GAAP and Adjusted EPS results for 4Q18 and FY 2018 were further positively impacted by the benefit of a lower tax rate year-over-year as a result of the Tax Reform Law enacted in 4Q17, allowing the company to invest pretax dollars in its employees, the communities of its members, technology and its integrated care delivery model to drive more affordable healthcare and better clinical outcomes; and a lower number of shares in 2018, primarily reflecting share repurchases.
Below is a summary of key consolidated and segment statistics comparing 4Q18 to 4Q17 and FY 2018 to FY 2017.
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Humana Inc. summary of quarter and FY results (dollars in millions) | | 4Q18 (a) | | | 4Q17 (b) | | | FY 2018 (c) | | | FY 2017 (d) | |
Consolidated results: | | | | | | | | | | | | | | | | |
Revenues – GAAP | | $ | 14,168 | | | $ | 13,189 | | | $ | 56,912 | | | $ | 53,767 | |
Revenues – Adjusted | | $ | 14,166 | | | $ | 12,995 | | | $ | 56,904 | | | $ | 52,816 | |
Pretax income – GAAP | | $ | 436 | | | $ | 490 | | | $ | 2,063 | | | $ | 4,020 | |
Pretax income – Adjusted | | $ | 480 | | | $ | 576 | | | $ | 2,898 | | | $ | 3,185 | |
EPS – GAAP | | $ | 2.58 | | | $ | 1.29 | | | $ | 12.16 | | | $ | 16.81 | |
EPS – Adjusted | | $ | 2.65 | | | $ | 2.06 | | | $ | 14.55 | | | $ | 11.71 | |
Benefits expense ratio – GAAP | | | 83.4 | % | | | 83.0 | % | | | 83.5 | % | | | 83.0 | % |
Benefits expense ratio – Adjusted | | | 83.4 | % | | | 83.0 | % | | | 83.7 | % | | | 83.5 | % |
Operating cost ratio – GAAP | | | 15.0 | % | | | 14.3 | % | | | 13.3 | % | | | 12.3 | % |
Operating cost ratio – Adjusted | | | 15.0 | % | | | 13.9 | % | | | 13.3 | % | | | 11.7 | % |
Operating cash flows– GAAP | | ($ | 333 | ) | | ($ | 2,911 | ) | | $ | 2,173 | | | $ | 4,051 | |
Operating cash flows– Adjusted | | ($ | 333 | ) | | $ | 218 | | | $ | 2,173 | | | $ | 4,051 | |
Parent company cash and short term investments | | | | | | | | | | $ | 578 | | | $ | 688 | |
Debt-to-total capitalization | | | | | | | | | | | 37.4 | % | | | 33.3 | % |
Retail segment results: | | | | | | | | | | | | | | | | |
Revenues – GAAP | | $ | 12,036 | | | $ | 10,948 | | | $ | 48,255 | | | $ | 44,726 | |
Benefits expense ratio – GAAP | | | 84.0 | % | | | 84.2 | % | | | 85.1 | % | | | 85.6 | % |
Operating cost ratio – GAAP | | | 12.9 | % | | | 11.8 | % | | | 11.1 | % | | | 9.6 | % |
Segment earnings – GAAP | | $ | 339 | | | $ | 391 | | | $ | 1,733 | | | $ | 1,978 | |
Segment earnings – Adjusted | | $ | 343 | | | $ | 397 | | | $ | 1,752 | | | $ | 2,002 | |
Group and Specialty segment results: | | | | | | | | | | | | | | | | |
Revenues – GAAP | | $ | 1,909 | | | $ | 1,891 | | | $ | 7,679 | | | $ | 7,449 | |
Benefits expense ratio – GAAP | | | 84.6 | % | | | 83.1 | % | | | 79.7 | % | | | 79.2 | % |
Operating cost ratio – GAAP | | | 23.9 | % | | | 21.9 | % | | | 23.6 | % | | | 21.4 | % |
Segment earnings (loss) – GAAP | | ($ | 11 | ) | | $ | 47 | | | $ | 361 | | | $ | 412 | |
Segment earnings (loss) – Adjusted | | ($ | 10 | ) | | $ | 48 | | | $ | 366 | | | $ | 415 | |
Healthcare Services segment results: | | | | | | | | | | | | | | | | |
Revenues – GAAP | | $ | 6,191 | | | $ | 6,018 | | | $ | 23,811 | | | $ | 23,958 | |
Operating cost ratio – GAAP | | | 96.8 | % | | | 96.0 | % | | | 96.3 | % | | | 95.5 | % |
Segment earnings – GAAP | | $ | 160 | | | $ | 213 | | | $ | 754 | | | $ | 967 | |
Adjusted EBITDA (f) | | $ | 223 | | | $ | 253 | | | $ | 969 | | | $ | 1,110 | |
2019 Earnings Guidance
The company provided its GAAP and Adjusted EPS guidance for the year ended December 31, 2019 (FY 2019) as detailed below. GAAP and Adjusted results for FY 2018 are also shown for comparison.
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Diluted earnings per common share | | FY 2019 Guidance (e) | | | FY 2018 (c) | |
GAAP | | ~$ | 16.60 to $17.10 | | | $ | 12.16 | |
Loss on Sale of KMG, a wholly-owned subsidiary | | | — | | | | 2.41 | |
Put/call valuation adjustments associated with 40% minority interest in Kindred at Home | | | — | | | | 0.18 | |
Amortization of identifiable intangibles | | | 0.40 | | | | 0.49 | |
Segment earnings associated with the Individual Commercial segment | | | — | | | | (0.41 | ) |
Adjustments to provisional estimates for the income tax effects related to the Tax Reform Law | | | — | | | | (0.28 | ) |
Adjusted(non-GAAP) – FY 2019 projected | | ~$ | 17.00 to $17.50 | | | $ | 14.55 | |
“Our solid execution in 2018 resulted in Adjusted EPS growth of over 20 percent and positions us well for 2019,” said Brian A. Kane, Chief Financial Officer. “Our 2019 guidance reflects Adjusted EPS growth of 17 to 20 percent combined with individual Medicare Advantage membership growth significantly in excess of the industry.”
2020 Preliminary Rate Notice
On Wednesday, January 30, 2019, after the stock market closed, the Centers for Medicare and Medicaid Services (CMS) issued its preliminary 2020 Medicare Advantage and Part D payment rates and proposed policy changes (collectively, the Advance Notice). CMS has invited public comment on the Advance Notice before publishing final rates on April 1, 2019 (the Final Notice).
In the Advance Notice, CMS estimates Medicare Advantage plans across the sector will, on average, experience a 1.59 percent increase in benchmark funding based on proposals included therein. As indicated by CMS, its estimate excludes the impact offee-for-service countyrebasing/re-pricing since the related impact is dependent upon finalization of certain data, which will be available with the publication of the Final Notice.
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