Molina Healthcare Reports First Quarter 2020 Financial Results
Reaffirms 2020 Earnings Guidance
|
Three Months Ended |
||||
2020 |
|
2019 |
|||
(In millions, except per share results) |
|||||
Premium Revenue |
|
|
|
|
|
Total Revenue |
|
|
|
|
|
Pre-Tax Income |
|
|
|
|
|
Net Income |
|
|
|
|
|
GAAP EPS – Diluted |
|
|
|
|
|
MCR |
86.3 |
% |
|
85.3 |
% |
G&A Ratio |
7.0 |
% |
|
7.3 |
% |
Effective Tax Rate |
29.8 |
% |
|
23.8 |
% |
After-Tax Margin |
3.9 |
% |
|
4.8 |
% |
Quarter Highlights:
- Premium revenue was
$4.3 billion for the first quarter of 2020, an 8.9% increase compared to the first quarter of 2019. - Medical care ratio (MCR) was 86.3% for the first quarter of 2020, compared to 85.3% for the first quarter of 2019.
- General and administrative (G&A) expense ratio decreased to 7.0% for the first quarter of 2020, compared to 7.3% for the first quarter of 2019.
- After-tax margin was 3.9% for the first quarter of 2020, compared to 4.8% for the first quarter of 2019.
- Net income was
$178 million for the first quarter of 2020, compared to$198 million for first quarter of 2019. - Operating cash flows for the first quarter of 2020 were
$136 million . - The Company reaffirmed its full year 2020 earnings guidance range of
$11.20 to$11.70 per diluted share.
“During this unprecedented time, our team has worked tirelessly to ensure that the needs of all of our constituencies continue to be addressed quickly and effectively,” said
Acquisition of Magellan Complete Care
On
Quarterly Performance Review
Premium Revenue
Premium revenue for the first quarter of 2020 increased 8.9% to
Medical Care Ratio
The consolidated MCR for the first quarter of 2020 increased to 86.3%, compared to 85.3% for the first quarter of 2019, reflecting an increase in the Marketplace MCR.
The prior period reserve development in the first quarter of 2020 was negligible. The first quarter of 2019 was positively impacted by approximately 140 basis points of favorable reserve development, primarily in the Medicaid line of business.
Given the timing of the COVID-19 outbreak and related progression, the impact of COVID-19 on the MCR was limited in the quarter.
The Company experienced medical cost pressure in the Medicaid line of business early in the quarter resulting from slightly higher than normal seasonal flu combined with early, but largely undetected COVID-19 costs diagnosed as severe respiratory illness and pneumonia. These increased costs were offset by abating medical care costs in all lines of business very late in the quarter, as elective and discretionary healthcare services began to be postponed and deferred.
MCR by line of business:
- Medicaid MCR: increased to 88.9%, compared to 88.5% for the first quarter of 2019. The prior year was positively impacted by the aforementioned favorable reserve development.
- Medicare MCR: decreased to 81.7%, compared to 84.7% for the first quarter of 2019, due to rate increases and increases in quality incentive premium revenues.
- Marketplace MCR: increased to 72.3%, compared to 62.2% for the first quarter of 2019, which is in line with expectations and reflects the lower prices the Company put into the market in 2020.
General and Administrative Expense Ratio
General and administrative expenses decreased to 7.0% of total revenues for the first quarter of 2020 due to higher revenues, compared to 7.3% for the first quarter of 2019. The current quarter also reflects incremental expense associated with the mobilization of the Company’s workforce to work at home and other new operational protocols related to COVID-19.
Balance Sheet
Cash and investments at the parent company amounted to
The Company completed its
Cash Flow
Operating cash flows for the first quarter of 2020 amounted to
Guidance
The Company reaffirmed its full year 2020 earnings guidance range of
- The impact of lower yields on investment income.
- Incremental general and administrative expenses related to COVID-19.
Full year 2020 guidance does not include:
- Membership increases related to the impact of COVID-19 on unemployment. While Medicaid and Marketplace enrollment is likely to increase due to widespread unemployment, the timing and number of potential enrollees are not certain and, therefore, are excluded from full year 2020 guidance.
- Impact of COVID-19 on net medical cost. Due to the uncertainty of COVID-19’s impact on utilization and medical costs, its impact on net medical cost is excluded from full year 2020 guidance.
- Previously announced acquisitions that have not yet closed.
While the timing, duration, and severity of COVID-19’s impact on the Company’s financial metrics and earnings on an intra-quarter basis and throughout the rest of the year are not entirely predictable, the Company is reaffirming the following full year 2020 guidance:
Full Year 2020 Guidance |
|||
Total Revenue |
|
|
|
GAAP EPS – Diluted |
|
|
|
|
|
|
|
Ratios: |
|
|
|
MCR |
|
86.2% - 86.4% |
|
G&A |
|
~7.2% |
|
After-Tax Margin |
|
3.7% - 3.8% |
|
___________________________________ | |||
All amounts are rounded and approximations. |
Conference Call
Management will host a conference call and webcast to discuss Molina Healthcare’s first quarter 2020 results at
About
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995
This earnings release and our accompanying oral remarks contain forward-looking statements regarding our 2020 guidance, as well as our plans, expectations, and our anticipation regarding future developments. Actual results could differ materially due to numerous known and unknown risks and uncertainties. These risks and uncertainties are discussed under the headings “Forward-Looking Statements” and “Risk Factors” in our Annual Report on Form 10-K for the year ended
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 developments 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
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME |
|||||||
|
Three Months Ended |
||||||
|
|
||||||
|
2020 |
|
2019 |
||||
|
(In millions, except per‑share amounts) |
||||||
Revenue: |
|
|
|
||||
Premium revenue |
$ |
4,304 |
|
|
$ |
3,952 |
|
Premium tax revenue |
150 |
|
|
138 |
|
||
Health insurer fees reimbursed |
66 |
|
|
— |
|
||
Investment income and other revenue |
29 |
|
|
29 |
|
||
Total revenue |
4,549 |
|
|
4,119 |
|
||
Operating expenses: |
|
|
|
||||
Medical care costs |
3,716 |
|
|
3,371 |
|
||
General and administrative expenses |
317 |
|
|
302 |
|
||
Premium tax expenses |
150 |
|
|
138 |
|
||
Health insurer fees |
68 |
|
|
— |
|
||
Depreciation and amortization |
20 |
|
|
25 |
|
||
Other |
4 |
|
|
3 |
|
||
Total operating expenses |
4,275 |
|
|
3,839 |
|
||
Operating income |
274 |
|
|
280 |
|
||
Other expenses, net: |
|
|
|
||||
Interest expense |
21 |
|
|
23 |
|
||
Other income, net |
— |
|
|
(3 |
) |
||
Total other expenses, net |
21 |
|
|
20 |
|
||
Income before income tax expense |
253 |
|
|
260 |
|
||
Income tax expense |
75 |
|
|
62 |
|
||
Net income |
$ |
178 |
|
|
$ |
198 |
|
|
|
|
|
||||
Net income per share - Diluted |
$ |
2.92 |
|
|
$ |
2.99 |
|
|
|
|
|
||||
Diluted weighted average shares outstanding |
61.0 |
|
|
66.2 |
|
||
|
|
|
|
||||
Operating Statistics: |
|
|
|
||||
Medical care ratio |
86.3 |
% |
|
85.3 |
% |
||
G&A ratio |
7.0 |
% |
|
7.3 |
% |
||
Premium tax ratio |
3.4 |
% |
|
3.4 |
% |
||
Effective income tax rate |
29.8 |
% |
|
23.8 |
% |
||
After-tax margin |
3.9 |
% |
|
4.8 |
% |
CONSOLIDATED BALANCE SHEETS |
|||||||
|
|
|
|
||||
|
2020 |
|
2019 |
||||
|
Unaudited |
|
|
||||
|
(Dollars in millions, except per-share amounts) |
||||||
ASSETS |
|||||||
Current assets: |
|
|
|
||||
Cash and cash equivalents |
$ |
2,365 |
|
|
$ |
2,452 |
|
Investments |
2,010 |
|
|
1,946 |
|
||
Receivables |
1,603 |
|
|
1,406 |
|
||
Prepaid expenses and other current assets |
346 |
|
|
163 |
|
||
Total current assets |
6,324 |
|
|
5,967 |
|
||
Property, equipment, and capitalized software, net |
385 |
|
|
385 |
|
||
|
168 |
|
|
172 |
|
||
Restricted investments |
82 |
|
|
79 |
|
||
Deferred income taxes |
71 |
|
|
79 |
|
||
Other assets |
99 |
|
|
105 |
|
||
Total assets |
$ |
7,129 |
|
|
$ |
6,787 |
|
|
|
|
|
||||
LIABILITIES AND STOCKHOLDERS’ EQUITY |
|||||||
Current liabilities: |
|
|
|
||||
Medical claims and benefits payable |
$ |
1,981 |
|
|
$ |
1,854 |
|
Amounts due government agencies |
777 |
|
|
664 |
|
||
Accounts payable, accrued liabilities and other |
743 |
|
|
484 |
|
||
Deferred revenue |
43 |
|
|
249 |
|
||
Current portion of long-term debt |
26 |
|
|
18 |
|
||
Total current liabilities |
3,570 |
|
|
3,269 |
|
||
Long-term debt |
1,596 |
|
|
1,237 |
|
||
Finance lease liabilities |
229 |
|
|
231 |
|
||
Other long-term liabilities |
87 |
|
|
90 |
|
||
Total liabilities |
5,482 |
|
|
4,827 |
|
||
Stockholders’ equity: |
|
|
|
||||
Common stock, |
— |
|
|
— |
|
||
Preferred stock, |
— |
|
|
— |
|
||
Additional paid-in capital |
140 |
|
|
175 |
|
||
Accumulated other comprehensive (loss) income |
(15 |
) |
|
4 |
|
||
Retained earnings |
1,522 |
|
|
1,781 |
|
||
Total stockholders’ equity |
1,647 |
|
|
1,960 |
|
||
Total liabilities and stockholders’ equity |
$ |
7,129 |
|
|
$ |
6,787 |
|
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS |
|||||||
|
Three Months Ended |
||||||
|
|
||||||
|
2020 |
|
2019 |
||||
|
(In millions) |
||||||
Operating activities: |
|
|
|
||||
Net income |
$ |
178 |
|
|
$ |
198 |
|
Adjustments to reconcile net income to net cash provided by operating activities: |
|
|
|
||||
Depreciation and amortization |
20 |
|
|
25 |
|
||
Deferred income taxes |
14 |
|
|
15 |
|
||
Share-based compensation |
12 |
|
|
9 |
|
||
Gain on debt repayment |
— |
|
|
(3 |
) |
||
Other, net |
(3 |
) |
|
6 |
|
||
Changes in operating assets and liabilities: |
|
|
|
||||
Receivables |
(197 |
) |
|
(29 |
) |
||
Prepaid expenses and other current assets |
(229 |
) |
|
20 |
|
||
Medical claims and benefits payable |
127 |
|
|
34 |
|
||
Amounts due government agencies |
113 |
|
|
(35 |
) |
||
Accounts payable, accrued liabilities and other |
247 |
|
|
(30 |
) |
||
Deferred revenue |
(206 |
) |
|
(4 |
) |
||
Income taxes |
60 |
|
|
43 |
|
||
Net cash provided by operating activities |
136 |
|
|
249 |
|
||
Investing activities: |
|
|
|
||||
Purchases of investments |
(578 |
) |
|
(185 |
) |
||
Proceeds from sales and maturities of investments |
493 |
|
|
366 |
|
||
Purchases of property, equipment, and capitalized software |
(21 |
) |
|
(6 |
) |
||
Other, net |
3 |
|
|
(4 |
) |
||
Net cash (used in) provided by investing activities |
(103 |
) |
|
171 |
|
||
Financing activities: |
|
|
|
||||
Common stock purchases |
(453 |
) |
|
— |
|
||
Proceeds from borrowings under term loan facility |
380 |
|
|
100 |
|
||
Cash paid for partial termination of warrants |
(30 |
) |
|
(103 |
) |
||
Cash paid for partial settlement of conversion option |
(27 |
) |
|
(115 |
) |
||
Cash received for partial settlement of call option |
27 |
|
|
115 |
|
||
Repayment of principal amount of convertible senior notes |
(12 |
) |
|
(46 |
) |
||
Other, net |
(3 |
) |
|
1 |
|
||
Net cash used in financing activities |
(118 |
) |
|
(48 |
) |
||
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents |
(85 |
) |
|
372 |
|
||
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period |
2,508 |
|
|
2,926 |
|
||
Cash, cash equivalents, and restricted cash and cash equivalents at end of period |
$ |
2,423 |
|
|
$ |
3,298 |
|
UNAUDITED HEALTH PLANS SEGMENT DATA (Dollars in millions) |
||||||||
|
|
|
|
|
|
|||
|
2020 |
|
2019 |
|
2019 |
|||
Ending Membership by Government Program: |
|
|
|
|
|
|||
Medicaid |
2,970,000 |
|
|
2,956,000 |
|
|
2,964,000 |
|
Medicare |
105,000 |
|
|
101,000 |
|
|
97,000 |
|
Marketplace |
329,000 |
|
|
274,000 |
|
|
332,000 |
|
Total |
3,404,000 |
|
|
3,331,000 |
|
|
3,393,000 |
|
|
|
|
|
|
|
|||
Ending Membership by Health Plan: |
|
|
|
|
|
|||
|
550,000 |
|
|
565,000 |
|
|
600,000 |
|
|
123,000 |
|
|
132,000 |
|
|
144,000 |
|
|
230,000 |
|
|
224,000 |
|
|
219,000 |
|
|
367,000 |
|
|
362,000 |
|
|
369,000 |
|
|
300,000 |
|
|
288,000 |
|
|
295,000 |
|
|
170,000 |
|
|
176,000 |
|
|
207,000 |
|
|
136,000 |
|
|
131,000 |
|
|
126,000 |
|
|
345,000 |
|
|
341,000 |
|
|
377,000 |
|
|
878,000 |
|
|
832,000 |
|
|
815,000 |
|
Other (1) |
305,000 |
|
|
280,000 |
|
|
241,000 |
|
Total |
3,404,000 |
|
|
3,331,000 |
|
|
3,393,000 |
|
__________________ | ||
(1) |
“Other” includes the |
|
Three Months Ended |
||||||||||||||||||||
|
2020 |
|
2019 |
||||||||||||||||||
|
Premium Revenue |
|
Medical Care Costs |
|
MCR (1) |
|
Premium Revenue |
|
Medical Care Costs |
|
MCR (1) |
||||||||||
|
|
|
|
|
|
||||||||||||||||
Medicaid |
$ |
3,286 |
|
|
$ |
2,921 |
|
|
88.9 |
% |
|
$ |
3,004 |
|
|
$ |
2,658 |
|
|
88.5 |
% |
Medicare |
634 |
|
|
517 |
|
|
81.7 |
|
|
551 |
|
|
466 |
|
|
84.7 |
|
||||
Marketplace |
384 |
|
|
278 |
|
|
72.3 |
|
|
397 |
|
|
247 |
|
|
62.2 |
|
||||
Consolidated |
$ |
4,304 |
|
|
$ |
3,716 |
|
|
86.3 |
% |
|
$ |
3,952 |
|
|
$ |
3,371 |
|
|
85.3 |
% |
__________________ |
||
(1) |
The MCR represents medical costs as a percentage of premium revenue. |
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 the 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 |
|
Year Ended 2019 |
||||||||
|
2020 |
|
2019 |
|
|||||||
|
Unaudited |
|
|
||||||||
Medical claims and benefits payable, beginning balance |
$ |
1,854 |
|
|
$ |
1,961 |
|
|
$ |
1,961 |
|
Components of medical care costs related to: |
|
|
|
|
|
||||||
Current period |
3,817 |
|
|
3,560 |
|
|
14,176 |
|
|||
Prior period |
(101 |
) |
|
(189 |
) |
|
(271 |
) |
|||
Total medical care costs |
3,716 |
|
|
3,371 |
|
|
13,905 |
|
|||
Change in non-risk and other provider payables |
(10 |
) |
|
171 |
|
|
24 |
|
|||
Payments for medical care costs related to: |
|
|
|
|
|
||||||
Current period |
2,274 |
|
|
2,197 |
|
|
12,554 |
|
|||
Prior period |
1,305 |
|
|
1,311 |
|
|
1,482 |
|
|||
Total paid |
3,579 |
|
|
3,508 |
|
|
14,036 |
|
|||
Medical claims and benefits payable, ending balance |
$ |
1,981 |
|
|
$ |
1,995 |
|
|
$ |
1,854 |
|
|
|
|
|
|
|
||||||
Days in claims payable, fee for service (1) |
49 |
|
|
52 |
|
|
50 |
|
______________________ |
||
(1) |
Claims payable includes primarily claims incurred but not paid, or IBNP. It also includes certain fee-for-service payables reported in medical claims and benefits payable amounting to |
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES
(In millions, except per diluted share amounts)
The Company believes that certain non-generally accepted accounting principles, or non-GAAP, financial 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, presented below, should be considered as supplements to, and not as substitutes for or superior to, GAAP measures.
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 to investors in assessing the Company’s ability to meet the cash demands of its operating units.
|
Three Months Ended |
||||||
2020 |
|
2019 |
|||||
Net income |
$ |
178 |
|
|
$ |
198 |
|
Adjustments: |
|
|
|
||||
Depreciation, and amortization of intangible assets and capitalized software |
20 |
|
|
25 |
|
||
Interest expense |
21 |
|
|
23 |
|
||
Income tax expense |
75 |
|
|
62 |
|
||
EBITDA |
$ |
294 |
|
|
$ |
308 |
|
Adjusted net income: Net income on a GAAP basis less amortization of intangible assets, restructuring costs, gain on debt repayment, and the aggregate income tax effect calculated at the statutory tax rate. The Company believes that adjusted net income is helpful to investors in assessing the Company’s financial performance exclusive of the non-cash impact of the amortization of purchased intangibles and the impact of certain expenses and other items that management believes are not indicative of longer-term business trends and operations.
Adjusted net income per diluted share: Adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.
|
Three Months Ended |
||||||||||||||
2020 |
|
2019 |
|||||||||||||
|
Amount |
|
Per Diluted Share |
|
Amount |
|
Per Diluted Share |
||||||||
Net income |
$ |
178 |
|
|
$ |
2.92 |
|
|
$ |
198 |
|
|
$ |
2.99 |
|
Adjustments: |
|
|
|
|
|
|
|
||||||||
Amortization of intangible assets |
4 |
|
|
0.06 |
|
|
5 |
|
|
0.07 |
|
||||
Restructuring costs |
4 |
|
|
0.07 |
|
|
3 |
|
|
0.04 |
|
||||
Gain on debt repayment |
— |
|
|
— |
|
|
(3 |
) |
|
(0.04 |
) |
||||
Subtotal, adjustments |
8 |
|
|
0.13 |
|
|
5 |
|
|
0.07 |
|
||||
Income tax effect (1) |
(2 |
) |
|
(0.03 |
) |
|
(1 |
) |
|
(0.02 |
) |
||||
Adjustments, net of tax effect |
6 |
|
|
0.10 |
|
|
4 |
|
|
0.05 |
|
||||
Adjusted net income |
$ |
184 |
|
|
$ |
3.02 |
|
|
$ |
202 |
|
|
$ |
3.04 |
|
________________________
(1) |
Income tax effect of adjustments calculated at the blended federal and state statutory tax rate of 23.1% and 22.6% for 2020, and 2019, respectively. |
View source version on businesswire.com: https://www.businesswire.com/news/home/20200430005884/en/
Investor Contact:
Media Contact:
Source:
Maya Gumennik Joins EverQuote as Head of Performance Marketing
Barry, Carole Kaye, FAU donors, die of COVID-19 less than a week apart
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News