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8-K - 8-K - MAGELLAN HEALTH INCf8-k.htm

Exhibit 99.1 

 

Picture 1

 

NEWS RELEASE

Media Contact: Lilly Ackley, ackleyl@magellanhealth.com, (860) 507-1923

Investor Contact: Joe Bogdan, jbogdan@magellanhealth.com, (860) 507-1910

 

Magellan Health Reports Third Quarter 2018 Financial Results

Lowers 2018 Earnings Guidance

 

Scottsdale, Ariz. – November 7, 2018 – Magellan Health, Inc. (NASDAQ: MGLN) today announced financial results for the third quarter ended September 30, 2018, as summarized below:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended 

 

Nine Months Ended 

 

 

 

September 30

 

September 30

 

(In millions, except per share amounts)

 

2018

 

2017 

 

Chg

 

2018 

 

2017 

 

Chg

 

Net revenue

 

$

1,853.5

 

$

1,419.4

 

30.6

%

$

5,469.5

 

$

4,144.2

 

32.0

%

Net income

 

$

27.1

 

$

32.5

 

-16.4

%

$

52.1

 

$

55.7

 

-6.4

%

Segment profit [1]

 

$

88.3

 

$

87.7

 

0.7

%

$

211.9

 

$

211.9

 

0.0

%

Adjusted net income [1]

 

$

36.2

 

$

40.4

 

-10.5

%

$

80.2

 

$

80.6

 

-0.5

%

Per share results:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share

 

$

1.09

 

$

1.32

 

-17.4

%

$

2.06

 

$

2.30

 

-10.4

%

Adjusted earnings per share [1]

 

$

1.45

 

$

1.64

 

-11.6

%

$

3.17 

 

$

3.33

 

-4.8

%


[1] Refer to the Basis of Presentation for a discussion of non-GAAP financial measures.

 

Highlights Include:

·

Net revenue increased 31 percent over the third quarter of 2017 to $1.9 billion.

·

Net income decreased 16 percent over the third quarter of 2017 to $27.1 million.

·

Segment profit was $88.3 million compared to $87.7 million in the third quarter of 2017.

·

Adjusted net income decreased 11 percent from the third quarter of 2017 to $36.2 million.

·

Unrestricted cash and investments were $232.2  million as of September 30, 2018. Approximately $134.2 million of the unrestricted cash and investments at September 30, 2018 related to excess capital and undistributed earnings held at regulated entities.

·

The Company is lowering its full year 2018 earnings guidance.

 

“In light of our recent performance and lowering of guidance, we acknowledge that our financial results have been below our expectations.  In the short-term, we expect the environment to remain challenging, but we see significant long-term opportunity in both our Healthcare and Pharmacy businesses,” said Barry M. Smith, chairman and chief executive officer of Magellan Health.  “We are


 

focused on partnering with our customers to increase the quality of healthcare for our members while effectively managing both the cost of care and administrative expenses.”

 

Net Revenue

Net revenue for the third quarter ended September 30, 2018, was $1.9 billion, an increase of 31 percent over the same period in 2017. This increase was mainly driven by net business growth and the annualization of revenue from prior year acquisitions.

 

Segment Profit

Segment profit was $88.3 million for the third quarter, compared to $87.7 million in the prior year quarter.

 

·

Healthcare segment profit was $61.7 million, which represents an increase of 7 percent compared to the third quarter of 2017. Healthcare results for the quarter include net favorable out of period adjustments of approximately $22 million, largely driven by favorable client settlements. Other material drivers of the quarterly change in segment profit included the incremental losses in Virginia and the impact of the October 2017 rate reduction in Florida, partially offset by the incremental earnings contribution from the Senior Whole Health acquisition that closed on October 31, 2017.

 

·

Pharmacy management segment profit was $33.6 million, which was a  decrease of 13 percent compared to the third quarter of 2017. This year over year decrease was primarily driven by a decline in earnings in our specialty carve-out business resulting from lost formulary management contracts.

 

·

Corporate costs inclusive of eliminations,  but excluding stock compensation expense, totaled $7.0 million, compared to $8.5 million in the third quarter of 2017. This change was due to costs in the prior year quarter related to the Senior Whole Health acquisition.

 

Cash Flow & Balance Sheet

Cash flow from operations for the nine months ended September 30, 2018, was $34.0 million versus $112.7 million in the nine months ended September 30, 2017. This year over year change is primarily related to the timing of receivable collections from states in the Company’s MCC businesses.

 

As of September 30, 2018, the Company’s unrestricted cash and investments totaled $232.2 million versus $261.2 million from the balance at December 31, 2017. Approximately $134.2 million of the unrestricted cash and investments at September 30, 2018, is related to excess capital and undistributed earnings held at regulated entities.

 

Restricted cash and investments at September 30, 2018, was $380.8 million versus the balance at December 31, 2017 of  $465.4 million. This decrease was primarily due to accounts receivable increases as well as improved capital efficiency through substituting a letter of credit for statutory surplus in one of the Company’s MCC markets.


 

Year to date through October 31, 2018, we repurchased approximately 680,000 shares for $53.2 million. We have approximately  $200 million remaining in our share repurchase authorization program which runs through October 22, 2020.

 

Outlook

The Company is lowering its 2018 full year earnings guidance ranges.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

Nov 7, 2018

    

July 27, 2018

2018 Guidance

 

Low

 

High

 

Low

 

High

Net revenue

 

$

7,300.0

 

$

7,500.0

 

$

7,300.0

 

$

7,500.0

Income before income taxes

 

$

97.0

 

$

131.0

 

$

132.0

 

$

170.0

Net income

 

$

68.0

 

$

88.0

 

$

93.0

 

$

117.0

Segment Profit[1]

 

$

290.0

 

$

310.0

 

$

330.0

 

$

350.0

Adjusted net income[1]

 

$

107.0

 

$

123.0

 

$

132.0

 

$

152.0

 

 

 

 

 

 

 

 

 

 

 

 

 

Per share results:

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share[2]

 

$

2.71

 

$

3.51

 

$

3.65

 

$

4.59

Adjusted earnings per share[1][2]

 

$

4.26

 

$

4.90

 

$

5.18

 

$

5.96

[1] Refer to the Basis of Presentation for a discussion of non-GAAP financial measures.

[2] 2018 EPS and Adjusted EPS guidance includes share repurchases and option exercises through the close of business October 31, 2018, but excludes the impact of any potential future activity.

 

The reduction in earnings guidance reflects the following:

 

·

Utilization pressures in our Healthcare business;

·

In MCC of Virginia, the unfavorable update to the Company’s expected risk scores for 2018;

·

Modestly lower margins in the Pharmacy business as a result of delayed timing of network rate improvement actions; and,

·

As result of operating efficiency initiatives, an initial estimate of severance and other costs that the Company anticipates to recognize in 2018.

 

The Company now estimates net income for the full year 2018 to be in the range of $68 million to $88 million, adjusted net income in the range of $107 million to $123 million, EPS in the range of $2.71 to $3.51 and adjusted EPS in the range of $4.26  to $4.90.  The full year segment profit guidance is expected to be in the range of $290 million to $310 million. The Company is maintaining its revenue range of $7.3 billion to $7.5 billion.

 

“After transforming our business and achieving strong top line growth over the past few years, we have significant earnings power in our current portfolio as we work to increase our margins to industry competitive levels,” said Jonathan N. Rubin, chief financial officer of Magellan Health.


 

Earnings Conference Call

Management will discuss the Company’s third quarter results on a conference call scheduled for Wednesday,  November  7, 2018 at 8:00 a.m. Eastern. To participate in the conference call, dial 1-800-857-1812 and use passcode “3rd Quarter 2018” approximately 10 minutes before the start of the call. The conference call will also be available live via webcast at Magellan's investor relations page at MagellanHealth.com. A telephonic replay will be available shortly after the conclusion of the call through December 7, 2018. This replay may be accessed by dialing 1-866-501-2962 (Domestic) or 1-203-369-1830 (International). A replay of the webcast will also be available at the site listed above for 30 days, beginning approximately two hours after its conclusion.

 

Basis of Presentation

In addition to results determined under Generally Accepted Accounting Principles (GAAP), Magellan provides certain non-GAAP financial measures that management believes are useful in assessing the Company’s performance. Following is a description of these important non-GAAP measures.

 

Segment profit is equal to net revenue less the sum of cost of care, cost of goods sold, direct service costs and other operating expenses, and includes income from unconsolidated subsidiaries, but excludes segment profit or loss from non-controlling interests held by other parties, stock compensation expense, special charges or benefits, as well as changes in the fair value of contingent consideration recorded in relation to acquisitions.

 

Adjusted net income and adjusted earnings per share reflect certain adjustments made for acquisitions completed after January 1, 2013, to exclude non‑cash stock compensation expense resulting from restricted stock purchases by sellers, changes in the fair value of contingent consideration, amortization of identified acquisition intangibles, as well as impairment of identified acquisition intangibles.

 

Included in the tables issued with this press release are the reconciliations from GAAP measures to the corresponding non-GAAP measures.

 

About Magellan Health: Magellan Health, Inc., a Fortune 500 company, is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.

 

Forward-Looking Statements

This release is intended to be disclosure through methods reasonably designed to provide broad, non-exclusionary distribution to the public in compliance with the Securities and Exchange Commission’s Fair Disclosure Regulation. This release contains forward-looking statements within the meaning of the Securities Exchange Act of 1934 and the Securities Act of 1933, as amended, which involve a number of risks and uncertainties, many of which are out of our control. All statements, other than statements of historical information provided herein, may be deemed to be forward-looking statements including,


 

without limitation, statements regarding 2018 guidance for net revenue, income before income taxes, net income, earnings per share, segment profit, adjusted net income, adjusted earnings per share, an initial estimate of severance and other costs that we anticipate to recognize in 2018, growth opportunities, business environment, long term opportunities and strategy. These statements are based on management’s analysis, judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes in circumstances. Without limiting the foregoing, the words “believes,” “anticipates,” “plans,” “expects,” “may,” “should,” “could,” “estimate,” “intend” and other similar expressions are intended to identify forward-looking statements. Actual results could differ materially due to, among other things, the possible election of certain of the Company’s customers to manage the healthcare services of their members directly; changes in rates paid to and/or by the Company by customers and/or providers; higher utilization of healthcare services by the Company’s risk members; delays, higher costs or inability to implement new business or other Company initiatives; the impact of changes in the contracting model for Medicaid contracts; termination or non-renewal of customer contracts; the impact of new or amended laws or regulations; governmental inquiries; litigation; competition; operational issues; healthcare reform; and general business conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section included within the Company’s Annual Report on Form 10-K for the year ended December 31, 2017, filed with the Securities and Exchange Commission on March 1, 2018, and the Company’s subsequent Quarterly Reports on Form 10-Q filed during 2018. Readers are cautioned not to place undue reliance on these forward-looking statements. The Company undertakes no obligation to publicly revise these forward-looking statements to reflect events or circumstances that arise after the date of this release. Segment profit, adjusted net income, and adjusted EPS information referred to herein may be considered a non-GAAP financial measure. Further information regarding these measures, including the reasons management considers this information useful to investors, are included in the Company’s most recent Annual Report on Form 10-K and on subsequent Form 10-Qs.


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands)

 

 

    

December 31, 2017

 

 

September 30, 2018

 

 

 

 

 

(unaudited)

ASSETS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Assets:

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

398,732 

 

 

$

234,264 

Accounts receivable, net

 

 

660,775 

 

 

 

820,748 

Short-term investments

 

 

310,578 

 

 

 

374,669 

Pharmaceutical inventory

 

 

40,945 

 

 

 

44,035 

Other current assets

 

 

72,323 

 

 

 

102,829 

Total Current Assets

 

 

1,483,353 

 

 

 

1,576,545 

Property and equipment, net

 

 

158,638 

 

 

 

154,826 

Long-term investments

 

 

17,287 

 

 

 

4,090 

Deferred income taxes

 

 

813 

 

 

 

1,071 

Other long-term assets

 

 

22,567 

 

 

 

51,391 

Goodwill

 

 

1,006,288 

 

 

 

1,015,076 

Other intangible assets, net

 

 

268,288 

 

 

 

245,516 

Total Assets

 

$

2,957,234 

 

 

$

3,048,515 

 

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS' EQUITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Liabilities:

 

 

 

 

 

 

 

Accounts payable

 

$

74,300 

 

 

$

73,144 

Accrued liabilities

 

 

193,635 

 

 

 

209,012 

Short-term contingent consideration

 

 

6,892 

 

 

 

7,131 

Medical claims payable

 

 

327,625 

 

 

 

402,497 

Other medical liabilities

 

 

177,002 

 

 

 

162,009 

Current debt, capital lease and deferred financing obligations

 

 

112,849 

 

 

 

64,778 

Total Current Liabilities

 

 

892,303 

 

 

 

918,571 

Long-term debt, capital lease and deferred financing obligations

 

 

740,888 

 

 

 

733,969 

Deferred income taxes

 

 

12,298 

 

 

 

12,802 

Tax contingencies

 

 

14,226 

 

 

 

14,326 

Long-term contingent consideration

 

 

1,925 

 

 

 

2,137 

Deferred credits and other long-term liabilities

 

 

19,100 

 

 

 

34,959 

Total Liabilities

 

 

1,680,740 

 

 

 

1,716,764 

 

 

 

 

 

 

 

 

Stockholders’ Equity:

 

 

 

 

 

 

 

Ordinary common stock

 

 

530 

 

 

 

535 

Additional paid-in capital

 

 

1,274,811 

 

 

 

1,324,176 

Retained earnings

 

 

1,399,495 

 

 

 

1,447,416 

Accumulated other comprehensive loss

 

 

(380)

 

 

 

(373)

Ordinary common stock in treasury, at cost

 

 

(1,397,962)

 

 

 

(1,440,003)

Total Stockholders’ Equity

 

 

1,276,494 

 

 

 

1,331,751 

Total Liabilities and Stockholders’ Equity

 

$

2,957,234 

 

 

$

3,048,515 

 


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

(Unaudited)

(In thousands, except per share amounts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30,

 

September 30,

 

 

2017

  

  

2018

 

2017

  

  

2018

Net revenue:

    

 

    

 

 

 

    

    

 

    

 

 

 

    

Managed care and other

 

$

834,358

 

 

$

1,235,787 

 

$

2,385,397 

 

 

$

3,670,890 

PBM

 

 

585,048

 

 

 

617,719 

 

 

1,758,771 

 

 

 

1,798,616 

Total net revenue

 

 

1,419,406

 

 

 

1,853,506 

 

 

4,144,168 

 

 

 

5,469,506 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Costs and expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cost of care

 

 

569,306

 

 

 

938,031 

 

 

1,634,624 

 

 

 

2,802,506 

Cost of goods sold

 

 

543,682

 

 

 

571,145 

 

 

1,648,670 

 

 

 

1,689,229 

Direct service costs and other operating expenses (1)(2)

 

 

227,372

 

 

 

265,471 

 

 

680,230 

 

 

 

793,700 

Depreciation and amortization

 

 

28,189 

 

 

 

33,047 

 

 

82,896 

 

 

 

97,302 

Interest expense

 

 

7,663

 

 

 

8,990 

 

 

16,711 

 

 

 

26,034 

Interest and other income

 

 

(1,781)

 

 

 

(4,139)

 

 

(3,801)

 

 

 

(9,978)

Total costs and expenses

 

 

1,374,431

 

 

 

1,812,545 

 

 

4,059,330 

 

 

 

5,398,793

Income before income taxes

 

 

44,975

 

 

 

40,961 

 

 

84,838 

 

 

 

70,713 

Provision for income taxes

 

 

11,739

 

 

 

13,816 

 

 

29,206 

 

 

 

18,565 

Net income

 

 

33,236

 

 

 

27,145 

 

 

55,632 

 

 

 

52,148 

Less: net income (loss) attributable to non-controlling interest

 

 

785

 

 

 

 

 

(66)

 

 

 

Net income attributable to Magellan

 

$

32,451

 

 

$

27,145 

 

$

55,698 

 

 

$

52,148 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weighted average number of common shares outstanding — basic

 

 

23,282

 

 

 

24,433 

 

 

23,135 

 

 

 

24,451 

Weighted average number of common shares outstanding — diluted

 

 

24,563

 

 

 

24,928 

 

 

24,241 

 

 

 

25,316 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to Magellan per common share — basic

 

$

1.39

 

 

$

1.11 

 

$

2.41 

 

 

$

2.13 

Net income attributable to Magellan per common share — diluted

 

$

1.32

 

 

$

1.09 

 

$

2.30 

 

 

$

2.06 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

$

33,236 

 

 

$

27,145 

 

$

55,632 

 

 

$

52,148 

Other comprehensive income:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unrealized gain on available-for-sale securities (3)

 

 

26 

 

 

 

194 

 

 

27 

 

 

 

Comprehensive income

 

 

33,262 

 

 

 

27,339 

 

 

55,659 

 

 

 

52,155 

Less: comprehensive income (loss) attributable to non-controlling interest

 

 

785 

 

 

 

 

 

(66)

 

 

 

Comprehensive income attributable to Magellan

 

$

32,477 

 

 

$

27,339 

 

$

55,725 

 

 

$

52,155 


(1)

Includes stock compensation expense of $10,323 and $9,320 for the three months ended September 30, 2017 and 2018, respectively, and $31,834 and $27,405 for the nine months ended September 30, 2017 and 2018, respectively.

(2)

Includes changes in fair value of contingent consideration of $(834) and $148 for the three months ended September 30, 2017 and 2018, respectively, and $(631) and $451 for the nine months ended September 30, 2017 and 2018, respectively.

(3)

Net of income tax provision of $16 and $61 for the three months ended September 30, 2017 and 2018, respectively, and $18 and $3 for the nine months ended September 30, 2017 and 2018, respectively.


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

September 30,

 

 

2017

    

 

2018

Cash flows from operating activities:

    

 

    

 

 

 

    

Net income

 

$

55,632 

 

 

$

52,148 

Adjustments to reconcile net income to net cash from operating activities:

 

 

 

 

 

 

 

Depreciation and amortization

 

 

82,896 

 

 

 

97,302 

Non-cash interest expense

 

 

3,120 

 

 

 

919 

Non-cash stock compensation expense

 

 

31,834 

 

 

 

27,405 

Non-cash income tax (benefit) provision

 

 

(2,160)

 

 

 

1,814 

Non-cash amortization on investments

 

 

3,052 

 

 

 

1,404 

Changes in assets and liabilities, net of effects from acquisitions of businesses:

 

 

 

 

 

 

 

Accounts receivable, net

 

 

(13,539)

 

 

 

(160,904)

Pharmaceutical inventory

 

 

9,609 

 

 

 

(3,090)

Other assets

 

 

(15,481)

 

 

 

(60,008)

Accounts payable and accrued liabilities

 

 

(70,006)

 

 

 

(13,781)

Medical claims payable and other medical liabilities

 

 

25,578 

 

 

 

73,667 

Contingent consideration

 

 

(631)

 

 

 

451 

Tax contingencies

 

 

158 

 

 

 

100 

Deferred credits and other long-term liabilities

 

 

2,408 

 

 

 

16,497 

Other

 

 

210 

 

 

 

93 

Net cash provided by operating activities

 

 

112,680 

 

 

 

34,017 

 

 

 

 

 

 

 

 

Cash flows from investing activities:

 

 

 

 

 

 

 

Capital expenditures

 

 

(42,703)

 

 

 

(51,244)

Acquisitions and investments in businesses, net of cash acquired

 

 

(3,200)

 

 

 

(402)

Purchases of investments

 

 

(341,280)

 

 

 

(453,007)

Proceeds from maturities and sales of investments

 

 

320,045 

 

 

 

400,683 

Net cash used in investing activities

 

 

(67,138)

 

 

 

(103,970)

 

 

 

 

 

 

 

 

Cash flows from financing activities:

 

 

 

 

 

 

 

Proceeds from issuance of debt

 

 

949,239 

 

 

 

Payments to acquire treasury stock

 

 

(15,457)

 

 

 

(41,039)

Proceeds from exercise of stock options

 

 

28,328 

 

 

 

22,587 

Payments on debt, capital lease and deferred financing obligations

 

 

(798,359)

 

 

 

(75,043)

Payments on contingent consideration

 

 

(1,032)

 

 

 

Other

 

 

(8,005)

 

 

 

(1,020)

Net cash provided by (used in) financing activities

 

 

154,714 

 

 

 

(94,515)

 

 

 

 

 

 

 

 

Net increase (decrease) in cash and cash equivalents

 

 

200,256 

 

 

 

(164,468)

Cash and cash equivalents at beginning of period

 

 

304,508 

 

 

 

398,732 

Cash and cash equivalents at end of period

 

$

504,764 

 

 

$

234,264 

 


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

CONSOLIDATED OPERATING RESULTS BY BUSINESS SEGMENT

(Unaudited)

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30,

 

September 30,

 

 

2017

    

    

2018

 

2017

    

    

2018

Healthcare

    

 

    

 

 

 

    

    

 

    

 

 

 

    

Managed care and other revenue

 

$

769,451 

 

 

$

1,176,439 

 

$

2,190,097 

 

 

$

3,488,928 

Cost of care

 

 

(569,306)

 

 

 

(938,031)

 

 

(1,634,624)

 

 

 

(2,802,506)

Direct service costs and other

 

 

(143,550)

 

 

 

(179,022)

 

 

(428,432)

 

 

 

(543,258)

Stock compensation expense (1)

 

 

2,623 

 

 

 

2,165 

 

 

8,388 

 

 

 

7,857 

Changes in fair value of contingent consideration (1)

 

 

(834)

 

 

 

148 

 

 

(631)

 

 

 

451 

Less: non-controlling interest segment profit (loss) (2)

 

 

789 

 

 

 

-

 

 

(56)

 

 

 

-

Healthcare segment profit

 

 

57,595 

 

 

 

61,699 

 

 

134,854 

 

 

 

151,472 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pharmacy Management

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Managed care and other revenue

 

 

65,131 

 

 

 

59,500 

 

 

195,970 

 

 

 

182,410 

PBM revenue

 

 

618,178 

 

 

 

665,734 

 

 

1,856,856 

 

 

 

1,940,726 

Cost of goods sold

 

 

(575,327)

 

 

 

(618,463)

 

 

(1,742,610)

 

 

 

(1,827,327)

Direct service costs and other

 

 

(74,976)

 

 

 

(74,491)

 

 

(225,782)

 

 

 

(221,018)

Stock compensation expense (1)

 

 

5,680 

 

 

 

1,359 

 

 

17,094 

 

 

 

4,252 

Pharmacy Management segment profit

 

 

38,686 

 

 

 

33,639 

 

 

101,528 

 

 

 

79,043 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate and Elimination (3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Managed care and other revenue

 

 

(224)

 

 

 

(152)

 

 

(670)

 

 

 

(448)

PBM revenue

 

 

(33,130)

 

 

 

(48,015)

 

 

(98,085)

 

 

 

(142,110)

Cost of goods sold

 

 

31,645 

 

 

 

47,318 

 

 

93,940 

 

 

 

138,098 

Direct service costs and other

 

 

(8,846)

 

 

 

(11,958)

 

 

(26,016)

 

 

 

(29,424)

Stock compensation expense (1)

 

 

2,020 

 

 

 

5,796 

 

 

6,352 

 

 

 

15,296 

Less: non-controlling interest segment profit (loss) (2)

 

 

(1)

 

 

 

-

 

 

(3)

 

 

 

-

Corporate and Elimination

 

 

(8,534)

 

 

 

(7,011)

 

 

(24,476)

 

 

 

(18,588)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Consolidated

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Managed care and other revenue

 

 

834,358 

 

 

 

1,235,787 

 

 

2,385,397 

 

 

 

3,670,890 

PBM revenue

 

 

585,048 

 

 

 

617,719 

 

 

1,758,771 

 

 

 

1,798,616 

Cost of care

 

 

(569,306)

 

 

 

(938,031)

 

 

(1,634,624)

 

 

 

(2,802,506)

Cost of goods sold

 

 

(543,682)

 

 

 

(571,145)

 

 

(1,648,670)

 

 

 

(1,689,229)

Direct service costs and other

 

 

(227,372)

 

 

 

(265,471)

 

 

(680,230)

 

 

 

(793,700)

Stock compensation expense (1)

 

 

10,323 

 

 

 

9,320 

 

 

31,834 

 

 

 

27,405 

Changes in fair value of contingent consideration (1)

 

 

(834)

 

 

 

148 

 

 

(631)

 

 

 

451 

Less: non-controlling interest segment profit (loss) (2)

 

 

788 

 

 

 

-

 

 

(59)

 

 

 

-

Consolidated segment profit

 

$

87,747 

 

 

$

88,327 

 

$

211,906 

 

 

$

211,927 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reconciliation of income before income taxes to segment profit:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before income taxes

 

$

44,975 

 

 

$

40,961 

 

$

84,838 

 

 

$

70,713 

Stock compensation expense

 

 

10,323 

 

 

 

9,320 

 

 

31,834 

 

 

 

27,405 

Changes in fair value of contingent consideration

 

 

(834)

 

 

 

148 

 

 

(631)

 

 

 

451 

Non-controlling interest segment (profit) loss

 

 

(788)

 

 

 

-

 

 

59 

 

 

 

-

Depreciation and amortization

 

 

28,189 

 

 

 

33,047 

 

 

82,896 

 

 

 

97,302 

Interest expense

 

 

7,663 

 

 

 

8,990 

 

 

16,711 

 

 

 

26,034 

Interest and other income

 

 

(1,781)

 

 

 

(4,139)

 

 

(3,801)

 

 

 

(9,978)

Segment profit

 

$

87,747 

 

 

$

88,327 

 

$

211,906 

 

 

$

211,927 


(1)

Stock compensation expense, changes in the fair value of contingent consideration recorded in relation to acquisitions and impairment of intangible assets are included in direct service costs and other operating expenses; however, these amounts are excluded from the computation of segment profit.

(2)

The non-controlling portion of AlphaCare's segment profit (loss) is excluded from the computation of segment profit.

(3)

Healthcare subcontracts with Pharmacy Management to provide pharmacy benefits management services for certain of Healthcare’s customers. In addition, Pharmacy Management provides pharmacy benefits management for the Company’s employees covered under its medical plan. As such, revenue, cost of goods sold and direct service costs and other related to these arrangements are eliminated.


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

NON-GAAP MEASURES

(Unaudited)

(In thousands, except per share amounts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

 

September 30,

 

September 30,

 

 

2017 

 

 

2018 

 

2017 

 

 

2018 

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to Magellan

 

$

32,451 

 

 

$

27,145 

 

$

55,698 

 

 

$

52,148 

Adjusted for acquisitions starting in 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock compensation expense

 

 

4,960 

 

 

 

 

 

14,718 

 

 

 

530 

Changes in fair value of contingent consideration

 

 

(834)

 

 

 

148 

 

 

(631)

 

 

 

451 

Amortization of acquired intangibles

 

 

8,424 

 

 

 

12,079 

 

 

25,189 

 

 

 

36,676 

Tax impact

 

 

(4,605)

 

 

 

(3,220)

 

 

(14,372)

 

 

 

(9,577)

Adjusted net income

 

$

40,396 

 

 

$

36,152 

 

$

80,602 

 

 

$

80,228 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income per common share attributable to Magellan —diluted

 

$

1.32 

 

 

$

1.09 

 

$

2.30 

 

 

$

2.06 

Adjusted for acquisitions starting in 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock compensation expense

 

 

0.20 

 

 

 

 

 

0.61 

 

 

 

0.02 

Changes in fair value of contingent consideration

 

 

(0.03)

 

 

 

0.01 

 

 

(0.03)

 

 

 

0.02 

Amortization of acquired intangibles

 

 

0.34 

 

 

 

0.48 

 

 

1.04 

 

 

 

1.45 

Tax impact

 

 

(0.19)

 

 

 

(0.13)

 

 

(0.59)

 

 

 

(0.38)

Adjusted earnings per share

 

$

1.64 

 

 

$

1.45 

 

$

3.33 

 

 

$

3.17 

 


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

FISCAL 2018 GUIDANCE

(In millions, except per share amounts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

July 27, 2018

 

November 7, 2018

 

 

Low

 

 

High

 

Low

 

 

High

 

 

 

 

 

 

 

 

 

 

 

Net revenue

 

$

7,300.0 

 

 

$

7,500.0 

 

$

7,300.0 

 

 

$

7,500.0 

Income before income taxes

 

 

132.0 

 

 

 

170.0 

 

 

97.0 

 

 

 

131.0 

Net income

 

 

93.0 

 

 

 

117.0 

 

 

68.0 

 

 

 

88.0 

Segment profit (1)

 

 

330.0 

 

 

 

350.0 

 

 

290.0 

 

 

 

310.0 

Adjusted net income (1)

 

 

132.0 

 

 

 

152.0 

 

 

107.0 

 

 

 

123.0 

Per share results:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Earnings per share (2)

 

 

3.65 

 

 

 

4.59 

 

 

2.71 

 

 

 

3.51 

Adjusted earnings per share (1)(2)

 

 

5.18 

 

 

 

5.96 

 

 

4.26 

 

 

 

4.90 


(1)

Refer to the Reconciliation of GAAP to Non-GAAP measures table.

(2)

Based on average fully diluted shares of 25.5 million and 25.1 million for July 27, 2018 guidance and November 7, 2018 guidance, respectively.


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

FISCAL 2018 GUIDANCE

RECONCILIATION OF GAAP TO NON-GAAP MEASURES

(In millions, except per share amounts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

July 27, 2018

    

November 7, 2018

 

 

Low

 

 

High

 

Low

 

 

High

 

 

 

 

 

 

 

 

 

 

 

Net income attributable to Magellan

 

$

93.0 

 

 

$

117.0 

 

$

68.0 

 

 

$

88.0 

Adjusted for acquisitions starting in 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock compensation expense

 

 

1.0 

 

 

 

1.0 

 

 

1.0 

 

 

 

1.0 

Changes in fair value of contingent consideration

 

 

-   

 

 

 

-   

 

 

-   

 

 

 

-   

Amortization of acquired intangibles

 

 

52.0 

 

 

 

47.0 

 

 

52.0 

 

 

 

47.0 

Tax impact

 

 

(14.0)

 

 

 

(13.0)

 

 

(14.0)

 

 

 

(13.0)

Adjusted net income

 

$

132.0 

 

 

$

152.0 

 

$

107.0 

 

 

$

123.0 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income per common share attributable to Magellan —Diluted

 

$

3.65 

 

 

$

4.59 

 

$

2.71 

 

 

$

3.51 

Adjusted for acquisitions starting in 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock compensation expense

 

 

0.04 

 

 

 

0.04 

 

 

0.04 

 

 

 

0.04 

Changes in fair value of contingent consideration

 

 

-   

 

 

 

-   

 

 

-   

 

 

 

-   

Amortization of acquired intangibles

 

 

2.04 

 

 

 

1.84 

 

 

2.07 

 

 

 

1.87 

Tax impact

 

 

(0.55)

 

 

 

(0.51)

 

 

(0.56)

 

 

 

(0.52)

Adjusted earnings per share

 

$

5.18 

 

 

$

5.96 

 

$

4.26 

 

 

$

4.90 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reconciliation of income before income taxes to segment profit:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Income before income taxes

 

$

132.0 

 

 

$

170.0 

 

$

97.0 

 

 

$

131.0 

Stock compensation expense

 

 

35.0 

 

 

 

33.0 

 

 

35.0 

 

 

 

31.0 

Changes in fair value of contingent consideration

 

 

-   

 

 

 

-   

 

 

-   

 

 

 

-   

Depreciation and amortization

 

 

137.0 

 

 

 

127.0 

 

 

135.0 

 

 

 

129.0 

Interest expense

 

 

37.0 

 

 

 

33.0 

 

 

36.0 

 

 

 

34.0 

Interest income

 

 

(11.0)

 

 

 

(13.0)

 

 

(13.0)

 

 

 

(15.0)

Segment profit

 

$

330.0 

 

 

$

350.0 

 

$

290.0 

 

 

$

310.0 

 


 

MAGELLAN HEALTH, INC. AND SUBSIDIARIES

HEALTHCARE SEGMENT HISTORICAL RECLASSIFICATION (1)

(Unaudited)

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the Quarter Ended

 

Year Ended

 

 

 

March 31,

 

June 30,

 

September

 

December 31,

 

December 31,

 

Healthcare Segment Results

    

2017

    

2017

    

30, 2017

    

2017

    

2017

 

Behavioral & Specialty Health revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk-based, non-EAP

 

$

315,344 

 

$

385,042 

 

$

372,755 

 

$

388,018 

 

$

1,461,159 

 

EAP risk-based

 

 

97,920 

 

 

100,009 

 

 

90,000 

 

 

94,118 

 

 

382,047 

 

ASO

 

 

56,291 

 

 

61,080 

 

 

66,785 

 

 

73,154 

 

 

257,310 

 

Magellan Complete Care revenue

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk-based, non-EAP

 

 

183,076 

 

 

196,281 

 

 

226,905 

 

 

447,654 

 

 

1,053,916 

 

ASO

 

 

12,745 

 

 

12,858 

 

 

13,006 

 

 

13,236 

 

 

51,845 

 

Managed care and other revenue

 

$

665,376 

 

$

755,270 

 

$

769,451 

 

$

1,016,180 

 

$

3,206,277 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MLR Behavioral & Specialty Health risk

 

 

87.5 

%  

 

91.4 

%  

 

89.3 

%  

 

85.7 

%  

 

88.5 

%

MLR Behavioral & Specialty Health EAP risk

 

 

71.7 

%  

 

69.5 

%  

 

65.8 

%  

 

67.0 

%  

 

68.6 

%

MLR Magellan Complete Care risk

 

 

74.3 

%  

 

82.4 

%  

 

78.1 

%  

 

85.7 

%  

 

81.5 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Membership

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Behavioral & Specialty Health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk (2)

 

 

12,000 

 

 

12,771 

 

 

13,232 

 

 

13,029 

 

 

 

 

EAP risk

 

 

14,533 

 

 

14,144 

 

 

14,228 

 

 

14,472 

 

 

 

 

ASO

 

 

26,983 

 

 

28,475 

 

 

28,337 

 

 

27,824 

 

 

 

 

Magellan Complete Care

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk

 

 

72 

 

 

73 

 

 

77 

 

 

120 

 

 

 

 

ASO

 

 

20 

 

 

20 

 

 

20 

 

 

21 

 

 

 

 

 

 

 

53,608 

 

 

55,483 

 

 

55,894 

 

 

55,466 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For the Quarter Ended

Healthcare Segment Results

    

March 31,
2018

    

June 30,
 2018

    

September 
30, 2018

Behavioral & Specialty Health revenue

 

 

 

 

 

 

 

 

 

Risk-based, non-EAP

 

$

373,052 

 

$

378,076 

 

$

377,615 

EAP risk-based

 

 

94,658 

 

 

91,275 

 

 

79,854 

ASO

 

 

62,639 

 

 

61,276 

 

 

65,326 

Magellan Complete Care revenue

 

 

 

 

 

 

 

 

 

Risk-based, non-EAP

 

 

613,829 

 

 

610,358 

 

 

639,584 

ASO

 

 

13,423 

 

 

13,903 

 

 

14,060 

Managed care and other revenue

 

$

1,157,601 

 

$

1,154,888 

 

$

1,176,439 

 

 

 

 

 

 

 

 

 

 

MLR Behavioral & Specialty Health risk

 

 

86.8 

%  

 

86.7 

%  

 

87.7 

MLR Behavioral & Specialty Health EAP risk

 

 

68.9 

%  

 

69.2 

%  

 

68.2 

MLR Magellan Complete Care risk

 

 

87.9 

%  

 

89.3 

%  

 

86.4 

 

 

 

 

 

 

 

 

 

 

Membership

 

 

 

 

 

 

 

 

 

Behavioral & Specialty Health

 

 

 

 

 

 

 

 

 

Risk (2)

 

 

12,334 

 

 

12,258 

 

 

12,325 

EAP risk

 

 

15,343 

 

 

14,890 

 

 

15,140 

ASO

 

 

29,533 

 

 

27,064 

 

 

26,551 

Magellan Complete Care

 

 

 

 

 

 

 

 

 

Risk

 

 

131 

 

 

132 

 

 

144 

ASO

 

 

21  

 

 

22 

 

 

22 

 

 

 

57,362  

 

 

54,366 

 

 

54,182 


(1)

During the third quarter of 2018, the Company re-evaluated how it was managing the Healthcare business segment and decided a reorganization was necessary to effectively manage the business going forward. As a result of this business reorganization, the Company concluded that changes to Healthcare’s reporting units were warranted. Healthcare now consists of two reporting units – Behavioral & Specialty Health and Magellan Complete Care (“MCC”).

(2)

May include some duplicate count of membership for customers that contract with Magellan for both behavioral and other specialty management services.

 

(MGLN-GEN)

 

###