Molina Healthcare, Inc.

Navigating the murky waters of federal health care plans is no easy feat, but Molina Healthcare's mission is to help Medicaid and Medicare members find their way to health care. Its Health Plan segment arranges for the delivery of health services to some 1.8 million people who receive their care through Medicaid, Medicare, and other government-funded programs in 9 states. Its Medicaid Solutions segment provides business process outsourcing (BPO) solutions to Medicaid agencies in five states for their Medicaid Management Information Systems (MMIS), the tool used to support administration of state health care entitlement programs. The family of founder C. David Molina controls the company through holdings and trusts.

Geographic Reach

Molina's health plans primarily operate in Washington, California, Texas, Ohio, and Michigan, as well as in New Mexico, Utah, Florida, and Wisconsin. The Medicaid Solutions business provides IT services in Idaho, Louisiana, Maine, New Jersey, and West Virginia; it also administers a drug rebate program in Florida.

A third component of the company, referred to as the direct delivery line of business (reported within the health plans segment), consists of about 25 primary care community clinics in California, Florida, New Mexico, and Washington. Molina also manages three county-owned primary care community clinics through a contract with Fairfax County, Virginia.

Operations

Altogether, Molina's operations provide plans or services to 4.3 million individuals in 15 states. Molina's health plans segment accounts for a majority (97% in 2012) of revenues. The company's health plans provide medical services through state networks of contracted hospitals and physicians that accept Molina health plan coverage.

Financial Analysis

Revenues increased 26% to some $6.0 billion in 2012. Growth was attributed to a 27% increase in health plan revenues (from increases in membership, benefits, and higher-premium member populations) and 17% increase in the Medicaid Solutions segment.

Despite experiencing steady revenue growth in recent years, profits fell for the second year in a row in 2012. Molina reported a net income decline of 53% to $9.8 million that year due to lower profit margins on health plans (from increased medical care costs) and higher administrative and general expenses. The company's profit decrease of 66% in 2011 to $20.8 million was largely due a $65 million impairment charge related to the expiration of the company's contract with the state of Missouri in mid-2011. The Missouri health plan had contributed premium revenue of about $230 million, or 5% of total premium revenue, in 2011 and held about 5% of the health plans segment's total membership.

Strategy

Molina grows in its existing markets by increasing services and adding physicians to its provider networks. It also looks to add new members by increasing its brand awareness through marketing and advertising campaigns. In addition, Molina enters new markets through both organic measures and through acquisitions, targeting entry into large markets with competitive provider communities. 

Molina's growth strategy also consists of opening additional primary care clinics in existing and new territories. The addition of more clinics helps Molina diversify its operations by expanding its involvement in the direct delivery of primary care. About 20% of Molina's California health plan membership is being served by its primary care clinics there.

Growing the direct delivery component of its business also helps Molina prepare for health care reform changes. Components of the health care reform bill call for increased health insurance coverage and changes to the way government health plans are reimbursed, which could impact the company's financial returns on health plan operations. In addition, Molina sees opportunities in the Affordable Care Act's provisions to expand state Medicaid programs, as well as by participating in dual eligibility programs designed to improve the coordination of care for members that are eligible for coverage under Medicaid and Medicare plans.

Mergers and Acquisitions

In 2011 Molina acquired its Long Beach, California, headquarters building for some $81 million. It had previously leased space in the building. The purchase will facilitate the company's spatial needs as it expands.

In 2010 the company entered a high-growth market with the acquisition of Abri Health Plan for about $15 million. Abri Health provides Medicaid managed care services in Wisconsin.

Also in 2010, Molina purchased the information management business that now operates as Molina Medicaid Solutions.

Company Background

Founded in 1980, Molina Healthcare is headed by founder C. David Molina's sons: Dr. J. Mario Molina, who serves as chairman and CEO, and John C. Molina, who is a director and the company's CFO.

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Molina Healthcare, Inc.


200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone: 1 (562) 435-3666
Fax: 1 (562) 4377235
www.molinahealthcare.com

STATS


  • Employer Type: Public
  • Stock Symbol: MOH,
  • Stock Exchange: , NYSE
  • CEO and President: J. Mario Molina
  • CEO and President: J. Mario Molina
  • CFO: John Molina

Major Office Locations

  • Long Beach, CA
  • Long Beach, CA

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