Molina Healthcare

Molina Healthcare
Traded as NYSE: MOH
S&P 400 Component
Industry Healthcare
Founded 1980
Founder Dr. C. David Molina (deceased)[1]
Headquarters Long Beach, California, USA
Revenue Increase US$ 14.18 billion (2015)[2]
Increase US$ 143 million (2015)[2]
Website molinahealthcare.com

Molina Healthcare (NYSE: MOH) is a managed care company headquartered in Long Beach, California, United States. In 2016, Molina Healthcare was ranked 201 in Fortune 500.[3] In 2015, the company's health plans served about 3.5 million people through government-based healthcare programs.[4]

History

Molina Healthcare was founded in 1980 by C. David Molina, an emergency room physician in Long Beach, CA.[5] He had seen an influx of patients using the emergency room for common illnesses such as a sore throat or the flu because they were being turned away by doctors who would not accept Medi-Cal. As a result of his emergency room work, Dr. Molina established his first primary care clinic with the goal of treating the lowest-income patients, regardless of their ability to pay.[6]

The company was run by Dr. Molina’s son, J. Mario Molina, MD, who was a physician. He was the president and CEO of the company. John Molina, Mario’s younger brother, was the current CFO of Molina Healthcare.[7] In May of 2017, in light of poor financial performance by the company, J. Mario and John were removed from their positions by the board, ending family control of the company.[8] The two took over the Molina’s operations after their father died in 1996 and continued to expand the company.

However there are reports that it was J Mario Molina's outspoken criticism of the current administration that motivated the firing.

“I’ve been a very vocal critic of what’s going on in Washington,” Molina told Politico. “I know the other health plan executives have been afraid to speak out. Maybe they’re smarter than I am, but I’m not going to back off.”[9]

FierceHealthCare.com reported: "Molina Healthcare had thrived in the ACA’s individual marketplaces, but revealed in February that it lost $110 million in the fourth quarter of fiscal year 2016, due at least in part to the fact that it had to pay significantly more into the risk adjustment program than it had anticipated. However, despite those losses, Molina beat Wall Street predictions for the first quarter of 2017, the results of which were announced a day after the brothers were fired."[10]

There has also been speculation by industry analysts about a sale of the company, which may present an additional motivation to remove members of the founder's family from leadership positions.[10]

C. David Molina’s daughter Martha Bernadett, MD is also a part of Molina Healthcare. Since receiving two Robert Wood Johnson Foundation awards in 2002, Dr. Bernadett has served as the Executive Vice President of Research and Innovation at Molina Healthcare. She founded the Molina Institute for Cultural Competency, Book Buddies and the Molina Foundation, a non-profit organization to promote access to education and health care to reduce disparities.[11]

In 2017, a federal court ruled that the US government owed Molina Healthcare $52 million under the Affordable Care Act's risk corridor program, after congressional Republicans had blocked the payments.[12]

Clinic Expansion

The first Molina Medical clinic was opened in Wilmington, CA in 1980. Since then, 29 clinics have opened in Northern California, Southern California, Washington, New Mexico, Florida and Utah.[13][14] Molina Medical Group (MMG) also runs state-owned clinics in Fairfax County, Virginia. The clinics were opened to provide health care to low-income families and individuals.

Becoming an HMO

Molina Healthcare has focused on government-paid health care programs such as SCHIP and Medicaid since it became a health maintenance organization in 1985. From 1985 to 1997, the company was only in California.

Expansion of Health Plans

In 2015, Molina Healthcare entered into an agreement to acquire some assets of the Medicaid and MIChild businesses of HealthPlus of Michigan and its subsidiary - HealthPlus Partners, Inc. In a similar deal, Molina Healthcare of Florida, Inc., which is a wholly owned subsidiary of the company, inked a deal to acquire some assets of Preferred Medical Plan, Inc.'s Floridian Medicaid business in 2015. Additionally, they signed an agreement with MyCare Chicago to purchase some Medicaid business assets. In 2015, Molina Healthcare acquired Providence Human Services (PHS) and Providence Community Services in a $200 million deal to expand their coverage into the behavioral and mental health services. In 2015, PHS underwent a rebranding to become Pathways. As of September 30, 2015, Molina Healthcare had over 3.5 million members in its health plans.[30] The health plans are operated by the respective subsidiaries in its states, each of which is a licensed HMO.[31]

Going Public

Molina Healthcare filed with the Securities and Exchange Commission for an initial stock offering in December 2002 and went public in July 2003 with a stock offering of $102 million. The shares were priced at $17.50, and Molina raised approximately $124 million in the initial public offering.[32] In its stock market debut, Molina sold 6.6 million shares at $20.30, making the company the third-best first day gainer of 2003.[33] As of 2013, Molina sold 296 million shares at $34.58.[34] Molina Healthcare was the first company from Inc. Magazine’s Inner City 100 list to go public.[35] As of February 20, 2014, there were approximately 125 holders of record of common stock.[34]

Entering Medicare Market

Molina Healthcare entered the Medicare market in 2006. The company currently offers Medicare health plan options in eleven states: California, Florida, Illinois, Michigan, New Mexico, Ohio, South Carolina, Texas, Utah, Washington, and Wisconsin.[36]

Entering MMIS Market

Molina Healthcare acquired Unisys’ health information management business in December 2010 to create Molina Medicaid Solutions (MMS).[37] MMS has Medicaid Management Information Systems (MMIS) contracts with Idaho, Louisiana, Maine, New Jersey and West Virginia. In June 2011 the state of Louisiana selected CNSI, a Maryland-based health care technology services company, to replace Molina as the state’s MMIS and fiscal agent operations. However, in March 2013, Gov. Bobby Jindal canceled that contract. A new fiscal agent had yet to be named at that time.[38] MMS also gained a contract with the U.S. Virgin Islands. Molina Medicaid Solutions will administer operations for the territory out of its West Virginia location.[39]

Entering Health Insurance Marketplace

Beginning in 2014, Molina Healthcare offers Marketplace plans in nine states where it offers Medicaid health plans – Covered California, Washington Healthplanfinder, and New Mexico Health Insurance Exchange through State Facilitated Marketplaces; Texas, Utah, Wisconsin, Ohio and Florida through Federally Facilitated Marketplace; and Michigan through Partnership Marketplace[40] On November 16, 2016 the Seattle Times reported that about 11 million people currently get their coverage through the exchange.[41]

Dual Eligible Demonstration Projects

Molina was selected to participate in dual eligible demonstration projects in California,[42] Ohio,[43] Illinois,[44] Michigan,[45] South Carolina[46] and Texas[46] to serve patients who are eligible for both Medicare and Medicaid.

Awards and Recognitions

Molina Healthcare was awarded the 2011 Alfred P. Sloan Award for Business Excellence in Workplace Flexibility. The award ranks Molina Healthcare in the top 20 percent of employers nationally in terms of its programs, policies and culture for creating an effective and flexible workplace.[47] In 2006, Molina Healthcare was named among the 100 best corporate citizens by Business Ethics magazine.[48] Time Magazine recognized Dr. J. Mario Molina, CEO of Molina Healthcare, as one of the 25 most influential Hispanics in America.[49]

Other Awards and Recognitions

Labor Litigation

In April 2011, a lawsuit was filed against the company and its outsourcing firm Cognizant Technologies in California state court. Both companies are accused of discriminating against American workers who claim they were fired and replaced with H-1B workers. The companies are accused of violating numerous federal and state labor laws. In July, the U.S. District Court, Central District of California ruled that there were no federal claims, which the plaintiff’s attorney had acknowledged in his Declaration in Support of (the plaintiff’s) Motion to Remand. Molina has expressed confidence it will “win in court because specific allegations have been examined and found false.”[56]

References

  1. ↑ Oliver, Myrna. "Dr. C. David Molina; Founded HMO for Medi-Cal Recipients". Los Angeles Times. Los Angeles Times. Retrieved 1 December 2016.
  2. 1 2 "10-K Item 6. Selected Financial Data". Retrieved 6 September 2016.
  3. ↑ "."
  4. ↑ , 10-Q 2015.
  5. ↑ In Good Company , Hispanic Magazine.
  6. ↑ In Down Economy, Molina Healthcare Soars to New Heights , Hispanic Business Magazine.
  7. ↑ How I Made It: J. Mario Molina and John Molina , Los Angeles Times.
  8. ↑ Livingston, Shelby (2 May 2017). "Molina Healthcare fires CEO and CFO amid 'disappointing' finances". Modern Healthcare. Retrieved 3 May 2017.
  9. ↑ "Ousted insurance exec: 'People are afraid of the administration'". POLITICO. Retrieved 2017-08-05.
  10. 1 2 "Ex-Molina CEO suggests political views got him fired | FierceHealthcare". www.fiercehealthcare.com. Retrieved 2017-08-05.
  11. ↑ , South Bay Conference for Women.
  12. ↑ Herman, Bob (2017-08-05). "Insurer wins $52 million in ACA payment lawsuit". Axios. Retrieved 2017-08-05.
  13. ↑ Molina Healthcare to open primary care clinic in Albuquerque - Albuquerque Business First. Bizjournals.com (2012-06-20). Retrieved on 2013-07-29.
  14. ↑ Molina Healthcare opens first Florida clinic in West Palm Beach - South Florida Business Journal. Bizjournals.com. Retrieved on 2013-07-29.
  15. ↑ , Alacrastore.
  16. ↑ , EHealthInsurance.
  17. ↑ , US News.
  18. ↑ , Bloomberg.
  19. ↑ , Reuters.
  20. ↑ , Journal Sentinel.
  21. ↑ Molina Healthcare Selected to Participate in the Illinois Integrated Care Delivery System for Dual Eligibles - Yahoo! Finance. Finance.yahoo.com (2012-11-15). Retrieved on 2013-07-29.
  22. ↑ https://finance.yahoo.com/news/moh-enters-state-south-carolina-182003163.html
  23. ↑ Molina Healthcare to Assume Lovelace Medicaid Contract in New Mexico - MarketWatch. Marketwatch.com (2013-07-03). Retrieved on 2015-11-04.
  24. ↑ First Coast Advantage Medicaid members to become Molina members - Jacksonville Business Journal. bizjournals.com/jacksonville (2014-12-01). Retrieved on 2015-11-04.
  25. ↑ Molina acquisition expands Medicaid business in Chicago market - Healthcare Dive]. healthcaredive.com (2015-07-23). Retrieved on 2015-11-04.
  26. 1 2 Molina Healthcare to Buy Subsidiaries of Providence Service - Zacks]. zacks.com (2015-09-04). Retrieved on 2015-11-04.
  27. ↑ Molina Healthcare Adds Online Access To Behavioral Health - OpenMinds]. openminds.com (2015-08-03). Retrieved on 2015-11-04.
  28. ↑ HealthPlus finalizes sale of its Medicaid, MIChild business to Molina Healthcare - EIN News]. world.einnews.com (2015-09-09). Retrieved on 2015-11-04.
  29. ↑ Molina Healthcare to Buy Loyola Physician Partners Medicaid Programme in Cook County, Illinois - MA Navigator]. manavigator.com (2015-10-12). Retrieved on 2015-11-04.
  30. ↑ http://phx.corporate-ir.net/phoenix.zhtml?c=137837&p=irol-SECText&TEXT=aHR0cDovL2FwaS50ZW5rd2l6YXJkLmNvbS9maWxpbmcueG1sP2lwYWdlPTEwNDA2MzA0JkRTRVE9MSZTRVE9OCZTUURFU0M9U0VDVElPTl9QQUdFJmV4cD0mc3Vic2lkPTU3
  31. ↑ , Reuters Profile: Molina Healthcare, Inc.
  32. ↑ , McDermott
  33. ↑ , The Street
  34. 1 2 , Media Corporate
  35. ↑ , Inc. Magazine
  36. ↑ http://www.molinahealthcare.com
  37. ↑ , Managed Care Information Center
  38. ↑ Shuler, Marsha. (2013-03-24) Jindal cancels contract | Home | The Advocate — Baton Rouge, LA. Theadvocate.com. Retrieved on 2013-07-29.
  39. ↑ http://stthomassource.com/content/news/local-news/2012/10/13/vi-partners-west-virginia-medicaid-information-system?mini=calendar/2012/10/all
  40. ↑ http://www.cnbc.com/id/101062927
  41. ↑ http://www.seattletimes.com/nation-world/obamacare-enrollment-surges-after-the-election/
  42. ↑ http://www.foxbusiness.com/news/2013/03/27/california-gets-federal-nod-for-largest-dual-eligible-plan/. Retrieved April 24, 2013. Missing or empty |title= (help)
  43. ↑ Molina Healthcare to participate in Ohio’s integrated care system for dual eligibles. MedCity News (2012-08-27). Retrieved on 2013-07-29.
  44. ↑ http://www3.illinois.gov/PressReleases/ShowPressRelease.cfm?SubjectID=2&RecNum=10692
  45. ↑ http://www.crainsdetroit.com/article/20140907/NEWS/309079979/goal-of-states-8b-test-to-coordinate-medicare-medicaid-care
  46. 1 2 http://www.modernhealthcare.com/article/20150421/NEWS/150429978
  47. ↑ Downtown Gazette
  48. ↑ Business Ethics Magazine
  49. ↑ Time Magazine
  50. ↑ http://www.topworkplaces.com/frontend.php/regional-list/company/jsonline/molina-health-care
  51. ↑ http://www.bizjournals.com/albuquerque/print-edition/2014/12/12/best-places-to-work-molina-healthcare-of-new.html
  52. ↑ https://www.whitehouse.gov/the-press-office/2014/07/11/president-obama-announces-new-partnership-private-sector-strengthen-amer
  53. ↑ http://www.businessinsider.com/least-stressful-companies-to-work-for-in-america-2015-5
  54. ↑ http://fortune.com/fortune500/molina-healthcare-301/
  55. ↑ http://fortune.com/fortune500/molina-healthcare-201/
  56. ↑ Fired IT workers file lawsuit claiming H-1B workers replaced them. Computerworld (2011-07-12). Retrieved on 2013-07-29.

Fortune 500 2012 List

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