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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 .
| 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?
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.
- Molina reported adjusted EPS of $6.08 on approximately $10.6 billion in premium revenue with a consolidated MCR of 89.2% in Q1 2025.
- The full-year guidance remains unchanged with premium revenue of about $42 billion and adjusted EPS guidance of at least $24.50, reflecting steady performance.
- Embedded earnings improved from roughly $7.75 to $8.65 per share, supported by new contracts such as the Illinois duals win and robust operational performance.
- The call highlighted a strong capital foundation with share repurchases (approximately 1.7 million shares at $500 million) and a healthy M&A pipeline to drive future long-term EPS growth of 13%-15%.
- Molina Healthcare reported Q1 2025 GAAP EPS of $5.45 and adjusted EPS of $6.08, with premium revenue of approximately $10.6 billion indicating solid top-line growth.
- The Company served approximately 5.8 million members, reflecting a modest membership increase year-over-year.
- It reaffirmed its full-year guidance with expected premium revenue of about $42 billion and adjusted earnings of at least $24.50 per diluted share, underlining strong future performance.