At a Glance
Other Lines of Business
See other notes on selling of Part D plans to WellCare as condition of CVS acquisition. There were 8.5M pharmacy members at the end of 2018.
Shareholder Call Summary
This is Molina Need to Update
Latest available call date: 11/1/2018
Reporting on Q3 ending performance.
Comparing Q3 to Q2
- Overall Medical Care Ratio (MCR) increased from 85.3% to 87.4%.
- Medicaid MCR went from 89.8% to 90.5%. Would have been flat if not for the CA risk corridor payments (see below).
- Marketplace MCR went from 57.4% to 64.1%.
- Net profit margin 4.2% for quarter (3.6% for year)
- Net income down $5M compared to previous quarter, with premium revenue decrease of 4% driving. Some of this decrease related to recognition of 2017 marketplace risk adjustment revenue being recognized in Q2 (so appeared to be step down in Q3). A $57M CA Medicaid risk corridor reduction was also recognized in this period.
- General and administrative (G&A) decreased from 6.9% to 6.6%.
- Sale of Molina MMIS ops to DXC completed September 30th for $233M.
Comparing Same Quarter, YOY
Net income $197M
Net loss ($97M)
State Market News
- Aetna was one of 8 interested bidders in the N.C. MCO procurement (October).
- A KS judge ruled the state's decision to replace Amerigroup with Aetna will stand (October).
- Aetna FL (Coventry) removed Mount Sinai Medical Center from its Medicaid netowork in a highly publicized fight during annual contract negotiations (October).
- Aetna OK was fined $25M for its denial of coverage for services to a stage 4 cancer patient (November)
- Buildout of accountable care product in N.C. with addition of Cone Health and Triad HealthCare Network (November). Already has Duke and WakeMed.
- Aetna (NJ, D.C. and CT) settled claims around PHI data breach for $17M. Centers on breach in 2017 with HIV/AIDS status info being mailed and a separate breach containng information about atrial fibrilation study patients.
END OF REPORT