Molina Healthcare, Inc. (NYSE:MOH) Q4 2022 Earnings Call Transcript

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Joe Zubretsky: Sure, Nathan. We actually consciously separated the two major components of our embedded earnings because one of them is, in our view, entirely controllable, harvesting the $4 of earning our target margins on latent contracts and M&A is something we have a proven track record of doing. We separated that from the $2 of lingering COVID era corridors because eliminating them is outside our control. They were put in place during COVID. They’re articulated as being related to COVID. There are three remaining two that matter. Washington, State of Washington and Mississippi, and we believe over time that they will either be compressed or eliminated, but we don’t control that. With respect to rates, I would say that states, our customers and their actuaries are vary at least aware of the potential for an acuity shift somewhere due to the redetermination process.

And the fact that they’re aware of it. And we would — and if or not, we will certainly make them aware if we experience it, leads us to believe that if there is a significant shift in acuity somewhere in the book of business that the actuarial soundest principle will prevail, and we’ll be able to have a productive conversation about that.

Mark Keim: Nathan, just to build on that, a number of our states were in 19 on Medicaid now. A number of our states have told us, if and when there’s any impact from that redetermination, they are quite willing to reopen that to revisit it. So we feel good between that commitment and our advocacy efforts that the rates will move as they need to.

Nathan Rich: Thank you.

Operator: The next question comes from Gary Taylor with Cowen. Please go ahead.

Gary Taylor: Hey. Good morning, guys. Most of my questions are answered, just two quick ones. One on the exchange membership loss driven by repricing. Is there any particular state you’d point out in your footprint or is that pretty evenly distributed that rate increase in the enrollment decline? And then just secondly, because 99% of all the incoming investor angst about Molina is around redetermination risk and potential impact on margins, et cetera. Just wondered if you could share with us any additional work you’ve done on low utilizers, zero utilizers, people, populations most likely to be redetermined, et cetera? I know you’ve shared some of that before and just anything else you might add to provide some comfort around your Medicaid, MLR guide would be helpful, I think. Thanks.

Joe Zubretsky: Gary, I’ll answer your second question first and then kick it to Mark for more detail. But the analysis that we’ve shared with you and investors is the same one, because we’re looking at all the data. And there’s so many theoretical arguments of why an acuity shift could happen. We focus on the numbers and the data. We look at members greater than one year duration, less than one year duration. We look at the MLR for members with less than one year duration, greater than one year duration. We look at members with zero to 25% MLRs. We look at the lapse rate of membership, which hasn’t gone to zero. There still is a disenrollment rate that occurs in the Medicaid book. So we look at all that data, and it leads us to believe that while maybe somewhere there could be a slight acuity shift probably in the expansion book, not in the tenant book or the ABD book, but manageable and will be easy to deal with, particularly because the states are aware of it and we believe we’ll have a productive rate discussion if and when there is a shift in acuity that makes the rates actually unsound.

Mark?

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