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.
- Kahn Swick & Foti reminds investors with losses exceeding $100,000 from purchases of Molina (NYSE: MOH) securities between February 5 and July 23, 2025 to file lead plaintiff motions by December 2, 2025.
- The suit alleges Molina failed to disclose material information during the class period, following its Q2 2025 report showing GAAP net income of $4.75 per diluted share (down 8% YoY) and a revised full-year adjusted EPS guidance of no less than $19.00.
- On July 24, 2025, Molina’s share price dropped $32.03 (16.84%), closing at $158.22 per share on heavy volume.
- Bragar Eagel & Squire, P.C. has filed a class action on behalf of Molina Healthcare investors for the Class Period Feb. 5, 2025 to July 23, 2025, with lead plaintiff applications due by Dec. 2, 2025.
- The complaint alleges Molina failed to disclose material adverse facts about its medical cost trend assumptions, a dislocation between premium rates and medical cost trends, and dependency on low utilization of key services, creating a substantial risk of FY 2025 guidance cuts and rendering prior public statements misleading.
- Investors are reminded to contact Bragar Eagel & Squire to petition the court to serve as lead plaintiff before the deadline.
- Grabar Law Office is probing whether Molina Healthcare (NYSE: MOH) officers and directors breached fiduciary duties by failing to disclose material adverse facts on medical cost trends and misaligned premium rates.
- The complaint alleges undisclosed dependence on low utilization of behavioral health, pharmacy, and inpatient/outpatient services, and an impending cut to FY2025 financial guidance.
- Eligible shareholders who bought MOH shares before February 5, 2025 and still hold them can seek corporate reforms, fund recovery, and incentive awards at no cost.
- Securities law firm Faruqi & Faruqi, LLP has launched an investigation into potential securities law violations at Molina Healthcare, urging affected investors to contact them directly.
- Molina’s July 7, 2025 Q2 release revealed $5.50 adjusted EPS, prompted a 10.2% downward revision of its full-year 2025 adjusted EPS guidance to $21.50–$22.50, and saw its stock drop 2.9%.
- On July 23, 2025 Molina further cut its guidance, reporting Q2 GAAP EPS of $4.75 (−8% YoY), lowering full-year 2025 adjusted EPS to ≥$19.00 and GAAP net income guidance to $912 million (−27%), triggering a 16.84% stock decline.
- Investors who acquired Molina Healthcare securities between February 5 and July 23, 2025 have until December 2, 2025 to file lead plaintiff applications in the class action lawsuit.
- The lawsuit alleges Molina failed to disclose material information when it reported Q2 2025 GAAP net income of $4.75 per diluted share (down 8% year-over-year) and cut full-year adjusted earnings guidance to no less than $19.00 per diluted share on July 23, 2025.
- Following the guidance cut, Molina’s share price fell $32.03 (16.84%) to $158.22 on July 24, 2025.
- The case is Hindlemann v. Molina Healthcare, Inc., No. 25-cv-09461, pending in the U.S. District Court for the Central District of California.
- Bragar Eagel & Squire reminds shareholders of a class action against Molina Healthcare (NYSE: MOH) covering Class Period: February 5, 2025 to July 23, 2025, with Lead Plaintiff Deadline: December 2, 2025.
- Complaint alleges failure to disclose adverse facts concerning medical cost trend assumptions and a dislocation between premium rates and cost trends.
- Plaintiffs claim Molina’s near-term growth depended on underutilization of behavioral health, pharmacy, and other services, and that FY2025 guidance was likely to be cut, rendering positive statements materially misleading.
- Faruqi & Faruqi is investigating potential claims against Molina Healthcare and urges investors who suffered losses exceeding $75,000 between February 5, 2025 and July 23, 2025 to contact partner Josh Wilson by the December 2, 2025 deadline to seek lead-plaintiff status.
- The complaint alleges Molina made false or misleading statements about its medical cost trend assumptions, premium-rate dislocations, service utilization impacts, and the likelihood of a fiscal 2025 guidance cut.
- On July 7, 2025, Molina reported Q2 2025 adjusted EPS of $5.50, missed expectations, and cut full-year adjusted EPS guidance by 10.2% at the midpoint to a range of $21.50–$22.50 per share.
- On July 23, 2025, the company disclosed Q2 GAAP net income of $4.75 per diluted share (down 8% YoY) and further reduced FY 2025 adjusted EPS guidance to no less than $19.00 (a 13.6% midpoint cut) and GAAP net income guidance to $912 million (down 27%).
- Bragar Eagel & Squire reminds investors that a class action has been filed against Molina Healthcare, Inc. (NYSE: MOH) for the period Feb. 5, 2025 to Jul. 23, 2025, with a lead plaintiff deadline of Dec. 2, 2025.
- The complaint alleges Molina failed to disclose material adverse facts about its medical cost trend assumptions and a dislocation between premium rates and medical cost trends, which distorted its financial outlook.
- It further claims Molina’s near-term growth was overly dependent on low utilization of behavioral health, pharmacy, and inpatient/outpatient services, making its FY 2025 guidance likely to be cut and prior positive statements materially misleading.
- 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.