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Did Molina Healthcare beat or miss consensus estimates last quarter?

- **2025 Performance**: Full-year EPS of $11.03 vs. $24.50 guidance due to 7.5% medical cost trend and Marketplace volatility.
- **2026 Outlook**: EPS guidance of $5 (underlying $7.50) reflects Florida CMS contract drag ($1.50) and MAPD exit ($1). Medicaid MCR 92.9% (1.2% margin), Medicare MCR 94% (negative 1.7%).
- **Growth Drivers**: $6B Florida CMS contract (Q4 2026 incept) and $50B RFP pipeline. Embedded earnings exceed $11 per share.
- **Risk Management**: 2% organic Medicaid attrition in 2026, reduced Marketplace exposure by 50%, and 70% renewal rate in ACA.
- **Long-Term Vision**: 2026 is Medicaid margin trough (1.2%), with potential for 300-400bps rate restoration and return to target margins by 2028.

**【CEO Summary Section】**
- **Q4 2025 Results**: Adjusted loss of $2.75 per share due to Medicaid retroactive items ($2 per share) and elevated utilization in Medicare and Marketplace. Full-year 2025 EPS was $11.03, below guidance due to 7.5% medical cost trend (vs. 4.5% initial estimate) and Marketplace volatility.
- **2026 Guidance**: Projected EPS of at least $5, with $1.50 drag from Florida CMS contract and $1 from MAPD exit. Underlying EPS of $7.50 assumes 4% Medicaid rates and 5% trend. Upside risks include trend moderation, rate adjustments, and Medicare/Marketplace performance.
- **Growth Initiatives**: Secured $6B Florida CMS contract (incepting Q4 2026) and renewed Wisconsin LTSS contract. $50B pipeline of new RFPs and active M&A pipeline for Medicaid accretion.
- **Long-Term Outlook**: 2026 is Medicaid margin trough (1.2% pretax), with potential for 300-400bps rate restoration. Embedded earnings exceed $11 per share, driven by new contracts and rate cycle recovery.

**【CFO Financial Commentary】**
- **Q4 2025 Financials**: $10.7B premium revenue, 93.5% Medicaid MCR (2% pretax margin ex retro items). Medicare MCR 97.5%, Marketplace MCR 99% due to behavioral health and drug trends.
- **2026 Financials**: $42B premium revenue (flat vs 2025), 0.8% pretax margin. Medicaid MCR 92.9% (1.2% margin), Medicare MCR 94% (negative 1.7%), Marketplace MCR 85.5% (1.7% margin). G&A ratio 6.4%, effective tax rate 30%.
- **Balance Sheet**: $223M parent company cash, 3.7x debt/EBITDA. Operating cash flow outflow of $535M in 2025 due to risk corridor settlements.

**【Q&A Highlights】**
- **Medicaid Margin Variance**: States underfunded by 300-400bps, but Molina maintains 2%+ pretax margin despite 7.5% trend. Florida CMS contract expected to reach target margins by 2028.
- **California Retro Items**: $135M impact from undocumented population corridor and LA County risk adjustment. Unlikely to recur in 2026.
- **Attrition Assumptions**: 2% organic Medicaid attrition in 2026 (vs. 4% in 2025), driven by reduced low/no users (5% decline in cohort).
- **Marketplace Strategy**: Reduced exposure by 50% to stabilize margins, with 70% renewals and 30% new members. Effectuation rate ~60%.
- **M&A Strategy**: Actively pursuing single-state payers in underpenetrated markets, targeting 20%+ revenue multiples for accretive acquisitions.

Molina Healthcare, Inc. (MOH) Q4 2025 Earnings Call Transcript

- **EPS Downgrade**: 2025 EPS revised to $14 (from $19), with Marketplace underperformance (50% of reduction) and Medicaid rate/trend imbalance as key drivers.
- **Marketplace Restructuring**: 2026 rate increases of 15-45%, reduced footprint by 20%, targeting breakeven on $1.5-$2B revenue.
- **Medicaid Margin Outlook**: 2026 baseline MCR of 91.3%, with potential upside from 100bps rate catch-up ($4.50 EPS) and $8.65 embedded earnings pipeline.
- **Balance Sheet Strength**: Parent company cash of $108M, RBC ratios at 340%, and debt-to-EBITDA of 2.5x support growth initiatives.
- **Growth Catalysts**: Georgia/Texas Medicaid wins, Medicare duals expansion, and $54B M&A pipeline targeting low-margin, book-value acquisitions.

**【CEO Summary Section】**
- **Q3 2025 Performance**: Adjusted EPS of $1.84, consolidated MCR of 92.6%, and premium revenue of $10.8 billion. Medicaid MCR of 92%, Medicare MCR of 93.6%, and Marketplace MCR of 95.6% reflect elevated medical cost trends across segments.
- **2025 Guidance Update**: Full year EPS revised to $14 (down from $19), driven by Marketplace underperformance (50% of EPS reduction) and Medicaid rate/trend imbalance. Full year MCR expected at 91.3%.
- **2026 Outlook**: Baseline EPS similar to 2025 guidance ($14), with potential upside from Medicaid rate catch-up (100bps of MCR yields $4.50 EPS) and embedded earnings ($8.65 per share pipeline). Marketplace revenue expected to decline to $1.5-$2 billion but targeted for breakeven margins.
- **Growth Initiatives**: $46 billion 2026 revenue target includes Georgia/Texas Medicaid wins, Medicare duals growth, and M&A pipeline of $54 billion opportunities. Share repurchases ($500M in Q3) reflect confidence in long-term margin targets despite short-term challenges.

**【CFO Financial Commentary】**
- **Q3 Financials**: GAAP net income of $278M, adjusted G&A ratio of 6.3%, and operating cash flow outflow of $237M due to risk corridor settlements. Parent company cash balance of $108M, RBC ratios at 340%, and debt-to-EBITDA of 2.5x.
- **2025 Guidance**: Full year premium revenue of $42.5B, MCR of 91.3%, and EPS of $14. Medicaid pretax margin of 3.2%, Medicare breakeven, and Marketplace negative pretax margin.
- **Capital Allocation**: Prioritized organic growth (Medicaid expansion, Medicare duals) over M&A, with disciplined approach to Marketplace exposure. 2026 G&A ratio expected to rise to 6.8% due to normalized compensation costs.

**【Q&A Highlights】**
- **Marketplace Strategy**: 2026 rate increases of 15-45% (30% average), reduced footprint by 20%, and exit from 50% of top-tier price positions to stabilize risk pool. Target mid-single-digit pretax margins on reduced revenue.
- **Medicaid Rates**: States 300-400bps underfunded, early 2026 rate cycle suggests modest catch-up (50bps above trend). LTSS, pharmacy, and behavioral health trends visible in rating cells support rate adequacy.
- **Embedded Earnings**: $8.65 per share pipeline includes $1 of implementation cost reversal and $0.40 Virginia contract loss. Partial realization in 2026 will depend on trend/rate alignment.
- **Medicare Performance**: MAPD margin improvement offset by FIDE/HIDE conversions. Bright ConnectiCare (MAPD) expected to reach target margins in 2026.
- **M&A Pipeline**: Full $54B pipeline with focus on low-margin, book-value acquisitions in struggling local plans. No plans to exit profitable Medicaid contracts despite industry-wide margin challenges.


Molina Healthcare, Inc. (MOH) Q3 2025 Earnings Call Transcript

- **Q2 Results**: Adjusted EPS $5.48, MCR 90.4%, pretax margin 3.3%. Medicaid MCR 91.3%, Marketplace MCR 85.4%.
- **2025 Guidance**: EPS floor $19 (down $5.50), MCR 90.2%, 140bps increase vs. prior guidance.
- **Segment Trends**: Medicaid trend 6%, Marketplace MCR 85% (83% normalized). Medicare MCR 90%.
- **Growth Targets**: 2026 premium $46B, 2027 $52B. Embedded earnings $8.65, $1 from reversing costs.
- **Marketplace Risk**: 30% enrollment decline in 2026, 10% of revenue kept stable.
- **Budget Bill Impact**: 15-20% expansion population reduction, gradual implementation.

**【CEO Summary Section】**
- **Q2 Financials**: Adjusted EPS of $5.48 on $10.9B premium revenue. Consolidated MCR of 90.4%, with Medicaid MCR at 91.3% and Marketplace MCR at 85.4%. Adjusted pretax margin of 3.3%.
- **Medical Cost Pressures**: Behavioral health, high-cost drugs, inpatient/outpatient utilization driving trend. Medicaid MCR 200-300bps below market average, but rate updates insufficient to offset trend.
- **2025 Guidance Update**: Full-year EPS floor of $19 (down $5.50 from initial $24.50). Consolidated MCR of 90.2%, with 140bps increase vs. prior guidance, 50% attributed to Marketplace.
- **Growth Initiatives**: 2026 premium target of $46B (9% YoY growth), 2027 target of $52B. Embedded earnings of $8.65 per share, with $1 from reversing implementation costs in 2026.
- **Budget Bill Impact**: 15-20% potential reduction in expansion population, gradual implementation expected. Marketplace enrollment decline of ~30% in 2026 due to subsidy expiration.

**【CFO Financial Commentary】**
- **Segment Performance**: 
  - **Medicaid**: Full-year MCR guidance of 90.9% (up 100bps), trend assumption increased to 6% from 5%. 55% of revenue renews in 2026, rate cycle well-timed.
  - **Medicare**: Full-year MCR of 90%, driven by dual eligibles and high-cost drugs. Pretax margin ~1.5%.
  - **Marketplace**: Full-year MCR of 85%, including 200bps from ConnectiCare and prior-year reconciliations. Normalized MCR of 83%, with 86% expected in H2. Pretax margin ~1%.
- **Balance Sheet**: Parent company cash of $100M, debt at 1.9x EBITDA. Days in claims payable (DCP) normalized to mid-40s.
- **G&A Efficiency**: Q2 ratio of 6.1%, guiding to 6.6% for 2025. Incentive comp reduction offsets trend-driven margin pressure.

**【Q&A Highlights】**
- **Medicaid MCR Outlook**: H2 MCR expected to increase to 91% vs. H1 90.8%, driven by trend outpacing rates. States showing willingness for off-cycle rate adjustments, but not included in guidance.
- **Marketplace Strategy**: 10% of revenue, targeting mid-single-digit margins. 2026 rate filings include 11% trend assumption, acuity shift from subsidy expiration, and program integrity policies.
- **Capital Deployment**: Prioritize organic growth, then M&A (small, single-state players). Share buybacks considered after M&A pipeline activity.
- **Embedded Earnings**: $8.65 unchanged, $1 from reversing implementation costs. 1/3 of balance ($2.25) expected to materialize in 2026, dependent on rate cycle.


Molina Healthcare, Inc. (MOH) Q2 2025 Earnings Call Transcript

- **Q1 Strong Performance**: $6.08 EPS, 89.2% MCR, and $10.6B premium revenue reflect disciplined cost management. 
- **Growth Momentum**: $800M Illinois D-SNP win adds $0.50 to embedded earnings, pushing 2026 target to $46B+ premium. 
- **Marketplace Challenges**: 400bps MCR drag from one-time items, but normalized 77.7% MCR shows underlying strength. 
- **Rate Environment**: States need 200-300bps rate increases; Molina could return to 89% MCR if rates adjust. 
- **Share Buybacks**: $500M repurchased in Q1, supporting long-term 13-15% EPS growth. 


**【CEO Key Highlights】**
- **Q1 2025 Financials**: Adjusted EPS of $6.08 on $10.6B premium revenue. Consolidated MCR of 89.2%, driven by strong medical cost management and rate improvements. Medicaid MCR at 90.3%, Medicare at 88.3%, and Marketplace at 81.7% (higher due to one-time items). 
- **Growth Initiatives**: Won Illinois D-SNP contract ($800M annual premium) and defended Nevada Medicaid. Embedded earnings increased to $8.65/share (from $7.75), with $0.50 from Illinois win. 
- **2025 Guidance**: Reaffirmed $42B premium and $24.50+ EPS. Medicaid rates slightly higher than expected (+50bps), offset by trend conservatism. Marketplace MCR guidance raised to 80% (from 79%). 
- **Political Risks**: Believes Medicaid changes will be marginal. States need 200-300bps rate increases to balance programs; Molina could return to 89% MCR if rates adjust. 

**【CFO Financial Details】**
- **Q1 Results**: $11B total revenue, $10.6B premium. G&A ratio 6.8%, down 20bps YoY. Operating cash flow $190M, share buybacks $500M (1.7M shares). 
- **Balance Sheet**: Parent cash $190M, debt 2x EBITDA. Days in claims payable 46% (lower due to payment timing). 
- **2025 Guidance Updates**: Full-year MCR 88.8% (unchanged). Medicaid MCR 89.9%, Medicare 89%, Marketplace 80%. G&A ratio 6.9% (better than prior 7.0%). 
- **Embedded Earnings**: $8.65/share (up $0.90), with $2.85/share expected in 2026. 

**【Q&A Key Themes】**
- **Marketplace Volatility**: 400bps MCR drag from risk adj. true-ups and ConnectiCare acquisition. Normalized MCR 77.7%; targeting mid-single-digit margins. 
- **Cost Trends**: Medicaid rates +5% vs. prior +4.5%, offset by trend conservatism. 85% of 2025 rates already known. 
- **M&A Pipeline**: Active with $52B 2027 target. States may open RFPs to more plans due to integration needs. 
- **Legislative Impact**: Unlikely to disrupt earnings; CMS finalizing 2026 rate updates with states. 
- **Virginia Contract Loss**: $0.40 EPS headwind from mid-year termination. 


Molina Healthcare (MOH)-24 Apr 25-2025 Q1 Earnings call transcript

- **Revenue Growth**: 2024 full year +19% to $38.6B; 2025 guidance $42B (+9%).
- **EPS Outlook**: 2025 EPS ≥$24.50 (+8% YoY), driven by Medicaid rate/trend alignment and Marketplace expansion.
- **Key Metrics**: 2025 Medicaid MCR 89.9% (100bps above target), Medicare MCR 89.0%, Marketplace MCR 79.0%.
- **Growth Drivers**: $7.75 embedded earnings for 2026+ from new contracts (Georgia, duals) and acquisitions (ConnectiCare).
- **Risks**: Medicaid trend pressure (2024: 6.5% vs. 2025: 4.5%), Medicare LTSS costs, and political uncertainty.

**【CEO Summary Section】**
- **Q4 2024 Performance**: Adjusted EPS of $5.05 on $10 billion premium revenue. Full year 2024 EPS of $22.65 (+8.5% YoY), premium revenue $38.6 billion (+19% YoY). Medicaid MCR 90.3%, Medicare 89.1%, Marketplace 75.4%.
- **2025 Guidance**: $42 billion premium revenue, EPS ≥$24.50 (+8% YoY). Medicaid MCR 89.9%, Medicare 89.0%, Marketplace 79.0%. Embedded earnings increased to $7.75 for 2026+.
- **Growth Initiatives**: Acquired ConnectiCare ($1.2B revenue), won Georgia Medicaid ($2B+), and expanded duals in 4 states (+$3B revenue). 2026 target: $46B premium; 2027: $52B.

**【CFO Financial Commentary】**
- **Q4 2024 Details**: GAAP net income $420M, non-GAAP EPS $5.05. G&A ratio 6.7% (6.3% Q4). Operating cash flow $644M (impacted by risk corridor payments).
- **2025 Financials**: EPS guidance includes $1 in contract implementation costs. Medicaid rates +4.5%, trend +4.5%. Medicare MCR 89.0% due to LTSS/medication costs. Marketplace MCR 79.0% vs. 75.4% in 2024.
- **Balance Sheet**: Parent company cash $445M post-ConnectiCare acquisition. Debt 1.7x EBITDA, share buybacks $500M in Q4.

**【Q&A Key Takeaways】**
- **Medicaid Trend**: 2024 full year trend 6.5% (3.25% core utilization). 2025 assumes 4.5% trend vs. 4.5% rate increases. Q4 2024 trend 1.2% vs. expected 0.5%.
- **Medicare Pressures**: LTSS, pharmacy costs, and Bright business drag. 2025 MCR 89.0% reflects conservative bids.
- **Marketplace Growth**: 60% YoY growth (50% organic). 2025 MCR 79.0% vs. 75.4% in 2024 due to reinvested margins.
- **Political Risks**: Minimal Medicaid cuts expected; states prioritize enrollment over funding cuts.
- **Embedded Earnings**: $7.75 for 2026+ from new contracts and acquisitions, supporting 13-15% long-term EPS growth.

Actual											3.02	4.79	3.36	-0.51	4.44	3.4	2.83	2.88	4.9	4.55	4.36	4.1	5.81	5.65	5.05	4.38	5.73	5.86	6.01	5.05	6.08	5.48	1.84	-2.75
Forecast											2.9682	4.9122	2.1969	0.9556	3.6738	3.3886	2.8008	2.7488	4.659	4.3315	4.2166	4.0166	5.193	5.0987	4.8802	4.3441	5.6848	5.5636	5.8051	5.7477	5.9687	5.6183	3.9041	0.3356	2.3775
Surprise	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	+1.75%	-2.49%	+52.94%	-153.37%	+20.86%	+0.34%	+1.04%	+4.77%	+5.17%	+5.04%	+3.40%	+2.08%	+11.88%	+10.81%	+3.48%	+0.83%	+0.80%	+5.33%	+3.53%	-12.14%	+1.86%	-2.46%	-52.87%	-919.43%	0.00%

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MOH Q1 2026 Earnings Preview

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MOH

MOH fundamentals

MOH Q1 2026 Earnings Preview

Earnings Call

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