Molina Healthcare Reports Fourth Quarter and Year-End 2024 Financial Results

Rhea-AI Summary

Molina Healthcare (NYSE: MOH) reported strong financial results for Q4 and full-year 2024. Full-year premium revenue reached $38.6 billion, a 19% increase year-over-year, driven by new contract wins, acquisitions, and growth in current markets. The company achieved $20.42 GAAP earnings per diluted share and $22.65 adjusted EPS for 2024, representing 9% and 8% growth respectively.

The company served approximately 5.5 million members as of December 31, 2024. The consolidated Medical Care Ratio (MCR) was 89.1%, with Medicaid MCR at 90.3%, Medicare MCR at 89.1%, and Marketplace MCR at 75.4%. For 2025, Molina projects premium revenue of approximately $42 billion and adjusted earnings of at least $24.50 per diluted share, including $1.00 per share in implementation costs for new contracts.

Positive

• Premium revenue increased 19% YoY to $38.6 billion
• GAAP EPS grew 9% to $20.42
• Adjusted EPS increased 8% to $22.65
• Strong 2025 guidance with projected 9% revenue growth
• Marketplace MCR of 75.4% exceeded expectations

Negative

• Consolidated MCR increased to 89.1% from 88.1% YoY
• Operating cash flow decreased to $644M from $1,662M YoY
• After-tax margin declined to 2.9% from 3.2% YoY
• Higher-than-expected Medicare utilization in 2024
• Medicaid MCR impacted by redetermination-related acuity shifts

Insights

Financial Analyst

The Q4 and full-year 2024 results reveal a complex picture of Molina Healthcare's operational performance. The 19% premium revenue growth to $38.6 billion demonstrates strong execution in market expansion and contract wins. However, beneath this impressive top-line growth, there are notable operational dynamics to consider.

The increase in Medical Care Ratio to 89.1% warrants attention, particularly in the Medicaid segment where higher utilization and redetermination-related acuity shifts impacted performance. The Medicare segment's 89.1% MCR reflects ongoing challenges in managing medical costs, while the Marketplace segment's strong 75.4% MCR demonstrates effective risk management in this line of business.

The 2025 guidance includes approximately $1.00 per share in implementation costs for new contracts, suggesting significant investment in future growth. The projected 13% earnings growth (adjusted for implementation costs) indicates management's confidence in operational execution. The embedded earnings from new stores at $7.75 per share represents substantial future value potential.

The decline in operating cash flow from $1.66 billion to $644 million primarily due to timing differences in government receivables requires monitoring, though it appears to be temporary. The company's capital deployment remains balanced, with $500 million in share repurchases during Q4 2024 demonstrating confidence in long-term value creation.

Introduces Full Year 2025 Revenue and Earnings Guidance

LONG BEACH, Calif.--(BUSINESS WIRE)-- Molina Healthcare, Inc. (NYSE: MOH) (the “Company”) today reported fourth quarter 2024 GAAP earnings per diluted share of $4.44 and adjusted earnings per diluted share of $5.05. The Company also reported full year 2024 GAAP earnings per diluted share of $20.42 and adjusted earnings per diluted share of $22.65. Financial results are summarized below:

	Three months ended				Year ended
	December 31,				December 31,
	2024		2023		2024		2023
(In millions, except per-share results)
Premium Revenue	$9,983		$8,362		$38,627		$32,529
Total Revenue	$10,499		$9,048		$40,650		$34,072
GAAP:
Net Income	$251		$216		$1,179		$1,091
EPS – Diluted	$4.44		$3.70		$20.42		$18.77
Medical Care Ratio (MCR)	90.2%		89.1%		89.1%		88.1%
G&A Ratio	6.3%		7.1%		6.7%		7.2%
After-tax Margin	2.4%		2.4%		2.9%		3.2%
Adjusted:
Net Income	$286		$255		$1,308		$1,213
EPS – Diluted	$5.05		$4.38		$22.65		$20.88
G&A Ratio	6.3%		7.0%		6.7%		7.2%
After-tax Margin	2.7%		2.8%		3.2%		3.6%
See the Reconciliation of Unaudited Non-GAAP Financial Measures at the end of this release.

Full Year Highlights

• As of December 31, 2024, the Company served approximately 5.5 million members.
• Premium revenue was approximately $38.6 billion for the full year 2024, an increase of 19% year over year.
• GAAP net income was $20.42 per diluted share for the full year 2024, an increase of 9% year over year.
• Adjusted net income was $22.65 per diluted share for the full year 2024, an increase of 8% year over year.
• The Company issued its full year 2025 earnings guidance with expected premium revenue of approximately $42 billion and adjusted earnings of at least $24.50 per diluted share, which includes approximately $1.00 per diluted share of implementation costs for recent Medicaid and Medicare Duals contract wins scheduled to commence in 2026 and yields approximately 13% growth over 2024.
• New store embedded earnings is now at $7.75 per diluted share and reflects recent Medicaid and Medicare Duals contract wins.

“I am very pleased our 2024 revenue growth exceeded our long-term targets and we produced consolidated pre-tax margins within our long-term target range,” said Joseph Zubretsky, President and Chief Executive Officer. “Our earnings growth profile is solid heading into 2025, and we continue to execute on the long-term growth opportunities within all of our businesses. We remain confident in our ability to achieve our long-term financial targets.”

Premium Revenue

Premium revenue was approximately $38.6 billion for the full year 2024, an increase of 19% year over year. The higher premium revenue reflects new contract wins, acquisitions, and growth in our current footprint, partially offset by the impact of Medicaid redeterminations.

Net Income

GAAP net income for the full year 2024 was $20.42 per diluted share, an increase of 9% year over year. Adjusted net income for the full year 2024 was $22.65 per diluted share, an increase of 8% year over year.

Medical Care Ratio (MCR)

• The consolidated MCR for the full year 2024 was 89.1% and reflects continued focus on managing medical costs and a well-balanced portfolio of businesses.
• The Medicaid MCR for the full year 2024 was 90.3%. Within that result, approximately 30 basis points were due to Medicaid “new store” plans, which have continued to improve in line with the Company’s expectations, and approximately 20 basis points were due to a premium rate reduction retroactive to 2023. Excluding the new stores and retroactive premium adjustment, the Medicaid MCR was approximately 89.8%, which is higher than the Company’s long-term expectations and primarily due to the impact of redetermination-related acuity shifts and higher utilization that occurred during the second half of 2024.
• The Medicare MCR for the full year 2024 was 89.1%, which primarily reflects higher-than-expected utilization, partially offset by benefit adjustments implemented for 2024.
• The Marketplace MCR for the full year 2024 was 75.4%, better than the Company’s expectations, reflecting strong operating performance.

General and Administrative Expense Ratio

The G&A ratio and the adjusted G&A ratio for the full year 2024 were both 6.7%, reflecting disciplined cost management, operating leverage, and several one-time items.

Balance Sheet

Cash and investments at the parent company were $445 million as of December 31, 2024 compared to $742 million as of December 31, 2023. The Company purchased approximately 1.7 million shares for $500 million in the fourth quarter of 2024.

Days in claims payable at December 31, 2024 was 48.

Cash Flow

Operating cash flow for the year ended December 31, 2024 was $644 million, compared to $1,662 million for the year ended December 31, 2023. The decrease in cash flow year-over-year was primarily driven by the net impact of timing differences in government receivables and payables, specifically risk corridor settlements and accruals.

2025 Guidance

Premium revenue for the full year is expected to be approximately $42 billion, an increase of approximately 9% from the full year 2024.

The Company expects its full year GAAP earnings per share in 2025 to be at least $22.50 per share and its full year adjusted earnings per share in 2025 to be at least $24.50 per share, representing 8% growth over the full year 2024. This increase primarily reflects growth in the Company’s legacy footprint and continued realization of new store embedded earnings, partially offset by approximately $1.00 per diluted share of expected implementation costs in 2025 for recent Medicaid and Medicare Duals contract wins, and yields approximately 13% growth over 2024.

Guidance metrics are summarized below:

	Full Year 2025 Guidance
	Premium Revenue	$42.0B
	Total Revenue	$44.0B
	GAAP Net Income	$1,251M
	Adjusted Net Income	$1,362M
	GAAP EPS – Diluted	>$22.50
	Adjusted EPS – Diluted	>$24.50
	Diluted weighted average shares	55.6M
	Year End Total Membership	5.9M
	Medicaid	5.0M
	Medicare	250K
	Marketplace	580K
	MCR	88.7%
	GAAP G&A Ratio	7.2%
	Adjusted G&A Ratio	7.0%
	Effective Tax Rate	25.3%
	GAAP After-tax Margin	2.8%
	Adjusted After-tax Margin	3.1%
	See the Reconciliations of Unaudited Non-GAAP Financial Measures at the end of this release.

Conference Call

Management will host a conference call and webcast to discuss Molina Healthcare’s fourth quarter and year ended December 31, 2024 results at 8:00 a.m. Eastern Time on Thursday, February 6, 2025. The number to call for the interactive teleconference is (877) 883-0383 and the confirmation number is 6464707. A telephonic replay of the conference call will be available through Thursday, February 13, 2025, by dialing (877) 344-7529 and entering confirmation number 2353454. A live audio broadcast of this conference call will be available on Molina Healthcare’s investor relations website, investors.molinahealthcare.com. A 30-day online replay will be available approximately an hour following the conclusion of the live broadcast.

About Molina Healthcare

Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces. For more information about Molina Healthcare, please visit molinahealthcare.com.

Safe Harbor Statement under the Private Securities Litigation Reform Act of 1995

This earnings release and the Company’s accompanying oral remarks contain forward-looking statements. The Company intends such forward-looking statements to be covered under the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements provide current expectations of future events based on certain assumptions, and all statements other than statements of historical fact contained in this earnings release and the Company’s accompanying oral remarks may be forward-looking statements. In some cases, you can identify forward-looking statements by words such as “guidance,” “future,” “anticipates,” “believes,” “embedded,” “estimates,” “expects,” “growth,” “intends,” “plans,” “predicts,” “projects,” “will,” “would,” “could,” “can,” “may,” or the negative of these terms or other similar expressions. Forward-looking statements contained in this earnings release include, but are not limited to, statements regarding the Company’s 2025 guidance, expectations with respect to continued realization of embedded earnings and underlying organic growth, and our management’s plans and objectives for future operations and business strategy.

Actual results could differ materially due to numerous known and unknown risks and uncertainties. These risks and uncertainties are discussed under the headings “Forward-Looking Statements,” and “Risk Factors,” in the Company’s Annual Report on Form 10‑K for the year ended December 31, 2023, which is on file with the U.S. Securities and Exchange Commission (the “SEC”), and in the Company’s other filings with the SEC, including its Quarterly Reports on Form 10-Q for the periods ended March 31, 2024, June 30, 2024, and September 30, 2024, which are on file with the SEC, and its Annual Report on Form 10-K for the year ended December 31, 2024, to be filed with the SEC.

These reports can be accessed under the investor relations tab of the Company’s website or on the SEC’s website at sec.gov. Given these risks and uncertainties, the Company can give no assurances that its forward-looking statements will prove to be accurate, or that any other results or developments projected or contemplated by its forward-looking statements will in fact occur, and the Company cautions investors not to place undue reliance on these statements. All forward-looking statements in this release represent the Company’s judgment as of February 5, 2025, and, except as otherwise required by law, the Company disclaims any obligation to update any forward-looking statement to conform the statement to actual results or changes in its expectations.

MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF INCOME
	Three Months Ended						Year Ended
	December 31,						December 31,
	2024			2023			2024			2023
	(In millions, except per-share amounts)
Revenue:
Premium revenue	$	9,983		$	8,362		$	38,627		$	32,529
Premium tax revenue		383			552			1,486			1,069
Investment income		111			114			452			394
Other revenue		22			20			85			80
Total revenue		10,499			9,048			40,650			34,072
Operating expenses:
Medical care costs		9,003			7,454			34,428			28,669
General and administrative expenses		665			645			2,743			2,462
Premium tax expenses		383			552			1,486			1,069
Depreciation and amortization		48			43			186			171
Other		20			38			100			128
Total operating expenses		10,119			8,732			38,943			32,499
Operating income		380			316			1,707			1,573
Interest expense		34			27			118			109
Income before income tax expense		346			289			1,589			1,464
Income tax expense		95			73			410			373
Net income	$	251		$	216		$	1,179		$	1,091
Net income per share – Diluted	$	4.44		$	3.70		$	20.42		$	18.77
Diluted weighted average shares outstanding		56.5			58.2			57.7			58.1

MOLINA HEALTHCARE, INC.
CONSOLIDATED BALANCE SHEETS
	December 31,
	2024				2023
	Unaudited
	(Dollars in millions, except per-share amounts)
ASSETS
Current assets:
Cash and cash equivalents	$	4,662			$	4,848
Investments		4,325				4,259
Receivables		3,299				3,104
Prepaid expenses and other current assets		487				331
Total current assets		12,773				12,542
Property, equipment, and capitalized software, net		288				270
Goodwill and intangible assets, net		1,938				1,449
Restricted investments		286				261
Deferred income taxes, net		207				227
Other assets		138				143
Total assets	$	15,630			$	14,892
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4,640			$	4,204
Amounts due government agencies		1,874				2,294
Accounts payable, accrued liabilities and other		1,331				1,252
Deferred revenue		51				418
Total current liabilities		7,896				8,168
Long-term debt		2,923				2,180
Finance lease liabilities		195				205
Other long-term liabilities		120				124
Total liabilities		11,134				10,677
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 56 million shares at December 31, 2024, and 58 million at December 31, 2023		—				—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding		—				—
Additional paid-in capital		462				410
Accumulated other comprehensive loss		(57	)			(82	)
Retained earnings		4,091				3,887
Total stockholders’ equity		4,496				4,215
Total liabilities and stockholders’ equity	$	15,630			$	14,892

MOLINA HEALTHCARE, INC.
UNAUDITED CONSOLIDATED STATEMENTS OF CASH FLOWS
	Year Ended
	December 31,
	2024				2023
	(In millions)
Operating activities:
Net income	$	1,179			$	1,091
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		186				171
Deferred income taxes		53				(31	)
Share-based compensation		116				115
Other, net		8				2
Changes in operating assets and liabilities:
Receivables		(78	)			(778	)
Prepaid expenses and other current assets		(57	)			(69	)
Medical claims and benefits payable		(40	)			580
Amounts due government agencies		(453	)			196
Accounts payable, accrued liabilities and other		115				328
Deferred revenue		(367	)			59
Income taxes		(18	)			(2	)
Net cash provided by operating activities		644				1,662
Investing activities:
Purchases of investments		(1,132	)			(1,433	)
Proceeds from sales and maturities of investments		1,111				772
Net cash paid in business combinations		(344	)			(3	)
Purchases of property, equipment, and capitalized software		(100	)			(84	)
Other, net		1				4
Net cash used in investing activities		(464	)			(744	)
Financing activities:
Common stock purchases		(1,000	)			—
Proceeds from senior notes offering, net of issuance costs		740				—
Proceeds from borrowings under credit facility		300				—
Repayment of credit facility		(300	)			—
Common stock withheld to settle employee tax obligations		(57	)			(60	)
Other, net		(30	)			2
Net cash used in financing activities		(347	)			(58	)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents		(167	)			860
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period		4,908				4,048
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	4,741			$	4,908

MOLINA HEALTHCARE, INC.
UNAUDITED SEGMENT DATA
(Dollars in millions)
		December 31,
		2024		2023
Ending Membership by Segment:
Medicaid		4,890,000		4,542,000
Medicare		242,000		172,000
Marketplace		403,000		281,000
Total		5,535,000		4,995,000

	Three Months Ended December 31,
	2024									2023
	Premium Revenue			Medical Margin			MCR (1)			Premium Revenue			Medical Margin			MCR (1)
Medicaid	$	8,041		$	791		90.2	%		$	6,782		$	731		89.2	%
Medicare		1,292			81		93.8				1,057			71		93.3
Marketplace		650			108		83.3				523			106		79.8
Consolidated	$	9,983		$	980		90.2	%		$	8,362		$	908		89.1	%

	Year Ended December 31,
	2024									2023
	Premium Revenue			Medical Margin			MCR (1)			Premium Revenue			Medical Margin			MCR (1)
Medicaid	$	30,579		$	2,979		90.3	%		$	26,327		$	2,973		88.7	%
Medicare		5,542			603		89.1				4,179			388		90.7
Marketplace		2,506			617		75.4				2,023			499		75.3
Consolidated	$	38,627		$	4,199		89.1	%		$	32,529		$	3,860		88.1	%
(1) The MCR represents medical costs as a percentage of premium revenue.

MOLINA HEALTHCARE, INC.
CHANGE IN MEDICAL CLAIMS AND BENEFITS PAYABLE
(Dollars in millions)
The Company’s claims liabilities include additional reserves to account for moderately adverse conditions based on historical experience and other factors including, but not limited to, variations in claims payment patterns, changes in utilization and cost trends, known outbreaks of disease, and large claims. The Company’s reserving methodology is consistently applied across all periods presented. The amounts displayed for “Components of medical care costs related to: Prior year” represent the amounts by which the original estimates of claims and benefits payable at the beginning of the year were more than the actual liabilities based on information (principally the payment of claims) developed since those liabilities were first reported. The following table presents the components of the change in medical claims and benefits payable for the periods indicated:
	Year Ended
	December 31,
	2024				2023
	Unaudited
Medical claims and benefits payable, beginning balance	$	4,204			$	3,528
Components of medical care costs related to:
Current year		35,103				29,096
Prior year		(675	)			(427	)
Total medical care costs		34,428				28,669
Payments for medical care costs related to:
Current year		31,060				25,615
Prior year		3,239				2,734
Total paid		34,299				28,349
Acquired balances, net of post-acquisition adjustments		476				96
Change in non-risk and other payables		(169	)			260
Medical claims and benefits payable, ending balance	$	4,640			$	4,204
Days in Claims Payable (1)		48				50

__________________
(1)		The Company calculates Days in Claims Payable using claims incurred but not paid, or IBNP, and other fee-for-service payables included in medical claims and benefits payable, and quarterly fee-for-service related costs included in medical care costs within the Company’s consolidated financial statements.

MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES
(In millions, except per diluted share amounts)
The Company believes that certain non-GAAP (generally accepted accounting principles) financial measures are useful supplemental measures to investors in comparing the Company’s performance to the performance of other public companies in the health care industry. The non-GAAP financial measures are also used internally to enable management to assess the Company’s performance consistently over time. These non-GAAP financial measures, presented below, should be considered as supplements to, and not as substitutes for or superior to, GAAP measures.
Adjustments represent additions and deductions to GAAP net income as indicated in the table below, which include the non-cash impact of amortization of acquired intangible assets, acquisition-related expenses, and the impact of certain expenses and other items that management believes are not indicative of longer-term business trends and operations.
Adjusted G&A Ratio represents the GAAP G&A ratio, recognizing adjustments.
Adjusted net income represents GAAP net income recognizing the adjustments, net of tax. The Company believes that adjusted net income is helpful to investors in assessing the Company’s financial performance.
Adjusted net income per diluted share represents adjusted net income divided by weighted average common shares outstanding on a fully diluted basis.
Adjusted after-tax margin represents adjusted net income, divided by total revenue.
	Three Months Ended December 31,																Year Ended December 31,
	2024								2023								2024								2023
	Amount				Per Diluted Share				Amount				Per Diluted Share				Amount				Per Diluted Share				Amount				Per Diluted Share
GAAP Net income	$	251			$	4.44			$	216			$	3.70			$	1,179			$	20.42			$	1,091			$	18.77
Adjustments:
Amortization of intangible assets	$	21			$	0.36			$	22			$	0.37			$	83			$	1.43			$	85			$	1.47
Acquisition-related expenses (1)		20				0.35				3				0.05				66				1.14				7				0.12
Other (2)		—				—				27				0.47				16				0.28				68				1.17
Subtotal, adjustments		41				0.71				52				0.89				165				2.85				160				2.76
Income tax effect		(6	)			(0.10	)			(13	)			(0.21	)			(36	)			(0.62	)			(38	)			(0.65	)
Adjustments, net of tax		35				0.61				39				0.68				129				2.23				122				2.11
Adjusted net income	$	286			$	5.05			$	255			$	4.38			$	1,308			$	22.65			$	1,213			$	20.88

__________________
(1)		Reflects non-recurring costs associated with acquisitions, including various transaction and certain integration costs.
(2)		The year ended December 31, 2024 includes non-recurring litigation. The year ended December 31, 2023, reflects a non-recurring credit loss on 2022 Marketplace risk adjustment receivables due to the insolvency of an issuer in the Texas risk pool, non-recurring litigation and one-time termination benefits.

MOLINA HEALTHCARE, INC.
RECONCILIATION OF UNAUDITED NON-GAAP FINANCIAL MEASURES (CONTINUED)
2025 GUIDANCE
	Amount				Per Diluted Share (2)
GAAP Net income	$	1,251			$	22.50
Adjustments:
Amortization of intangible assets		96				1.73
Acquisition-related expenses		51				0.92
Subtotal, adjustments		147				2.65
Income tax effect (1)		(36	)			(0.65	)
Adjustments, net of tax		111				2.00
Adjusted net income	$	1,362			$	24.50

__________________
(1)		Income tax effect calculated at the statutory tax rate of approximately 24.1%.
(2)		Computations assume approximately 55.6 million diluted weighted average shares outstanding.

Non-GAAP Financial Measures

The Company includes in this release the financial measure, “new store embedded earnings,” which is a non-GAAP measure. The term is defined as the incremental diluted earnings per share impact that we expect to achieve between 2026 and 2028 related to newly awarded but not yet commenced state Medicaid contracts, and recently closed and announced acquisitions. The incremental impact reflects the expected full-year earnings for the newly-awarded California, Iowa, Nebraska, New Mexico, Texas, and Georgia Medicaid contracts, the newly-awarded Idaho, Massachusetts, Michigan, and Ohio Medicare Duals contracts, and the California Medicare Health Plans and ConnectiCare acquisitions, not yet included in the 2025 full-year guidance issued by the Company. This measure excludes amortization of intangible assets and non-recurring costs associated with acquisitions, including various transaction and integration costs. The Company and management believe this measure is useful to investors in assessing the Company’s expected performance related to new Medicaid contracts and acquisitions, and is used internally to enable management to assess the Company’s performance consistently over time. New store embedded earnings should be considered as a supplement to, and not as a substitute for or superior to, GAAP measures. Management is unable to reconcile this measure to the growth in GAAP earnings per share, the most directly comparable GAAP measure, without unreasonable effort due to the unknown impact from the amortization of intangible assets related to recently announced acquisitions, which cannot be determined until purchase accounting valuations are completed. Non-recurring costs associated with the recently announced acquisitions are estimated at approximately $20 million.

View source version on businesswire.com: https://www.businesswire.com/news/home/20250205459828/en/

Investor Contact: Jeffrey Geyer, Jeffrey.Geyer@molinahealthcare.com, 305-317-3012

Media Contact: Caroline Zubieta, Caroline.Zubieta@molinahealthcare.com, 562-951-1588

Source: Molina Healthcare, Inc.

FAQ

What was Molina Healthcare's (MOH) revenue growth in 2024?

Molina Healthcare's premium revenue grew 19% year-over-year to $38.6 billion in 2024.

What is MOH's earnings guidance for 2025?

Molina expects adjusted earnings of at least $24.50 per diluted share and premium revenue of approximately $42 billion for 2025.

How did MOH's Medical Care Ratio (MCR) perform in 2024?

The consolidated MCR for 2024 was 89.1%, with Medicaid at 90.3%, Medicare at 89.1%, and Marketplace at 75.4%.

What was the impact of share buybacks on MOH in Q4 2024?

Molina purchased approximately 1.7 million shares for $500 million in the fourth quarter of 2024.

What caused the decrease in MOH's operating cash flow in 2024?

Operating cash flow decreased from $1,662M to $644M primarily due to timing differences in government receivables and payables, specifically risk corridor settlements and accruals.