Operator
Operator
Ladies and gentlemen, thank you for standing by. Welcome to the Molina Healthcare Second Quarter 2016 Earnings Conference Call. During the presentation, all participants will be in a listen-only mode. Afterwards, we will conduct a question-and-answer session. As a reminder, this conference is being recorded Wednesday, July 27, 2016. I would now like to turn the conference over to Mr. Juan José Orellana, Senior Vice President of Investors Relations. Please go ahead. Juan José Orellana - Senior Vice President of Investor Relations & Marketing: Thank you, Pascal. Hello, everyone, and thank you for joining us. The purpose of this call is to discuss Molina Healthcare's financial results for the second quarter ended June 30, 2016. The company issued its earnings release reporting these results today after the market closed, and this release is now posted for viewing on our company website. On the call with me today are Dr. Mario Molina, our CEO; John Molina, our CFO; Terry Bayer, our COO; Joseph White, our Chief Accounting Officer. After the completion of our prepared remarks, we will open the call to take your questions. If you have multiple questions, we ask that you get back in the queue so that others can have an opportunity to ask their questions. Our comments today will contain forward-looking statements under the Safe Harbor Provisions of the Private Securities Litigation Reform Act. All of our forward-looking statements are based on our current expectations and assumptions, which are subject to numerous risk factors that could cause our actual results to differ materially. A description of such risk factors can be found in our earnings release, and in our reports filed with the Securities and Exchange Commission, including our Form 10-K annual report, our Form 10-Q quarterly reports, and our Form 8-K current reports. These reports can be accessed under the Investor Relations tab of our company's website or the SEC's website. All forward-looking statements made during today's call represent our judgment as of July 27, 2016, and we disclaim any obligation to update such statements, except as required by securities laws. This call is being recorded and a 30-day replay of the conference call will be available at our company's website, molinahealthcare.com. I would now like to turn the call over to Dr. Mario Molina. Joseph Mario Molina - Chairman, President & Chief Executive Officer: Thank you, Juan José. Thanks to everyone for joining us. I'm pleased to report that the results we published today represent a significant improvement over the first quarter. We earned $33 million in net income, or $0.58 per diluted share, and adjusted net income of $38 million, or $0.67 per diluted share. I call attention to our adjusted net income, because so many of you are now gauging our performance by that metric. We believe that adjusted net income per diluted share is very helpful in assessing our financial performance, because it removes the non-cash amortization of purchased intangibles. Last quarter, we shared with you some specific improvements that we needed to make to our operations. The results we have reported today speak to the progress we have made. We remain confident about Puerto Rico. We continue to improve our information technology and medical management infrastructure. We're making good progress in Texas, and the issues we identified in Ohio in the first quarter are substantially resolved. Now, let me take these in order. First, we told you that progress in Puerto Rico would take time, but we have reasons to be optimistic. While bad news in the Commonwealth continues to capture headlines, many of the underlying developments tell a more positive story. Governor Padilla has argued consistently that payments for essential public services are a priority. There are more than words behind the Governor's commitment. As of today, Puerto Rico is current on its premium payments, and we believe they will continue to make payments on a timely basis. I'm also happy to report that our rate discussions with the Commonwealth have gone well and that we received a rate increase of approximately 2.5% that was effective on July 1. Stepping away from the macroeconomic situation on the island, there remains much that is within our control. We have identified numerous utilization management and provider contracting opportunities in Puerto Rico that give us a great deal of confidence in the future. We also remain vigilant of Zika infection trends in Puerto Rico and are actively contributing to prevention and education efforts on the island. In addition, health officials in Florida are investigating two possible non-travel-related Zika cases. Again, this is not a Medicaid-specific risk, but a general public health threat, and the concern now is a lack of adequate funding to local government agencies to respond to Zika in a comprehensive manner. During the first quarter, we discussed the substantial growth in our enrollment and the stresses that this growth placed upon our information technology and medical management infrastructure. In order to avoid a repeat of what happened in the first quarter, we have re-prioritized and accelerated improvements that were already planned and budgeted for 2016. Costs associated with these enhancements have already been contemplated in our 2016 outlook. Two improvements are worth specific mention. In the area of information technology, we have supplemented our systems with a hyper-converged infrastructure. This software-centric architecture enables us to achieve a greater level of scalability, improved operational efficiency, shorter deployment times, and enhanced security by tightly integrating our computing, storage, and virtualization resources. On the medical management front, we have also selected a new software platform to manage pharmacy and medical care. This effort will further unify our medical and pharmacy clinical management within one platform rather than managing these two functions separately. We also spoke to the utilization management and provider contracting issues that contributed to our problems in Texas during the first quarter. Even without the benefit of the out-of-period quality revenue adjustments that John will talk about in a few minutes, the medical care ratio of the Texas health plan would have been approximately 85.3% in the second quarter. That is well under the 92.8% medical care ratio we reported in the first quarter. We continue to work with local providers in innovative ways to supplement our contracted provider network. We entered into an agreement with Memorial Hermann in Houston to add this prestigious hospital to our network in 2017. Finally, we shared with you our opinion that the problems experienced by our Ohio health plan in the first quarter were transitory in nature. Today's results support that opinion. The medical care ratio of the Ohio health plan decreased to 89.7% in the second quarter of 2016 from 92% in the first quarter. Health plan and corporate staff have worked together to address the root causes of the utilization management issues that contributed to our first-quarter results. We're pleased with our progress to date. This quarter has given us added confidence that we're making use of the right tools and getting the right results. I look forward to updating you again on our progress. I would now like to turn the call over to John. John C. Molina, JD - Chief Financial Officer & Director: Thank you, Mario, and hello, everyone. Today, as Mario said, we reported adjusted net income per diluted share of $0.67 for the second quarter compared to $0.51 per diluted share on an adjusted basis for the first quarter. These results were driven by lower medical costs as reflected by a 60 basis point improvement in our medical care ratio compared to the first quarter. Comparing our year-over-year performance is no longer meaningful given our growth, changes in product mix and acquisition activity. So, I will focus most of this discussion on sequential comparisons. While changes in accounting estimates resulted in several significant out-of-period adjustments during the quarter and for the year-to-date, it is important to note that in total these items only added $0.04 of a benefit to our quarterly results. For the first half of the year, these adjustments were, in fact, a $0.19 drag on our performance. In other words, however important these items might be to a particular geography or program, they were not significant to our consolidated quarterly results. The important facts about the quarter are as follows. As Mario said, we have reasons to be optimistic in Puerto Rico. Effective July 1, we received a 2.5% increase in premiums on the island. We also have multiple medical management and provider contracting opportunities that we are pursuing while we speak. Operationally, we have addressed the infrastructure problems that contributed to our first quarter difficulties. Despite the noise around our 2015 estimate change, we are satisfied with our marketplace performance. Through June 30 of 2016, the medical care ratio of our marketplace business for 2016 dates of service alone is approximately 78%. This accounts for risk adjustment accruals that we're making for calendar year 2016. And we believe that our marketplace pricing for 2017 is adequate. Finally, the primary drivers of our margin improvement resulted from the work that has been accomplished in Ohio and Texas. The medical care ratio in our Ohio health plan decreased by 230 basis points over the first quarter of 2016. Improvement in Texas was even more pronounced. Even without the benefit of out-of-period quality revenue adjustments, the medical care ratio of our Texas health plan was approximately 85.3% in the second quarter, that is well under the 92.8% medical care ratio that we reported in the first quarter. Now, let's quickly review the significant out-of-period adjustments in the second quarter. All of these adjustments are the result of new information we received during the quarter that required us to make changes to our accounting estimates. First, we recorded increased pre-tax income of $51 million or $0.58 per share relating to the recognition of previously-deferred Texas quality revenue. The Texas Department of Health and Human Services notified us this quarter that it would allow health plans to retain all outstanding quality revenue for calendar years 2014 through 2016. Based on that notification, we recognized $51 million of revenue for 2014, 2015 and the first quarter of 2016 that had previously been deferred. Of the $51 million, $44 million related to 2015 and 2014 dates of service, and $7 million related to the first quarter of 2016. As you know, we have been very transparent about the measurement difficulties with this program and the related accounting treatments, which has affected our earnings. We're happy to be able to put this to rest for a while. Second, we recorded a $37 million or $0.42 per share decrease to pre-tax income related to marketplace 2015 dates of service. As a reminder, on June 30, 2016, CMS published its final update on risk transfer and reinsurance payments for the 2015 calendar year, and we adjusted our accruals accordingly. Based on information received in 2016, we now know that our 2015 accruals were light. We continue to refine our accrual methodology as we get more information and believe we are more accurately reserved for the 2016 benefit year. I want to emphasize that our marketplace strategy has been to provide an accessible extension of our Medicaid product to those individuals whose eligibility for Medicaid tends to fluctuate due to variability in their income. Remember, the segment most likely to purchase an exchange product from Molina includes those individuals under 250% of the federal poverty level. Approximately 90% of our marketplace members continue to receive a government subsidy for co-pays and premiums, and it's no coincidence that we have grown significantly in states that have not expanded their Medicaid programs. We continue to have a disciplined approach to our pricing strategy, and we believe that we have adequately priced our marketplace products for 2017. An important consideration as you analyze our marketplace pricing is to compare our pricing with that of other health plans that primarily serve Medicaid members, as opposed to those that primarily serve commercial members. Next, we recorded an $11 million or $0.12 per share decrease to pre-tax income for 2015 dates of service related to Puerto Rico. As disclosed in our 10-Q for the first quarter, this matter arose as a result of enrollment discrepancies between our health plan and the Commonwealth in the early stages of our contract. Let me be clear. We believe that we have a valid claim to all of the premiums withheld. Nevertheless, we reduced premium revenue by $11 million during the second quarter in connection with this matter. The company is affirming its previously-announced earnings outlook. That outlook anticipates earnings per diluted share in the range of $2.15 to $2.60, and adjusted earnings per diluted share in the range of $2.50 to $2.95. We believe that adjusted net income per diluted share is very helpful in assessing our financial performance, because it removes the non-cash amortization of purchased intangibles. Furthermore, we expect our 2016 marketplace margins, measured absent the impact of the 2015 true-ups, to decline significantly during the second half of the year, as a result of four factors. One, we will incur higher costs as members reach the limits of the cost-sharing provisions of their insurance coverage. Two, higher-cost members will be added through the special enrollment period. Three, there will be attrition among lower utilizing members. And four, utilization among new members will increase as they become more engaged with our networks. While we expect our Ohio and Texas health plans will continue to perform well, additional improvement over and above the performance this quarter will be difficult to achieve. In particular, the decline in marketplace margins that we expect in the second half will be especially notable in Texas. Puerto Rico will begin to improve, but slowly and towards the end of the year. Rate increases will provide a modest lift to the second half performance as follows. For Medicaid rates in 2016 and excluding Medicaid expansion, we receive increases of approximately 3% in California and 2.5% in Puerto Rico, both effective July 1, and approximately 3% in Texas effective September 1. For Medicaid expansion rates in 2016, we saw decreases of approximately 11% in California and approximately 2% in Ohio, both effective July 1. Finally, and somewhat related, we saw the implementation of a medical care ratio floor of 86% for the South Carolina Medicaid business effective July 1. At June 30, 2016, days and claims payable were up two days to 48 days from the previous quarter, and cash and investments were in excess of $4.3 billion. Cash flow from operations was $139 million, in line with the prior quarter, and we held more than $465 million in cash and investments at the parent. Finally, we wanted to provide you with ample notice that we are postponing our 2016 fall Investor Day in September in order to have a more meaningful discussion that includes our third quarter results. We've moved that to another date. We will communicate that new date once it has been selected. It was a very good quarter, and I want to thank all of those employees who worked very hard to make it such a success. This concludes our prepared remarks. We're ready to take questions.