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Biotech / Medical : Oxford Health Plan (OXHP)

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To: Michael Burry who wrote (586)12/16/1997 11:37:00 AM
From: Thomas Haegin  Read Replies (1) of 2068
 
Michael and all other Faithfuls,

since nobody else seems to be able to challenge you on your figures back from 12/10, I'll try. But I cannot really either because, basically, I think they add up to yours quite well :) Here I go:

I assume end-of-qtr 12/31 enrollment of 2'050'000. This translates to an average enrollment during the 4th qtr of 1'996'300. By observing the premiums earned trend per average head count over the history of quarterly income statements, I assume that OXHP earned $575 per head during the 4th quarter (I may be aiming $5 to $10 low here). I further assume that OXHP spent $475 per head on medical expenses during the 4th qtr. (let's assume for a moment that I have found a plausible model for me to stick out my head here and postulate this figure). We know from the IS that OXHP spent $94 per head on MG&A in the 3rd qtr. I go with this figure for the 4th qtr as well (total MG&A therefore still increases because of slightly higher enrollment). This means that OXHP made a net $6 per head or (rounded-off) $12m on operations, before other regular income and all one-time items.

Every $ retained either by increased premium prices or lower costs goes to the bottom line with $2m of additional net revenue (that's quite a useful figure in itself IMO).

I assume they earned $19m in the 4th qtr from 3rd-party-admin and investment income (maybe a little too low). This results in total 31m oprating income, before one-time items. Increase or decrese this figure as you like by assuming other numbers.

In one-time items we have charges $164m for NY, $36m for non-NY, partially offset by a gain of $18m on an asset sale. I would be in favor of just assuming a net $182m one-time-charge, because it's a matter of timing only when the $36m charge will be taken.

So we should brace ourselves for a loss in the order of $150 for the 4th quarter which has to offset against equity. Therefore the Wiggins statement for equity being around $500m as on 12/31/97 seems OK to me.

I try now to get a shot at the liability side of the balance sheet as of 12731/97: Going back to $475 per head (avg. head count 1'996'300) for medical expenses for the 4th qtr, we arrive at a total of $948m before charges or 948 + 164 + 36 = $1148m including the announced medical charges. Using this number in the model I cited above , I would assume that 4th quarter medical claims in the BS will be $670m. Here it seems I get another figure than Michael.

I would expect that the A/P to rise again in light of continuing extra overhead costs: lawyers, MIS people, IT people, geographical expansion, etc. I'm guessing only: I just put at $107m. I have to guess the unearned premiums also: I have no idea, I put them at $40m. Equity we have said is $495m then (assuming a loss of $150m). This means that total capitalization should be around 670 + 107 + 40 + 495 = $1312m.

Can somebody get hold of their assets side? I need to let go now, too many figures. Any comments or corrections on assumptions welcome.
Thomas
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