Molina Healthcare, Inc. (MOH) is a Fortune 500 company that provides managed healthcare services primarily under the Medicaid and Medicare programs, as well as through state insurance marketplaces known as the Marketplace . The company serves approximately 5.0 million members across 20 states as of December 31, 2023 . Molina operates through four main segments: Medicaid, Medicare, Marketplace, and Other, focusing on both organic growth through new state procurement opportunities and inorganic growth via mergers and acquisitions .
- Medicaid - Provides managed healthcare services under the Medicaid program, representing the largest segment in terms of revenue contribution .
- Medicare - Offers healthcare services under the Medicare program, catering to eligible senior citizens and certain younger people with disabilities .
- Marketplace - Delivers healthcare services through state insurance marketplaces, offering plans to individuals and families .
- Other - Includes long-term services and supports consultative services in Wisconsin, which is not significant to the consolidated results .
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| Name | Position | External Roles | Short Bio | |
|---|---|---|---|---|
Debra J. Bacon Executive | EVP, Medicaid | None | EVP, Medicaid since 2023, extensive experience in Medicaid operations; previously at CVS/Aetna Medicaid. | |
James E. Woys Executive | Chief Operating Officer (COO) | None | COO since 2023, over 40 years of healthcare experience; previously EVP of Health Plan Services at Molina and COO at Health Net. | |
Jeff D. Barlow Executive | Chief Legal Officer and Secretary | None | Chief Legal Officer since 2010, joined Molina in 2004; extensive legal expertise in corporate governance and securities law. | |
Joseph M. Zubretsky Executive | President and CEO | None | CEO since 2017, led Molina's turnaround and growth; previously held executive roles at Aetna and The Hanover Group. | View Report → |
Mark L. Keim Executive | Chief Financial Officer (CFO) | None | CFO since 2021, extensive experience in corporate strategy and finance; previously at The Hanover Insurance Group and Aetna. | |
Maurice S. Hebert Executive | Chief Accounting Officer (CAO) | None | CAO since 2018, previously held senior finance roles at Tufts Health Plan and WellCare Health Plans. | |
Barbara L. Brasier Board | Director | Director at John Bean Technologies, Lancaster Colony Corporation, Henny Penny | Director since 2019, over 40 years of corporate finance experience; previously CFO at Herc Rentals and SVP at Mondelez International. | |
Dale B. Wolf Board | Chairman of the Board | Chairperson at eHealth, Inc.; Board Member at Adapt Healthcare | Chairman since 2017, extensive healthcare leadership experience; previously CEO of Coventry Health Care and OneCall Care Management. | |
Daniel Cooperman Board | Director | Adviser at Text IQ; Fellow at Stanford's Rock Center for Corporate Governance | Director since 2013, former General Counsel at Apple and Oracle; extensive legal and governance expertise. | |
Dr. Stephen H. Lockhart Board | Director | Board Member at West Pharmaceutical Services, NRC Health, Packard Foundation | Director since 2020, board-certified anesthesiologist with expertise in health equity; previously Chief Medical Officer at Sutter Health. | |
Richard C. Zoretic Board | Director | Board Member at InnovAge Holding Corp., Aveanna Healthcare | Director since 2018, over 30 years of healthcare leadership experience; previously COO at Amerigroup and EVP at WellPoint. | |
Richard M. Schapiro Board | Director | CEO of SchapiroCo LLC; Director at Transamerica Corporation | Director since 2015, over 35 years of investment banking experience; advised Molina on its IPO and follow-on offering. | |
Ronna E. Romney Board | Vice-Chair of the Board | Director at Park-Ohio Holdings Corp. | Director since 2003, extensive governance experience; previously served on presidential commissions under Reagan and Bush. | |
Steven J. Orlando Board | Director | None | Director since 2005, extensive experience in corporate finance and accounting; previously CFO for various companies and CPA at Coopers & Lybrand. |
- Given that your consolidated Medical Cost Ratio (MCR) was higher than expected at 89.2% due to pressures in Medicaid and Medicare, how do you plan to manage these pressures moving forward, and do you anticipate further increases in MCR in the upcoming quarters?
- You've indicated that your net trend in Medicaid increased from 3% to 6% over your initial guidance, partly due to higher utilization among existing members ("stayers"); what strategies are you implementing to prevent further acceleration of this trend, and how confident are you that it will stabilize?
- With the significant acuity shifts stemming from Medicaid enrollment dropping from 92 million to 72 million, how confident are you that state rate adjustments will sufficiently capture this increased acuity, especially considering potential lags in the rate-setting process?
- As you rely on corridor protections and profit-sharing arrangements to buffer against mismatches between rates and trends, how sustainable is this approach if trends continue to rise or if corridors become insufficient to absorb increased costs?
- Behavioral health utilization has become a national trend beyond isolated cases like Kentucky; what specific measures are you taking to manage rising behavioral health costs across different states, and how are these expenses impacting your overall cost management strategies?
Research analysts who have asked questions during MOLINA HEALTHCARE earnings calls.
Andrew Mok
Barclays
6 questions for MOH
Justin Lake
Wolfe Research, LLC
6 questions for MOH
Ryan Langston
TD Cowen
6 questions for MOH
George Hill
Deutsche Bank
4 questions for MOH
John Stansel
JPMorgan Chase & Co.
4 questions for MOH
Joshua Raskin
Nephron Research
4 questions for MOH
Michael Ha
Robert W. Baird & Co.
4 questions for MOH
Sarah James
Cantor Fitzgerald
4 questions for MOH
Scott Fidel
Stephens Inc.
4 questions for MOH
Stephen Baxter
Wells Fargo & Company
4 questions for MOH
A.J. Rice
UBS Group AG
3 questions for MOH
Albert Rice
UBS
3 questions for MOH
Erin Wright
Morgan Stanley
3 questions for MOH
Jason Cassorla
Guggenheim Partners
3 questions for MOH
Kevin Fischbeck
Bank of America
3 questions for MOH
Lance Wilkes
Sanford C. Bernstein & Co., LLC
3 questions for MOH
Adam Ron
Bank of America Corporation
2 questions for MOH
Josh Raskin
Nathron Research
2 questions for MOH
Stephen Baxter
Wells Fargo
2 questions for MOH
David Windley
Jefferies Financial Group Inc.
1 question for MOH
Hua Ha
Robert W. Baird & Co. Incorporated
1 question for MOH
Joanna Gajuk
Bank of America
1 question for MOH
Michael Hall
Robert W. Baird & Co. Incorporated
1 question for MOH
Competitors mentioned in the company's latest 10K filing.
| Company | Description |
|---|---|
The company competes with national, regional, and local Medicaid managed care companies, and health maintenance organizations, principally on the basis of size, location, quality of the provider network, quality of service, and reputation. The primary competitor for low-income Marketplace membership is this company. | |
The company faces competition from large national health plans, including this corporation, in the Medicaid managed care industry. It is also a large competitor in the Medicare market across the country. | |
This company is one of the primary competitors in the Medicaid managed care industry. | |
This company is a primary competitor in the Medicaid managed care industry and a large competitor in the Medicare market across the country. | |
This company is a large competitor in the Medicare market across the country. |
| Customer | Relationship | Segment | Details |
|---|---|---|---|
California | Serves Medi-Cal members under contracts with the Department of Health Care Services (DHCS) | Medicaid | $4,121 million (13% of consolidated Medicaid premium revenue in 2024) |
Texas | Holds contracts for the STAR+PLUS program and awarded contracts for the STAR & CHIP programs | Medicaid | $4,126 million (14% of consolidated Medicaid premium revenue in 2024) |
Washington | Managed care contract with the Washington State Health Care Authority for Apple Health Integrated Managed Care | Medicaid | $3,998 million (13% of consolidated Medicaid premium revenue in 2024) |
New York | Operates under contracts with the New York State Medicaid program (Magellan, Affinity, AgeWell) | Medicaid | $3,373 million (11% of consolidated Medicaid premium revenue in 2024) |
Notable M&A activity and strategic investments in the past 3 years.
| Company | Year | Details |
|---|---|---|
ConnectiCare Holding Company, Inc. | 2025 | Acquisition closed on February 1, 2025 for $350 million, adding approximately 140,000 members and expected to contribute about $1.2 billion in revenue; this deal supports Molina's growth strategy and expansion in the Connecticut market. |
Bright Health Medicare (Brand New Day and Central Health Plan of California) | 2024 | Acquisition closed on January 1, 2024 for $441 million, adding roughly 109,000 Medicare members by acquiring Brand New Day and Central Health Plan of California; the deal aligns with Molina’s strategic growth in its Medicare segment, using the acquisition method with asset and liability allocations to realize operational synergies. |
My Choice Wisconsin | 2023 | Acquisition closed on September 1, 2023 with a preliminary purchase price of approximately $74 million, adding about 40,000 Medicaid MLTSS members; the transaction also involved detailed asset and goodwill allocations aimed at enhancing operational synergies and supporting Molina’s strategic expansion. |
AgeWell New York MLTC Business | 2022 | Acquisition closed on October 1, 2022 for approximately $106 million, incorporating 13,000 Medicaid members and a business that generated $700 million in premium revenue, subject to regulatory approvals; this deal strengthens Molina’s portfolio in the Medicaid managed long‐term care space. |
Cigna Corporation's Texas Medicaid and MMP Contracts | 2022 | Acquisition completed on January 1, 2022 for a total purchase consideration of $60 million, where about $36 million was for membership and provider network assets and the remaining $24 million was allocated to goodwill to drive synergies and margin improvement in underperforming health plans. |
Recent press releases and 8-K filings for MOH.
- Faruqi & Faruqi is investigating potential claims against Molina Healthcare for allegedly misleading investors on medical cost trends and utilization assumptions, following multiple FY2025 guidance cuts.
- On July 7, 2025, Molina reported Q2 adjusted EPS of $5.50 and cut full-year 2025 adjusted EPS guidance by 10.2% at the midpoint to $21.50–$22.50.
- On July 23, 2025, Molina further lowered its FY2025 adjusted EPS guidance to no less than $19.00 and trimmed GAAP net income guidance by 27% to $912 million.
- Molina’s share price fell 16.84% to $158.22 on July 24, 2025, after the second guidance revision.
- Investors with losses over $75,000 between February 5 and July 23, 2025, have until December 2, 2025, to seek lead plaintiff status in the proposed class action.
- KSF reminds investors who suffered over $100,000 in losses on Molina stock between February 5, 2025 and July 23, 2025 of the December 2, 2025 deadline to apply as lead plaintiff in the class action.
- The lawsuit alleges Molina failed to disclose material information when it reported Q2 2025 results on July 23, 2025, including GAAP net income of $4.75 per diluted share (down 8% YoY) and cut full-year adjusted EPS guidance to no less than $19.00.
- Following the guidance cut, Molina’s share price plunged $32.03 (16.84%) to $158.22 on July 24, 2025, on heavy trading volume.
- The case, Hindlemann v. Molina Healthcare, Inc. (No. 25-cv-09461), is pending in the U.S. District Court for the Central District of California.
- Class Period: Feb. 5–Jul. 23, 2025, with a Dec. 2, 2025 deadline to file for lead plaintiff in the Molina Healthcare, Inc. (NYSE: MOH) lawsuit.
- Complaint claims Molina failed to disclose adverse medical cost trend assumptions, a dislocation between premium rates and medical costs, reliance on underutilization of behavioral health, pharmacy, and service lines, and that FY 2025 guidance was likely to be cut, rendering positive statements materially misleading.
- Investors wishing to participate can contact Bragar Eagel & Squire, P.C. to discuss their rights before the deadline.
- Premium revenue was $10.8 billion for Q3 2025, up 12% year-over-year.
- GAAP EPS was $1.51 and adjusted EPS was $1.84 for Q3 2025.
- Membership totaled approximately 5.6 million as of September 30, 2025, up 30,000 from a year earlier.
- The Company raised full-year 2025 guidance to ~$42.5 billion in premium revenue and ~$14.00 in adjusted EPS.
- Non-GAAP EPS guidance cut to ~$14 for fiscal 2025, down from prior estimates near $19, due to rising medical costs in its marketplace segment.
- Q3 revenue rose 10.9% year-over-year to $11.47 billion, while non-GAAP EPS of $1.84 missed expectations by $2.05.
- Full-year 2025 revenue forecast maintained at $44.5 billion with premium revenue projected to grow 10%, though margins are under pressure.
- A securities fraud class action lawsuit alleges Molina failed to disclose the severity of medical cost pressures timely, with a lead plaintiff motion deadline of December 2, 2025.
- Kahn Swick & Foti, LLC reminds investors with losses over $100,000 they have until December 2, 2025 to file lead plaintiff applications in a class action for securities bought between February 5 and July 23, 2025.
- On July 23, 2025, Molina reported GAAP net income of $4.75 per diluted share for Q2 (an 8% YoY decline) and cut its full-year 2025 adjusted EPS guidance to at least $19.00 due to challenging medical cost trends.
- Following the guidance cut, Molina shares plunged 16.84% (a $32.03 drop) to close at $158.22 on July 24, 2025.
- The Portnoy Law Firm advises Molina investors of a class action for purchases between February 5, 2025 and July 23, 2025; deadline to file is December 2, 2025
- On July 7, 2025, Molina reported Q2 adjusted EPS of $5.50 and cut full-year guidance midpoint by 10.2% to $21.50–22.50 citing medical cost pressures
- On July 23, 2025, Molina further cut full-year adjusted EPS guidance to ≥ $19.00 and GAAP net income guidance to $912 million, attributing cuts to accelerating medical costs
- Molina’s stock fell 2.9% to $232.61 on July 7 and 16.84% to $158.22 on July 24, 2025 after the announcements
- Faruqi & Faruqi is investigating potential claims against Molina for alleged misleading statements on medical cost trends and a dislocation between premium rates and costs.
- The complaint alleges undisclosed adverse facts about medical cost trend assumptions and dependency on underutilization of behavioral health, pharmacy, and inpatient/outpatient services, resulting in misstated FY2025 guidance.
- On July 7, 2025, Molina reported 2Q adjusted EPS of $5.50 and cut full-year 2025 adjusted EPS guidance midpoint by 10.2%, from at least $24.50 to $21.50–22.50 per share.
- On July 23, 2025, the company further reduced its full-year adjusted EPS guidance to no less than $19.00 (a 13.6% midpoint cut) and cut GAAP net income outlook to $912 million.
- Investors who purchased Molina securities between February 5 and July 23, 2025 may seek lead plaintiff status by the December 2, 2025 deadline by contacting partner Josh Wilson.
- Class action filed against Molina Healthcare for alleged securities fraud; investors must file by December 2, 2025 to seek lead plaintiff status.
- Complaint centers on medical cost pressures and a “dislocation” between premium rates and accelerating medical trends across all lines of business.
- Molina reported Q2 2025 adjusted EPS of $5.50, below expectations, and cut full-year 2025 adjusted EPS guidance twice—from at least $24.50 to $21.50–22.50, then to no less than $19.00.
- Share price fell 2.9% to $232.61 on July 7 and 16.84% to $158.22 on July 24, 2025, following the guidance cuts.
- Molina shareholders are urged to file a lead plaintiff motion in a securities fraud class action by December 2, 2025, covering investors who acquired MOH between Feb 5 and Jul 23, 2025.
- The complaint alleges Molina made materially false and misleading statements about its medical cost trend assumptions, premium rate dislocation, and utilization dependencies, and misrepresented its 2025 financial guidance.
- In Q2 2025, Molina reported adjusted EPS of $5.50, missing expectations, and cut full-year adjusted EPS guidance from ≥$24.50 to $21.50–22.50 (down 10.2%), then to no less than $19.00, and slashed GAAP net income outlook by 27% to $912 million.
- Following these updates, Molina shares fell 2.9% to $232.61 on Jul 7, 2025, and 16.84% to $158.22 on Jul 24, 2025, on unusually heavy trading volume.