Coventry Health Care, Inc. (NYSE: CVH) today reported
consolidated operating results for the quarter ended March 31,
2013. Operating revenues totaled $3.5 billion for the quarter with
net earnings of $135.4 million, or earnings per diluted share (EPS)
of $1.00.
“I am pleased to report the Company’s strong start to 2013,”
said Allen F. Wise, Chairman and Chief Executive Officer of
Coventry. “These first quarter results position the Company well to
achieve its financial and operational goals in 2013 as we look
towards combining our strengths with those of Aetna after
satisfying all remaining regulatory requirements.”
First Quarter 2013 Consolidated Highlights
- First quarter EPS increased by 61% from
the prior year quarter excluding the $0.58 one-time impact from the
previously disclosed Medicare Advantage Risk Adjustment Data
Validation (RADV) prior period reserve release during the first
quarter of 2012
- Total revenues were down 4.7% from the
prior year quarter
- Excluding the $141.8 million favorable
revenue impact of the RADV prior period reserve release during the
first quarter of 2012, total revenues were down by less than
1%
- Selling, general, and administrative
(SG&A) expense of 14.8% of total revenue includes costs of
$11.1 million, or $0.05 EPS, associated with the pending Aetna
transaction
- Medicare Advantage Coordinated Care
Plan (MA-CCP) membership was 309,000, an increase of 59,000
members, or 24%, from the prior year quarter driven by successful
execution during the 2013 Annual Enrollment Period
- The Company’s Kentucky Medicaid
business generated a positive contribution to earnings with an MLR
of 92.3% in the first quarter, an improvement of 440 basis points
(bps) from the fourth quarter of 2012 and 2,860 bps from the first
quarter of 2012
- The Company successfully launched
Medicaid operations in the New East Zone in Pennsylvania during the
quarter, bringing the Company’s total Medicaid membership in
Pennsylvania to approximately 98,000
- GAAP cash flows from operations were
$222.2 million, or 164% of net income
Selected First Quarter 2013 Highlights
Medicare Advantage
- Excluding the $141.8 million favorable
revenue impact of the RADV prior period reserve release during the
first quarter of 2012, Medicare Advantage revenue increased by 20%
from the prior year quarter
- As of March 31, 2013, slightly more
than 50% of the Company’s current MA-CCP membership resides in
contracts rated 4.0 Stars
- The MA-CCP Medical Loss Ratio (MLR) was
84.6% in the quarter
Medicare Part D
- As of March 31, 2013, Medicare Part D
membership was 1,450,000, a decrease of 8,000 members, or 1%, from
the prior year quarter, driven by the reduction in Coventry’s
auto-assign footprint for 2013
- The Medicare Part D MLR was 93.4% in
the quarter, a decrease of 150 bps from the prior year quarter
Medicaid
- As of March 31, 2013, Medicaid
membership was 892,000, a decrease of 32,000 members, or 3%, from
the prior year quarter. The decrease was driven by the previously
announced termination of the Company’s contract with the State of
Kansas effective December 31, 2012, partially offset by expansion
to additional regions in Pennsylvania throughout 2012 and 2013 and
expansion in Nebraska effective July 1, 2012.
- The Medicaid MLR was 86.4% in the
quarter, a decrease of 1,360 bps from the prior year quarter
Commercial
- As of March 31, 2013, total commercial
membership was 2,182,000, a decrease of 22,000 members, or 1%, from
the prior quarter
- The commercial risk MLR was 77.9% in
the quarter, a decrease of 200 bps from the prior year quarter
Balance Sheet
- Investment portfolio in a net
unrealized gain position of $88 million as of March 31, 2013
- Health Plan Days in Claims Payable
(DCP) of 51.43, an increase of 2.39 days from the prior
quarter
- $950 million in free cash at the parent
at quarter-end
- Board of Directors approval of the
Company’s first quarter 2013 cash dividend paid on April 9,
2013
- Debt-to-Capital of 24.7%, a 50 bps
reduction from the prior year quarter
Cautionary Statement Regarding Forward-Looking
Statements
Among the risk factors that may materially affect our business,
operations or financial condition are the ability to accurately
estimate and control future health care costs; the ability to
increase premiums to offset increases in our health care costs;
general economic conditions and disruptions in the financial
markets; changes in legal requirements and healthcare industry
practices from recently enacted federal or state laws or
regulations, court decisions, or government audits, investigations
and proceedings; guaranty fund assessments under state insurance
guaranty association law; changes in government funding and various
other risks associated with our participation in Medicare and
Medicaid programs; our ability to effectively implement and manage
new or less seasoned markets, including the implementation of
appropriate risk adjustment revenue and management of the
associated medical costs and the effect on our medical loss ratio;
a reduction in the number of members in our health plans; the
ability to acquire additional managed care businesses, enter into
new markets and to successfully integrate acquired businesses into
our operations, particularly while our merger with Aetna is
pending; an ability to attract new members or to increase or
maintain our premium rates; the non-renewal or termination of our
government contracts, unsuccessful bids for business with
government agencies or renewal of government contracts,
unsuccessful bids for business with government agencies or renewal
of government contracts on less favorable terms; failure of
independent agents and brokers to continue to market our products
to employers; a failure to obtain cost-effective agreements with a
sufficient number of providers that could result in higher medical
costs and a decrease in our membership; negative publicity
regarding the managed health care industry generally or our Company
in particular; a failure to effectively protect, maintain and
develop our information technology systems; compromises of our data
security; periodic reviews, audits and investigations under our
contracts with federal and state government agencies; litigation
including litigation based on new or evolving legal theories;
volatility in our stock price and trading volume; our indebtedness,
which imposes certain restrictions on our business and operations;
an inability to generate sufficient cash to service our
indebtedness; our ability to receive cash from our regulated
subsidiaries; an impairment of our intangible assets; our
certificate of incorporation, our bylaws and Delaware law, which
could delay, discourage or prevent a change in control of our
Company that our stockholders may consider favorable; changes in
government funding related to automatic spending cuts that are
occurring due to federal sequestration; and our proposed merger
with Aetna, including, but not limited to, risks related to our
failure to complete the merger with Aetna, our ability to attract,
retain and motivate our key employees and executives in light of
the pending merger, and limitations on our ability to conduct our
business between now and the closing of the merger.
Coventry Health Care (www.coventryhealthcare.com) is a
diversified national managed health care company based in Bethesda,
Maryland, dedicated to delivering high-quality health care
solutions at an affordable price. Coventry provides a full
portfolio of risk and fee-based products including Medicare and
Medicaid programs, group and individual health insurance, workers’
compensation solutions, and network rental services. With a
presence in every state in the nation, Coventry’s products
currently serve approximately 5 million individuals helping them
receive the greatest possible value for their health care
investment.
COVENTRY HEALTH CARE, INC. CONSOLIDATED STATEMENTS
OF OPERATIONS (Amounts in thousands, except per share
data) Quarters Ended March 31, 2013
2012 Operating revenues: (unaudited)
(unaudited) Managed care premiums $ 3,236,663 $ 3,386,268
Management services 283,572 305,699
Total
operating revenues 3,520,235
3,691,967 Operating expenses: Medical costs
2,686,651 2,808,348 Cost of sales 59,485 67,952 Selling, general,
and administrative 520,300 502,888 Depreciation and amortization
37,631 36,303
Total operating expenses
3,304,067 3,415,491 Operating
earnings 216,168 276,476 Operating earnings
percentage of total revenues 6.1% 7.5%
Interest expense 24,582 25,557 Other income, net 30,330
24,434
Earnings before income taxes
221,916
275,353
Provision for income taxes 86,547 104,634
Net earnings $ 135,369 $ 170,719
Net earnings per share: Basic earnings per common
share $ 1.01 $ 1.21 Diluted earnings per common share $ 1.00 $ 1.20
Weighted average common shares outstanding, basic 133,464
139,323 Weighted average common shares outstanding, diluted 134,300
140,167
COVENTRY HEALTH CARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS (Amounts in
thousands) March 31, December 31,
2013 2012 (unaudited) Assets: Current
assets: Cash and cash equivalents $ 1,531,678 $ 1,399,162
Short-term investments 120,745 121,742 Accounts receivable, net
260,809 272,077 Other receivables, net 945,218 892,815 Other
current assets 195,479 196,323 Total current assets 3,053,929
2,882,119 Long-term investments 2,713,291 2,658,582 Property
and equipment, net 261,668 266,818 Goodwill 2,591,488 2,591,488
Other intangible assets, net 302,118 318,592 Other long-term assets
32,783 33,389
Total assets $ 8,955,277
$ 8,750,988 Liabilities and
Stockholders’ Equity: Current liabilities: Medical
liabilities $ 1,476,557 $ 1,418,914 Accounts payable and other
accrued liabilities 509,930 488,175 Deferred revenue 150,999
137,981 Total current liabilities 2,137,486 2,045,070
Long-term debt 1,585,312 1,585,190 Other long-term liabilities
396,476 397,813
Total liabilities 4,119,274
4,028,073 Stockholders’ equity
4,836,003 4,722,915 Total
liabilities and stockholders’ equity $ 8,955,277
$ 8,750,988 COVENTRY HEALTH CARE,
INC. CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS
(Amounts in thousands) (unaudited) Quarter
Ended March 31, 2013 Cash flows from operating
activities: Net earnings $ 135,369 Adjustments to earnings:
Depreciation and amortization 37,631 Amortization of stock
compensation 5,972 Changes in assets and liabilities: Accounts
receivable, net 11,268 Other receivables, net (52,403) Medical
liabilities 57,643 Accounts payable and other accrued liabilities
20,252 Deferred revenue 13,018 Other operating activities (6,525)
Net cash flows from operating activities 222,225
Cash
flows from investing activities: Capital expenditures, net
(15,871) Payments for investments, net of sales and maturities
(61,321) Net cash flows from investing activities (77,192)
Cash flows from financing activities: Proceeds from issuance
of stock 4,397 Payments for repurchase of stock (664) Excess tax
benefit from stock compensation 565 Payments for cash dividends
(16,815) Net cash flows from financing activities (12,517)
Net change in cash and cash equivalents for current period 132,516
Cash and cash equivalents at beginning of period 1,399,162
Cash
and cash equivalents at end of period $ 1,531,678
Cash and Investments:
Cash and cash equivalents $ 1,531,678 Short-term investments
120,745 Long-term investments 2,713,291 Total cash and investments
$ 4,365,714
COVENTRY
HEALTH CARE, INC. SELECTED OPERATING STATISTICS
(Unaudited) Total Q1 2013
2012 Q4 2012 Q3 2012
Q2 2012 Q1 2012 Membership by
Product (000s)
Commercial Risk 1,404 1,474
1,489 1,519 1,549 Health Plan Commercial ASO 778 730 736 729 725
Medicare Advantage 309 259 256 253 250 Medicaid Risk 892 974 998
932 924 Other National ASO 339 347 350 354 356 Medicare Part D
1,450 1,578 1,545
1,494 1,458
Total Membership
5,172 5,362
5,374 5,281
5,262
Revenues by Product
Type (000s)
Commercial Risk $ 1,322,718 $
5,737,626 $ 1,403,010 $ 1,409,863 $ 1,443,478 $ 1,481,275
Commercial Management Services 108,084 429,209
100,736 101,138 113,558
113,777
Total Commercial Products
1,430,802 6,166,835 1,503,746 1,511,001
1,557,036 1,595,052 Medicare Advantage 831,378
2,912,143 695,815 697,724 684,291 834,312 Medicaid Risk 690,800
2,809,579 712,845 730,996 697,679 668,060 Medicare Part D
406,548 1,514,518 363,032
343,185 394,877 413,423
Total
Government Programs 1,928,726 7,236,240
1,771,692 1,771,905 1,776,847 1,915,795
Workers’ Compensation 175,488
757,779 183,289
187,992 194,576
191,922 Corporate and Eliminations (14,781)
(47,491) (12,910) (13,115)
(10,663) (10,802)
Total Revenues
$ 3,520,235 $ 14,113,363 $
3,445,817 $ 3,457,783 $
3,517,796 $ 3,691,967
Consolidated Coventry
Operating Income % of Revenues 6.1% 5.4% 5.2% 4.6% 4.1% 7.5%
SGA % of Revenues 14.8% 14.7% 16.0% 15.1% 14.3% 13.6% Total
Health Plan Medical Liabilities (000s) (1) $ 1,322,392 $ 1,258,279
$ 1,321,436 $ 1,315,078 $ 1,313,458 Health Plan Days in Claims
Payable (DCP) (1) 51.43 49.04 50.90 49.77 49.47 Total Debt
(millions) $ 1,585.3 $ 1,585.2 $ 1,585.1 $ 1,584.9 $ 1,584.8 Total
Capital (millions) $ 6,421.3 $ 6,308.1 $ 6,211.4 $ 6,091.2 $
6,287.5 Debt to Capital 24.7% 25.1% 25.5% 26.0% 25.2%
COVENTRY HEALTH CARE, INC.
SELECTED REVENUE AND MEDICAL COST STATISTICS
(Unaudited) Total Q1 2013
2012 Q4 2012 Q3 2012
Q2 2012 Q1 2012 Revenue PMPM
Commercial Risk $ 306.18 $ 310.15 $ 310.27 $
308.42 $ 309.91 $ 311.92 Medicare Advantage(2) $ 899.28 $ 938.71 $
897.31 $ 908.57 $ 902.61 $ 1,048.93 Medicare Part D(3) $ 81.10 $
85.94 $ 84.58 $ 86.24 $ 87.55 $ 85.44 Medicaid $ 266.74 $ 242.35 $
240.38 $ 241.92 $ 248.48 $ 238.74
MLR%
Consolidated Total 83.0% 84.0%
82.7% 84.4% 85.9% 82.9% Commercial Risk 77.9% 81.7% 82.2%
81.5% 83.0% 79.9% Medicare Advantage(2) 84.6% 81.1% 83.9% 83.1%
84.1% 74.1% Medicare Part D 93.4% 85.4% 70.7% 84.2% 90.0% 94.9%
Medicaid 86.4% 94.1% 90.4% 93.0% 93.3% 100.0% (1) “Total
Health Plan Medical Liabilities” and “Health Plan Days in Claims
Payable” exclude the impact of the Kansas Medicaid business for the
first quarter of 2013 as the contract with the State of Kansas
ended effective December 31, 2012. (2) First quarter 2012
Medicare Advantage statistics for Revenue PMPM and MLR% include the
favorable impact from the release of MA-CCP RADV audit reserves.
Excluding this impact, the comparable Revenue PMPM was $923.87 and
the comparable MLR% was 82.9% for the first quarter 2012. For the
full year, the comparable Revenue PMPM was $907.99 and the
comparable MLR% was 83.5%. (3) Revenue PMPM excludes the
impact of CMS risk-share premium adjustments and revenue ceded to
external parties.
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