Molina Healthcare, Inc. offers cost-effective Medicaid-related solutions to
meet the health care needs of low-income families and individuals, and to assist
government agencies in their administration of the Medicaid program.We envision
a future where everyone receives quality health care, and our mission is to
provide quality health care to people receiving government assistance. To execute
on our vision and mission, we dedicate ourselves to the following core values:
Caring - We care about those we serve and advocate on their behalf.
Enthusiasm - We enthusiastically address problems and seek creative solutions.
Respect - We respect each other and value ethical business practices.
Focus - We focus on our mission.
Thrift - We are careful with scarce resources.
Accountability - We are personally accountable for our actions and collaborate
to get results.
Feedback - We strive to improve the organization and achieve meaningful change
through feedback and coaching.
According to the U.S. Department of Health and Human Services (HHS), by late
2015 nearly 18 million people nationally gained health insurance by signing
up for Medicaid or the Health Insurance Marketplace (Marketplace), since several
of the Affordable Care Acts coverage provisions took effect. The uninsured
rate has fallen from a high of 18% to nearly 11%; the lowest uninsured rate
in 50 years according to an ongoing study by the Centers for Disease Control
and Prevention.
In addition, as states continue to seek cost-effective strategies to manage
the care of individuals with more complex healthcare and behavioral needs, we
believe that the movement toward the integration of behavioral health and medical
care will continue.
Our growth strategy has four components:
Expansion into new geographies;
Transitioning members and benefits from fee for service to managed care; and
Developing and acquiring new products and capabilities.
Significant accomplishments in support of our strategic growth initiatives during
2015 and early 2016 included:
Growth and retention in our existing markets.
We retained and grew existing business with our re-procurement wins in Michigan
and Washington. Our new contract in Michigan expanded our service area across
all of the Lower Peninsula, spanning an additional 18 counties. The Washington
win, along with the acquisition described below, strengthens our position in
the southwestern region of that state.
Our Florida and Michigan health plans acquired Medicaid contracts which added
approximately 192,000 new members in 2015.
Our Marketplace enrollment grew from approximately 15,000 members in 2014, to
over 200,000 members as of December 31, 2015.
Molina Medicaid Solutions entered into a 10-year contract with the state of
New Jersey to design and operate that states new Medicaid management information
system (MMIS).
Expansion into new geographies. Our Puerto Rico health plan began serving its
first members in April 2015. As of December 31, 2015, our Puerto Rico plan enrollment
amounted to approximately 348,000 members.
Transitioning members and benefits from fee for service to managed care. In
2015, we saw strong growth in our Medicare-Medicaid Plan (MMP) and Aged, Blind
or Disabled (ABD) programs. While smaller programs in total membership, they
translate to strong revenue growth because these members bring much higher premiums
when compared with our other members, including those in the Temporary Assistance
for Needy Families, Medicaid expansion and Marketplace programs.
Developing and acquiring new products and capabilities. We acquired Pathways
Health and Community Support LLC (Pathways), formerly known as Providence Human
Services, LLC, a division of The Providence Service Corporation. Pathways is
one of the largest national providers of accessible, outcome-based behavioral/mental
health and social services with operations in 23 states and the District of
Columbia. We believe this acquisition will complement our Health Plans segment
services with behavioral health and other services that focus on social determinants
of health, as we increasingly arrange for healthcare services for members with
complex needs.
From a strategic perspective, we believe our organizational structure allows
us to participate in an expanding sector of the economy and continue our mission
to provide quality health care to people receiving government assistance. Our
approach to our business is based on the following strengths:
Flexible Health Services Portfolio. We offer a comprehensive suite of Medicaid
services, ranging from quality care, disease management, cost management, and
direct delivery of health care services, to state-level Medicaid management
information systems (MMIS) administration through our Molina Medicaid Solutions
segment. Our health plan care delivery systems are diverse and readily adaptable
to different markets and changing conditions. We arrange health care services
with a variety of providers, including independent physicians and medical groups,
hospitals, ancillary providers, and our own clinics. Our systems support multiple
types of contract models. Our provider networks are well-suited, based on medical
specialty, member proximity, and cultural sensitivity, to provide services to
our members. We believe that our Molina Medicaid Solutions platform, which is
based on commercial off-the-shelf technology, has the flexibility to meet a
wide variety of state Medicaid administrative needs in a timely and cost-effective
manner.
Focus on People Receiving Government Assistance. Our experience over more than
35 years has allowed us to develop strong relationships with the constituents
we serve, establish significant expertise as a government contractor, and develop
sophisticated disease management, care coordination and health education programs
that address the particular health care needs of our members. We also benefit
from a thorough understanding of the cultural and linguistic needs of Medicaid
populations.
Scalable Administrative Infrastructure. Our operations share common systems
platforms, which allow for economies of scale and common experience in meeting
the needs of state Medicaid programs. We have centralized and standardized various
functions and practices to increase administrative efficiency. In addition,
we have designed our administrative and operational infrastructure to be scalable
for cost-effective expansion into new and existing markets.
Seasoned Management Team. Dr. C. David Molina founded our company in 1980
as a provider organization serving the Medicaid population in Southern California.
Today, we remain a provider-focused company led by his son, Dr. J. Mario Molina,
whose tenure with Molina is over 19 years. The rest of our named executive officers
have been with Molina for periods ranging from 10 years to 20 years. We believe
that this extensive experience allows senior management to take a longer-term
view of our operations, while maintaining consistency.
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