Partnership HealthPlan of California Finance Committee ... · FISCAL YEAR 20/21 JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN YTD Interest Income 101,518 101,518 Cash & Investments

Partnership HealthPlan of California Finance Committee Meeting Agenda

September 16, 2020 | 8:00 a.m. to 9:30 a.m.

Held at PHC’s Southeast Regional Office at 4665 Business Center Drive, Fairfield, CA 94534 (Board Room – 3rd Floor)

Video Conference Location PHC’s Southwest Regional Office at 495 Tesconi Circle, Santa Rosa, CA 95401,

PHC’s Northwest Regional Office at 1036 5th Street, Eureka, CA 95501, PHC’s Northeast Regional Office at 2525 Airpark, Redding, CA 96001

Per Governor Newsom Executive Order, N-25-20, that relates to social distancing measures being taken for COVID-19. The Executive Order authorizes public meetings with Brown Act requirements to be held via teleconference or telephone. It waives the Brown Act requirement for physical presence at the meeting for members, the clerk, and/ or other personnel of the body as a condition of participation for a quorum. However, the Executive Order requires at least one public location consistent with ADA requirements to be made available for members of the public to attend the meeting, so all PHC offices will be available for members of the public to attend the meeting in-person.

Finance Committee Members: Dave Jones, Chair, Dick Fogg, Randall Hempling, Karen Larsen, Viola Lujan, Kathryn Powell, Nancy Starck

I. Agenda Items Lead Page # Time 1. Agenda Dave Jones, Chair 1 8:00

2. Finance Committee Minutes – August 19, 2020 - Decision Dave Jones, Chair 2

3. Commissioner Comments At this time, committee members may provide comments and announcements.

Commissioners --

4. Public Comments At this time, members of the public may address the committee on any non-agenda item of interest to the public that is within the subject matter jurisdiction of the committee. There will also be an opportunity to address the committee on a scheduled agenda item during the committee's consideration of that item. Speakers will be limited to three (3) minutes.

Public --

II. New Business 1. CEO’s Health Plan Update – Information Liz Gibboney 62. Approve July 2020 Metrics and Financials – Decision Patti McFarland 7

III. Adjournment 9:30

Government Code §54957.5 requires that public records related to items on the open session agenda for a regular finance meeting be made available for public inspection. Records distributed less than 72 hours prior to the meeting are available for public inspection at the same time they are distributed to all members, or a majority of the members of the committee. The Finance Committee has designated the Administrative Assistant to the CFO as the contact for Partnership HealthPlan of California located at 4665 Business Center Drive, Fairfield, CA 94534, for the purpose of making those public records available for inspection. The Finance Committee Meeting Agenda and supporting documentation is available for review from 8:00 AM to 5:00 PM, Monday through Friday at all PHC regional offices (see locations above). It can also be found online at www.partnershiphp.org.

PHC meeting rooms are accessible to people with disabilities. Individuals who need special assistance or a disability-related modification or accommodation (including auxiliary aids or services) to participate in this meeting, or who have a disability and wish to request an alternative format for the agenda, meeting notice, agenda packet or other writings that may be distributed at the meeting, should contact the Administrative Assistant to the CFO at least two (2) working days before the meeting at (707) 863-4207 or by email at [email protected]. Notification in advance of the meeting will enable the Administrative Assistant to make reasonable arrangements to ensure accessibility to this meeting and to materials related to it.

This agenda contains a brief description of each item to be considered. Except as provided by law, no action shall be taken on any item not appearing on the agenda.

Finance Committee Packet, 091620: Page 1 of 23

Intentionally Left Blank

Page 1 of 5

PARTNERSHIP HEALTHPLAN OF CALIFORNIA MEETING MINUTES

Per Governor Newsom Executive Order, N-25-20 that relates to social distancing measures being taken for COVID-19. The Executive Order authorizes public meetings with Brown Act requirements to be held via teleconference or telephone. It waives the Brown Act requirement for physical presence at the meeting for members, the clerk, and/ or other personnel of the body as a condition of participation for a quorum. However, the Executive Order requires at least one public location consistent with ADA requirements to be made available for members of the public to attend the meeting, so all PHC offices will be available for members of the public to attend the meeting in-person.

Committee: Finance Committee Date/Time: July 15, 2020 / 8:00 – 9:30 AM Members Present: Dave Jones – Chairperson, Randall Hempling, Richard Fogg, Karen Larsen*, Kathryn Powell*, Nancy Starck*, Viola Lujan* Members Absent: Alicia Hardy Staff Present: Liz Gibboney, Patti McFarland, Amy Turnipseed*, Mary Kerlin*, Jeff Ingram, Wendell Coats*, Wendi West*,

Olevia O’Donovan, Kamille Gholson*, Katrina Dupont*, Staff Absent: Margaret Kisliuk, Marisa Dominguez, Sonja Bjork, Kirt Kemp, Dani Ogren, Melanie Lam Guests: Joseph D’Angina (Common Spirit; North State CA Market); Matt Gal (Adventist Health Northern California) *

* Attendance via Telephone/Video Conference

DECISION AGENDA ITEMS DISCUSSION / CONCLUSIONS RECOMMENDATIONS / ACTION TARGET DATE DATE

RESOLVED

Approval of July 15, 2020, Meeting Minutes

Mr. Dave Jones – Chairperson, confirmed a quorum and called the meeting to order at 8:02 am. He stated there are no changes to the agenda. The July 15, 2020, meeting minutes were presented for approval.

Action: Decision Mr. Dick Fogg motioned to approve minutes; Mr. Randall Hempling seconded the motion.

Approval was unanimous. Motion carried.

8/19/20 8/19/20

AGENDA CHANGES AND DELETIONS

None

COMMISSIONER COMMENTS

None .

PUBLIC COMMENTS

None

NEW BUSINESS


CEO’s Health Plan Update

Presenter: Liz Gibboney, CEO

Ms. Gibboney made a quick announcement that this would be an abbreviated meeting since the office received an evacuation order from the Solano County Emergency Services office due to the fires.

Ms. Gibboney provided various PHC and Federal/State level updates, as follows:

COVID-19 Response

Staffing: PHC Staff continue to work from home. The Staff will be given at least 60-days notice when the ‘Return To Office” date is finalized.

Wellness & Recovery Program: This program has officially launched, with 7 CA counties in ODS actively participating. Providers are being added to the network and calls from members are being referred to either local health services or substance abuse providers. There will more updates in the weeks to come on this outreach.

2019 HEDIS Scores: DHCS has revamped the expectations, narrowing down the list of required metrics but still encouraging providers to get higher scores. Details will be shared at the August 2020 Board meeting. PHC has had a 10% increase in the HEDIS score, which is a significant increase, but there is still room for improvement.

County Office of Emergency Services/Planning Meetings: PHC would like to thank Ms. Karen Larsen and the Yolo County staff for starting the emergency coordination due to the wild fire season. We are holding county-by-county meetings in order to coordinate and avoid mistakes from last year’s fire season, when DHCS had chaotic and confusing evacuation orders.

CDPH Director Resignation: Dr. Sonia Angell suddenly resigned from her position. Sandra Shewry will serve as acting director of CDPH temporarily; she was vice president at the California Health Care Foundation and previously director of the Department of Health Care Services.

CA State Budget: The State is awaiting the assembly of the additional coronavirus stimulus health package. This

Action: Information only 8/19/20 8/19/20


package will include money for health care, but there is no saying how much yet.

DHCS Waiver Renewal: The DHCS waiver is getting a one-year extension.

CalRx (Governor’s Executive Order on Pharmacy): The pharmacy carve-out is still moving forward. However, DHCS has not been clear about which drugs will be removed. Health plans have raised awareness on issues in order to get real time data from Magellan (vendor).

“Long Term Care at Home” Program: DHCS is taking a pause as they re-tool and focus their attention in Central Valley due to the COVID-19 outbreak at many of the facilities. They are working to facilitate the discharged members to home health care. PHC continues to participate in on-going committee meetings.

State Legislative Visits: Health plans did not escape the cuts, while telehealth flexibility is getting more attention.

Prop 56 Behavioral Health Integration Grants: All health grants have been moved forward for consideration and providers are still interested. PHC is awaiting the final numbers from DHCS, as PHC requested $50M out of the $100M budgeted by the State. Mr. Jones asked if there are any

comments or questions for Ms. Gibboney and her report.

No additional questions were asked.

Approve June 2020 Metrics and Financials

Presenter: Patti McFarland, CFO

Ms. Patti McFarland stated that this is the last financial statement for FY 2019-20.

Financial Performance: PHC reported a loss of $3.3M in the month with a $27.7M year-to-date loss primarily due to the rate decrease retro back to July 2019. $10M was set aside in February for COVID-19 related expenses and, so far, we have spent a little over $9 M. There are many unknowns at this time but we expect to have a better gauge before the auditors complete their review.

Action: Decision 8/19/20 8/19/20


Membership: Usually at this time of the year, membership numbers drop. However, this year we have had a steady increase in numbers due to the pause in redeterminations.

Staff have worked on an internal model to calculate the potential risk corridor impacts for the 18-month bridge period. The initial review shows PHC will likely not owe additional funds back, but there are 6 remaining months that will be included in the calculation.

Lab costs have been significantly more than we budgeted, yet we have not received all billings from Quest yet. We fully expect to have some heavy lab expenses after this final year closes.

In response to Mr. Fogg, Mr. Ingram stated that membership for June showed 556k and 563k for July. Ms. McFarland added that PHC could see the membership increase to be over 600k, and they should be able to handle up to 850k members.

In response to Mr. Gal’s question, Ms. McFarland stated that people are keeping their current health benefits including those with private health plans.

Ms. Gibboney also added that the county offices are experiencing backlog while cleaning up the eligibility system, as the State did not process numbers dating back to April.

Ms. McFarland replied that the Staff expects the redetermination to be gradual as the counties continue with their redeterminations for the past six months. It is also a matter of timing, to get as close to an accurate count as possible.

Mr. Dick Fogg asked about the July membership, and how many will the Staff be able to handle.

Mr. Matt Gal of Adventist Health asked if anyone has a theory on why the membership is not going up as expected, besides redeterminations.

Mr. Gal asked if PHC foresees a gradual redetermination increase.

Mr. Jones asked if there are any more questions or comments.

No additional questions or comments

Mr. Jones asked for motion. Mr. Dick Fogg motioned to approve the June 2020 Financials; seconded by Mr. Hempling.

Approval was unanimous.


Minutes Prepared and Submitted by: Olevia E. O’Donovan Reviewed and Edited by: Katrina Dupont Minutes Reviewed and Submitted by: Jeff Ingram

Chairman Signature of Approval_______________________ Date__________________

Motion carried.

Adjournment Meeting adjourned at approximately 8:21 am.


Finance Committee

Report from the Chief Executive Officer

September, 2020

General Issues:

COVID‐19 Response

2019 PCP QIP Virtual Care Grants

Remote Monitoring Equipment Program

DHCS/State & Federal Issues:

MediCal Request for Information (“RFI”) Issued

MediCalRx (Governor’s Executive Order on Pharmacy)

“Long Term Care at Home” Program

Prop 56 Behavioral Health Integration Grants

Federal Issues


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Member Months by County:

County Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20Solano 106,461 106,294 106,010 105,954 104,966 104,320 103,705 103,837 104,382 105,160 106,286 108,251 109,675

Napa 27,681 27,663 27,592 27,694 27,775 27,717 27,400 27,461 27,602 27,704 28,054 28,761 29,024

Yolo 50,909 50,690 50,117 50,432 50,217 49,882 49,385 49,291 49,486 49,829 50,637 51,083 51,287

Sonoma 104,559 104,234 103,702 103,285 102,775 102,023 101,505 101,091 101,320 101,427 102,421 103,740 105,162

Marin 37,294 37,295 37,353 37,123 36,840 36,660 36,439 37,028 37,095 37,390 38,427 39,127 39,647

Mendocino 36,820 36,899 36,172 36,032 35,496 34,983 34,735 34,659 34,710 34,658 34,987 35,431 35,834

Lake 30,040 29,994 29,985 29,939 29,681 29,387 29,242 29,276 29,423 29,411 29,700 29,925 30,226

Del Norte 11,120 11,107 11,113 11,200 11,090 11,070 11,126 11,085 11,132 11,146 11,225 11,238 11,309

Humboldt 52,179 52,016 52,035 52,103 52,086 52,009 51,646 51,353 51,707 51,648 52,507 53,023 53,552

Lassen 7,062 7,097 7,051 7,147 7,101 7,127 7,069 7,100 7,188 7,172 7,264 7,332 7,405

Modoc 3,158 3,202 3,218 3,200 3,212 3,268 3,228 3,234 3,288 3,279 3,333 3,580 3,617

Shasta 58,572 58,629 58,710 58,867 58,575 58,353 57,967 57,731 57,744 57,626 58,651 59,493 60,091

Siskiyou 17,065 16,994 17,011 17,126 16,917 16,819 16,616 16,695 16,780 16,718 16,890 16,889 17,038

Trinity 4,128 4,104 4,139 4,127 4,134 4,157 4,168 4,150 4,238 4,318 4,424 4,560 4,597

All Counties Total 547,048 546,218 544,208 544,229 540,865 537,775 534,231 533,991 536,095 537,486 544,806 552,433 558,464

Medi-Cal Region 1: Solano, Napa, Yolo & Marin; Medi-Cal Region 2: Sonoma, Mendocino & Rural 8 Counties

549,804

549,079 548,358 547,639 546,924 546,211

545,502 544,795 544,092

543,391

542,694 541,999

550,951

547,048

546,218

544,208 544,229

540,865

537,775 534,231 533,991

536,095 537,486

544,806

552,433

558,464

530,000

535,000

540,000

545,000

550,000

555,000

560,000

565,000

570,000

575,000

580,000

JU L ‐ 1 9 AUG ‐ 1 9 S E P ‐ 1 9 OC T ‐ 1 9 NOV ‐ 1 9 DEC ‐ 1 9 J AN ‐ 2 0 F EB ‐ 2 0 MAR ‐ 2 0 APR ‐ 2 0 MAY ‐ 2 0 J UN ‐ 2 0 J U L ‐ 2 0

PARTNERSHIP HEALTHPLAN OF CALIFORNIAACTUAL V. PROJECTED MEDI‐CAL ENROLLMENT

JULY 2019 ‐ JULY 2020

Projected (Budgeted) Actual


Avg / Month44,074 As of

FINANCIAL INDICATORS Jul-20 YTD Jul-20

Total Enrollment 556,087 556,087 556,087

Total Revenue 244,622,822 244,622,822 244,622,822

Total Healthcare Costs 228,533,285 228,533,285 228,533,285

Total Administrative Costs 10,312,619 10,312,619 10,312,619

Medi-Cal Hospital & Managed Care Taxes 12,073,441 12,073,441 12,073,441

Total Current Year Surplus (Deficit) (6,296,523) (6,296,523) (6,296,523)

Total Claims Payable 401,016,137 401,016,137 401,016,137

Total Fund Balance 570,393,219 570,393,219 570,393,219

Reserve Fund - Required Reserves 385,127,705 385,127,705 385,127,705

Reserve Fund - Capital Assets 106,003,559 106,003,559 106,003,559

Reserve Fund - Strategic Use of Reserves 85,732,498 85,732,498 85,732,498

Unrestricted Fund Balance (6,470,543) (6,470,543) (6,470,543)

Fund Balance as % of Reserved Funds 98.88% 98.88% 98.88%

Current Ratio 1.11:1 1.11:1 1.11:1

Medical Loss Ratio w/o Tax 98.06% 98.06% 98.06%

Admin Ratio w/o Tax 4.42% 4.42% 4.42%

Profit Margin Ratio -2.57% -2.57% -2.57%

Avg / Month

As of

FINANCIAL INDICATORS Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 YTD Jun-20

Total Enrollment 543,170 542,248 540,608 540,739 537,716 533,109 529,498 529,996 529,967 533,267 541,793 549,727 6,451,838 537,653

Total Revenue 232,220,019 233,979,321 225,758,449 230,938,231 229,446,952 224,684,937 228,161,239 262,181,867 243,017,331 215,347,435 238,525,763 300,134,253 2,864,395,797 238,699,650

Total Healthcare Costs 221,560,592 223,257,443 217,724,528 221,071,036 220,349,586 213,467,348 217,778,911 249,977,860 229,442,696 229,554,207 232,176,270 225,283,853 2,701,644,332 225,137,028

Total Administrative Costs 9,697,468 9,586,960 10,254,919 10,262,335 9,240,143 10,220,597 10,838,094 9,708,553 9,716,836 11,220,585 11,465,014 11,300,360 123,511,865 10,292,655

Medi-Cal Hospital & Managed Care Taxes - - - - - - - - - - - 66,895,309 66,895,309 5,574,609

Total Current Year Surplus (Deficit) 961,959 1,134,918 (2,220,998) (395,140) (142,777) 996,992 (455,766) 2,495,454 3,857,799 (25,427,357) (5,115,521) (3,345,269) (27,655,709) (2,304,642)

Total Claims Payable 309,950,812 333,658,113 318,826,076 337,397,003 359,352,408 356,763,714 343,462,447 386,117,714 361,702,417 370,832,533 406,814,324 398,614,218 398,614,218 356,957,648

Total Fund Balance 605,307,407 606,442,325 604,221,326 603,826,187 603,683,410 604,680,402 604,224,636 606,720,090 610,577,890 585,150,533 580,035,012 576,689,740 576,689,740 599,296,581

Reserve Fund - Required Reserves 364,887,643 362,362,468 361,460,827 362,216,840 361,706,326 360,992,575 360,861,118 366,433,312 368,054,608 370,295,182 372,235,768 383,510,669 383,510,669 366,251,445

Reserve Fund - Capital Assets 105,166,231 108,043,421 108,574,111 107,960,113 108,326,115 107,925,149 107,752,145 106,982,789 106,790,050 106,243,555 106,632,636 106,298,090 106,298,090 107,224,534

Reserve Fund - Strategic Use of Reserves 59,756,800 59,651,513 59,380,941 57,548,808 56,942,396 91,126,990 89,751,571 89,450,038 88,442,860 87,252,581 86,761,514 86,128,793 86,128,793 76,016,234

Unrestricted Fund Balance 75,496,733 76,384,923 74,805,447 76,100,426 76,708,573 44,635,688 45,859,802 43,853,951 47,290,372 21,359,215 14,405,094 752,188 752,188 49,804,368

Fund Balance as % of Reserved Funds 114.25% 114.41% 114.13% 114.42% 114.56% 107.97% 108.21% 107.79% 108.40% 103.79% 102.55% 100.13% 100.13% 109.06%

Current Ratio 1.29:1 1.28:1 1.23:1 1.27:1 1.25:1 1.26:1 1.26:1 1.18:1 1.21:1 1.20:1 1.17:1 1.13:1 1.13:1 1.22:1

Medical Loss Ratio w/o Tax 95.41% 95.42% 96.44% 95.73% 96.04% 95.01% 95.45% 95.35% 94.41% 106.60% 97.33% 96.59% 96.58% 96.58%

Admin Ratio w/o Tax 4.18% 4.10% 4.54% 4.44% 4.03% 4.55% 4.75% 3.70% 4.00% 5.21% 4.81% 4.84% 4.42% 4.42%

Profit Margin Ratio 0.41% 0.49% -0.98% -0.17% -0.06% 0.44% -0.20% 0.95% 1.59% -11.81% -2.14% -1.11% -0.97% -0.97%

Partnership HealthPlan of CaliforniaComparative Financial Indicators Monthly ReportFiscal Year 2020 - 2021 & Fiscal Year 2019 - 2020


$108.0 $108.6 $108.0 $108.3 $107.9 $107.8 $107.0 $106.8 $106.2 $106.6 $106.3 $106.0

$362.4 $361.5 $362.2 $361.7 $361.0 $360.9 $366.4 $368.1 $370.3 $372.2 $383.5 $385.1

$59.7 $59.4 $57.5 $56.9

$91.1 $89.8 $89.5 $88.4 $87.3 $86.8 $86.1

$85.7

$76.4 $74.8 $76.1$76.7 $44.6 $45.9 $43.9 $47.3

$21.4$14.4 $0.7

-$6.5

-$100.0

$0.0

$100.0

$200.0

$300.0

$400.0

$500.0

$600.0

$700.0

Aug 2019 Sep 2019 Oct 2019 Nov 2019 Dec 2019 Jan 2020 Feb 2020 Mar 2020 Apr 2020 May 2020 Jun 2020 Jul 2020

Partnership HealthPlan of CaliforniaFund Balance Comparison

(in Millions of Dollars)

Required Reserves - Capital Required Reserves - Other Strategic Use of Reserves Unrestricted Funds

For the Past 12 Months Ending July 31, 2020


CURRENT MONTH

PRIORMONTH INC / DEC MEMBERSHIP SUMMARY

CURRENT YTD AVG

PRIOR YTD AVG VARIANCE

228,855 226,191 2,664 Medi-Cal Region 1 228,855 220,591 8,264 327,232 323,536 3,696 Medi-Cal Region 2 327,232 322,579 4,653 556,087 549,727 6,360 TOTAL 556,087 543,170 12,917

ACTUALMONTH

BUDGETMONTH

$ VARIANCE MONTH FINANCIAL SUMMARY

ACTUAL YTD

BUDGET YTD

$ VARIANCE YTD

244,622,822 249,546,787 (4,923,965) Total Revenue 244,622,822 249,546,787 (4,923,965) 228,533,285 231,506,002 2,972,717 Total Healthcare Costs 228,533,285 231,506,002 2,972,717

10,312,619 12,343,620 2,031,001 Total Administrative Costs 10,312,619 12,343,620 2,031,001 12,073,441 12,468,750 395,309 Medi-Cal Managed Care Tax 12,073,441 12,468,750 395,309 (6,296,523) (6,771,585) 475,062 Total Current Year Surplus (Deficit) (6,296,523) (6,771,585) 475,062

98.06% 97.35%Medical Loss Ratio (HC Costs as a % of

Rev, excluding Managed Care Tax) 98.06% 97.35%

4.42% 5.19%Admin Ratio (Admin Costs as a % of Rev, excluding Managed Care Tax) 4.42% 5.19%

PARTNERSHIP HEALTHPLAN OF CALIFORNIAMembership and Financial SummaryFor The Period Ending July 31, 2020

Page 1 of 1


July 2020 June 2020

A S S E T SCurrent Assets

Cash &Cash Equivalents 447,722,427 440,065,715

ReceivablesAccrued Interest 128,900 304,900 State DHS - Cap Rec 290,092,484 288,522,978 Other Healthcare Receivable 1,004,222 1,023,184 Miscellaneous Receivable 89,188 60,206

Total Receivables 291,314,794 289,911,268

Other Current AssetsPayroll Clearing 4,307 11,685 Prepaid Expenses 5,302,606 4,826,634

Total Other Current Assets 5,306,913 4,838,319

Total Current Assets 744,344,134 734,815,302

Non-Current AssetsFixed Assets

Motor Vehicles 140,518 140,518 Furniture & Fixtures 7,518,859 7,518,859 Computer Equipment - HP 541,886 541,886 Computer Equipment 19,549,031 19,549,031 Computer Software 18,604,265 18,604,265 Leasehold Improvements 962,374 962,374 Land 6,767,292 6,767,292 Building 55,932,088 55,932,088 Building Improvements 28,441,439 28,441,439 Accum Depr - Motor Vehicles (117,350) (116,040)Accum Depr - Furniture (6,318,861) (6,273,989) Accum Depr - Comp Equip - HP (541,886) (541,886)Accum Depr - Comp Equipment (12,223,022) (11,825,074) Accum Depr - Comp Software (15,394,975) (15,209,620) Accum Depr - Leasehold Improvements (956,384) (954,312)Accum Depr - Building (6,425,313) (6,305,800) Accum Depr - Bldg Improvements (5,820,126) (5,660,851) Construction Work-In-Progress 15,343,724 14,736,360

Total Fixed Assets 106,003,559 106,306,540

Other Non-Current AssetsDeposits - 46,100 Board-Designated Reserves 384,827,705 383,210,669 Knox-Keene Reserves 300,000 300,000 Prepaid - Other Non-Current 1,138,909 1,138,909 Net Pension Asset 1,350,224 1,350,224 Deferred Outflows Of Resources 927,581 927,581

Total Other Non-Current Assets 388,544,419 386,973,483

Total Non-Current Assets 494,547,978 493,280,023

Total Assets 1,238,892,112 1,228,095,325

PARTNERSHIP HEALTHPLAN OF CALIFORNIABalance Sheet

As Of July 31, 2020

Page 1 of 2


July 2020 June 2020

PARTNERSHIP HEALTHPLAN OF CALIFORNIABalance Sheet

As Of July 31, 2020

L I A B I L I T I E S & F U N D B A L A N C E Liabilities

Current LiabilitiesAccounts Payable 141,165,311 131,459,703 Unearned Income 117,214 110,032 Suspense Account 1,084,572 308,691 Capitation Payable 5,690,829 5,155,881 State DHS - Cap Payable 33,300,733 33,300,733 Accrued Healthcare Costs 8,556,256 9,001,560 Claims Payable 98,718,301 115,723,316 Incurred But Not Reported-IBNR 302,297,836 282,890,902 Quality Improvement Programs 77,045,972 72,932,898

Total Current Liabilities 667,977,024 650,883,716

Non-Current LiabilitiesDeferred Inflows Of Resources 521,869 521,869

Total Non-Current Liabilities 521,869 521,869

Total Liabilities 668,498,893 651,405,585

Fund BalanceUnrestricted Fund Balance (6,470,543) 743,738

Reserved FundsReserve Fund-Board Designated 369,827,705 368,210,669 Reserve Fund-Board Designated-Infrastructure 15,000,000 15,000,000 Reserve Fund-Board Designated-Capital Assets 106,003,559 106,306,540 Reserve Fund-Strategic Use Of Reserve 85,732,498 86,128,793 Reserve For Restricted Fund-Knox-Keene 300,000 300,000

Total Reserved Funds 576,863,762 575,946,002

Total Fund Balance 570,393,219 576,689,740

Total Liabilities And Fund Balance 1,238,892,112 1,228,095,325

Page 2 of 2


Current Month Activity Year-To-Date Activity

CASH FLOWS FROM OPERATING ACTIVITIES:Cash Received From:Capitation from California Department of Health Care Service 242,838,379 242,838,379Other Revenues 1,108 1,108Cash Payments to Providers for Medi-Cal Members

Capitation Payments (36,659,658) (36,659,658) Medical Claims Payments (181,266,170) (181,266,170)

Cash Payments to Vendors (4,627,064) (4,627,064) Cash Payments to Employees (10,790,004) (10,790,004) Net Cash (Used) Provided by Operating Activities 9,496,591 9,496,591

CASH FLOWS FROM CAPITAL FINANCING & RELATED ACTIVITIES:Purchases of Capital Assets (500,361) (500,361) Net Cash Used by Capital Financial & Related Activities (500,361) (500,361)

CASH FLOWS FROM INVESTING ACTIVITIES:Board-Designated Reserve Transfers (1,617,036) (1,617,036) Interest and Dividends on Investments 277,518 277,518Net Cash (Used) Provided by Investing Activities (1,339,518) (1,339,518)

NET (DECREASE) INCREASE IN CASH & CASH EQUIVALENTS 7,656,712 7,656,712

CASH & CASH EQUIVALENTS, BEGINNING 440,065,715 440,065,715

CASH & CASH EQUIVALENTS, ENDING 447,722,427 447,722,427

RECONCILIATION OF OPERATING (LOSS) INCOME TO NET CASH PROVIDED (USED) BY OPERATING ACTIVITIES:

TOTAL OPERATING (LOSS) INCOME (6,398,039) (6,398,039) DEPRECIATION 910,345 910,345CHANGES IN ASSETS AND LIABILITIES:Other Receivables (10,020) (10,020) California Department of Health Services Receivable (1,569,506) (1,569,506) Other Assets (529,496) (529,496) Accounts Payable and Accrued Expenses 10,578,315 10,578,315Accrued Claims Payable 2,401,919 2,401,919Quality Improvement Programs 4,113,073 4,113,073Net Cash Provided (Used) by Operating Activities 9,496,591 9,496,591

PARTNERSHIP HEALTHPLAN OF CALIFORNIAStatement of Cash Flow

For The Period Ending July 31, 2020

Page 1 of 1


ACTUALMONTH

BUDGETMONTH

$ VARIANCE MONTH

ACTUAL MONTH PMPM

BUDGET MONTH PMPM

ACTUAL YTD

BUDGET YTD

$ VARIANCE

YTD

ACTUAL YTD

PMPM

BUDGET YTD

PMPM

556,087 556,087 - TOTAL MEMBERSHIP 556,087 556,087 -

REVENUE244,407,885 249,313,703 (4,905,818) 439.51 448.34 State Capitation Revenue 244,407,885 249,313,703 (4,905,818) 439.51 448.34

101,518 115,133 (13,615) 0.18 0.21 Interest Income 101,518 115,133 (13,615) 0.18 0.21 113,419 117,951 (4,532) 0.20 0.21 Other Revenue 113,419 117,951 (4,532) 0.20 0.21

244,622,822 249,546,787 (4,923,965) 439.89 448.76 TOTAL REVENUE 244,622,822 249,546,787 (4,923,965) 439.89 448.76

HEALTHCARE COSTS14,368,703 14,348,065 (20,638) 25.84 25.80 Global Subcapitation 14,368,703 14,348,065 (20,638) 25.84 25.80

1,996,458 2,094,318 97,860 3.59 3.77 Capitated Medical Groups 1,996,458 2,094,318 97,860 3.59 3.77

Physician Services5,417,695 5,298,778 (118,917) 9.74 9.53 PCP Capitation 5,417,695 5,298,778 (118,917) 9.74 9.53

181,362 181,607 245 0.33 0.33 Specialty Capitation 181,362 181,607 245 0.33 0.33 31,119,283 29,958,757 (1,160,526) 55.96 53.87 Non-Capitated Physician Services 31,119,283 29,958,757 (1,160,526) 55.96 53.87

36,718,340 35,439,142 (1,279,198) 66.03 63.73 Total Physician Services 36,718,340 35,439,142 (1,279,198) 66.03 63.73

Inpatient Hospital16,621,370 16,168,284 (453,086) 29.89 29.08 Hospital Capitation 16,621,370 16,168,284 (453,086) 29.89 29.08 53,889,868 48,931,124 (4,958,744) 96.91 87.99 Inpatient Hospital - FFS 53,889,868 48,931,124 (4,958,744) 96.91 87.99 2,396,478 2,396,478 - 4.31 4.31 Hospital Stoploss 2,396,478 2,396,478 - 4.31 4.31

72,907,716 67,495,886 (5,411,830) 131.11 121.38 Total Inpatient Hospital 72,907,716 67,495,886 (5,411,830) 131.11 121.38

29,890,822 33,323,626 3,432,804 53.75 59.93 Long Term Care 29,890,822 33,323,626 3,432,804 53.75 59.93

26,996,142 28,207,698 1,211,556 48.55 50.73 Pharmacy 26,996,142 28,207,698 1,211,556 48.55 50.73

Ancillary Services859,588 799,458 (60,130) 1.55 1.44 Ancillary Services - Capitated 859,588 799,458 (60,130) 1.55 1.44

33,034,573 35,296,539 2,261,966 59.41 63.47 Ancillary Services - Non-Capitated 33,034,573 35,296,539 2,261,966 59.41 63.47 33,894,161 36,095,997 2,201,836 60.96 64.91 Total Ancillary Services 33,894,162 36,095,997 2,201,835 60.96 64.91

Other Medical2,021,560 2,630,410 608,850 3.64 4.73 Quality Assurance 2,021,560 2,630,410 608,850 3.64 4.73

380,000 1,076,450 696,450 0.68 1.94 Healthcare Investment Funds 380,000 1,076,450 696,450 0.68 1.94 79,500 98,199 18,699 0.14 0.18 Advice Nurse 79,500 98,199 18,699 0.14 0.18 4,595 9,622 5,027 0.01 0.02 HIPP Payments 4,595 9,622 5,027 0.01 0.02

2,950,299 4,361,600 1,411,301 5.31 7.84 Transportation 2,950,299 4,361,600 1,411,301 5.31 7.84 5,435,954 8,176,281 2,740,327 9.78 14.71 Total Other Medical 5,435,954 8,176,281 2,740,327 9.78 14.71

6,324,989 6,324,989 - 11.37 11.37 Quality Improvement Programs 6,324,989 6,324,989 - 11.37 11.37

228,533,285 231,506,002 2,972,717 410.98 416.33 TOTAL HEALTHCARE COSTS 228,533,285 231,506,002 2,972,717 410.98 416.33

ADMINISTRATIVE COSTS6,926,801 7,752,032 825,231 12.46 13.94 Employee 6,926,801 7,752,032 825,231 12.46 13.94

3,374 90,622 87,248 0.01 0.16 Travel And Meals 3,374 90,622 87,248 0.01 0.16 1,135,997 1,590,493 454,496 2.04 2.86 Occupancy 1,135,997 1,590,493 454,496 2.04 2.86

335,050 438,462 103,412 0.60 0.79 Operational 335,050 438,462 103,412 0.60 0.79 1,232,192 1,399,657 167,465 2.22 2.52 Professional Services 1,232,192 1,399,657 167,465 2.22 2.52

679,205 1,072,354 393,149 1.22 1.93 Computer And Data 679,205 1,072,354 393,149 1.22 1.93 10,312,619 12,343,620 2,031,001 18.55 22.20 TOTAL ADMINISTRATIVE COSTS 10,312,619 12,343,620 2,031,001 18.55 22.20

12,073,441 12,468,750 395,309 21.71 22.42 Medi-Cal Managed Care Tax 12,073,441 12,468,750 395,309 21.71 22.42

(6,296,523) (6,771,585) 475,062 (11.35) (12.19) TOTAL CURRENT YEAR SURPLUS

(DEFICIT) (6,296,523) (6,771,585) 475,062 (11.35) (12.19)

PARTNERSHIP HEALTHPLAN OF CALIFORNIA

For The Period Ending July 31, 2020Statement of Revenues and Expenses

**The Notes to the Financial Statement are an Integral Part of this Statement**

Page 1 of 1Finance Committee Packet, 091620: Page 17 of 23

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Partnership HealthPlan of CaliforniaInvestment ScheduleJuly 31, 2020

Name of Investment Investment Type Yield to Maturity

Trade Date Maturity Date

Call Date Face Value Market Value Credit Rating Agency

Credit Rating

FUNDS HELD FOR INVESTMENT:

Highmark Money Market Cash & Cash Equiv NA Various NA NA NA 1,532,484$ NA NRCertificate of Deposit for Knox Keene Cash & Cash Equiv 0.00015 9/12/2015 1/3/2021 NA NA 300,000$ NA NR

FUNDS HELD FOR OPERATIONS:

Merrill Lynch Institutional Cash for Operations NA NA NA NA NA 68,226,797$ Merrill Lynch MMA - Checking Cash for Operations NA NA NA NA NA 158,314$ UB - General, MMA, and Sweeps Cash for Operations NA NA NA NA NA 644,992,345$ Government Investment Pools (LAIF) Cash for Operations NA NA NA NA NA 75,020,620$ Government Investment Pools (County) Cash for Operations NA NA NA NA NA 40,155,136$ West America Payroll Cash for Operations NA NA NA NA NA 2,461,136$ Petty Cash Cash for Operations NA NA NA NA NA 3,300$

GRAND TOTAL: 832,850,132$

Required Reserves (Liquid)Board Designated Assets 384,827,705$ Knox Keene Reserves 300,000$ Total Required Reserves (Liquid) 385,127,705$

Cash on Hand / Cash Days Available:Including Required Reserves 832,850,132$ Excluding Required Reserves 447,722,427$

Cash Days Available incl. Required Reserves 110.41

Cash Days Available excl. Required Reserves 59.35


Partnership HealthPlan of CaliforniaInvestment Yield Trends

11 10 9 8 7 6 5 4 3 2 1 1

FISCAL YEAR 20/21 JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN YTD

Interest Income 101,518 101,518Cash & Investments at Historical Cost (1) 447,722,427 447,722,427

Computed Yield (2) 0.27%Total Rate of Return (3) 0.27%CA Pooled Money Investment Account (PMIA) (4) 0.92%

FISCAL YEAR 19/20 JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN YTD

Interest Income 539,906 498,345 494,906 466,588 476,303 467,858 479,686 483,937 510,749 303,132 234,195 210,740 6,305,862Cash & Investments at Historical Cost (1) 340,928,511 360,668,380 450,471,374 358,134,538 382,162,687 373,861,975 357,469,528 536,443,228 410,288,975 417,818,994 445,816,378 440,065,715

Computed Yield (2) 1.79% 1.70% 1.46% 1.38% 1.54% 1.49% 1.57% 1.30% 1.29% 0.88% 0.65% 0.57%Total Rate of Return (3) 1.90% 1.78% 1.60% 1.59% 1.57% 1.56% 1.57% 1.48% 1.48% 1.42% 1.34% 1.27%CA Pooled Money Investment Account (PMIA) (4) 2.38% 2.34% 2.28% 2.19% 2.10% 2.04% 1.97% 1.91% 1.79% 1.65% 1.36% 1.22%

NOTES:

(1) Investment balances include Restricted Cash and Board Designated ReservesYTD for Cash & Investments is average year-to-date

(2) Computed yield is calculated by annualizing the current month's interest divided by the current month's average balance.

(3) Total Rate of Return is computed based on year-to-date interest income annualized divided by an average of the fiscal year's portfolio's market value at month-end.

(4) LAIF limits the amount a single government entity can deposit into LAIF; currently that amount is set at $65 million.


0.010%0.110%0.210%0.310%0.410%0.510%0.610%0.710%0.810%0.910%1.010%1.110%1.210%1.310%1.410%1.510%1.610%1.710%1.810%1.910%2.010%2.110%2.210%2.310%2.410%2.510%

JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN

Per

cen

tage

Yie

ld

Periods

Partnership HealthPlan of California Investment Yield Trends

FISCAL YEAR 20/21

PMIA 20/21

FISCAL YEAR 19/20

PMIA 19/20


Documents

Partnership HealthPlan of California Finance Committee ... · FISCAL YEAR 20/21 JUL AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY JUN YTD Interest Income 101,518 101,518 Cash & Investments