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8-K - MOLINA HEALTHCARE, INC. 8-K - MOLINA HEALTHCARE, INC.a6615809.htm
Exhibit 99.1
 
 
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Contact:
Juan José Orellana
Investor Relations
562-435-3666, ext. 111143


MOLINA HEALTHCARE REPORTS
FOURTH QUARTER AND YEAR-END 2010 RESULTS


·  
Earnings per diluted share for 2010 of $1.98, up 66% over 2009
·  
Annual premium revenues of $4 billion, up 9% over 2009
·  
Annual operating income of $105 million, up 100% over 2009
·  
Aggregate membership up 11% over 2009

Long Beach, California (February 17, 2011) – Molina Healthcare, Inc. (NYSE: MOH) today reported its financial results for the fourth quarter and year ended December 31, 2010.

Net income for the quarter was $17.6 million, or $0.58 per diluted share, compared with a net loss of $4.5 million, or $0.18 per diluted share, for the quarter ended December 31, 2009.  Net income for the year ended December 31, 2010, was $55.0 million, or $1.98 per diluted share, compared with net income of $30.9 million, or $1.19 per diluted share, for the year ended December 31, 2009.
 
“Our strong 2010 results reflect a year of accomplishment and growth.  We continue to deliver on our strategy of providing a diversified suite of health care services to meet the needs of low-income families and the government programs that serve them,” said J. Mario Molina, M.D., president and chief executive officer of Molina Healthcare.  “By delivering administrative value to state agencies through our Molina Medicaid Solutions segment and by continuing to provide quality, cost-effective care in the increasingly challenging rate environment, we have positioned our Company to continue to deliver strong revenue growth and management of medical costs in 2011.”

Guidance

The Company confirms its guidance issued on January 26, 2011.

Overview of Financial Results

Fourth Quarter 2010 Compared with Third Quarter 2010

Net income for the fourth quarter of 2010 increased $1.5 million from the third quarter of 2010.  Operating income increased over 11%, primarily due to lower fee-for-service medical care costs.  Medical care costs as a percentage of premium revenue (the medical care ratio) were 82.7% in the fourth quarter of 2010 compared with 84.2% in the third quarter of 2010.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 2
February 17, 2011

 
Fourth Quarter 2010 Compared with Fourth Quarter 2009

Health Plans Segment

Premium revenue grew 8.4% in the fourth quarter of 2010 compared with the fourth quarter of 2009, due to a membership increase of 10.9%.  On a PMPM basis, however, consolidated premium revenue decreased 3.0% because of declines in premium rates.  The decrease in PMPM revenue was primarily due to the transfer of the pharmacy benefit to the state fee-for-service program in Ohio effective February 1, 2010.  Exclusive of the transfer of the pharmacy benefit in Ohio, Medicaid premium revenue PMPM was unchanged from the fourth quarter of 2009.  Medicare enrollment exceeded 24,000 members at December 31, 2010, and Medicare premium revenue for the quarter was $76.5 million compared with $40.0 million in the fourth quarter of 2009.

The medical care ratio decreased to 82.7% in the fourth quarter of 2010 compared with 87.5% for the same period of 2009.

The medical care ratio of the California health plan decreased to 81.9% in the fourth quarter of 2010 from 90.4% in the fourth quarter of 2009, primarily due to lower inpatient facility fee-for-service costs resulting from provider network restructuring and improved medical management.

The medical care ratio of the Florida health plan increased to 100.2% in the fourth quarter of 2010 from 97.1% in the fourth quarter of 2009, primarily due to higher capitation costs and higher fee-for-service costs in the outpatient and physician categories.  The Company has undertaken a number of measures – focused on both utilization and unit cost reductions – to improve the profitability of the Florida health plan.

The medical care ratio of the Michigan health plan increased to 81.9% in the fourth quarter of 2010 from 80.0% in the fourth quarter of 2009, primarily due to lower premium revenue PMPM and higher inpatient facility fee-for-service costs.

The medical care ratio of the New Mexico health plan decreased to 82.1% in the fourth quarter of 2010 from 85.3% in the fourth quarter of 2009, primarily due to reduced fee-for-service costs which more than offset a premium reduction of approximately 9% PMPM effective November 1, 2010.

The medical care ratio of the Ohio health plan decreased to 74.5% in the fourth quarter of 2010 from 87.5% in the fourth quarter of 2009, due to an increase in Medicaid premium PMPM of approximately 6% effective January 1, 2010, (exclusive of the reduction related to pharmacy benefits) and reduced fee-for-service costs in the outpatient and physician categories, partially offset by higher inpatient facility fee-for-service costs.

The medical care ratio of the Utah health plan decreased to 83.2% in the fourth quarter of 2010 from 95.4% in the fourth quarter of 2009, primarily due to reduced fee-for-service costs in the outpatient and physician categories and an increase in Medicaid premium PMPM of approximately 7% effective July 1, 2010.

The medical care ratio of the Washington health plan decreased to 83.2% in the fourth quarter of 2010 from 87.0% in the fourth quarter of 2009, primarily due to reduced fee-for-service costs in the outpatient and physician categories and an increase in Medicaid premium PMPM of approximately 2.5% effective July 1, 2010.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 3
February 17, 2011
 
 
Days in medical claims and benefits payable.  Beginning January 1, 2010, and for all prior periods presented, the Company is reporting days in medical claims and benefits payable relating to fee-for-service medical claims only.  This computation includes only fee-for-service medical care costs and related liabilities and therefore calculates the extent of reserves for those liabilities that are most subject to estimation.

The days in medical claims and benefits payable amount reported prior to 2010 included all medical care costs (fee-for-service, capitation, pharmacy, and administrative), and all medical claims liabilities, including those liabilities that are typically paid concurrently, or shortly after the costs are incurred, such as capitation cost and pharmacy costs.  Medical claims liabilities used in this calculation do not include accrued costs, such as salaries, associated with the administrative portion of medical costs.

By including only fee-for-service medical costs and liabilities in this computation, the Company’s days in claims payable metric will be more indicative of the size of the Company’s reserves for liabilities subject to a substantial degree of estimation.  The days in medical claims and benefits payable, excluding the Company’s Wisconsin health plan acquired September 1, 2010, were as follows:

(Dollars in thousands)
 
Dec. 31,
2010
   
Sept. 30,
2010
   
Dec. 31,
2009
 
Days in claims payable – fee-for-service only
 
42 days
   
42 days
   
44 days
 
Number of claims in inventory at end of period
    143,600       110,200       93,100  
Billed charges of claims in inventory at end of period
  $ 218,900     $ 158,900     $ 131,400  

Consolidated Expenses

General and administrative expenses, or G&A, were $100.4 million, or 9.3% of total revenue, for the fourth quarter of 2010 compared with $77.0 million, or 8.0% of total revenue, for the fourth quarter of 2009.  The increase in the G&A ratio was the result of higher administrative expenses for the Health Plan segment, driven in part by the cost of the Company’s Medicare expansion, higher variable compensation expense as a result of substantially improved financial performance in 2010, and the acquisition of Molina Medicaid Solutions.

   
Three Months Ended December 31,
 
   
2010
   
2009
 
   
Amount
   
% of Total
Revenue
   
Amount
   
% of Total
Revenue
 
   
(In thousands)
 
Medicare-related administrative costs
  $ 9,275       0.9 %   $ 5,721       0.6 %
Non Medicare-related administrative costs:
                               
Molina Medicaid Solutions segment administrative costs
    1,974       0.2              
Health Plans segment administrative payroll, including employee incentive compensation
    72,350       6.7       53,905       5.6  
All other Health Plans segment administrative expense
    16,775       1.5       17,420       1.8  
    $ 100,374       9.3 %   $ 77,046       8.0 %
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 4
February 17, 2011

 
Premium tax expense decreased to 3.4% of premium revenue in the fourth quarter of 2010 from 4.3% in the fourth quarter of 2009, primarily due to lower premium taxes in California.  California premium taxes in the fourth quarter of 2009 included an adjustment imposed by the state that was retroactive to January 1, 2009.  No such retroactive adjustment was made in the fourth quarter of 2010.

Depreciation and amortization expense related to the Company’s Health Plans segment is all recorded in “Depreciation and Amortization” in the Company’s consolidated statements of operations.  Depreciation and amortization related to the Company’s Molina Medicaid Solutions segment is recorded within three different captions in the Company’s consolidated statements of operations as follows:

·  
Amortization of purchased intangibles relating to customer relationships is reported as amortization in “Depreciation and Amortization;”
·  
Amortization of purchased intangibles relating to contract backlog is recorded as a reduction of service revenue; and
·  
Depreciation is recorded as cost of service revenue.

The following table presents all depreciation and amortization recorded in the Company’s consolidated statements of operations, regardless of whether the item appears as depreciation and amortization, a reduction of revenue, or as cost of service revenue, and reconciles that amount to the condensed consolidated statements of cash flows.

   
Three Months Ended December 31,
 
   
2010
   
2009
 
   
Amount
   
% of Total
Revenue
   
Amount
   
% of Total
Revenue
 
   
(In thousands)
 
Depreciation and amortization
  $ 12,470       1.2 %   $ 9,642       1.0 %
Amortization recorded as reduction of service revenue
    4,070       0.4              
Depreciation recorded as cost of service revenue
    3,740       0.3              
Depreciation and amortization reported in the condensed consolidated statements of cash flows
  $ 20,280       1.9 %   $ 9,642       1.0 %

Interest expense was $3.5 million for the fourth quarter of 2010, consistent with the fourth quarter of 2009.

Income tax expense (benefit) was recorded at an effective rate of 41.2% in the fourth quarter of 2010 compared with (53.7%) in the fourth quarter of 2009.  The lower rate in 2009 was primarily due to the Company’s pre-tax loss recognized during the quarter and higher than previously estimated California enterprise zone tax credits.

Through December 31, 2009, the Company’s income tax expense included both the Michigan business income tax, or BIT, and the Michigan modified gross receipts tax, or MGRT.  Effective January 1, 2010, the Company has recorded the MGRT as a premium tax and not as an income tax.  The Company will continue to record the BIT as an income tax.  For the fourth quarter and year ended December 31, 2009, premium tax expense and income tax expense have been reclassified to conform to this presentation.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 5
February 17, 2011

 
Year Ended December 31, 2010, Compared with Year Ended December 31, 2009

Health Plans Segment

Premium revenue grew 9% in the year ended December 31, 2010, compared with the same period in 2009, due to a membership increase of 10.9%.  On a PMPM basis, however, consolidated premium revenue decreased 2.1% because of declines in premium rates.  The decrease in PMPM revenue was primarily due to the transfer of the pharmacy benefit to the state fee-for-service programs in Ohio (effective February 1, 2010) and Missouri (effective October 1, 2009).  Exclusive of the transfer of the pharmacy benefit in Ohio and Missouri, Medicaid premium revenue PMPM increased approximately 1.5% from 2009.  Medicare enrollment exceeded 24,000 members at December 31, 2010, and Medicare premium revenue for 2010 was $265.2 million compared with $135.9 million for the same period in 2009.

The medical care ratio decreased to 84.5% for 2010 compared with 86.8% for 2009.

The medical care ratio of the California health plan decreased to 83.5% for the year ended December 31, 2010, from 92.2% for the same period in 2009, primarily due to lower inpatient facility fee-for-service costs resulting from provider network restructuring and improved medical management.

The medical care ratio of the Florida health plan increased to 95.4% for the year ended December 31, 2010, from 93.8% for 2009, primarily due to higher capitation costs and higher fee-for-service costs in the outpatient and physician categories.

The medical care ratio of the Michigan health plan increased to 83.7% for the year ended December 31, 2010, from 81.5% for 2009, primarily due to higher inpatient facility fee-for-service costs.

The medical care ratio of the New Mexico health plan decreased to 80.6% for the year ended December 31, 2010, from 85.7% for the same period in 2009, primarily due to reduced fee-for-service costs which more than offset decreased premium revenue PMPM.

The medical care ratio of the Ohio health plan decreased to 79.1% for the year ended December 31, 2010, from 86.1% for the same period in 2009, primarily due to an increase in Medicaid premium PMPM of approximately 6% effective January 1, 2010, (exclusive of the reduction related to pharmacy benefits), partially offset by higher inpatient facility fee-for-service costs.

The medical care ratio of the Utah health plan decreased to 91.3% for the year ended December 31, 2010, from 91.8% for the same period in 2009, due to improved financial performance in the second half of 2010.  That improved financial performance was the result of reduced fee-for-service costs in the second half of 2010 and an increase in Medicaid premium PMPM of approximately 7% effective July 1, 2010.

The medical care ratio of the Washington health plan decreased to 83.9% for the year ended December 31, 2010, from 84.5% for the same period in 2009, primarily due to reduced fee-for-service costs which more than offset decreased premium revenue PMPM.  Premium revenue PMPM decreased for all of 2010 compared to 2009 because the rate increase of approximately 2.5% effective July 1, 2010, was not enough to offset decreases received during the second half of 2009.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 6
February 17, 2011

 
Consolidated Expenses

General and administrative expenses were $346.0 million, or 8.5% of total revenue, for 2010 compared with $276.0 million, or 7.5% of total revenue, for 2009.  The increase in the G&A ratio was the result of higher administrative expenses for the Health Plan segment, driven in part by the cost of the Company’s Medicare expansion, higher variable compensation expense as a result of substantially improved financial performance in 2010, employee severance and settlement costs of $5.5 million, and costs relating to the acquisitions of Molina Medicaid Solutions and the Wisconsin health plan.

   
Year Ended December 31,
 
   
2010
   
2009
 
   
Amount
   
% of Total
Revenue
   
Amount
   
% of Total
Revenue
 
   
(In thousands)
 
Medicare-related administrative costs
  $ 30,254       0.7 %   $ 18,564       0.5 %
Non Medicare-related administrative costs:
                               
Employee severance and settlement costs
    5,548       0.1       1,257        
Molina Medicaid Solutions segment administrative costs
    5,135       0.1              
Molina Medicaid Solutions and Wisconsin plan acquisition costs
    2,957       0.1              
Health Plans segment administrative payroll, including employee incentive compensation
    239,146       5.9       204,432       5.6  
All other Health Plans segment administrative expense
    62,953       1.6       51,774       1.4  
    $ 345,993       8.5 %   $ 276,027       7.5 %

Premium tax expense was 3.5% of premium revenue in 2010, consistent with 2009.

Depreciation and amortization expense is reported as discussed earlier.  The following table presents all depreciation and amortization recorded in the Company’s statements of operations regardless of whether the item appears as depreciation and amortization, a reduction of revenue, or as cost of service revenue, and reconciles that amount to the condensed consolidated statements of cash flows.

   
Year Ended December 31,
 
   
2010
   
2009
 
   
Amount
   
% of Total
Revenue
   
Amount
   
% of Total
Revenue
 
   
(In thousands)
 
Depreciation and amortization
  $ 45,704       1.1 %   $ 38,110       1.0 %
Amortization recorded as reduction of service revenue
    8,316       0.2              
Depreciation recorded as cost of service revenue
    6,745       0.2              
Depreciation and amortization reported in the condensed consolidated statements of cash flows
  $ 60,765       1.5 %   $ 38,110       1.0 %

Interest expense increased to $15.5 million for 2010 compared with $13.8 million for 2009.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 7
February 17, 2011

 
Income tax expense was recorded at an effective rate of 38.6% for the year ended December 31, 2010, compared with 19.1% in the same period of 2009.  The lower rate in 2009 was primarily due to discrete tax benefits recorded in 2009 as a result of settling tax examinations, and higher than previously estimated tax credits.

Molina Medicaid Solutions Segment (acquired May 1, 2010)

Molina Medicaid Solutions contributed $2.6 million to operating income for the year ended December 31, 2010, but reported an operating loss of $3.6 million for the quarter ended December 31, 2010.  The operating loss for the fourth quarter of 2010 was primarily the result of system stabilization costs incurred for two of Molina Medicaid Solutions’ contracts.

Performance of Molina Medicaid Solutions for the quarter and year ended December 31, 2010, was as follows:

   
Three Months
Ended
   
Year
Ended
 
   
December 31, 2010
 
   
(In thousands)
 
Service revenue before amortization
  $ 40,554     $ 98,125  
Amortization of contract backlog recorded as contra-service revenue
    (4,070 )     (8,316 )
Service revenue
    36,484       89,809  
                 
Cost of service revenue
    36,788       78,647  
General and administrative costs
    1,974       5,135  
Amortization of customer relationships intangibles
    1,275       3,418  
Operating (loss) income
  $ (3,553 )   $ 2,609  

Cash Flow

Cash provided by operating activities for 2010 was $161.6 million compared with $155.4 million for 2009, an increase of $6.2 million.

Deferred revenue, which was a source of operating cash totaling $88.2 million in 2009, was a use of operating cash totaling $41.9 million in 2010.  The change in deferred revenue was offset by increases in net income, depreciation and amortization, and other current liabilities.

Cash used in investing activities increased significantly in 2010 compared with 2009 due chiefly to the acquisition of Molina Medicaid Solutions, which totaled $131.3 million.

Cash provided by financing activities increased due to funds generated by the Company’s equity offering in the third quarter of 2010, which totaled $111.1 million net of issuance costs.  Amounts borrowed under the Company’s credit facility to fund the acquisition of Molina Medicaid Solutions in the second quarter of 2010 were repaid in the third quarter using proceeds from the equity offering.

At December 31, 2010, the Company had cash and investments (not including restricted investments) of $771.7 million, including non-current auction rate securities with a fair value of $20.4 million.  At December 31, 2010, the parent company had unrestricted cash and investments of $65.1 million, including auction rate securities with a fair value of $6.0 million.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 8
February 17, 2011

Investment income decreased to $6.3 million in 2010 compared with $9.1 million in 2009.  This decline was due primarily to lower interest rates.

Reconciliation of Non-GAAP to GAAP Financial Measures

EBITDA (1)

   
Three Months Ended
December 31,
   
Year Ended
December 31,
 
   
2010
   
2009
   
2010
   
2009
 
   
(In thousands)
 
Operating income (loss)
  $ 33,432     $ (5,804 )   $ 105,001     $ 51,934  
Add back:
                               
Depreciation and amortization reported in the condensed consolidated statements of cash flows
    20,280       9,642       60,765       38,110  
EBITDA
  $ 53,712     $ 3,838     $ 165,766     $ 90,044  

(1)  
The Company calculates EBITDA consistently on a quarterly and annual basis by adding back depreciation and amortization to operating income.  EBITDA is not prepared in conformity with GAAP because it excludes depreciation and amortization, as well as interest expense, and the provision for income taxes.  This non-GAAP financial measure should not be considered as an alternative to the GAAP measures of net income, operating income, operating margin, or cash provided by operating activities, nor should EBITDA be considered in isolation from these GAAP measures of operating performance.  Management uses EBITDA as a supplemental metric in evaluating the Company’s financial performance, in evaluating financing and business development decisions, and in forecasting and analyzing future periods.  For these reasons, management believes that EBITDA is a useful supplemental measure to investors in evaluating the Company’s performance and the performance of other companies in its industry.

Equity Offering

The Company issued 4,350,000 shares in connection with the equity offering it conducted in the third quarter of 2010 as described earlier.  The offering added approximately 1.7 million shares to the weighted average number of common shares outstanding for the year ended December 31, 2010.

Conference Call

The Company’s management will host a conference call and webcast to discuss its fourth quarter and year-end results at 5:00 p.m. Eastern time on Thursday, February 17, 2011.  The number to call for the interactive teleconference is (212) 271-4657.  A telephonic replay of the conference call will be available from 7:00 p.m. Eastern time on Thursday, February 17, 2011, through 6:00 p.m. on Friday, February 18, 2011, by dialing (800) 633-8284 and entering confirmation number 21502798.  A live broadcast of Molina Healthcare’s conference call will be available on the Company’s website, www.molinahealthcare.com, or at www.earnings.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. provides quality and cost-effective Medicaid-related solutions to meet the health care needs of low-income families and individuals and to assist state agencies in their administration of the Medicaid program.  Molina’s licensed health plans in California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas, Utah, Washington, and Wisconsin currently serve approximately 1.6 million members, and the Company’s subsidiary, Molina Medicaid Solutions, provides business processing and information technology administrative services to Medicaid agencies in Idaho, Louisiana, Maine, New Jersey, and West Virginia, and drug rebate administration services in Florida.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 9
February 17, 2011

 
Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995: This earnings release contains “forward-looking statements” regarding the Company’s plans, expectations, and anticipated future events.  Actual results could differ materially due to numerous known and unknown risks and uncertainties, including, without limitation, risk factors related to the following:

·  
significant budgetary pressures on state governments and their potential inability to maintain the currently agreed-upon payment rates to our health plans, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria;
·  
increases in our Aged, Blind or Disabled membership at our California and Texas health plans consistent with our expectations;
·  
uncertainties regarding the impact of the Patient Protection and Affordable Care Act, including its possible repeal, judicial overturning of the individual insurance mandate, the effect of various implementing regulations, and uncertainties regarding the likely impact of other federal or state health care and insurance reform measures;
·  
management of our medical costs, including seasonal flu patterns and rates of utilization that are consistent with our expectations;
·  
the success of our efforts to retain existing government contracts in connection with upcoming state requests for proposals (RFPs) in Washington and Louisiana;
·  
the success of our efforts to obtain new government contracts in connection with upcoming RFPs in both existing states (Texas and Florida) and new states (Arizona, Georgia, and Illinois) and our ability to grow our revenues through 2012 consistent with our expectations;
·  
the accurate estimation of incurred but not reported medical costs across our health plans;
·  
risks associated with the continued growth in new Medicaid and Medicare enrollees;
·  
retroactive adjustments to premium revenue or accounting estimates which require adjustment based upon subsequent developments, including Medicaid pharmaceutical rebates;
·  
the continuation and renewal of the government contracts of our health plans and of Molina Medicaid Solutions and the terms on which such contracts are renewed;
·  
the timing of receipt and recognition of revenue and the amortization of expense under the state contracts of Molina Medicaid Solutions;
·  
additional administrative costs and the potential payment of additional amounts to providers and/or the state as a result of MMIS implementation issues in Idaho;
·  
the certification of the MMIS systems in both Maine and Idaho during 2011;
·  
government audits and reviews, including the audit of our Medicare plans by CMS;
·  
changes with respect to our provider contracts and the loss of providers;
·  
the establishment of a federal or state medical cost expenditure floor as a percentage of the premiums we receive, and the interpretation and implementation of medical cost expenditure floors, administrative cost and profit ceilings, and profit sharing arrangements;
·  
the interpretation and implementation of at-risk premium rules regarding the achievement of certain quality measures;
·  
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 or arbitration matters;
·  
restrictions and covenants in our credit facility, and the approach of its maturity date in May 2012;
·  
the relatively small number of states in which we operate health plans;
·  
the availability of financing to fund and capitalize our acquisitions and start-up activities and to meet our liquidity needs;
·  
a state’s failure to renew its federal Medicaid waiver;
·  
an inadvertent unauthorized disclosure of protected health information;
·  
changes generally affecting the managed care or Medicaid management information systems industries;
·  
increases in government surcharges, taxes, and assessments;
·  
changes in general economic conditions, including unemployment rates;

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 Company website or on the SEC’s website at www.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 forwardlooking statements in this release represent our judgment as of February 17, 2011, and we disclaim any obligation to update any forward-looking statements to conform the statement to actual results or changes in our expectations.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 10
February 17, 2011
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per-share data)

   
Three Months Ended
December 31,
   
Year Ended
December 31,
 
   
2010
   
2009
   
2010
   
2009
 
Revenue:
                       
Premium revenue
  $ 1,042,889     $ 962,411     $ 3,989,909     $ 3,660,207  
Service revenue
    36,484             89,809        
Investment income
    1,379       1,813       6,259       9,149  
Total operating revenue
    1,080,752       964,224       4,085,977       3,669,356  
                                 
Expenses:
                               
Medical care costs
    862,491       842,371       3,370,857       3,176,236  
Cost of service revenue
    36,788             78,647        
General and administrative expenses
    100,374       77,046       345,993       276,027  
Premium tax expenses (1)
    35,197       40,969       139,775       128,581  
Depreciation and amortization
    12,470       9,642       45,704       38,110  
Total expenses
    1,047,320       970,028       3,980,976       3,618,954  
Gain on purchase of convertible senior notes
                      1,532  
Operating income (loss)
    33,432       (5,804 )     105,001       51,934  
Interest expense
    (3,453 )     (3,860 )     (15,509 )     (13,777 )
                                 
Income (loss) before income taxes
    29,979       (9,664 )     89,492       38,157  
Income tax expense (benefit) (1)
    12,351       (5,192 )     34,522       7,289  
Net income (loss)
  $ 17,628     $ (4,472 )   $ 54,970     $ 30,868  
                                 
Net income (loss) per share:
                               
Basic
  $ 0.58     $ (0.18 )   $ 2.00     $ 1.19  
Diluted
  $ 0.58     $ (0.18 )   $ 1.98     $ 1.19  
                                 
Weighted average number of common shares and potentially dilutive common shares outstanding
    30,495       25,552       27,754       25,984  
                                 
Operating Statistics:
                               
Ratio of medical care costs paid directly to providers to premium revenue
    80.4 %     85.5 %     82.3 %     84.8 %
Ratio of medical care costs not paid directly to providers to premium revenue
    2.3       2.0       2.2       2.0  
Medical care ratio (2)
    82.7 %     87.5 %     84.5 %     86.8 %
General and administrative expense ratio (3)
    9.3 %     8.0 %     8.5 %     7.5 %
Premium tax ratio (1), (2)
    3.4 %     4.3 %     3.5 %     3.5 %
Effective tax rate (1)
    41.2 %     (53.7 )%     38.6 %     19.1 %

(1)
Effective January 1, 2010, the Company has recorded the MGRT as a premium tax and not as an income tax.  For the three months and year ended December 31, 2009, premium tax expense and income tax expense have been reclassified to conform to this presentation.
(2)
Medical care ratio represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium taxes as a percentage of premium revenue.
(3)
Computed as a percentage of total operating revenue.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 11
February 17, 2011
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except per-share data)

   
Dec. 31,
2010
   
Dec. 31,
2009
 
             
ASSETS
 
Current assets:
           
Cash and cash equivalents
  $ 455,886     $ 469,501  
Investments
    295,375       174,844  
Receivables
    168,190       136,654  
Income and related taxes refundable
          6,067  
Deferred income taxes
    15,716       8,757  
Prepaid expenses and other current assets
    22,772       14,383  
Total current assets
    957,939       810,206  
Property and equipment, net
    100,537       78,171  
Deferred contract costs
    28,444        
Intangible assets, net
    105,500       80,846  
Goodwill and indefinite-lived intangible assets
    212,228       133,408  
Investments
    20,449       59,687  
Restricted investments
    42,100       36,274  
Receivable for ceded life and annuity contracts
    24,649       25,455  
Other assets
    17,368       19,988  
    $ 1,509,214     $ 1,244,035  
                 
LIABILITIES AND STOCKHOLDERS’ EQUITY
 
Current liabilities:
               
Medical claims and benefits payable
  $ 354,356     $ 315,316  
Accounts payable and accrued liabilities
    137,930       71,732  
Deferred revenue
    60,086       101,985  
Income taxes payable
    13,176        
Total current liabilities
    565,548       489,033  
Long-term debt
    164,014       158,900  
Deferred income taxes
    16,235       12,506  
Liability for ceded life and annuity contracts
    24,649       25,455  
Other long-term liabilities
    19,711       15,403  
Total liabilities
    790,157       701,297  
                 
Stockholders’ equity:
               
Common stock, $0.001 par value; 80,000 shares authorized,
outstanding 30,309 shares at December 31, 2010, and 25,607 shares
at December 31, 2009
    30       26  
Preferred stock, $0.001 par value; 20,000 shares authorized,
no shares outstanding
           
Additional paid-in capital
    251,627       129,902  
Accumulated other comprehensive loss
    (2,192 )     (1,812 )
Retained earnings
    469,592       414,622  
Total stockholders’ equity
    719,057       542,738  
    $ 1,509,214     $ 1,244,035  
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 12
February 17, 2011
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)

   
Three Months Ended
December 31,
   
Year Ended
December 31,
 
   
2010
   
2009
   
2010
   
2009
 
Operating activities:
                       
Net income (loss)
  $ 17,628     $ (4,472 )   $ 54,970     $ 30,868  
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
                               
Depreciation and amortization
    20,280       9,642       60,765       38,110  
Unrealized loss (gain) on trading securities
          115       (4,170 )     (3,394 )
(Gain) loss on rights agreement
          (104 )     3,807       3,100  
Deferred income taxes
    (8,555 )     (2,323 )     (4,092 )     (1 )
Stock-based compensation
    2,263       1,755       9,531       7,485  
Non-cash interest on convertible senior notes
    1,314       1,219       5,114       4,782  
Gain on purchase of convertible senior notes
                      (1,532 )
Amortization of deferred financing costs
    502       832       1,780       1,872  
Tax deficiency from employee stock compensation
    (292 )     (45 )     (968 )     (749 )
Changes in operating assets and liabilities:
                               
Receivables
    57,357       7,475       (7,539 )     (8,092 )
Prepaid expenses and other current assets
    (1,449 )     (71 )     (9,756 )     383  
Medical claims and benefits payable
    416       12,202       34,363       22,874  
Accounts payable and accrued liabilities
    25,351       (10,877 )     40,482       (26,467 )
Deferred revenue
    22,438       17,350       (41,899 )     88,181  
Income taxes
    15,931       (7,610 )     19,258       (2,049 )
Net cash provided by operating activities
    153,184       25,088       161,646       155,371  
                                 
Investing activities:
                               
Purchases of property and equipment
    (16,620 )     (7,480 )     (48,538 )     (35,870 )
Purchases of investments
    (140,222 )     (59,429 )     (302,842 )     (186,764 )
Sales and maturities of investments
    39,913       54,595       225,106       204,365  
Net cash paid in business combinations
    (3,512 )     (394 )     (130,743 )     (11,294 )
Increase in deferred contract costs
    (8,703 )           (29,319 )      
(Increase) decrease in restricted investments
    2,947       6,126       (5,566 )     1,928  
Change in other long-term assets and liabilities
    490       587       2,830       (10,078 )
Net cash used in investing activities
    (125,707 )     (5,995 )     (289,072 )     (37,713 )
                                 
Financing activities:
                               
Amount borrowed under credit facility
                105,000        
Proceeds from common stock offering, net of issuance costs
    (115 )           111,131        
Repayment of amount borrowed under credit facility
                (105,000 )      
Treasury stock purchases
                      (27,712 )
Purchase of convertible senior notes
                      (9,653 )
Credit facility fees paid
                (1,671 )      
Excess tax benefits from employee stock compensation
    (125 )     5       295       31  
Proceeds from employee stock plans
    2,194       934       4,056       2,015  
Net cash provided by (used in) financing activities
    1,954       939       113,811       (35,319 )
Net increase (decrease) in cash and cash equivalents
    29,431       20,032       (13,615 )     82,339  
Cash and cash equivalents at beginning of period
    426,455       449,469       469,501       387,162  
Cash and cash equivalents at end of period
  $ 455,886     $ 469,501     $ 455,886     $ 469,501  
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 13
February 17, 2011
 
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED MEMBERSHIP DATA

Total Ending Membership By Health Plan:
 
Dec. 31,
2010
   
Sept. 30,
2010
   
Dec. 31,
2009
 
California
    344,000       349,000       351,000  
Florida
    61,000       57,000       50,000  
Michigan
    227,000       225,000       223,000  
Missouri
    81,000       79,000       78,000  
New Mexico
    91,000       91,000       94,000  
Ohio
    245,000       241,000       216,000  
Texas
    94,000       96,000       40,000  
Utah
    79,000       78,000       69,000  
Washington
    355,000       353,000       334,000  
Wisconsin (1)
    36,000       28,000        
      1,613,000       1,597,000       1,455,000  
                         
Total Ending Membership By State
for the Medicare Advantage Plans (1):
                       
California
    4,900       4,300       2,100  
Florida
    500       500        
Michigan
    6,300       5,700       3,300  
New Mexico
    600       600       400  
Texas
    700       600       500  
Utah
    8,900       8,600       4,000  
Washington
    2,600       2,300       1,300  
      24,500       22,600       11,600  
                         
Total Ending Membership By State
for the Aged, Blind or Disabled Population:
                       
California
    13,900       13,500       13,900  
Florida
    10,000       9,500       8,800  
Michigan
    31,700       31,400       32,200  
New Mexico
    5,700       5,700       5,700  
Ohio
    28,200       27,900       22,600  
Texas
    19,000       18,900       17,600  
Utah
    8,000       7,900       7,500  
Washington
    4,000       3,700       3,200  
Wisconsin (1)
    1,700       1,700        
      122,200       120,200       111,500  

(1)  
The Company acquired the Wisconsin health plan on September 1, 2010.  As of December 31, 2010, the Wisconsin health plan had approximately 3,000 Medicare Advantage members covered under a reinsurance contract with a third party; these members are not included in the membership tables herein.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 14
February 17, 2011
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN
(Amounts in thousands except per member per month amounts)
 
               Three Months Ended December 31, 2010  
             
Premium Revenue
        Medical Care Costs                
       
Member
Months (1)
       Total        
PMPM
       
Total
       
PMPM
       
Medical
Care Ratio
       Premium
Tax
Expense (2)
 
California
    1,039     $ 130,060     $ 125.18     $ 106,452     $ 102.46       81.9 %   $ 1,759  
Florida
    181       46,648       257.35       46,760       257.96       100.2       3  
Michigan (2)
    679       161,411       237.66       132,146       194.57       81.9       9,882  
Missouri
    242       53,978       223.40       44,525       184.28       82.5        
New Mexico
    270       85,635       316.84       70,287       260.05       82.1       2,139  
Ohio
    734       218,641       297.78       162,851       221.80       74.5       17,107  
Texas
    282       57,835       205.13       48,121       170.68       83.2       1,004  
Utah
    236       67,036       284.00       55,760       236.23       83.2        
Washington
    1,061       196,013       184.78       163,008       153.67       83.2       3,235  
Wisconsin (3)
    106       23,723       224.90       21,420       203.07       90.3        
Other (4)
          1,909             11,161                   68  
      4,830     $ 1,042,889     $ 215.93     $ 862,491     $ 178.58       82.7 %   $ 35,197  
 

               Three Months Ended December 31, 2009    
             
Premium Revenue
        Medical Care Costs                
       
Member
Months (1)
       Total        
PMPM
       
Total
       
PMPM
       
Medical
Care Ratio
       Premium
Tax
Expense (2)
 
California
    1,059     $ 127,716     $ 120.56     $ 115,506     $ 109.03       90.4 %   $ 6,035  
Florida
    141       35,910       254.97       34,882       247.67       97.1       6  
Michigan (2)
    651       151,845       233.07       121,457       186.43       80.0       10,443  
Missouri
    232       52,507       226.21       45,954       197.97       87.5        
New Mexico
    279       102,079       365.48       87,090       311.82       85.3       3,008  
Ohio
    637       216,849       340.60       189,796       298.11       87.5       15,759  
Texas
    119       41,205       347.41       31,633       266.71       76.8       683  
Utah
    206       51,912       252.21       49,528       240.63       95.4        
Washington
    997       179,617       180.21       156,251       156.77       87.0       5,033  
Wisconsin (3)
                                         
Other (4)
          2,771             10,274                   2  
      4,321     $ 962,411     $ 222.68     $ 842,371     $ 194.91       87.5 %   $ 40,969  
 
(1)  
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)  
Effective January 1, 2010, the Company has recorded the Michigan gross receipts tax, or MGRT, as a premium tax and not as an income tax.  The 2009 amounts have been reclassified to conform to this presentation.
(3)  
The Company acquired the Wisconsin health plan on September 1, 2010.
(4)  
“Other” medical care costs primarily include medically related administrative costs at the parent company.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 15
February 17, 2011
 
 
MOLINA HEALTHCARE, INC.
UNAUDITED SELECTED FINANCIAL DATA BY HEALTH PLAN
(Amounts in thousands except per member per month amounts)
 
                Year Ended December 31, 2010  
             
Premium Revenue
        Medical Care Costs                
       
Member
Months (1)
       Total        
PMPM
       
Total
       
PMPM
       
Medical
Care Ratio
       Premium
Tax
Expense (2)
 
California
    4,197     $ 506,871     $ 120.77     $ 423,021     $ 100.79       83.5 %   $ 6,912  
Florida
    664       170,683       256.87       162,839       245.07       95.4       1  
Michigan (2)
    2,708       630,134       232.66       527,596       194.80       83.7       39,187  
Missouri
    946       210,852       222.98       180,291       190.66       85.5        
New Mexico
    1,104       366,784       332.02       295,633       267.61       80.6       9,300  
Ohio
    2,817       860,324       305.42       680,802       241.69       79.1       67,358  
Texas
    708       188,716       266.72       162,714       229.97       86.2       3,251  
Utah
    921       258,076       280.27       235,576       255.84       91.3        
Washington
    4,141       758,849       183.27       636,617       153.75       83.9       13,513  
Wisconsin (3)
    134       30,033       224.75       27,574       206.35       91.8        
Other (4)
          8,587             38,194                   253  
      18,340     $ 3,989,909     $ 217.56     $ 3,370,857     $ 183.80       84.5 %   $ 139,775  
 
 
                Year Ended December 31, 2009  
             
Premium Revenue
        Medical Care Costs                
       
Member
Months (1)
       Total        
PMPM
       
Total
       
PMPM
       
Medical
Care Ratio
       Premium
Tax
Expense (2)
 
California
    4,135     $ 481,717     $ 116.49     $ 443,892     $ 107.34       92.2 %   $ 16,446  
Florida
    386       102,232       264.94       95,936       248.62       93.8       16  
Michigan (2)
    2,523       557,421       220.94       454,431       180.12       81.5       36,482  
Missouri
    927       230,222       248.25       191,585       206.59       83.2        
New Mexico
    1,042       404,026       387.67       346,044       332.03       85.7       11,043  
Ohio
    2,411       803,521       333.33       691,402       286.82       86.1       47,849  
Texas
    402       134,860       335.69       110,794       275.78       82.2       2,513  
Utah
    793       207,297       261.43       190,319       240.02       91.8        
Washington
    3,847       726,137       188.77       613,876       159.58       84.5       14,175  
Wisconsin (3)
                                         
Other (4)
          12,774             37,957                   57  
      16,466     $ 3,660,207     $ 222.24     $ 3,176,236     $ 192.85       86.8 %   $ 128,581  
 
(1)  
A member month is defined as the aggregate of each month’s ending membership for the period presented.
(2)  
Effective January 1, 2010, the Company has recorded the Michigan gross receipts tax, or MGRT, as a premium tax and not as an income tax.  The 2009 amounts have been reclassified to conform to this presentation.
(3)  
The Company acquired the Wisconsin health plan on September 1, 2010.
(4)  
“Other” medical care costs primarily include medically related administrative costs at the parent company.
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 16
February 17, 2011

 
MOLINA HEALTHCARE, INC.
 
UNAUDITED SELECTED FINANCIAL DATA
 
(Dollars in thousands except per member per month amounts)

The following tables provide the details of the Company’s medical care costs for the periods indicated:

   
Three Months Ended
December 31, 2010
   
Three Months Ended
December 31, 2009
 
   
Amount
   
PMPM
   
% of Total
Medical
Care Costs
   
Amount
   
PMPM
   
% of Total
Medical
Care Costs
 
Fee-for-service
  $ 597,183     $ 123.64       69.2 %   $ 556,118     $ 128.68       66.0 %
Capitation
    145,166       30.06       16.8       145,187       33.59       17.2  
Pharmacy
    84,645       17.53       9.8       108,617       25.13       12.9  
Other
    35,497       7.35       4.2       32,449       7.51       3.9  
    $ 862,491     $ 178.58       100.0 %   $ 842,371     $ 194.91       100.0 %
 
 
   
Year Ended
December 31, 2010
   
Year Ended
December 31, 2009
 
   
Amount
   
PMPM
   
% of Total
Medical
Care Costs
   
Amount
   
PMPM
   
% of Total
Medical
Care Costs
 
Fee-for-service
  $ 2,360,858     $ 128.73       70.0 %   $ 2,077,489     $ 126.14       65.4 %
Capitation
    555,487       30.29       16.5       558,538       33.91       17.6  
Pharmacy
    325,935       17.77       9.7       414,785       25.18       13.1  
Other
    128,577       7.01       3.8       125,424       7.62       3.9  
    $ 3,370,857     $ 183.80       100.0 %   $ 3,176,236     $ 192.85       100.0 %

The following table provides the details of the Company’s medical claims and benefits payable as of the dates indicated:

   
Dec. 31,
2010
   
Sept. 30,
2010
   
Dec. 31,
2009
 
Fee-for-service claims incurred but not paid (IBNP)
  $ 275,259     $ 271,285     $ 246,508  
Capitation payable
    49,598       53,410       39,995  
Pharmacy payable
    14,649       14,663       20,609  
Other
    14,850       13,982       8,204  
    $ 354,356     $ 353,340     $ 315,316  
 
 
 
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MOH Reports Fourth Quarter and Year-End 2010 Results
Page 17
February 17, 2011

MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in thousands, except per-member amounts)
(Unaudited)

The Company’s claims liability includes an allowance for adverse claims development based on historical experience and other factors including, but not limited to, variation 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 negative amounts displayed for “Components of medical care costs related to: Prior periods” represent the amount by which the Company’s original estimate of claims and benefits payable at the beginning of the period exceeded the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported.  The following table shows the components of the change in medical claims and benefits payable as of the periods indicated:

   
Year Ended
 
   
Dec. 31,
2010
   
Dec. 31,
2009
 
Balances at beginning of period
  $ 315,316     $ 292,442  
Balance of acquired subsidiary
    3,228        
Components of medical care costs related to:
               
Current period
    3,420,235       3,227,794  
Prior periods
    (49,378 )     (51,558 )
Total medical care costs
    3,370,857       3,176,236  
Payments for medical care costs related to:
               
Current period
    3,085,388       2,920,015  
Prior periods
    249,657       233,347  
Total paid
    3,335,045       3,153,362  
Balances at end of period
  $ 354,356     $ 315,316  
                 
Benefit from prior period as a percentage of:
               
Balance at beginning of period
    15.7 %     17.6 %
Premium revenue
    1.2 %     1.4 %
Total medical care costs
    1.5 %     1.6 %
                 
Claims Data (1):
               
Days in claims payable, fee for service only
    42       44  
Number of members at end of period
    1,613,000       1,455,000  
Number of claims in inventory at end of period
    143,600       93,100  
Billed charges of claims in inventory at end of period
  $ 218,900     $ 131,400  
Claims in inventory per member at end of period
    0.09       0.06  
Billed charges of claims in inventory per member at end of period
  $ 135.71     $ 90.31  
Number of claims received during the period
    14,554,800       12,930,100  
Billed charges of claims receivedduring the period
  $ 11,686,100     $ 9,769,000  

(1)  
“Claims Data” does not include the Company’s Wisconsin health plan acquired September 1, 2010.
 

 
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