UNITED STATES SECURITIES AND EXCHANGE COMMISSIONWASHINGTON, D.C. 20549FORM 10-Q |
|X| | QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 FOR THE QUARTERLY PERIOD ENDED MARCH 31, 2004 |
OR |
|_| | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 |
Commission File Number 001-12115CONTINUCARE
CORPORATION |
Florida (State or other jurisdiction of incorporation or organization) |
59-2716023 (I.R.S. Employer Identification No.) |
80 Southwest Eighth Street (305)
350-7515 Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months, and (2) has been subject to such filing requirements for the past 90 days. Yes |X| No |_| Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act). Yes |_| No |X| At May 14, 2004, the Registrant had 50,300,186 shares of $0.0001 par value common stock outstanding. |
CONTINUCARE CORPORATIONINDEX |
2 |
PART I - FINANCIAL INFORMATIONITEM 1. - FINANCIAL STATEMENTSCONTINUCARE CORPORATIONCONDENSED CONSOLIDATED BALANCE SHEETS |
March 31, 2004 (Unaudited) |
June 30, 2003 |
|||||||
---|---|---|---|---|---|---|---|---|
ASSETS | ||||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 1,206,002 | $ | 160,743 | ||||
Certificates of deposit, current | 100,905 | 101,258 | ||||||
Accounts receivable, net of allowance for doubtful accounts of | ||||||||
$4,927,000 and $4,823,000, respectively | 186,651 | 323,443 | ||||||
Other receivables | 386,550 | 410,765 | ||||||
Due from Medicare, net | 155,003 | 258,930 | ||||||
Due from HMOs, net of a liability for incurred but not reported | ||||||||
medical claims expense of $11,758,000 and $13,014,000, respectively | 3,050,084 | 1,414,469 | ||||||
Prepaid expenses and other current assets | 614,507 | 565,935 | ||||||
Total current assets | 5,699,702 | 3,235,543 | ||||||
Certificates of deposit | | 30,000 | ||||||
Assets related to home health operations held for sale | | 540,398 | ||||||
Equipment, furniture and leasehold improvements, net | 475,919 | 430,382 | ||||||
Goodwill | 14,342,510 | 14,342,510 | ||||||
Managed care contracts, net of accumulated amortization of $1,982,000 | ||||||||
and $1,717,000, respectively | 1,528,822 | 1,793,431 | ||||||
Deferred financing costs, net of accumulated amortization of $4,016,000 | ||||||||
and $3,562,000, respectively | 971,903 | 518,382 | ||||||
Other assets, net | 105,753 | 109,330 | ||||||
Total assets | $ | 23,124,609 | $ | 20,999,976 | ||||
LIABILITIES AND SHAREHOLDERS EQUITY | ||||||||
Current liabilities: | ||||||||
Accounts payable | $ | 649,091 | $ | 683,488 | ||||
Accrued expenses | 2,759,361 | 2,283,048 | ||||||
Liabilities related to terminated IPA, net | 37,254 | 110,345 | ||||||
Credit facility | 2,287,604 | 2,315,000 | ||||||
Current portion of convertible subordinated notes payable | 48,384 | 233,716 | ||||||
Current portion of long-term debt | 402,384 | 2,640,943 | ||||||
Current portion of related party notes payable | 63,854 | 63,854 | ||||||
Accrued interest payable | 37,206 | 51,754 | ||||||
Current portion of capital lease obligations | 88,202 | 70,913 | ||||||
Total current liabilities | 6,373,340 | 8,453,061 | ||||||
Deferred gain on extinguishment of debt | 3,500,000 | 3,850,000 | ||||||
Capital lease obligations, less current portion | 118,860 | 125,606 | ||||||
Convertible subordinated notes payable, less current portion | 4,122,751 | 4,122,751 | ||||||
Long term debt, less current portion | 1,055,828 | 1,341,947 | ||||||
Related party notes payable, less current portion | 965,406 | 997,333 | ||||||
Total liabilities | 16,136,185 | 18,890,698 | ||||||
Commitments and contingencies | ||||||||
Shareholders equity: | ||||||||
Common stock; $0.0001 par value; 100,000,000 shares authorized, | ||||||||
46,221,194 shares issued and 43,225,001 shares outstanding at | ||||||||
March 31, 2004 and 45,375,194 shares issued and 42,379,001 | ||||||||
shares outstanding at June 30, 2003 | 4,323 | 4,239 | ||||||
Additional paid-in capital | 61,501,165 | 60,279,880 | ||||||
Accumulated deficit | (49,092,363 | ) | (52,750,140 | ) | ||||
Treasury stock (2,996,193 shares) | (5,424,701 | ) | (5,424,701 | ) | ||||
Total shareholders equity | 6,988,424 | 2,109,278 | ||||||
Total liabilities and shareholders equity | $ | 23,124,609 | $ | 20,999,976 | ||||
THE ACCOMPANYING
NOTES ARE AN INTEGRAL PART
|
CONTINUCARE CORPORATIONCONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) |
Three-Months Ended March 31, |
||||||||
---|---|---|---|---|---|---|---|---|
2004 |
2003 |
|||||||
Revenue | ||||||||
Medical services revenue, net | $ | 25,705,431 | $ | 24,187,129 | ||||
Management fee revenue | 195,274 | | ||||||
Total revenue | 25,900,705 | 24,187,129 | ||||||
Operating expenses | ||||||||
Medical services: | ||||||||
Medical claims | 18,984,500 | 18,345,344 | ||||||
Other direct costs | 3,009,934 | 2,771,354 | ||||||
Total medical services | 21,994,434 | 21,116,698 | ||||||
Administrative payroll and employee benefits | 1,031,724 | 977,798 | ||||||
General and administrative | 716,270 | 1,592,384 | ||||||
Total operating expenses | 23,742,428 | 23,686,880 | ||||||
Income from operations | 2,158,277 | 500,249 | ||||||
Other income (expense) | ||||||||
Interest income | 716 | 1,341 | ||||||
Interest expense | (253,602 | ) | (80,535 | ) | ||||
Income from continuing operations | 1,905,391 | 421,055 | ||||||
Income (loss) from discontinued operations: | ||||||||
Home health operations | (394,156 | ) | (417,049 | ) | ||||
Terminated IPA | | 294,370 | ||||||
Total loss from discontinued operations | (394,156 | ) | (122,679 | ) | ||||
Net income | $ | 1,511,235 | $ | 298,376 | ||||
Basic net income per common share: | ||||||||
Income from continuing operations | $ | .05 | $ | .01 | ||||
Loss from discontinued operations | (.01 | ) | | |||||
Net income | $ | .04 | $ | .01 | ||||
Diluted net income per common share: | ||||||||
Income from continuing operations | $ | .04 | $ | .01 | ||||
Loss from discontinued operations | (.01 | ) | | |||||
Net income | $ | .03 | $ | .01 | ||||
Basic weighted average number of common shares outstanding | 42,599,649 | 40,555,094 | ||||||
Diluted weighted average number of common shares outstanding | 49,256,367 | 40,555,094 | ||||||
THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
|
CONTINUCARE CORPORATIONCONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) |
Nine-Months Ended March 31, |
||||||||
---|---|---|---|---|---|---|---|---|
2004 |
2003 |
|||||||
Revenue | ||||||||
Medical services revenue, net | $ | 74,812,607 | $ | 71,651,111 | ||||
Management fee revenue | 519,733 | | ||||||
Total revenue | 75,332,340 | 71,651,111 | ||||||
Operating expenses | ||||||||
Medical services: | ||||||||
Medical claims | 55,932,729 | 54,749,622 | ||||||
Other direct costs | 8,761,813 | 8,144,176 | ||||||
Total medical services | 64,694,542 | 62,893,798 | ||||||
Administrative payroll and employee benefits | 2,918,040 | 2,909,282 | ||||||
General and administrative | 4,297,005 | 4,568,507 | ||||||
Gain on extinguishment of debt | (350,000 | ) | | |||||
Total operating expenses | 71,559,587 | 70,371,587 | ||||||
Income from operations | 3,772,753 | 1,279,524 | ||||||
Other income (expense) | ||||||||
Interest income | 2,792 | 5,068 | ||||||
Interest expense | (742,203 | ) | (690,477 | ) | ||||
Medicare settlement related to terminated operations | 2,218,278 | | ||||||
Income from continuing operations | 5,251,620 | 594,115 | ||||||
Income (loss) from discontinued operations: | ||||||||
Home health operations (including loss on disposal of $457,000) | (1,666,934 | ) | (1,404,849 | ) | ||||
Terminated IPA | 73,091 | 44,984 | ||||||
Total loss from discontinued operations | (1,593,843 | ) | (1,359,865 | ) | ||||
Net income (loss) | $ | 3,657,777 | $ | (765,750 | ) | |||
Basic net income (loss) per common share: | ||||||||
Income from continuing operations | $ | .12 | $ | .01 | ||||
Loss from discontinued operations | (.03 | ) | (.03 | ) | ||||
Net income (loss) | $ | .09 | $ | (.02 | ) | |||
Diluted net income (loss) per common share: | ||||||||
Income from continuing operations | $ | .11 | $ | .01 | ||||
Loss from discontinued operations | (.03 | ) | (.03 | ) | ||||
Net income (loss) | $ | .08 | $ | (.02 | ) | |||
Basic weighted average number of common shares outstanding | 42,452,016 | 40,251,186 | ||||||
Diluted weighted average number of common shares outstanding | 48,255,033 | 40,251,186 | ||||||
THE ACCOMPANYING
NOTES ARE AN INTEGRAL PART
|
CONTINUCARE
CORPORATION
|
Nine Months
Ended March 31, |
||||||||
---|---|---|---|---|---|---|---|---|
2004 |
2003 |
|||||||
CASH FLOWS FROM OPERATING ACTIVITIES | ||||||||
Net income (loss) | $ | 3,657,777 | $ | (765,750 | ) | |||
Loss from discontinued operations | 1,593,843 | 1,359,865 | ||||||
Income from continuing operations | 5,251,620 | 594,115 | ||||||
Adjustments to reconcile net income (loss) to cash provided by | ||||||||
operating activities: | ||||||||
Depreciation and amortization, including amortization of deferred | ||||||||
loan costs | 838,467 | 869,922 | ||||||
Gain on equipment disposals | | 500 | ||||||
Gain on extinguishment of debt | (350,000 | ) | | |||||
Provision for bad debts | 104,296 | 12,357 | ||||||
Medicare settlement related to terminated operations | (2,218,278 | ) | | |||||
Director compensation paid through the issuance of restricted | ||||||||
common stock | | 123,000 | ||||||
Changes in operating assets and liabilities: | ||||||||
Decrease (increase) in accounts receivable | 32,496 | (169,508 | ) | |||||
Increase in prepaid expenses and other current assets | (48,572 | ) | (38,593 | ) | ||||
Decrease in other receivables | 24,215 | 415,484 | ||||||
Increase in other assets | (1,507 | ) | (20,158 | ) | ||||
(Increase) decrease in due from HMOs, net | (1,635,615 | ) | 471,629 | |||||
(Increase) decrease in due to/from Medicare, net | 103,926 | 153,968 | ||||||
Increase in accounts payable and accrued expenses | 441,916 | 350,719 | ||||||
(Decrease) increase in accrued interest payable | (14,548 | ) | 11,477 | |||||
Net cash provided by continuing operations | 2,528,416 | 2,774,912 | ||||||
Net cash used in discontinued operations | (1,182,540 | ) | (1,421,260 | ) | ||||
Net cash provided by operating activities | 1,345,876 | 1,353,652 | ||||||
CASH FLOWS FROM INVESTING ACTIVITIES | ||||||||
Proceeds from equipment disposals | | 500 | ||||||
Proceeds from maturities of restricted cash, net | 30,353 | 100,056 | ||||||
Property and equipment additions | (64,070 | ) | (79,230 | ) | ||||
Net cash (used in) provided by continuing operations | (33,717 | ) | 21,326 | |||||
Net cash used in discontinued operations | (938 | ) | (20,568 | ) | ||||
Net cash (used in) provided by investing activities | (34,655 | ) | 758 | |||||
CASH FLOWS FROM FINANCING ACTIVITIES | ||||||||
Payments on convertible subordinated notes | (185,332 | ) | (205,423 | ) | ||||
Payments on related party notes | (31,927 | ) | (31,927 | ) | ||||
Principal repayments under capital lease obligations | (51,277 | ) | (94,601 | ) | ||||
Third party assumption of capital lease obligations | | (1,789 | ) | |||||
Net decrease in credit facility | (27,396 | ) | (515,000 | ) | ||||
Payments for deferred financing costs | (15,000 | ) | | |||||
Proceeds from exercises of stock options | 351,369 | | ||||||
Advances from HMOs | | 75,000 | ||||||
Payment on advances from HMOs | | (75,000 | ) | |||||
Repayments to Medicare per agreements | (306,399 | ) | (488,380 | ) | ||||
Net cash used in continuing operations | (265,962 | ) | (1,337,120 | ) | ||||
Net cash used in discontinued operations | | (81,506 | ) | |||||
Net cash used in financing activities | (265,962 | ) | (1,418,626 | ) | ||||
Net increase (decrease) in cash and cash equivalents | 1,045,259 | (64,216 | ) | |||||
Cash and cash equivalents at beginning of period | 160,743 | 180,410 | ||||||
Cash and cash equivalents at end of period | $ | 1,206,002 | $ | 116,194 | ||||
SUPPLEMENTAL SCHEDULE OF NONCASH INVESTING AND FINANCING ACTIVITY: | ||||||||
Stock issued for deferred financing costs | $ | 870,000 | $ | 645,540 | ||||
Note payable issued for refunds due to Medicare for overpayments | $ | | $ | 694,800 | ||||
Purchase of furniture and fixtures with proceeds of capital lease obligations | $ | 61,820 | $ | 56,463 | ||||
THE ACCOMPANYING
NOTES ARE AN INTEGRAL PART
|
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
Goodwill | $ | 320,882 | ||||||
Equipment, furniture and leasehold improvements | 111,640 | |||||||
Other | 24,868 | |||||||
$ | 457,390 | |||||||
The home health operations contributed $0.5 million and $1.2 million in revenue and generated an operating loss of $0.4 million during both of the three-month periods ended March 31, 2004 and 2003, respectively, before any corporate overhead allocation or interest expense. The home health operations contributed $3.1 million and $3.1 million in revenue and generated an operating loss of $1.2 million (prior to recording the disposal charge discussed above) and $1.4 million during the nine-month periods ended March 31, 2004 and 2003, respectively, before any corporate overhead allocation or interest expense. Approximately 10 employees were terminated as a result of these transactions. In accordance with Statement of Financial Accounting Standard No. 146, "Accounting for Costs Associated with Exit or Disposal Activities" ("SFAS No. 146"), the Company recorded $0.2 million of costs for severance payments and accrued for lease obligations in the third quarter of Fiscal 2004. The remaining loss incurred during the third quarter of Fiscal 2004 related to the operations of the private home health subsidiary prior to its February 7, 2004 sale and the cost of winding up all of the home health agencies activities, including billing and collection of outstanding accounts receivables. The Company estimates that further losses in the fourth quarter of Fiscal 2004, primarily related to collection efforts of outstanding receivables, will be approximately $25,000, but there can be no assurance that any such losses will be limited to the fourth quarter of Fiscal 2004 or to any particular amount. 9 |
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
Period Ended March 31, |
Three-Months |
Nine-Months |
||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2004 |
2003 |
2004 |
2003 |
|||||||||||
Basic weighted average number of shares outstanding | 42,599,649 | 40,555,094 | 42,452,016 | 40,251,186 | ||||||||||
Effect of dilutive securities stock options | 1,831,717 | | 978,016 | | ||||||||||
Dilutive effect of convertible debt | 4,825,001 | | 4,825,001 | | ||||||||||
Diluted weighted average number of shares outstanding | 49,256,367 | 40,555,094 | 48,255,033 | 40,251,186 | ||||||||||
Not included in calculation of dilutive earnings per share | ||||||||||||||
as impact is antidilutive: | ||||||||||||||
Stock options outstanding | 450,000 | 2,716,000 | 450,000 | 2,716,000 | ||||||||||
Warrants | 760,000 | 760,000 | 760,000 | 760,000 |
NOTE 9 DIRECTOR COMPENSATIONOn September 23, 2002, the Company issued a combined total of 800,000 shares of restricted common stock to Board members as compensation for their services. The value of the restricted stock award of $112,000 (based on the closing price of the Companys common stock on September 23, 2002) has been recorded as director compensation in the three-month period ended September 30, 2002. Also on September 23, 2002, two of the Board members elected to receive their compensation in the form of stock options, which represented a combined total of 400,000 stock options. The fully vested stock options have an exercise price of $.36 per share and are valid for a ten-year period. On October 30, 2002, the Company issued 100,000 shares of restricted common stock to a newly elected Board member. The value of the 100,000 shares of restricted stock awarded of $11,000 (based on the closing price of the Companys common stock on October 30, 2002) was recorded as director compensation in the second quarter of Fiscal 2003. NOTE 10 INCOME TAXESAlthough the Company had income from operations and net income for the nine-month period ended March 31, 2004, a provision for income taxes has not been recorded as the Company believes it will be able to utilize certain of its net operating loss carryforwards to offset any income tax liability. NOTE 11 CONTINGENCIESThe Company is a party to the case of JOAN LINDAHL v. HUMANA MEDICAL PLAN, INC., COLUMBIA HOSPITAL COPRORATION OF SOUTH BROWARD d/b/a WESTSIDE REGIONAL MEDICAL CENTER, INPHYNET CONTRACTING SERVICES, INC., CONTINUCARE MEDICAL MANAGEMENT, INC., LUIS GUERRERO AND JARSLAW PARKOLAP. This case was filed on January 24, 2002 in the Circuit Court of the 17th Judicial Circuit in and for Broward County, Florida and served on the companies and individuals in February 2003. The complaint alleges vicarious liability for medical malpractice and seeks damages in excess of $15,000. The stay on the case has recently been lifted. The Company intends to defend itself against this case vigorously, but its outcome cannot be predicted. The Companys ultimate liability, if any, with respect to the lawsuit is presently not determinable. 12 |
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
|
ITEM 2. | MANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS |
Unless otherwise indicated or the context otherwise requires, all references in this Form 10-Q to we, us, our, Continucare or the Company refers to Continucare Corporation and its consolidated subsidiaries. CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTSWe caution our investors that certain important factors may affect our actual results and could cause such results to differ materially from any forward-looking statement which may have been deemed to have been made in this report or which are otherwise made by us or on our behalf. For this purpose, any statements contained in this report that are not statements of historical fact may be deemed to be forward-looking statements. Without limiting the generality of the foregoing, words such as may, will, expect, believe, anticipate, intend, plan, could, would, estimate, continue or pursue, or the negative or other variations thereof or comparable terminology are intended to identify forward-looking statements. Such statements include, but are not limited to the following: |
| Our ability to make capital expenditures and respond to capital needs; |
| Our ability to enhance the services we provide to our members; |
| Our ability to strengthen our medical management capabilities; |
| Our ability to improve our physician network; |
| Our ability to renew our managed care agreements and negotiate terms which are favorable to us and affiliated physicians; |
| Our ability to respond to future changes in Medicare reimbursement levels and reimbursement rates from other third parties; |
| Our ability to establish relationships and expand into new geographic markets; and |
| The potential impact on our claims loss ratio as a result of Medicare Risk Adjustments ("MRA"). |
Forward-looking statements involve risks and uncertainties that cannot be predicted or quantified and, consequently, actual results may differ materially from those expressed or implied by such forward-looking statements. Such risks and uncertainties include, but are not limited to the following: |
| Our ability to service our indebtedness and respond to capital needs; |
| Our ability to achieve expected levels of patient volumes and control the costs of providing services; |
| Pricing pressures exerted on us by managed care organizations; |
| The level of payment we receive from governmental programs and other third party payors; |
| Our ability to attract and retain qualified medical professionals; |
| Future legislative changes in governmental regulations, including possible changes in Medicare programs that may impact reimbursements to health care providers and insurers; |
14 |
| The impact of MRA on payments we receive for our managed care operations; |
| Technological and pharmaceutical improvements that increase the cost of providing, or reduce the demand for, health care; |
| Changes in our revenue mix; |
| Our ability to enter into and renew managed care provider agreements on acceptable terms; |
| Loss of significant contracts; |
| Delays in receiving payments; |
| The collectibility of our uninsured accounts and deductible and co-pay amounts; |
| Federal and state investigations; |
| Changes in estimates and judgments associated with our critical accounting policies; |
| Impairment charges that could be required in future periods; |
| General economic conditions; and |
| Uncertainties generally associated with the healthcare business. |
We assume no responsibility to update our forward-looking statements as a result of new information, future events or otherwise. Additional information concerning these and other risks and uncertainties is contained our filings with the Securities and Exchange Commission, including the section entitled Risk Factors in our Annual Report on Form 10-K for the year ended June 30, 2003. GeneralWe are a provider of outpatient healthcare services in Florida. Through various capitated or percentage of premium arrangements, we are responsible for providing primary care medical services or overseeing the provision of primary care services by affiliated physicians to approximately 16,100 patients on a full-risk basis and approximately 14,900 patients on a limited or non-risk basis at March 31, 2004. Over 94% of our revenue is generated by providing services to Medicare-eligible members under full-risk agreements that require us to assume responsibility to provide and pay for all of our patients medical needs in exchange for a percentage of premium. Prior to their disposition in January and February of 2004, which is discussed below, we provided home health care services to recovering, disabled, chronically ill and terminally ill patients in their homes. In an effort to streamline operations and stem operating losses, effective January 1, 2003, we terminated the Medicare and Medicaid lines of business for all of the physician contracts associated with one of our independent practice associations, which consisted of 29 physicians at the time of termination. Additionally, in December 2003, we implemented a plan to dispose of our home health operations. The home health disposition occurred in three separate transactions which concluded on or prior to February 7, 2004. As a result of these transactions, the operations of the terminated IPA and our home health agencies are shown as discontinued operations. In addition to terminating and disposing of unprofitable operations, we have focused our attention on strengthening our financial position. Effective March 30, 2004, we obtained an extension of the maturity date for our credit facility (the Credit Facility) until March 31, 2005. Prior to the extension of the maturity date, the Credit Facility was personally guaranteed by Dr. Frost. In order to obtain the extension of the maturity date, Dr. Frost was required to renew his personal guarantee. In consideration of Dr. Frosts reaffirmation of his personal guarantee, the Company issued 300,000 shares of common stock to an entity controlled by Dr. Frost. The shares of common stock issued were valued at $870,000 based on the market price of the Companys common stock on March 26, 2004, the date on which the guarantee was renewed. This amount has been recorded as deferred financing costs and will be amortized over the term of the guarantee. The terms of the Credit Facility remained substantially unchanged, except for the removal of a financial covenant that previously required us to maintain a minimum fixed charge coverage ratio. 15 |
As part of our efforts to strengthen our financial position, we have initiated several transactions to reduce our outstanding long term liabilities. On March 31, 2004 the outstanding principal balance of our Convertible Subordinated Notes Payable (the Notes) was approximately $3.9 million. On April 12, 2004, we called the Notes for redemption in accordance with their terms, subject to the Noteholders right to convert the Notes prior to the redemption date into shares of our common stock. On May 12, 2004, all Noteholders converted their Notes and received 3,922,538 shares of common stock representing the conversion and cancellation of the outstanding principal balance of the Notes and the unpaid accrued interest through the conversion date. On April 22, 2004, we sold 2,333,333 shares of our common stock for $3.5 million to twelve accredited investors in a private transaction. The proceeds were used to retire approximately $1.4 million of long-term debt bearing interest at rates ranging from 12.625% to 13.875%, to reduce the balance outstanding under the Credit Facility by approximately $1.7 million and for general corporate purposes. In connection with the transaction, Frost Nevada Investments Trust, an entity controlled by Dr. Frost, (Frost Nevada) converted a convertible promissory note having an outstanding principal balance and unpaid accrued interest of approximately $0.8 million into 820,000 shares of common stock in accordance with the terms of that note. Medicare ConsiderationsSubstantially all of our net medical services revenue from continuing operations is based upon Medicare funded programs. Any changes that would limit, reduce or delay receipt of Medicare funding or any developments that would disqualify us from receiving Medicare funding could have a material adverse effect on our business, results of operations, prospects, financial results, financial condition or cash flows. Due to the diverse range of proposals put forth and the uncertainty of any proposals adoption, we cannot predict what impact any Medicare reform proposal ultimately adopted may have on our business, financial position or results of operations. 16 |
RESULTS OF OPERATIONSThe following discussion and analysis should be read in conjunction with the unaudited condensed consolidated financial statements and notes thereto appearing elsewhere in this Form 10-Q. COMPARISON OF THE THREE-MONTH PERIOD ENDED MARCH 31, 2004 TO THE THREE- MONTH PERIOD ENDED MARCH 31, 2003. Revenue from Continuing Operations Medical services revenue increased 6.3% to $25.7 million for the three-month period ended March 31, 2004 from $24.2 million for the three-month period ended March 31, 2003. Revenue generated by our Medicare full-risk contracts increased approximately 9.0% on a per member per month basis partially offset by a decrease of 1.7% in Medicare member months. Member months are the number of members per month multiplied by the months for which services were provided. The increase in Medicare revenue is primarily due to higher per member premiums resulting from the Medicare Prescription Drug Improvement and Modernization Act of 2003 (DIMA) and the increased phase-in of the Medicare risk adjustment program, both of which became effective in January 2004. 17 |
Management fee income of $0.2 million during the three-month period ended March 31, 2004 relates to revenue we receive under our limited risk and non-risk contracts with HMOs. The management fee income primarily relates to the Physician Group Participation Agreement that we executed in April 2003. (See Note 5 to our Condensed Consolidated Financial Statements.) No such agreements existed during the three-month period ended March 31, 2003. Revenue from continuing operations generated by our managed care entities under contracts with Humana Medical Plans, Inc. (Humana) accounted for 75.5% and 76.1% of our medical services revenue for the three-month periods ended March 31, 2004 and 2003, respectively. Revenue from continuing operations generated by our managed care entities under contracts with Vista Healthplan of South Florida, Inc. and its related affiliated companies (Vista) accounted for 24.5% and 23.9% of our medical services revenue for the three-month periods ended March 31, 2004 and 2003, respectively. Expenses from Continuing Operations Medical services expenses for the three-month period ended March 31, 2004 were $22.0 million or 84.9% of total revenues compared to $21.1 million or 87.3% of total revenues for the three-month period ended March 31, 2003. Medical services expense includes medical claims expense as well as other direct costs associated with providing medical services. Medical claims represent the costs of medical services provided to our members in our managed care operations by providers other than us but for which we are financially responsible for under the terms of our full risk contracts with HMOs. Claims expense was $19.0 million and $18.3 million for the three-month periods ended March 31, 2004 and 2003, respectively, or 73.3% and 75.8% of total revenues. For the three-month period ended March 31, 2004 and 2003, respectively, our claims expense as a percentage of our medical services revenues (also referred to as our claims loss ratio) was 73.9% and 75.8%. Our claims loss ratio for continuing operations for the fiscal year ended June 30, 2003 was 76.5%. Our claim loss ratio varies due to fluctuations in utilization, medical costs and premium revenues. During the three-month period ended March 31, 2004, medical claims expense increased primarily due to higher stop-loss insurance costs per member per month. The increase in revenue due to DIMA and the increased phase-in of the Medicare risk adjustment discussed above more than offset the increase in claims expense and resulted in a lower claims loss ratio for the three-month period ended March 31, 2004. Effective March 1, 2004, certain benefits offered to Medicare members were enhanced by the HMOs for whom we treat patients in response to DIMA. We anticipate that these benefit changes will result in an increase in our claims loss ratio in future periods. We cannot quantify what impact, if any, these developments may have on our results of operations in future periods. Other direct costs include the salaries and benefits of health professionals providing primary care services, capitation payments to our contracted primary care IPA physicians, and other costs necessary to provide medical care to our patients. Other direct costs were $3.0 million and $2.8 million for the three-month periods ended March 31, 2004 and 2003, respectively, or 11.6% and 11.5% of total revenues. The increase primarily relates to annual salary increases and to a higher proportion of our medical malpractice insurance cost being allocated to our managed care operations. General and administrative expenses for the three-month period ended March 31, 2004 were $0.7 million or 2.3% of total revenues compared to $1.6 million or 6.6% of total revenues for the three-month period ended March 31, 2003. During the third quarter of Fiscal 2004, we settled two lawsuits and reduced our accrual for legal claims by $0.8 million. Income from Operations Income from operations for the three-month period ended March 31, 2004 was $2.2 million or 8.3% of total revenues, compared to $0.5 million or 2.1% of total revenues for the three-month period ended March 31, 2003. 18 |
Interest Expense Interest expense was $0.3 million for the three-month period ended March 31, 2004 as compared to $81,000 for the three-month period ended March 31, 2003. The increase was due to certain deferred financing costs which became fully amortized during the second quarter of Fiscal 2003 offset by additional deferred financing costs incurred in the fourth quarter of Fiscal 2003. Loss from Discontinued Operations-Home Health Operations On December 16, 2003, we announced the disposal of our home health operations. The disposition occurred in transactions with three entities that acquired substantially all of the existing home health operations in separate transactions that concluded on or prior to February 7, 2004. Accordingly, the home health operations are shown as discontinued operations. The home health operations contributed $0.5 million and $1.2 million in revenue and generated an operating loss of $0.4 million (which includes a charge of $0.2 million for severance costs and to accrue for lease obligations) and $0.4 million during the three-month periods ended March 31, 2004 and 2003, respectively. Loss from Discontinued Operations-Terminated IPA Effective January 1, 2003, we terminated the Medicare and Medicaid lines of business for all of the physician contracts associated with one of our independent practice associations (the Terminated IPA.) The Terminated IPA, which consisted of 29 physicians at the time of the termination and is reported as discontinued operations, contributed $4.5 million in medical services revenue and generated operating income of $45,000 during the three-month period ended March 31, 2003. The Terminated IPA did not contribute any revenue or operating income during the three-month period ended March 31, 2004. Net Income Net income was $1.5 million for three-month period ended March 31, 2004 as compared to net income of $0.3 million for the three-month period ended March 31, 2003. COMPARISON OF THE NINE-MONTH PERIOD ENDED MARCH 31, 2004 TO THE NINE-MONTH PERIOD ENDED MARCH 31, 2003. Revenue from Continuing Operations Medical services revenue increased 4.4% to $74.8 million for the nine-month period ended March 31, 2004 from $71.7 million for the nine-month period ended March 31, 2003. Revenue generated by our Medicare full-risk contracts increased approximately 4.0% on a per member per month basis in addition to an increase of 1.0% in Medicare member months. The increase in Medicare revenue is primarily due to higher per member premiums resulting from the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and the increased phase-in of the Medicare risk adjustment program, both of which became effective in January 2004. Management fee income of $0.5 million during the nine-month period ended March 31, 2004 relates to revenue we received under our limited risk and non-risk contracts with HMOs. The management fee income primarily relates to the Physician Group Participation Agreement that we executed in April 2003. (See Note 5 to our Condensed Consolidated Financial Statements.) No such agreements existed during the nine-month period ended March 31, 2003. Revenue from continuing operations generated by our managed care entities under contracts with Humana accounted for 74.2% and 78.0% of our medical services revenue for the nine-month periods ended March 31, 2004 and 2003, respectively. Revenue from continuing operations generated by our managed care entities under contracts with Vista accounted for 25.8% and 22.0% of our medical services revenue for the nine-month periods ended March 31, 2004 and 2003, respectively. 19 |
Expenses from Continuing Operations Medical services expenses for the nine-month period ended March 31, 2004 were $64.7 million or 85.9% of total revenues compared to $62.9 million or 87.8% of total revenues for the nine-month period ended March 31, 2003. Claims expense was $55.9 million and $54.7 million for the nine-month periods ended March 31, 2004 and 2003, respectively, or 74.2% and 76.4% of total revenue. For the nine-month periods ended March 31, 2004 and 2003, respectively, our claims loss ratio was 74.8% and 76.4%. Our claims loss ratio for the fiscal year ended June 30, 2003 was 76.5%. During the nine-month period ended March 31, 2004, medical claims expense increased primarily due to a 1% increase in Medicare member months and higher stop-loss insurance costs per member per month. The increase in revenue due to DIMA and the increased phase-in of the Medicare risk adjustment discussed above more than offset the increase in claims expense and resulted in a lower claims loss ratio for the nine-month period ended March 31, 2004. Effective March 1, 2004, certain benefits offered to Medicare members were enhanced by the HMOs for whom we treat patients in response to DIMA. We anticipate that these benefit changes will result in an increase in our claims loss ratio in future periods. We cannot quantify what impact, if any, these developments may have on our results of operations in future periods. Other direct costs were $8.8 million and $8.1 million for the nine-month periods ended March 31, 2004 and 2003, respectively, or 11.6% and 11.4% of total revenues. The increase primarily relates to annual salary increases and to a higher proportion of our medical malpractice insurance cost being allocated to our managed care operations. General and administrative expenses for the nine-month period ended March 31, 2004 were $4.3 million or 5.7% of total revenues compared to $4.6 million or 6.4% of total revenues for the nine-month period ended March 31, 2003. In December 2002, we recorded a recovery of professional fees of $135,000 for litigation covered under our directors and officers insurance policy. No similar recovery was recorded in the second quarter of Fiscal 2004. During the third quarter of Fiscal 2004, we settled two lawsuits and reduced our accrual for legal claims by $0.8 million which was offset by separation costs of $0.3 million to our former president which were recorded in the second quarter of Fiscal 2004. The $0.4 million gain on extinguishment of debt recognized during the nine-month period ended March 31, 2004 relates to the $3.9 million contract modification note with one of our HMO partners that was cancelled in April 2003. Simultaneously with the note cancellation, we executed a Physician Group Participation Agreement (PGP Agreement) with the HMO to assume management responsibilities on a non-risk basis for certain of the HMOs members. The PGP Agreement is for a period of two years and contains a provision for liquidated damages in the amount of $4.0 million, which can be asserted by the HMO under certain circumstances. Because there were contingent circumstances under which any future payments of liquidated damages to the HMO could equal the amount of debt forgiven, the $3.9 million gain that we otherwise would have recognized from the extinguishment of the debt in the fourth quarter of Fiscal 2003, was deferred. To the extent that the HMO reduces the liquidated damages, we will recognize a portion of the deferred gain in a manner consistent with the reduction in the liquidated damages. On November 7, 2003, the HMO notified us that the maximum amount of liquidated damages had been reduced to $3.5 million. Accordingly, we recognized $0.4 million of the deferred gain on extinguishment of debt during the nine-month period ended March 31, 2004. No similar transaction occurred during the nine-month period ended March 31, 2003. Income from Operations Income from operations for the nine-month period ended March 31, 2004 was $3.8 million, or 5.0% of total revenues, compared to $1.3 million or 1.8% of total revenues for the nine-month period ended March 31, 2003. 20 |
Medicare Settlement Related to Terminated Operations During the nine-month period ended March 31, 2004, we recorded other income of $2.2 million relating to the settlement of an alleged Medicare obligation. The alleged obligation related to rehabilitation clinics that were previously operated by one of our former subsidiaries and were sold in 1999. The Centers for Medicare and Medicaid Services (CMS) had alleged that Medicare overpayments were made relating to services rendered by these clinics and other related clinics during a period in which the clinics were operated by entities other than us. In an effort to resolve the matter with CMS and avoid aggressive collection efforts that could have disrupted our business, in 2002 we entered into a memorandum of understanding under which we began making payments to resolve the alleged liability while retaining the right to dispute the alleged overpayments. We requested that CMS reconsider the alleged liability and in October 2003 we were notified that the liability had been reduced from the originally asserted amount of $2.4 million to $0.2 million. Loss from Discontinued Operations-Home Health Operations Our home health operations contributed $3.1 million and $3.1 million in revenue and generated an operating loss of $1.7 million (which includes charges in connection with the disposition of $0.5 million and $0.2 million in the second and third quarters of Fiscal 2004, respectively) and $1.4 million during the nine-month periods ended March 31, 2004 and 2003, respectively. Income (loss) from Discontinued Operations-Terminated IPA The terminated IPA contributed $4.5 million in medical services revenue and generated operating income of $45,000 during the nine-month period ended March 31, 2003. The terminated IPA did not contribute any revenue but generated operating income of $73,000 during the nine-month period ended March 31, 2004. Income generated by discontinued operations during the nine-month period ended March 31, 2004 resulted from a settlement with the HMO which eliminated all amounts due to and amounts due from the HMO incurred prior to the termination of the contracts on January 1, 2003. Net Income (Loss) Net income for the nine-month period ended March 31, 2004 was $3.7 million compared to a net loss of $0.8 million for the nine-month period ended March 31, 2003. LIQUIDITY AND CAPITAL RESOURCESIn prior periods there had been significant uncertainty as to whether we would be able to fund our working capital requirements and satisfy our debt obligations as they became due in Fiscal 2004. At March 31, 2004, the working capital deficit was $0.7 million, total indebtedness accounted for 56.7% of our total capitalization and we had principal and interest of $2.3 million outstanding under our Credit Facility. During the third quarter and continuing into the fourth quarter of Fiscal 2004, the following events occurred which have improved our financial position. Effective March 30, 2004, we obtained an extension of the maturity date for our Credit Facility until March 31, 2005. Prior to the extension of the maturity date, the Credit Facility was personally guaranteed by Dr. Frost. In order to obtain the extension of the maturity date, Dr. Frost was required to renew his personal guarantee. In consideration of Dr. Frosts renewal of his personal guarantee, we issued 300,000 shares of common stock to an entity controlled by Dr. Frost. The terms and conditions of the Credit Facility remain substantially unchanged, except for the removal of a financial covenant that previously required us to maintain a minimum fixed charge coverage ratio. 21 |
At March 31, 2004, the outstanding principal balance of our Convertible Subordinated Notes Payable (the Notes) was approximately $3.9 million. On April 12, 2004, we called the Notes for redemption in accordance with their terms, subject to the Noteholders right to convert the Notes prior to the redemption date into shares of our common stock at a conversion price of $1.00 per share. On May 12, 2004 all Noteholders converted the Notes and received 3,922,538 shares of common stock representing the conversion and cancellation of the entire outstanding principal balance of the Notes and the unpaid accrued interest through the conversion date. On April 22, 2004, we sold 2,333,333 shares of our common stock for $3.5 million to twelve accredited investors in a private transaction. The proceeds were used to retire approximately $1.4 million of long-term debt bearing interest at rates ranging from 12.625% to 13.875%, to reduce the balance outstanding under the credit facility by approximately $1.7 million and for general corporate purposes. In connection with the transaction, Frost Nevada converted a convertible promissory note having an outstanding principal balance and unpaid accrued interest of approximately $0.8 million into 820,000 shares of common stock in accordance with the terms of that note. In April 2003, we executed a PGP Agreement with one of our HMO partners. Pursuant to the PGP Agreement, we will assume certain management responsibilities on a non-risk basis for the HMOs Medicare, Commercial and Medicaid members assigned to selected primary care physicians in Miami-Dade and Broward counties of Florida. Revenue from this contract will consist of a monthly management fee intended to cover our costs for providing these services. Simultaneously with the execution of the PGP Agreement, we restructured the terms of a $3.9 million contract modification note with the HMO. Pursuant to the restructuring, the contract modification note was cancelled. The PGP Agreement is for a period of two years and contains a provision for liquidated damages in the amount of $4 million which can be asserted by the HMO in the event that one of the following occurs: (i) continued participation by us under the PGP Agreement may affect adversely the health, safety or welfare of a member or bring the HMO or its provider networks into disrepute; (ii) we engage in or acquiesce to any act of bankruptcy, receivership or reorganization; (iii) we are excluded from participation in any federal healthcare program; (iv) the HMO determines that we have not used our best efforts to perform under the PGP Agreement; or (v) we materially breach the PGP Agreement. Because there were contingent circumstances under which any future payments of liquidated damages to the HMO could equal the amount of debt forgiven, the gain that we otherwise would have recognized from the extinguishment of the debt in the fourth quarter of Fiscal 2003, was deferred. Under the terms of the PGP Agreement, if we remain in compliance with the terms of the agreement, the HMO, at its option, may reduce the liquidated damages at specified dates during the two-year term of the PGP Agreement. To the extent that the HMO reduces the liquidated damages, we will recognize a portion of the deferred gain in a manner consistent with the reduction in the liquidated damages. On November 7, 2003, we were notified that the maximum amount of the liquidated damages had been reduced to $3.5 million. Accordingly, we recognized $0.4 million of the deferred gain on extinguishment of debt in the second quarter of Fiscal 2004. On May 6, 2004, we were notified that the liquidated damages had been further reduced to $3.0 million. Accordingly, we will recognize $0.5 million of the deferred gain on extinguishment of debt in the fourth quarter of Fiscal 2004. In December 2003, we implemented a plan to dispose of our home health agencies. The disposition occurred in transactions with three entities that acquired substantially all of the existing home health operations in separate transactions that concluded on or prior to February 7, 2004. As a result, the home health operations are shown as discontinued operations. The home health operations contributed $3.1 million and $2.8 million in revenue and generated an operating loss of $1.7 million, which includes charges in connection with the disposition of $0.5 million and $0.2 million recorded in the second and third quarters of Fiscal 2004, respectively, and $1.4 million during the nine-month periods ended March 31, 2004 and 2003, respectively. We estimate that further losses in the fourth quarter of Fiscal 2004, primarily related to collection efforts of outstanding receivables, will be approximately $25,000, but there can be no assurance that any such losses will be limited to the fourth quarter of Fiscal 2004 or to any particular amount. 22 |
In Fiscal 2004, our claims loss ratio has improved due in part to an increase in revenue resulting from DIMA and the increased phase-in of the Medicare risk adjustment. Effective March 1, 2004, certain benefits offered to Medicare members were enhanced by the HMOs for whom we treat patients in response to DIMA. We anticipate that these benefit changes will result in an increase in the claims loss ratio in future periods. Such increases in the claims loss ratio could reduce the profitability and cash flows from our operations through the remainder of Fiscal 2004. We cannot predict what impact, if any, these developments may have on our results of operations. Based on the events that have occurred in the fourth quarter of Fiscal 2004 and have resulted in reducing our long term obligations to less than $500,000, we believe that we will be able to fund all our capital commitments, operating cash requirements and satisfy any remaining obligations from a combination of cash on hand and anticipated cash flows from operations. In October 2003, Spencer Angel resigned as the Companys President and Chief Executive Officer. In accordance with the terms of Mr. Angels severance agreement, he will receive $250,000, payable through September 2004 in accordance with the Companys normal payroll practices in addition to certain amounts that were paid at the time of his resignation. We also paid Mr. Angel a lump-sum cash severance payment of $17,500 and repurchased 800,000 stock options held by him for $68,000. These two amounts were paid on Mr. Angels severance date. Our income from continuing operations was $5.3 million for the nine-month period ended March 31, 2004. Cash provided by continuing operations for the nine-month period ended March 31, 2004 was $2.5 million. The following were the most significant items which are reflected in the income from continuing operations but did not impact our cash flows from operations during the nine-month period ended March 31, 2004: |
| The net decrease in due to/from Medicare of $2.1 million is primarily due to the settlement with CMS related to alleged Medicare obligations of certain rehabilitation clinics that were previously operated by us and which were sold in 1999. This settlement increased income from continuing operations without impacting our cash flow. |
| Depreciation and amortization, including the amortization of deferred financing costs, reduced income from continuing operations by $0.8 million, without reducing cash from operations. |
| Increases in accounts payable and accrued expenses reduced income from continuing operations by $0.4 million, without reducing cash from operations. |
| Our net receivable from HMOs increased by $1.6 million and impacted our income from continuing operations but did not provide cash during the nine-month period ended March 31, 2004. |
| Our net income increased by $0.4 million as a result of the gain on extinguishment of debt without impacting our cash flows. |
Our cash used in investing activities by continuing operations of $34,000 for the nine-month period ended March 31, 2004 includes $30,000 in proceeds from maturities of restricted cash offset by $64,000 for the purchase of equipment. Our cash used in financing activities for the nine-month period ended March 31, 2004 was $0.3 million, primarily due to payments on our credit facility and other various notes payable of $0.6 million offset by proceeds of $0.4 million received upon the exercise of stock options. Other factors that could affect our liquidity and cash flow which are also discussed above under the caption CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS and in our Annual Report on Form 10-K for the year ended June 30, 2003. 23 |
Item 6. Exhibits and Reports on Form 8-K |
(a) | Exhibits |
10.1 | Letter agreement dated March 26, 2004 regarding Dr. Phillip Frosts guarantee of the credit facility. |
10.2 | Letter agreement dated March 19, 2004 regarding extension of credit facility. |
10.3 | Form of Stock Purchase Agreement, dated April 22, 2004. |
31.1 | Section 302 Certification of the Chief Executive Officer. |
31.2 | Section 302 Certification of the Chief Financial Officer. |
32.1 | Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. |
32.2 | Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. |
(b) | Reports on Form 8-K |
Date Filed | Item No. | Description |
February 13, 2004 | Items 2 and 7 | We announced the completion of the previously announced disposition of our home health agencies. |
25 |
Dated: May 14, 2004 |
CONTINUCARE CORPORATION By: /s/ Janet L. Holt Janet L. Holt Chief Financial Officer |
26 |
EXHIBIT INDEX |
Description | Exhibit Number | ||||
---|---|---|---|---|---|
Letter agreement dated March 26, 2004 regarding Dr. Phillip Frosts guarantee of | |||||
the credit facility | 10.1 | ||||
Letter agreement dated March 19, 2004 regarding extension of credit facility | 10.2 | ||||
Form of Stock Purchase Agreement dated April 22, 2004 | 10.3 | ||||
Section 302 Certification of the Chief Executive Officer | 31.1 | ||||
Section 302 Certification of the Chief Financial Officer | 31.2 | ||||
Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section | |||||
906 of the Sarbanes-Oxley Act of 2002 | 32.1 | ||||
Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section | |||||
906 of the Sarbanes-Oxley Act of 2002 | 32.2 |
|