
|
|
4
|
|
Washington
|
|
|
2.1
|
|
|
|
559
|
|
|
|
264.40
|
|
|
|
500
|
|
|
|
236.32
|
|
|
|
89.4
|
|
|
|
59
|
|
Wisconsin
|
|
|
0.4
|
|
|
|
99
|
|
|
|
244.88
|
|
|
|
96
|
|
|
|
235.88
|
|
|
|
96.3
|
|
|
|
3
|
|
Other(3)
|
|
|
-
|
|
|
|
3
|
|
|
|
-
|
|
|
|
19
|
|
|
|
-
|
|
|
|
-
|
|
|
|
(16
|
)
|
|
|
|
12.8
|
|
|
|
$
|
4,029
|
|
|
|
$
|
316.72
|
|
|
|
$
|
3,594
|
|
|
|
$
|
282.54
|
|
|
|
89.2
|
%
|
|
|
$
|
435
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30, 2015
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical Margin
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
California
|
|
|
1.7
|
|
|
|
$
|
503
|
|
|
|
$
|
285.14
|
|
|
|
$
|
459
|
|
|
|
$
|
259.85
|
|
|
|
91.1
|
%
|
|
|
$
|
44
|
|
Florida
|
|
|
1.1
|
|
|
|
257
|
|
|
|
244.35
|
|
|
|
217
|
|
|
|
205.97
|
|
|
|
84.3
|
|
|
|
40
|
|
Illinois
|
|
|
0.3
|
|
|
|
102
|
|
|
|
337.55
|
|
|
|
98
|
|
|
|
325.91
|
|
|
|
96.6
|
|
|
|
4
|
|
Michigan
|
|
|
0.8
|
|
|
|
237
|
|
|
|
307.27
|
|
|
|
200
|
|
|
|
258.67
|
|
|
|
84.2
|
|
|
|
37
|
|
New Mexico
|
|
|
0.7
|
|
|
|
322
|
|
|
|
466.46
|
|
|
|
276
|
|
|
|
400.27
|
|
|
|
85.8
|
|
|
|
46
|
|
Ohio
|
|
|
1.1
|
|
|
|
509
|
|
|
|
510.30
|
|
|
|
432
|
|
|
|
433.75
|
|
|
|
85.0
|
|
|
|
77
|
|
Puerto Rico
|
|
|
1.1
|
|
|
|
194
|
|
|
|
179.33
|
|
|
|
184
|
|
|
|
170.32
|
|
|
|
95.0
|
|
|
|
10
|
|
South Carolina
|
|
|
0.4
|
|
|
|
93
|
|
|
|
276.36
|
|
|
|
67
|
|
|
|
196.92
|
|
|
|
71.3
|
|
|
|
26
|
|
Texas
|
|
|
0.8
|
|
|
|
512
|
|
|
|
635.74
|
|
|
|
468
|
|
|
|
581.42
|
|
|
|
91.5
|
|
|
|
44
|
|
Utah
|
|
|
0.2
|
|
|
|
80
|
|
|
|
288.60
|
|
|
|
72
|
|
|
|
258.88
|
|
|
|
89.7
|
|
|
|
8
|
|
Washington
|
|
|
1.6
|
|
|
|
410
|
|
|
|
249.39
|
|
|
|
371
|
|
|
|
225.46
|
|
|
|
90.4
|
|
|
|
39
|
|
Wisconsin
|
|
|
0.3
|
|
|
|
75
|
|
|
|
233.15
|
|
|
|
56
|
|
|
|
175.62
|
|
|
|
75.3
|
|
|
|
19
|
|
Other(3)
|
|
|
-
|
|
|
|
10
|
|
|
|
-
|
|
|
|
29
|
|
|
|
-
|
|
|
|
-
|
|
|
|
(19
|
)
|
|
|
|
10.1
|
|
|
|
$
|
3,304
|
|
|
|
$
|
328.96
|
|
|
|
$
|
2,929
|
|
|
|
$
|
291.65
|
|
|
|
88.7
|
%
|
|
|
$
|
375
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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.
|
(3) "Other" medical care costs include primarily medically related
administrative costs at the parent company, and direct delivery
costs.
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month
amounts)
|
|
|
|
|
|
|
|
Six Months Ended June 30, 2016
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
California
|
|
|
4.0
|
|
|
|
$
|
1,095
|
|
|
|
$
|
271.14
|
|
|
|
$
|
962
|
|
|
|
$
|
238.30
|
|
|
|
87.9
|
%
|
|
|
$
|
133
|
|
Florida
|
|
|
3.4
|
|
|
|
953
|
|
|
|
284.53
|
|
|
|
839
|
|
|
|
250.58
|
|
|
|
88.1
|
|
|
|
114
|
|
Illinois
|
|
|
1.2
|
|
|
|
303
|
|
|
|
261.43
|
|
|
|
269
|
|
|
|
232.06
|
|
|
|
88.8
|
|
|
|
34
|
|
Michigan
|
|
|
2.4
|
|
|
|
756
|
|
|
|
316.18
|
|
|
|
681
|
|
|
|
285.13
|
|
|
|
90.2
|
|
|
|
75
|
|
New Mexico
|
|
|
1.5
|
|
|
|
678
|
|
|
|
450.62
|
|
|
|
601
|
|
|
|
399.17
|
|
|
|
88.6
|
|
|
|
77
|
|
Ohio
|
|
|
2.0
|
|
|
|
971
|
|
|
|
481.44
|
|
|
|
882
|
|
|
|
437.35
|
|
|
|
90.8
|
|
|
|
89
|
|
Puerto Rico
|
|
|
2.0
|
|
|
|
351
|
|
|
|
172.98
|
|
|
|
349
|
|
|
|
171.95
|
|
|
|
99.4
|
|
|
|
2
|
|
South Carolina
|
|
|
0.6
|
|
|
|
171
|
|
|
|
276.61
|
|
|
|
138
|
|
|
|
223.58
|
|
|
|
80.8
|
|
|
|
33
|
|
Texas
|
|
|
2.2
|
|
|
|
1,255
|
|
|
|
575.87
|
|
|
|
1,074
|
|
|
|
492.65
|
|
|
|
85.5
|
|
|
|
181
|
|
Utah
|
|
|
0.9
|
|
|
|
224
|
|
|
|
252.08
|
|
|
|
208
|
|
|
|
234.46
|
|
|
|
93.0
|
|
|
|
16
|
|
Washington
|
|
|
4.1
|
|
|
|
1,065
|
|
|
|
260.05
|
|
|
|
958
|
|
|
|
233.84
|
|
|
|
89.9
|
|
|
|
107
|
|
Wisconsin
|
|
|
0.8
|
|
|
|
196
|
|
|
|
247.57
|
|
|
|
188
|
|
|
|
236.92
|
|
|
|
95.7
|
|
|
|
8
|
|
Other(3)
|
|
|
-
|
|
|
|
6
|
|
|
|
-
|
|
|
|
33
|
|
|
|
-
|
|
|
|
-
|
|
|
|
(27
|
)
|
|
|
|
25.1
|
|
|
|
$
|
8,024
|
|
|
|
$
|
320.17
|
|
|
|
$
|
7,182
|
|
|
|
$
|
286.57
|
|
|
|
89.5
|
%
|
|
|
$
|
842
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Six Months Ended June 30, 2015
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical Margin
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
California
|
|
|
3.4
|
|
|
|
$
|
1,014
|
|
|
|
$
|
294.85
|
|
|
|
$
|
911
|
|
|
|
$
|
264.97
|
|
|
|
89.9
|
%
|
|
|
$
|
103
|
|
Florida
|
|
|
2.0
|
|
|
|
568
|
|
|
|
291.33
|
|
|
|
498
|
|
|
|
255.45
|
|
|
|
87.7
|
|
|
|
70
|
|
Illinois
|
|
|
0.6
|
|
|
|
206
|
|
|
|
339.72
|
|
|
|
188
|
|
|
|
309.66
|
|
|
|
91.2
|
|
|
|
18
|
|
Michigan
|
|
|
1.5
|
|
|
|
457
|
|
|
|
298.87
|
|
|
|
385
|
|
|
|
251.57
|
|
|
|
84.2
|
|
|
|
72
|
|
New Mexico
|
|
|
1.4
|
|
|
|
636
|
|
|
|
462.62
|
|
|
|
568
|
|
|
|
413.48
|
|
|
|
89.4
|
|
|
|
68
|
|
Ohio
|
|
|
2.1
|
|
|
|
1,024
|
|
|
|
498.96
|
|
|
|
845
|
|
|
|
412.05
|
|
|
|
82.6
|
|
|
|
179
|
|
Puerto Rico
|
|
|
1.1
|
|
|
|
194
|
|
|
|
179.33
|
|
|
|
184
|
|
|
|
170.32
|
|
|
|
95.0
|
|
|
|
10
|
|
South Carolina
|
|
|
0.7
|
|
|
|
184
|
|
|
|
271.35
|
|
|
|
141
|
|
|
|
206.88
|
|
|
|
76.2
|
|
|
|
43
|
|
Texas
|
|
|
1.6
|
|
|
|
894
|
|
|
|
565.45
|
|
|
|
820
|
|
|
|
518.60
|
|
|
|
91.7
|
|
|
|
74
|
|
Utah
|
|
|
0.5
|
|
|
|
157
|
|
|
|
289.42
|
|
|
|
146
|
|
|
|
268.72
|
|
|
|
92.8
|
|
|
|
11
|
|
Washington
|
|
|
3.2
|
|
|
|
786
|
|
|
|
245.22
|
|
|
|
723
|
|
|
|
225.47
|
|
|
|
91.9
|
|
|
|
63
|
|
Wisconsin
|
|
|
0.6
|
|
|
|
135
|
|
|
|
216.85
|
|
|
|
105
|
|
|
|
168.58
|
|
|
|
77.7
|
|
|
|
30
|
|
Other(3)
|
|
|
-
|
|
|
|
20
|
|
|
|
-
|
|
|
|
51
|
|
|
|
-
|
|
|
|
-
|
|
|
|
(31
|
)
|
|
|
|
18.7
|
|
|
|
$
|
6,275
|
|
|
|
$
|
336.21
|
|
|
|
$
|
5,565
|
|
|
|
$
|
298.18
|
|
|
|
88.7
|
%
|
|
|
$
|
710
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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.
|
(3) "Other" medical care costs include primarily medically related
administrative costs at the parent company, and direct delivery
costs.
|
|
|
|
|
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED HEALTH PLANS SEGMENT FINANCIAL DATA
(In millions, except percentages and per-member per-month
amounts)
|
|
|
|
|
|
|
|
Three Months Ended June 30, 2016
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical
Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
TANF and CHIP
|
|
|
7.5
|
|
|
|
$
|
1,302
|
|
|
|
$
|
173.57
|
|
|
|
$
|
1,202
|
|
|
|
$
|
160.26
|
|
|
|
92.3
|
%
|
|
|
$
|
100
|
|
Medicaid Expansion
|
|
|
1.9
|
|
|
|
742
|
|
|
|
378.19
|
|
|
|
634
|
|
|
|
323.56
|
|
|
|
85.6
|
|
|
|
108
|
|
Marketplace
|
|
|
1.8
|
|
|
|
373
|
|
|
|
206.88
|
|
|
|
323
|
|
|
|
178.79
|
|
|
|
86.4
|
|
|
|
50
|
|
ABD
|
|
|
1.2
|
|
|
|
1,168
|
|
|
|
991.38
|
|
|
|
1,038
|
|
|
|
881.80
|
|
|
|
88.9
|
|
|
|
130
|
|
MMP
|
|
|
0.2
|
|
|
|
315
|
|
|
|
2,093.29
|
|
|
|
270
|
|
|
|
1,792.78
|
|
|
|
85.6
|
|
|
|
45
|
|
Medicare
|
|
|
0.2
|
|
|
|
129
|
|
|
|
997.44
|
|
|
|
127
|
|
|
|
974.30
|
|
|
|
97.7
|
|
|
|
2
|
|
|
|
|
12.8
|
|
|
|
$
|
4,029
|
|
|
|
$
|
316.72
|
|
|
|
$
|
3,594
|
|
|
|
$
|
282.54
|
|
|
|
89.2
|
%
|
|
|
$
|
435
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended June 30, 2015
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical
Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
TANF and CHIP
|
|
|
6.5
|
|
|
|
$
|
1,169
|
|
|
|
$
|
178.38
|
|
|
|
$
|
1,063
|
|
|
|
$
|
162.24
|
|
|
|
91.0
|
%
|
|
|
$
|
106
|
|
Medicaid Expansion
|
|
|
1.4
|
|
|
|
582
|
|
|
|
419.67
|
|
|
|
474
|
|
|
|
341.67
|
|
|
|
81.4
|
|
|
|
108
|
|
Marketplace
|
|
|
0.8
|
|
|
|
161
|
|
|
|
204.22
|
|
|
|
90
|
|
|
|
113.21
|
|
|
|
55.4
|
|
|
|
71
|
|
ABD
|
|
|
1.1
|
|
|
|
1,053
|
|
|
|
984.99
|
|
|
|
947
|
|
|
|
885.84
|
|
|
|
89.9
|
|
|
|
106
|
|
MMP
|
|
|
0.1
|
|
|
|
198
|
|
|
|
1,784.30
|
|
|
|
214
|
|
|
|
1,934.40
|
|
|
|
108.4
|
|
|
|
(16
|
)
|
Medicare
|
|
|
0.2
|
|
|
|
141
|
|
|
|
1,059.90
|
|
|
|
141
|
|
|
|
1,062.71
|
|
|
|
100.3
|
|
|
|
-
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
10.1
|
|
|
|
$
|
3,304
|
|
|
|
$
|
328.96
|
|
|
|
$
|
2,929
|
|
|
|
$
|
291.65
|
|
|
|
88.7
|
%
|
|
|
$
|
375
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Six Months Ended June 30, 2016
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical
Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
TANF and CHIP
|
|
|
14.9
|
|
|
|
$
|
2,626
|
|
|
|
$
|
176.00
|
|
|
|
$
|
2,400
|
|
|
|
$
|
160.85
|
|
|
|
91.4
|
%
|
|
|
$
|
226
|
|
Medicaid Expansion
|
|
|
3.8
|
|
|
|
1,421
|
|
|
|
371.82
|
|
|
|
1,208
|
|
|
|
316.13
|
|
|
|
85.0
|
|
|
|
213
|
|
Marketplace
|
|
|
3.4
|
|
|
|
782
|
|
|
|
228.19
|
|
|
|
657
|
|
|
|
191.62
|
|
|
|
84.0
|
|
|
|
125
|
|
ABD
|
|
|
2.4
|
|
|
|
2,280
|
|
|
|
976.58
|
|
|
|
2,079
|
|
|
|
890.71
|
|
|
|
91.2
|
|
|
|
201
|
|
MMP
|
|
|
0.3
|
|
|
|
655
|
|
|
|
2,157.55
|
|
|
|
587
|
|
|
|
1,932.73
|
|
|
|
89.6
|
|
|
|
68
|
|
Medicare
|
|
|
0.3
|
|
|
|
260
|
|
|
|
1,013.04
|
|
|
|
251
|
|
|
|
977.35
|
|
|
|
96.5
|
|
|
|
9
|
|
|
|
|
25.1
|
|
|
|
$
|
8,024
|
|
|
|
$
|
320.17
|
|
|
|
$
|
7,182
|
|
|
|
$
|
286.57
|
|
|
|
89.5
|
%
|
|
|
$
|
842
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Six Months Ended June 30, 2015
|
|
|
|
Member
Months(1)
|
|
|
Premium Revenue
|
|
|
Medical Care Costs
|
|
|
MCR(2)
|
|
|
Medical
Margin
|
|
|
|
|
|
Total
|
|
|
PMPM
|
|
|
Total
|
|
|
PMPM
|
|
|
|
|
TANF and CHIP
|
|
|
12.0
|
|
|
|
$
|
2,141
|
|
|
|
$
|
177.93
|
|
|
|
$
|
1,960
|
|
|
|
$
|
162.89
|
|
|
|
91.6
|
%
|
|
|
$
|
181
|
|
Medicaid Expansion
|
|
|
2.7
|
|
|
|
1,089
|
|
|
|
409.29
|
|
|
|
867
|
|
|
|
325.84
|
|
|
|
79.6
|
|
|
|
222
|
|
Marketplace
|
|
|
1.4
|
|
|
|
355
|
|
|
|
258.66
|
|
|
|
246
|
|
|
|
179.15
|
|
|
|
69.3
|
|
|
|
109
|
|
ABD
|
|
|
2.1
|
|
|
|
1,993
|
|
|
|
940.23
|
|
|
|
1,810
|
|
|
|
853.56
|
|
|
|
90.8
|
|
|
|
183
|
|
MMP
|
|
|
0.2
|
|
|
|
423
|
|
|
|
1,986.04
|
|
|
|
413
|
|
|
|
1,942.20
|
|
|
|
97.8
|
|
|
|
10
|
|
Medicare
|
|
|
0.3
|
|
|
|
274
|
|
|
|
1,036.95
|
|
|
|
269
|
|
|
|
1,020.01
|
|
|
|
98.4
|
|
|
|
5
|
|
|
|
|
18.7
|
|
|
|
$
|
6,275
|
|
|
|
$
|
336.21
|
|
|
|
$
|
5,565
|
|
|
|
$
|
298.18
|
|
|
|
88.7
|
%
|
|
|
$
|
710
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(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)
|
|
|
The following tables provide the details of our medical care costs
for the periods indicated:
|
|
|
|
|
|
|
|
Three Months Ended June 30,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
Amount
|
|
|
PMPM
|
|
|
% of
Total
|
|
|
Amount
|
|
|
PMPM
|
|
|
% of
Total
|
Fee for service
|
|
|
$
|
2,620
|
|
|
|
$
|
206.01
|
|
|
|
72.9
|
%
|
|
|
$
|
2,103
|
|
|
|
$
|
209.34
|
|
|
|
71.8
|
%
|
Pharmacy
|
|
|
529
|
|
|
|
41.59
|
|
|
|
14.7
|
|
|
|
392
|
|
|
|
39.01
|
|
|
|
13.3
|
|
Capitation
|
|
|
304
|
|
|
|
23.87
|
|
|
|
8.5
|
|
|
|
248
|
|
|
|
24.72
|
|
|
|
8.5
|
|
Direct delivery
|
|
|
18
|
|
|
|
1.39
|
|
|
|
0.5
|
|
|
|
27
|
|
|
|
2.78
|
|
|
|
1.0
|
|
Other
|
|
|
123
|
|
|
|
9.68
|
|
|
|
3.4
|
|
|
|
159
|
|
|
|
15.80
|
|
|
|
5.4
|
|
|
|
|
$
|
3,594
|
|
|
|
$
|
282.54
|
|
|
|
100.0
|
%
|
|
|
$
|
2,929
|
|
|
|
$
|
291.65
|
|
|
|
100.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Six Months Ended June 30,
|
|
|
|
2016
|
|
|
2015
|
|
|
|
Amount
|
|
|
PMPM
|
|
|
% of
Total
|
|
|
Amount
|
|
|
PMPM
|
|
|
% of
Total
|
Fee for service
|
|
|
$
|
5,357
|
|
|
|
$
|
213.77
|
|
|
|
74.6
|
%
|
|
|
$
|
4,051
|
|
|
|
$
|
217.05
|
|
|
|
72.8
|
%
|
Pharmacy
|
|
|
1,054
|
|
|
|
42.05
|
|
|
|
14.7
|
|
|
|
743
|
|
|
|
39.81
|
|
|
|
13.4
|
|
Capitation
|
|
|
599
|
|
|
|
23.87
|
|
|
|
8.3
|
|
|
|
465
|
|
|
|
24.90
|
|
|
|
8.3
|
|
Direct delivery
|
|
|
34
|
|
|
|
1.36
|
|
|
|
0.5
|
|
|
|
54
|
|
|
|
2.93
|
|
|
|
1.0
|
|
Other
|
|
|
138
|
|
|
|
5.52
|
|
|
|
1.9
|
|
|
|
252
|
|
|
|
13.49
|
|
|
|
4.5
|
|
|
|
|
$
|
7,182
|
|
|
|
$
|
286.57
|
|
|
|
100.0
|
%
|
|
|
$
|
5,565
|
|
|
|
$
|
298.18
|
|
|
|
100.0
|
%
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The following table provides the details of our medical claims and
benefits payable as of the dates indicated:
|
|
|
|
|
|
|
|
|
|
June 30,
|
|
|
December 31,
|
|
|
|
2016
|
|
|
2015
|
Fee-for-service claims incurred but not paid (IBNP)
|
|
|
$
|
1,292
|
|
|
|
$
|
1,191
|
Pharmacy payable
|
|
|
103
|
|
|
|
88
|
Capitation payable
|
|
|
37
|
|
|
|
140
|
Other (1)
|
|
|
334
|
|
|
|
266
|
|
|
|
$
|
1,766
|
|
|
|
$
|
1,685
|
|
|
|
|
|
|
|
|
|
|
(1) "Other" medical claims and benefits payable include amounts
payable to certain providers for which we act as an intermediary
on behalf of various state agencies without assuming financial
risk. Such receipts and payments do not impact our consolidated
statements of income. As of June 30, 2016 and December 31, 2015,
we had recorded non-risk provider payables of approximately $191
million and $167 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 were more than the actual amount of the liability based on
information (principally the payment of claims) developed since that
liability was first reported. The following table presents the
components of the change in medical claims and benefits payable for the
periods indicated:
|
|
|
|
|
|
|
|
|
|
|
|
|
Year Ended
|
|
|
|
Six Months Ended June 30,
|
|
|
December 31,
|
|
|
|
2016
|
|
|
2015
|
|
|
2015
|
|
|
|
|
|
|
|
|
|
|
Medical claims and benefits payable, beginning balance
|
|
|
$
|
1,685
|
|
|
|
$
|
1,201
|
|
|
|
$
|
1,201
|
|
Components of medical care costs related to:
|
|
|
|
|
|
|
|
|
|
Current period
|
|
|
7,371
|
|
|
|
5,703
|
|
|
|
11,935
|
|
Prior period
|
|
|
(189
|
)
|
|
|
(138
|
)
|
|
|
(141
|
)
|
Total medical care costs
|
|
|
7,182
|
|
|
|
5,565
|
|
|
|
11,794
|
|
|
|
|
|
|
|
|
|
|
|
Change in non-risk provider payables
|
|
|
24
|
|
|
|
14
|
|
|
|
48
|
|
Payments for medical care costs related to:
|
|
|
|
|
|
|
|
|
|
Current period
|
|
|
5,885
|
|
|
|
4,449
|
|
|
|
10,448
|
|
Prior period
|
|
|
1,240
|
|
|
|
839
|
|
|
|
910
|
|
Total paid
|
|
|
7,125
|
|
|
|
5,288
|
|
|
|
11,358
|
|
Medical claims and benefits payable, ending balance
|
|
|
$
|
1,766
|
|
|
|
$
|
1,492
|
|
|
|
$
|
1,685
|
|
|
|
|
|
|
|
|
|
|
|
Benefit from prior period as a percentage of:
|
|
|
|
|
|
|
|
|
|
Balance at beginning of period
|
|
|
11.3
|
%
|
|
|
11.5
|
%
|
|
|
11.8
|
%
|
Premium revenue, trailing twelve months
|
|
|
1.3
|
%
|
|
|
1.2
|
%
|
|
|
1.1
|
%
|
Medical care costs, trailing twelve months
|
|
|
1.4
|
%
|
|
|
1.4
|
%
|
|
|
1.2
|
%
|
|
|
|
|
|
|
|
|
|
|
Fee-For-Service Claims Data:
|
|
|
|
|
|
|
|
|
|
Days in claims payable, fee for service
|
|
|
48
|
|
|
|
49
|
|
|
|
48
|
|
Number of members at end of period
|
|
|
4,233,000
|
|
|
|
3,352,000
|
|
|
|
3,533,000
|
|
Number of claims in inventory at end of period
|
|
|
530,900
|
|
|
|
463,200
|
|
|
|
380,800
|
|
Billed charges of claims in inventory at end of period
|
|
|
$
|
1,279
|
|
|
|
$
|
905
|
|
|
|
$
|
816
|
|
Claims in inventory per member at end of period
|
|
|
0.13
|
|
|
|
0.14
|
|
|
|
0.11
|
|
Billed charges of claims in inventory per member at end of period
|
|
|
$
|
302.06
|
|
|
|
$
|
269.93
|
|
|
|
$
|
230.91
|
|
Number of claims received during the period
|
|
|
26,279,000
|
|
|
|
18,679,000
|
|
|
|
40,173,300
|
|
Billed charges of claims received during the period
|
|
|
$
|
31,649
|
|
|
|
$
|
21,505
|
|
|
|
$
|
46,211
|
|
View source version on businesswire.com: http://www.businesswire.com/news/home/20160727006389/en/
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