Earnings call transcript: Molina Healthcare Q1 2026 EPS beats, stock rises 5.23%

Molina Healthcare Inc. (MOH) reported its first-quarter earnings for 2026, surpassing analyst expectations with an adjusted earnings per share (EPS) of $2.35 compared to the forecasted $2.17. This 8.29% EPS surprise comes despite a slight revenue miss, with actual revenue at $10.8 billion against a forecast of $10.87 billion. Following the announcement, Molina’s stock rose by 5.23% to $161 in premarket trading, reflecting investor optimism.

Molina Healthcare demonstrated robust financial performance in the first quarter of 2026, with its EPS significantly surpassing expectations. The company’s strategic focus on integrating Medicare-Medicaid products has proven effective, contributing to better-than-expected performance in the Medicare segment. Despite a minor revenue miss, the overall financial health of the company remains strong.

Molina’s actual EPS of $2.35 outperformed the forecasted $2.17, representing an 8.29% surprise. This strong EPS result highlights the company’s effective cost management and operational efficiency. However, revenue slightly missed the expected $10.87 billion, a minor shortfall that did not significantly impact investor sentiment.

Following the earnings announcement, Molina’s stock rose by 5.23% to $161 in premarket trading. This increase contrasts with broader market trends, suggesting specific investor confidence in Molina’s strategic direction and financial performance. The stock’s movement within its 52-week range indicates a positive outlook from investors.

Molina Healthcare reaffirmed its full-year 2026 guidance, projecting premium revenue of approximately $42 billion and an adjusted EPS of at least $5.00. The company continues to focus on strategic product transitions and cost management to drive future growth.

Molina’s executives expressed confidence in the company’s strategic initiatives, with the CEO stating, "Our successful transition of Medicare-Medicaid Plan members to new integrated products has exceeded our expectations, positioning us well for future growth." The CFO highlighted the company’s strong cash flow generation and balance sheet health.

During the earnings call, analysts inquired about Molina’s plans for managing Medicaid membership attrition and its impact on revenue. Executives emphasized ongoing efforts to enhance member engagement and cost management strategies to mitigate these challenges.

Andrew Mok, Analyst, Barclays4: Good morning, and welcome to Molina Healthcare’s first quarter 2026 earnings call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing star then zero on your telephone keypad. After today’s presentation, there will be an opportunity to ask questions. To ask a question, you may press star then one on your telephone keypad. To withdraw your question, please press star then two. Please note, this event is being recorded. As a reminder, please limit yourself to one question. I would now like to turn the conference over to Jeff Geyer, Vice President, Investor Relations at Molina Healthcare. Please go ahead.

Jeff Geyer, Vice President, Investor Relations, Molina Healthcare: Good morning, and welcome to Molina Healthcare’s first quarter 2026 earnings call. Joining me today are Molina’s President and CEO, Joe Zubretsky, and our CFO, Mark Keim. A press release announcing our first quarter 2026 earnings was distributed after the market closed yesterday and is available on our investor relations website. Shortly after the conclusion of this call, a replay will be available for 30 days. The numbers to access the replay are in the earnings release. For those of you who listen to the rebroadcast of this presentation, we remind you that all of the remarks are made as of today, Thursday, April 23rd, 2026, and have not been updated subsequent to the initial earnings call. On this call, we will refer to certain non-GAAP measures. A reconciliation of these measures with the most directly comparable GAAP measures can be found in the earnings release.

During the call, we will be making certain forward-looking statements, including, but not limited to, statements regarding our 2026 guidance, the medical cost and utilization trend during the year, the political, legislative, and regulatory landscape, the impact of Medicaid work requirements and redeterminations, our expected growth and margin expansion, the estimated amount of our embedded earnings power and future earnings realization, Medicaid rate adjustments and updates, our RFP awards, and our acquisitions and M&A activity. Listeners are cautioned that all of our forward-looking statements are subject to certain risks and uncertainties that could cause our actual results to differ materially from our current expectations. We advise listeners to review the risk factors discussed in our Form 10-K annual report filed with the SEC, as well as our risk factors listed in our Form 10-Q and Form 8-K filings with the SEC.

After the completion of our prepared remarks, we will open the call to take your questions. I will now turn the call over to our Chief Executive Officer, Joe Zubretsky. Joe?

Joe Zubretsky, President and Chief Executive Officer, Molina Healthcare: Thank you, Jeff, and good morning. Today, I will discuss several topics, our reported financial results for the first quarter, our full year 2026 guidance, which we reaffirm at approximately $42 billion of premium revenue and at least $5 in adjusted earnings per share, the political and regulatory landscape, and a brief glimpse of our Investor Day agenda and growth outlook. Let me start with our first quarter performance. Last night, we reported adjusted earnings per share of $2.35 on $10.2 billion of premium revenue. We would characterize the result as solid under the circumstances, but that characterization is against the backdrop of current modest expectations. Our 91.1% consolidated MCR reflects strong operating performance as we continue to navigate a challenging medical cost environment. We produced a 1.6% adjusted pre-tax margin in the quarter. In Medicaid in the first quarter, the business produced an MCR of 92%.

While the January 1st rate updates came in as expected, our medical cost trend was modestly favorable to our expectations. We continued to work to enhance our medical cost management protocols to address the areas of high cost trend we observed in 2025. Last year, we observed a 7.5% medical cost trend that included 250 basis points of acuity shift related to the post-pandemic redetermination process. However, the acuity shift in core utilization impacts diminished as the year progressed. Our expectation that the acuity shift trend that we had experienced in 2025 was behind us and would not recur is holding up. We feel confident in our 5% medical cost trend assumption for 2026. In Medicare, we reported a first quarter MCR of 89.8%. At the beginning of the year, we successfully completed the transition of MMP members to the new integrated products.

Our dual business is the strategic focus for us in Medicare. As previously mentioned, we will exit the MAPD product for 2027. In Marketplace, the first quarter MCR was 84%. Membership stands at 305,000 and is slightly higher than our prior guidance. The profile of our membership is as expected following our decision to reduce our exposure in this highly volatile segment. The majority of our members are renewal members, and we remain concentrated in the silver tier, which leads to greater stability and predictability in our membership base. Turning now to our 2026 guidance. Although the quarter was strong when compared to internal and external expectations, we are merely reaffirming our full year 2026 adjusted earnings per share guidance of at least $5. Our full year 2026 premium revenue guidance remains at approximately $42 billion.

We note that our forecast for Medicaid membership attrition increased slightly, but the associated revenue loss is projected to be offset by a higher revenue in Marketplace. We remain optimistic that states may provide off-cycle and retro rate updates throughout the year as they did last year. We are keenly aware that medical cost trend and earnings came in modestly favorable to expectations in the quarter. That being said, merely reaffirming our prior full year guidance is a prudent approach at this early point in the year and in this current environment. When we report second quarter results, we will update our full year 2026 guidance to reflect the first and second quarter results, which will provide a time-tested base off of which to project the second half of the year. Turning now to the political and legislative landscape.

In Medicaid, states continue to evaluate their processes on how to implement work requirements in biannual redeterminations. The guidance from CMS affords states some flexibility on how to proceed with these requirements, particularly as it relates to the timing of these reviews. We are working closely with our state partners on the administrative requirements needed to implement these new policies. We continue to believe that membership impacts will be minor and emerge gradually through 2027 and 2028, and therefore, any impact due to changes in the risk pool will be small. In Medicare, we are pleased with the improvement in the CMS final rate notice compared to the preliminary notice. In addition, the continued progress of states promoting the integration of Medicaid and Medicare supports the long-term competitive position of our dual products.

In Marketplace, as we approach the 2027 pricing cycle, we will likely remain cautious as it is still possible for disruptive regulatory changes to occur. We look forward to updating you on our three-year outlook at our Investor Day event on Friday, May 8th. We see a clear path to margin expansion through the correction of the rate and trend imbalance that exists today, and the revenue growth opportunities continu