Continucare Corporation
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED SEPTEMBER 30, 2007 |
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OR |
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
Commission File Number 001-12115
CONTINUCARE CORPORATION
(Exact name of registrant as specified in its charter)
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Florida
(State or other jurisdiction
of incorporation or organization)
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59-2716023
(I.R.S. Employer Identification No.) |
7200 Corporate Center Drive
Suite 600
Miami, Florida 33126
(Address of principal executive offices)
(Zip Code)
(305) 500-2000
(Registrants telephone number, including area code)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed
by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months, and
(2) has been subject to such filing requirements for the past 90 days. Yes x No o
Indicate by check mark whether the registrant is a large filer, an accelerated filer or a
non-accelerated filer. See definition of accelerated filer and large accelerated filer in Rule
12b-2 of the Exchange Act.
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Large accelerated filer o
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Accelerated filer x
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Non-accelerated filer o |
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the
Exchange Act). Yes o No x
At October 31, 2007, the Registrant had 69,935,586 shares of $0.0001 par value common stock
outstanding.
CONTINUCARE CORPORATION
INDEX
2
PART I FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED BALANCE SHEETS
(Unaudited)
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September 30, |
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June 30, |
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2007 |
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2007 |
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ASSETS |
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Current assets: |
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Cash and cash equivalents |
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$ |
14,207,823 |
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$ |
7,262,247 |
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Other receivables, net |
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282,221 |
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308,111 |
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Due from HMOs, net of a liability for incurred but not reported
medical claims of approximately $22,675,000 and
$23,618,000 at September 30, 2007 and June 30, 2007, respectively. |
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9,759,638 |
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13,525,092 |
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Prepaid expenses and other current assets |
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736,501 |
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1,273,593 |
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Deferred tax assets, net |
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625,995 |
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740,264 |
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Total current assets |
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25,612,178 |
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23,109,307 |
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Certificates of deposit, restricted |
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1,253,300 |
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1,176,635 |
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Property and equipment, net |
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8,504,257 |
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8,509,454 |
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Goodwill, net of accumulated amortization of approximately $7,610,000 |
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73,204,582 |
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73,670,225 |
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Intangible assets, net of accumulated amortization of approximately $1,239,000 and
$929,000 at September 30, 2007 and June 30, 2007, respectively |
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7,421,333 |
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7,731,000 |
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Managed care contracts, net of accumulated amortization of
approximately $3,214,000 and $3,126,000 at September 30, 2007 and
June 30, 2007, respectively |
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296,219 |
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384,422 |
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Deferred tax assets, net |
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2,351,191 |
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2,289,811 |
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Other assets, net |
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122,089 |
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66,694 |
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Total assets |
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$ |
118,765,149 |
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$ |
116,937,548 |
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LIABILITIES AND SHAREHOLDERS EQUITY |
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Current liabilities: |
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Accounts payable |
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$ |
737,796 |
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$ |
1,007,869 |
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Accrued expenses and other current liabilities |
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3,499,753 |
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4,542,097 |
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Income taxes payable |
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1,351,688 |
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67,398 |
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Total current liabilities |
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5,589,237 |
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5,617,364 |
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Capital lease obligations, less current portion |
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174,401 |
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165,191 |
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Deferred tax liabilities |
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6,332,542 |
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6,215,483 |
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Other liabilities |
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843,341 |
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881,125 |
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Total liabilities |
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12,939,521 |
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12,879,163 |
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Commitments and contingencies |
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Shareholders equity: |
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Common stock, $0.0001 par value: 100,000,000 shares authorized;
70,118,086 shares issued and 69,935,586 shares outstanding at
September 30, 2007 and 70,043,086 shares issued and outstanding
at June 30, 2007 |
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7,012 |
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7,004 |
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Additional paid-in capital |
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124,461,826 |
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124,616,091 |
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Accumulated deficit |
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(18,643,210 |
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(20,564,710 |
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Total shareholders equity |
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105,825,628 |
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104,058,385 |
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Total liabilities and shareholders equity |
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$ |
118,765,149 |
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$ |
116,937,548 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
3
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF INCOME (Unaudited)
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Three Months Ended |
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September 30, |
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2007 |
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2006 |
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Revenue |
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$ |
60,922,664 |
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$ |
35,933,599 |
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Operating expenses: |
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Medical services: |
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Medical claims |
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44,877,196 |
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27,061,040 |
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Other direct costs |
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6,593,078 |
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3,311,195 |
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Total medical services |
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51,470,274 |
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30,372,235 |
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Administrative payroll and employee benefits |
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2,733,233 |
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1,625,235 |
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General and administrative |
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3,774,330 |
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1,836,359 |
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Total operating expenses |
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57,977,837 |
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33,833,829 |
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Income from operations |
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2,944,827 |
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2,099,770 |
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Other income (expense): |
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Interest income |
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159,113 |
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154,122 |
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Interest expense |
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(7,418 |
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(2,934 |
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Income before income tax provision |
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3,096,522 |
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2,250,958 |
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Income tax provision |
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1,175,022 |
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853,839 |
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Net income |
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$ |
1,921,500 |
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$ |
1,397,119 |
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Net income per common share: |
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Basic |
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$ |
.03 |
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$ |
.03 |
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Diluted |
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$ |
.03 |
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$ |
.03 |
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Weighted average common shares outstanding: |
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Basic |
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70,041,548 |
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50,247,936 |
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Diluted |
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71,234,950 |
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51,521,917 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
4
CONTINUCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited)
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Three Months Ended |
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September 30, |
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2007 |
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2006 |
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CASH FLOWS FROM OPERATING ACTIVITIES |
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Net income |
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$ |
1,921,500 |
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$ |
1,397,119 |
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Adjustments to reconcile net income to net cash provided by operating activities: |
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Depreciation and amortization |
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615,311 |
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170,834 |
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Loss on disposal of fixed assets |
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35,924 |
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Provision for bad debts |
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63,579 |
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50,225 |
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Compensation expense related to issuance of stock options |
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310,461 |
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320,784 |
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Excess tax benefits related to exercise of stock options |
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(125,419 |
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Deferred tax expense |
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(109,268 |
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674,715 |
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Changes in operating assets and liabilities: |
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Other receivables, net |
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(37,689 |
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(136,335 |
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Due from HMOs, net |
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4,314,488 |
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73,655 |
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Prepaid expenses and other current assets |
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522,092 |
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141,258 |
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Other assets, net |
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(55,395 |
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94,321 |
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Accounts payable |
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(270,073 |
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85,296 |
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Accrued expenses and other current liabilities |
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(826,890 |
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(1,236,068 |
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Income taxes payable |
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1,284,290 |
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155,030 |
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Net cash provided by operating activities |
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7,732,406 |
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1,701,339 |
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CASH FLOWS FROM INVESTING ACTIVITIES |
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Purchase of certificates of deposit |
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(76,665 |
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(18,143 |
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Proceeds from sales of fixed assets |
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25,000 |
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Purchase of property and equipment |
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(218,280 |
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(319,326 |
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Acquisition costs related to MDHC Companies |
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(183,581 |
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Net cash used in investing activities |
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(294,945 |
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(496,050 |
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CASH FLOWS FROM FINANCING ACTIVITIES |
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Repayment on long-term debt |
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(6,083 |
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Excess tax benefits related to exercise of stock options |
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125,419 |
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Principal repayments under capital lease obligations |
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(21,083 |
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(21,617 |
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Proceeds from exercise of stock options |
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49,500 |
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14,875 |
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Payment of fees related to issuance of stock |
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(45,000 |
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Repurchase of common stock |
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(469,219 |
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Net cash provided by (used in) financing activities |
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(491,885 |
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118,677 |
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Net increase in cash and cash equivalents |
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6,945,576 |
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1,323,966 |
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Cash and cash equivalents at beginning of period |
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7,262,247 |
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10,681,685 |
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Cash and cash equivalents at end of period |
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$ |
14,207,823 |
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$ |
12,005,651 |
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SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES: |
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Purchase of property and equipment with proceeds of capital lease obligations |
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$ |
30,610 |
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$ |
57,031 |
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SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION: |
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Cash paid for taxes |
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$ |
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$ |
30,000 |
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Cash paid for interest |
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$ |
7,418 |
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$ |
2,934 |
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THE ACCOMPANYING NOTES ARE AN INTEGRAL PART
OF THESE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
5
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1 UNAUDITED INTERIM INFORMATION
The accompanying unaudited condensed consolidated financial statements of Continucare Corporation
(Continucare or the Company) have been prepared in accordance with accounting principles
generally accepted in the United States for interim financial information and with the instructions
to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the
information and footnotes required by accounting principles generally accepted in the United States
for complete financial statements. In the opinion of management, all adjustments (consisting of
normal recurring accruals) considered necessary for a fair presentation have been included.
Operating results for the three-month period ended September 30, 2007 are not necessarily
indicative of the results that may be reported for the remainder of the fiscal year ending June 30,
2008 or future periods. Except as otherwise indicated by the context, the terms the Company or
Continucare mean Continucare Corporation and its consolidated subsidiaries. All references to a
fiscal year refer to the Companys fiscal year which ends June 30. As used herein, Fiscal 2008
refers to the fiscal year ending June 30, 2008, Fiscal 2007 refers to the fiscal year ended June
30, 2007, and Fiscal 2006 refers to the fiscal year ended June 30, 2006.
The balance sheet at June 30, 2007 has been derived from the audited financial statements at that
date but does not include all of the information and footnotes required by accounting principles
generally accepted in the United States for complete financial statements.
For further information, refer to the consolidated financial statements and footnotes thereto
included in the Companys Annual Report on Form 10-K for Fiscal 2007. These interim condensed
consolidated financial statements should be read in conjunction with the consolidated financial
statements and notes to consolidated financial statements included in that report.
Certain reclassifications have been made to the prior year amounts to conform to the current year
presentation.
NOTE 2 GENERAL
The Company is a provider of primary care physician services on an outpatient basis in Florida.
The Company provides medical services to patients through employee physicians, advanced registered
nurse practioners and physicians assistants. Additionally, the Company provides practice
management services to independent physician affiliates (IPAs). Substantially all of the
Companys revenue is derived from managed care agreements with three health maintenance
organizations, Humana Medical Plans, Inc. (Humana), Vista Healthplan of South Florida, Inc. and
its affiliated companies (Vista) and Wellcare Health Plans, Inc. and its affiliated companies
(Wellcare) (collectively, the HMOs). The Company was incorporated in 1996 as the successor to
a Florida corporation formed earlier in 1996.
NOTE 3 ACQUISITION
Effective October 1, 2006, the Company completed its acquisition (the Acquisition) of Miami Dade
Health Centers, Inc. and its affiliated companies (collectively, the MDHC Companies). In
connection with the completion of the Acquisition and in consideration for the assets acquired
pursuant to the Acquisition, the Company paid the MDHC Companies approximately $5.7 million in
cash, issued to the MDHC Companies 20.0 million shares of the Companys common stock and assumed or
repaid certain indebtedness and liabilities of the MDHC Companies. The 20.0 million shares of the
Companys common stock issued in connection with the Acquisition were issued pursuant to an
exemption under the Securities Act of 1933, as amended, and 1.5 million of such 20.0 million shares
were placed in escrow as security for indemnification obligations of the MDHC Companies and their
principal owners, and, in Fiscal 2007, 264,142 of such shares were cancelled in connection with
post-closing purchase price adjustments. Pursuant to the terms of the Acquisition, the Company
paid the principal owners of the MDHC Companies an additional $1.0 million in cash in October 2007.
The Company will also make certain other payments to the principal owners of the MDHC Companies
not expected to exceed $0.1 million depending on the collection of certain receivables that were
fully reserved on the books of the MDHC Companies as of December 31, 2005.
6
The purchase price, including acquisition costs, of approximately $66.2 million has been allocated
to the estimated fair value of acquired tangible assets of $13.9 million, identifiable intangible
assets of $8.7 million and assumed liabilities of $15.3 million as of October 1, 2006, resulting in
goodwill totaling $58.9 million. This purchase price allocation includes certain adjustments
recorded during the three-month period ended September 30, 2007 that resulted in a decrease in
goodwill of approximately $0.5 million. These adjustments primarily related to Medicare risk
adjustment payments relating to the operations of the MDHC Companies for periods prior to
completion of our acquisition. The identifiable intangible assets of $8.7 million consist of
estimated fair values of $1.6 million assigned to the trade name, $6.2 million to customer
relationships and $0.9 million to a noncompete agreement. The trade name was determined to have an
estimated useful life of six years and the customer relationships and noncompete agreements were
each determined to have an estimated useful life of eight and five years, respectively. The fair
value of the identifiable intangible assets was determined, with the assistance of an outside
valuation firm, based on standard valuation techniques. The Acquisition consideration of $66.2
million includes the estimated fair value of Continucares common stock issued to the MDHC
Companies of $58.5 million, cash paid to the principal owners of $5.7 million at the closing of the
Acquisition, cash paid to the principal owners of $1.0 million in October 2007, and acquisition
costs of approximately $1.0 million. The estimated fair value of the 20.0 million shares of
Continucares common stock issued effective October 1, 2006 to the MDHC Companies was based on a
per share consideration of $2.96 which was calculated based upon the average of the closing market
prices of Continucares common stock for the period two days before through two days after the
announcement of the execution of the Asset Purchase Agreement for the Acquisition. The fair value
of the 264,142 shares cancelled in Fiscal 2007 in connection with post-closing purchase price
adjustments was approximately $0.7 million based upon the closing market price of Continucares
common stock on the dates the shares were cancelled.
On September 26, 2006, the Company entered into two term loan facilities funded out of lines of
credit (the Term Loans) with maximum loan amounts of $4.8 million and $1.0 million, respectively.
Each of the Term Loans requires mandatory monthly payments that reduce the lines of credit under
the Term Loans. Subject to the terms and conditions of the Term Loans, any prepayments made to the
Term Loans may be re-borrowed on a revolving basis so long as the line of credit applicable to such
Term Loan, as reduced by the mandatory monthly payment, is not exceeded. The $4.8 million and $1.0
million Term Loans mature on October 31, 2011 and October 31, 2010, respectively. Each of the Term
Loans (i) has variable interest rates at a per annum rate equal to the sum of 2.4% and the
One-Month LIBOR rate (5.12% at September 30, 2007), (ii) requires the Company and its subsidiaries,
on a consolidated basis, to maintain a tangible net worth of $12 million and a debt coverage ratio
of 1.25 to 1 and (iii) are secured by substantially all of the assets of the Company and its
subsidiaries, including those assets acquired pursuant to the Acquisition. Effective October 1,
2006, the Company fully drew on these Term Loans to fund certain portions of the cash payable upon
the closing of the Acquisition and these drawings were repaid during Fiscal 2007. As of September
30, 2007, the Company had no outstanding principal balance on its Term Loans.
Also effective September 26, 2006, the Company amended the terms of its existing credit facility
that provides for a revolving loan to the Company of $5.0 million (the Credit Facility). As a
result of this amendment, the Company, among other things, eliminated the financial covenant which
previously required the Companys EBITDA to exceed $1,500,000 on a trailing 12-month basis any time
during which amounts are outstanding under the Credit Facility and replaced such covenant with
covenants requiring the Company and its subsidiaries, on a consolidated business, to maintain a
tangible net worth of $12 million and a debt coverage ratio of 1.25 to 1. Effective October 1,
2006, the Company drew approximately $1.8 million under the Credit Facility to fund portions of the
cash payable upon the closing of the Acquisition and this drawing was repaid during Fiscal 2007.
The Credit Facility has a maturity date of December 31, 2009. As of September 30, 2007, the
Company had no outstanding principal balance on its Credit Facility.
As a result of the Acquisition of the MDHC Companies, the Company became a party to two lease
agreements for office space owned by certain of the principal owners of the MDHC Companies, one of
which the Company terminated effective September 30, 2007. For the three-month period ended
September 30, 2007, expenses related to these two leases were approximately $0.1 million.
7
The following unaudited pro forma consolidated financial information is presented for illustrative
purposes only and presents the actual operating results for the Company for the three-month period
ended September 30, 2007 and the
pro forma operating results for the Company for the three-month period ended September 30, 2006 as
though the Acquisition of the MDHC Companies occurred at the beginning of the period. The
unaudited pro forma consolidated financial information is not intended to be indicative of the
operating results that actually would have occurred if the transaction had been consummated on the
date indicated, nor is the information intended to be indicative of future operating results. The
unaudited pro forma consolidated financial information does not give effect to any integration
expenses or cost savings or unexpected acquisition costs that may be incurred or realized in
connection with the Acquisition. For the three-month period ended September 30, 2006, pre-tax
non-continuing compensation expenses incurred by the MDHC Companies of approximately $8.3 million
are included in the unaudited pro forma consolidated net income. The unaudited pro forma financial
information reflects adjustments for the amortization of intangible assets established as part of
the Acquisition consideration allocation in connection with the Acquisition, additional
depreciation expense resulting from the property adjustment to reflect estimated fair value,
additional rent expense related to a lease for a warehouse building excluded from the Acquisition,
a reduction in interest income resulting from the use of cash for payment of the cash consideration
in the Acquisition and the income tax effect on the pro forma adjustments. The pro forma
adjustments are based on estimates which may change as additional information is obtained. In
addition, adjustments to goodwill subsequent to the Acquisition may result primarily from
adjustments to amounts due from HMOs, other receivables and accrued expenses as additional
information is obtained.
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
|
|
September 30, |
|
|
|
2007 |
|
|
2006 |
|
Revenue |
|
$ |
60,922,664 |
|
|
$ |
59,176,383 |
|
Net income (loss) |
|
|
1,921,500 |
|
|
|
(4,628,872 |
) |
Diluted earnings (loss) per
share |
|
|
.03 |
|
|
|
(.06 |
) |
The Acquisition was accounted for by the Company under the purchase method of accounting in
accordance with SFAS No. 141, Business Combinations. Accordingly, the results of operations of
the MDHC Companies have been included in the Companys consolidated statements of income from the
date of acquisition.
NOTE 4 RECENT ACCOUNTING PRONOUNCEMENTS
In September 2006, the Financial Accounting Standards Board (FASB) issued Statement of Financial
Accounting Standards (SFAS) No. 157, Fair Value Measurements (SFAS 157). SFAS 157 defines
fair value, establishes a framework for measuring fair value in accordance with accounting
principles generally accepted in the United States, and expands disclosures about fair value
measurements. The provisions of SFAS 157 are effective for fiscal years beginning after November
15, 2007. The Company is currently evaluating the impact SFAS 157 will have, if any, on the
Companys financial position, results of operations and cash flows.
In February 2007, the FASB issued SFAS No. 159, The Fair Value Option for Financial Assets and
Financial Liabilities, Including an amendment of FASB Statement No. 115 (SFAS 159). SFAS 159
permits companies to voluntarily choose to measure many financial assets and financial liabilities
at fair value. Upon initial adoption, SFAS No. 159 permits companies with a one-time chance to
elect the fair value option for existing eligible items. The effect of the first measurement to
fair value is reported as a cumulative-effect adjustment to the opening balance of retained
earnings in the year SFAS No. 159 is adopted. SFAS No. 159 is effective as of the beginning of
fiscal years starting after November 15, 2007. The Company is currently assessing the potential
impact, if any, that the adoption of SFAS No. 159 will have on its consolidated financial position,
results of operations and cash flows.
NOTE 5 STOCK-BASED COMPENSATION
Effective July 1, 2005, the Company adopted SFAS No. 123(R), Share-Based Payment, which is a
revision of SFAS No. 123 (SFAS 123(R)), using the modified prospective transition method.
The Company calculates the fair value for employee stock options using a Black-Scholes option
pricing model at the time the stock options are granted and that amount is amortized over the
vesting period of the stock options,
8
which is generally up to four years. The fair value for
employee stock options granted during the three-month periods ended September 30, 2007 and 2006 was
calculated based on the following assumptions: risk-free interest rate ranging from 3.71% to 4.22%
and 5.08% to 5.16%, respectively; dividend yield of 0%; volatility factor of the expected market
price of the Companys common stock of 59.5% and 64.9%, respectively; and weighted-average expected
life of the options ranging from 3 to 6 years depending on the vesting provisions of each option.
The expected life of the options is based on the historical exercise behavior of the Companys
employees. The expected volatility factor is based on the historical volatility of the market
price of the Companys common stock as adjusted for certain events that management deemed to be
non-recurring and non-indicative of future events.
For each of the three-month periods ended September 30, 2007 and 2006, the Company recognized
share-based compensation expense of $0.3 million. For the three-month period ended September 30,
2007, the Company had no excess tax benefits resulting from the exercise of stock options. For the
three-month period ended September 30, 2006, the Company recognized excess tax benefits of
approximately $0.1 million resulting from exercise of stock options. The excess tax benefits had a
positive effect on cash flow from financing activities with a corresponding reduction in cash flow
from operating activities for the three-month period ended September 30, 2006 of $0.1 million.
NOTE 6 DEBT
The Company has in place a Credit Facility that provides for a revolving loan to the Company of
$5.0 million and two Term Loans with maximum loan amounts available for borrowing totaling $5.4
million as of September 30, 2007 (see Note 3). Effective July 10, 2007, the Company obtained an
extension of the maturity date of the Credit Facility until December 31, 2009. At September 30,
2007, there was no outstanding principal balance on the Credit Facility or the Term Loans. The
Credit Facility and Term Loans have variable interest rates at a per annum rate equal to the sum of
2.5% and the 30-day Dealer Commercial Paper Rate (5.05% at September 30, 2007) and the sum of 2.4%
and the one-month LIBOR (5.12% at September 30, 2007), respectively. All assets, excluding
capitalized lease assets, of the Company serve as collateral for the Credit Facility and Term
Loans.
NOTE 7 EARNINGS PER SHARE
A reconciliation of the denominator of the basic and diluted earnings per share computation is as
follows:
|
|
|
|
|
|
|
|
|
|
|
Three-Months Ended |
|
|
|
September 30, |
|
|
|
2007 |
|
|
2006 |
|
Basic weighted average number of shares outstanding |
|
|
70,041,548 |
|
|
|
50,247,936 |
|
Dilutive effect of stock options |
|
|
1,193,402 |
|
|
|
1,273,981 |
|
|
|
|
|
|
|
|
Diluted weighted average number of shares outstanding |
|
|
71,234,950 |
|
|
|
51,521,917 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Not included in calculation of diluted earnings per
share as impact is antidilutive: |
|
|
|
|
|
|
|
|
Stock options outstanding |
|
|
358,000 |
|
|
|
595,000 |
|
Warrants |
|
|
760,000 |
|
|
|
760,000 |
|
NOTE 8 INCOME TAXES
The Company accounts for income taxes under FASB Statement No. 109, Accounting for Income Taxes
(SFAS 109). Deferred income tax assets and liabilities are determined based upon differences
between the financial reporting and tax bases of assets and liabilities and are measured using the
enacted tax rates and laws that will be in effect when the differences are expected to reverse.
The Company recorded an income tax provision of $1,175,022 and $853,839 for the three-month periods
ended September 30, 2007 and 2006, respectively.
9
In July 2006, the FASB issued Interpretation 48 (FIN 48), Accounting for Uncertainty in Income
Taxes An Interpretation of FASB Statement No. 109. FIN 48 clarifies the accounting for
uncertainty in income taxes recognized in an enterprises financial statements in accordance with
SFAS 109. FIN 48 prescribes a recognition threshold and measurement attribute for the financial
statement recognition and measurement of a tax position taken or expected to be taken in a tax
return.
Effective July 1, 2007, the Company adopted the provisions of FIN 48. The implementation of FIN 48
had no impact on our liability for unrecognized tax benefits which was approximately $0.8 million
at September 30, 2007 and July 1, 2007 and is included in other liabilities on the condensed
consolidated balance sheet. The total amount of unrecognized tax benefits that if recognized would
affect the effective tax rate is $0.8 million, which includes accrued interest and penalties of
approximately $20,000 at September 30, 2007 and July 1, 2007. The Company recognizes interest
accrued related to unrecognized tax benefits in interest expense and penalties in operating
expense. The Company does not currently anticipate that the total amount of unrecognized tax
benefits will significantly increase or decrease by the end of Fiscal 2008. The Company is no
longer subject to tax examinations by tax authorities for fiscal years ended on or prior to June
30, 2004.
NOTE 9 CONTINGENCIES
A subsidiary of the Company is a party to the case of Curtis Williams and Tangee Williams vs.
Tomas A. Cabrera, M.D., Tomas A. Cabrera, M.D., P.A., Rafael L. Nogues, M.D., Rafael L. Nogues,
M.D., P.A., Miami Dade Health & Rehabilitation Services, Inc., Jose Gabriel Ortiz, M.D., and Palm
Springs General Hospital, Inc. of Hialeah. This case was filed in November 2006 in the Circuit
Court of the 11th Judicial Circuit in and for Dade County, Florida. The complaint
alleges vicarious liability for medical practice. In October 2007, the case was settled. The
Companys liability under the terms of the settlement will not exceed the accrual recorded for this
claim.
The Company is also involved in other legal proceedings incidental to its business that arise from
time to time out of the ordinary course of business including, but not limited to, claims related
to the alleged malpractice of employed and contracted medical professionals, workers compensation
claims and other employee-related matters, and minor disputes with equipment lessors and other
vendors. The Company has recorded an accrual for claims related to legal proceedings, which
includes amounts for insurance deductibles and projected exposure, based on managements estimate
of the ultimate outcome of such claims.
ITEM 2. MANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Unless otherwise indicated or the context otherwise requires, all references in this Form 10-Q
to we, us, our, Continucare or the Company refers to Continucare Corporation and its
consolidated subsidiaries. All references to the MDHC Companies refer to Miami Dade Health
Centers, Inc. and its affiliated companies.
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
We caution our investors that certain important factors may affect our actual results and
could cause such results to differ materially from any forward-looking statement which may have
been deemed to have been made in this report or which are otherwise made by us or on our behalf.
For this purpose, any statements contained in this report that are not statements of historical
fact may be deemed to be forward-looking statements. Without limiting the generality of the
foregoing, words such as may, will, expect, believe, anticipate, intend, plan,
predict, should, potential, could, would, estimate, continue or pursue, or the
negative other variations thereof or comparable terminology are intended to identify
forward-looking statements. Such statements include, but are not limited to the following:
|
|
|
Our ability to make capital expenditures and respond to capital needs; |
|
|
|
|
Our ability to enhance the services we provide to our patients; |
|
|
|
|
Our ability to strengthen our medical management capabilities; |
|
|
|
|
Our ability to improve our physician network; |
10
|
|
|
Our ability to enter into or renew our managed care agreements and negotiate terms
which are favorable to us and affiliated physicians; |
|
|
|
|
The estimated increase in, or fair value of, our intangible assets as a result of
our acquisition of the MDHC Companies (the Acquisition), and its impact on us; |
|
|
|
|
Our ability to respond to future changes in Medicare and Medicaid reimbursement
levels and reimbursement rates from other third parties; |
|
|
|
|
Our compliance with applicable laws and regulations; |
|
|
|
|
Our ability to establish relationships and expand into new geographic markets; |
|
|
|
|
Our ability to timely open our Continucare ValuClinic health centers; |
|
|
|
|
Our ability to expand our network through additional medical centers or other
facilities; |
|
|
|
|
The potential impact on our claims loss ratio as a result of the Medicare Risk
Adjustments (MRA), the Medicare Prescription Drug, Improvement and Modernization Act
of 2003 (the Medicare Modernization Act) and the enhanced benefits our affiliated
health maintenance organizations (HMOs) offer under their Medicare Advantage Plans; |
|
|
|
|
Changes in the component of our medical claims expense attributable to the Medicare
Prescription Drug program; |
|
|
|
|
The ability of our stop-loss insurance coverage to limit the financial risk to us of
our risk arrangements with the health maintenance organizations (HMOs); |
|
|
|
|
Our ability to utilize our net operating losses for Federal income tax purposes; |
|
|
|
|
The impact of the newly effective Medicare prescription drug plan on our results of
operations; and |
|
|
|
|
Our intent to repurchase our common stock under our stock repurchase program. |
Forward-looking statements involve risks and uncertainties that cannot be predicted or
quantified and, consequently, actual results may differ materially from those expressed or implied
by such forward-looking statements. Such risks and uncertainties include, but are not limited to
the following:
|
|
|
Our dependence on three HMOs for substantially all of our revenues; |
|
|
|
|
Our ability to achieve expected levels of patient volumes and control the costs of
providing services; |
|
|
|
|
Pricing pressures exerted on us by managed care organizations; |
|
|
|
|
The level of payments we receive from governmental programs and other third party
payors; |
|
|
|
|
Our and our HMO affiliates ability to improve efficiencies in utilization with
respect to the Medicare Prescription Drug program; |
|
|
|
|
Our ability to successfully integrate the MDHC Companies operations and personnel; |
|
|
|
|
The realization of the expected synergies and benefits of the MDHC Acquisition; |
|
|
|
|
Our ability to maintain compliance with Section 404 of the Sarbanes-Oxley Act of 2002; |
|
|
|
|
Our ability to serve a significantly larger patient base; |
|
|
|
|
Trends in patient enrollment and retention; |
|
|
|
|
Our ability to successfully recruit and retain qualified medical professionals; |
|
|
|
|
Future legislative or regulatory changes, including possible changes in Medicare and
Medicaid programs that may impact reimbursements to health care providers and insurers
or the benefits we expect to realize from the MDHC Acquisition; |
|
|
|
|
Our ability to comply with applicable laws and regulations; |
|
|
|
|
The impact of the Medicare Modernization Act and MRA on payments we receive for our
respective managed care operations; including the risk that any additional premiums we
may receive as a result of the newly effective Medicare prescription drug plan will not
be sufficient to compensate us for the expenses that we incur as a result of that plan; |
|
|
|
|
Technological and pharmaceutical improvements that increase the cost of providing,
or reduce the demand for, health care; |
|
|
|
|
Changes in our revenue mix and claims loss ratio; |
|
|
|
|
Changes in the range of medical services we or the MDHC Companies provide or for
which our HMO affiliates offer coverage; |
11
|
|
|
|
Our ability to enter into and renew managed care provider agreements on acceptable
terms; |
|
|
|
|
Loss of significant contracts with HMOs; |
|
|
|
|
The ability of our compliance program to detect and prevent regulatory compliance
problems; |
|
|
|
|
Delays in receiving payments; |
|
|
|
|
Increases in the cost of insurance coverage, including our stop-loss coverage, or
the loss of insurance coverage; |
|
|
|
|
The collectibility of our uninsured accounts and deductible and co-pay amounts; |
|
|
|
|
Federal and state investigations; |
|
|
|
|
Lawsuits for medical malpractice and the outcome of any such litigation; |
|
|
|
|
Our estimate of the proportion of our total assets comprised by intangible assets
immediately following the MDHC Acquisition; |
|
|
|
|
Our liability for medical claims incurred but not reported in a period exceeding our
estimates; |
|
|
|
|
Changes in estimates and judgments associated with our critical accounting policies; |
|
|
|
|
Our dependence on our information processing systems and the management information
systems of our HMO affiliates; |
|
|
|
|
Impairment charges that could be required in future periods, including with respect
to the goodwill resulting from the MDHC acquisition; |
|
|
|
|
The impact on our liquidity of any repurchases of our common stock; |
|
|
|
|
The inherent uncertainty in financial forecasts which are based upon assumptions
which may prove incorrect or inaccurate; |
|
|
|
|
General economic conditions; and |
|
|
|
|
Uncertainties generally associated with the health care business. |
We assume no responsibility to update our forward-looking statements as a result of new
information, future events or otherwise. Additional information concerning these and other risks
and uncertainties is contained in our filings with the Securities and Exchange Commission,
including the section entitled Risk Factors in our Annual Report on Form 10-K for Fiscal 2007 and
in Item 1A of Part Two of this
Form 10-Q.
General
We are a provider of primary care physician services. Through our network of 18 medical
centers, we provide primary care medical services on an outpatient basis. We also provide practice
management services to 15 independent physician affiliates (IPAs). All of our medical centers
and IPAs are located in Miami-Dade, Broward and Hillsborough Counties, Florida. As of September
30, 2007, we provided services to or for approximately 27,200 patients on a risk basis and
approximately 11,400 patients on a non-risk basis. For the three-months ended September 30, 2007,
approximately 89% and 9% of our revenue was generated by providing services to Medicare-eligible
and Medicaid-eligible members, respectively, under risk arrangements that require us to assume
responsibility to provide and pay for all of our patients medical needs in exchange for a
capitated fee, typically a percentage of the premium received by an HMO from various payor sources.
Effective October 1, 2006, we completed the Acquisition of the MDHC Companies. Accordingly,
the revenues, expenses and results of operations of the MDHC Companies have been included in our
consolidated statements of income from the date of acquisition. See Note 3 to the condensed
consolidated financial statements included herein for unaudited pro forma financial information for
the three-month period ended September 30, 2006 presenting our operating results as though the
Acquisition occurred at the beginning of that accounting period.
Medicare and Medicaid Considerations
Substantially all of our revenue is generated by providing services to Medicare-eligible
members and Medicaid-eligible members. The federal government and state governments, including
Florida, from time to time
explore ways to reduce medical care costs through Medicare and Medicaid reform, specifically,
and through health care reform generally. Any changes that would limit, reduce or delay receipt of
Medicare or Medicaid funding or mandate increased benefit levels or any developments that would
disqualify us from receiving Medicare or Medicaid funding could have a material adverse effect on
our business, results of operations, prospects, financial results, financial condition and cash
flows. Due to the diverse range of proposals put forth and the uncertainty of any proposals
adoption, we cannot predict what impact any Medicare reform proposal ultimately adopted may have on
our business, financial position or results of operations.
12
On January 1, 2006, the Medicare Prescription Drug Plan created by the Medicare Modernization
Act became effective. As a result, our HMO affiliates have established or expanded prescription
drug benefit plans for their Medicare Advantage members. Under the terms of our risk arrangements,
we are financially responsible for a substantial portion of the cost of the prescription drugs our
patients receive, and, in exchange, our HMO affiliates have agreed to provide us with an additional
per member capitated fee related to prescription drug coverage. However, there can be no assurance
that the additional fee that we receive will be sufficient to reimburse us for the additional costs
that we may incur under the new Medicare Prescription Drug Plan.
In addition, the premiums our HMO affiliates receive from the Centers for Medicare and
Medicaid Services (CMS) for their Medicare Prescription Drug Plans is subject to periodic
adjustment, positive or negative, based upon the application of risk corridors that compare their
plans revenues targeted in their bids to actual prescription drug costs. Variances exceeding
certain thresholds may result in CMS making additional payments to the HMOs or require the HMOs to
refund to CMS a portion of the payments they received. Our contracted HMO affiliates estimate and
periodically adjust premium revenues related to the risk corridor payment adjustment, and a portion
of the HMOs estimated premium revenue adjustment is allocated to us. As a result, the revenues
recognized under our risk arrangements with our HMO affiliates are net of the portion of the
estimated risk corridor adjustment allocated to us. The portion of any such risk corridor
adjustment that the HMOs allocate to us may not directly correlate to the historical utilization
patterns of our patients or the costs that we may incur in future periods. During the three-month
periods ended September 30, 2007 and 2006, our HMO affiliates allocated to us adjustments related
to their risk corridor payments which had the effect of reducing our operating income by
approximately $1.0 million and $0.8 million, respectively.
The Medicare Prescription Drug Plan has also been subject to significant public criticism and
controversy, and members of Congress have discussed possible changes to the program as well as ways
to reduce the programs cost to the federal government. We cannot predict what impact, if any,
these developments may have on the Medicare Prescription Drug Plan or on our future financial
results.
Critical Accounting Policies and Estimates
Our significant accounting policies are described in Note 2 to the consolidated financial
statements included in our Annual Report on Form 10-K for Fiscal 2007. Included within these
policies are certain policies which contain critical accounting estimates and, therefore, have been
deemed to be critical accounting policies. Critical accounting estimates are those which require
management to make assumptions about matters that were uncertain at the time the estimate was made
and for which the use of different estimates, which reasonably could have been used, or changes in
the accounting estimates that are reasonably likely to occur from period to period, could have a
material impact on the presentation of our financial condition, changes in financial condition or
results of operations.
We base our estimates and assumptions on historical experience, knowledge of current events
and anticipated future events, and we continuously evaluate and update our estimates and
assumptions. However, our estimates and assumptions may ultimately prove to be incorrect or
incomplete and our actual results may differ materially. We believe the following critical
accounting policies involve the most significant judgments and estimates used in the preparation of
our consolidated financial statements.
13
Revenue Recognition
Under our risk contracts with HMOs, we receive a percentage of premium or other capitated fee
for each patient that chooses one of our physicians as their primary care physician. Revenue under
these agreements is generally recorded in the period we assume responsibility to provide services
at the rates then in effect as determined by the respective contract. As part of the Medicare
Advantage program, CMS periodically recomputes the premiums to be paid to the HMOs based on updated
health status of participants and updated demographic factors. We record any adjustments to this
revenue at the time that the information necessary to make the determination of the adjustment is
received from the HMO or CMS.
Under our risk agreements, we assume responsibility for the cost of all medical services
provided to the patient, even those we do not provide directly, in exchange for a percentage of
premium or other capitated fee. To the extent that patients require more frequent or expensive
care, our revenue under a contract may be insufficient to cover the costs of care provided. When
it is probable that expected future health care costs and maintenance costs under a contract or
group of existing contracts will exceed anticipated capitated revenue on those contracts, we
recognize losses on our prepaid health care services with HMOs. No contracts were considered loss
contracts at September 30, 2007 because we have the right to terminate unprofitable physicians and
close unprofitable centers under our managed care contracts.
Under our limited risk and non-risk contracts with HMOs, we receive a capitation fee based on
the number of patients for which we are providing services on a monthly basis. The capitation fee
is recorded as revenue in the period in which services are provided as determined by the respective
contract.
Payments under both our risk contracts and our non-risk contracts (for both the Medicare
Advantage program as well as Medicaid) are also subject to reconciliation based upon historical
patient enrollment data. We record any adjustments to this revenue at the time that the
information necessary to make the determination of the adjustment is received from the HMO or the
applicable governmental body.
Medical Claims Expense Recognition
The cost of health care services provided or contracted for is accrued in the period in which
the services are provided. This cost includes our estimate of the related liability for medical
claims incurred in the period but not yet reported, or IBNR. IBNR represents a material portion of
our medical claims liability which is presented in the balance sheet net of amounts due from HMOs.
Changes in this estimate can materially affect, either favorably or unfavorably, our results of
operations and overall financial position.
We develop our estimate of IBNR primarily based on historical claims incurred per member per
month. We adjust our estimate if we have unusually high or low utilization or if benefit changes
provided under the HMO plans are expected to significantly increase or reduce our claims exposure.
We also adjust our estimate for differences between the estimated claims expense recorded in prior
months to actual claims expense as claims are paid by the HMO and reported to us.
To further corroborate our estimate of medical claims, an independent actuarial calculation is
performed for us on a quarterly basis. This independent actuarial calculation indicates that IBNR
as of September 30, 2007 was between approximately $22.5 million and $26.2 million. Based on our
internal analysis and the independent actuarial calculation, as of September 30, 2007, we recorded
a liability of approximately $22.7 million for IBNR. The decrease in the liability for IBNR of
$0.9 million or 4.0% to $22.7 million as of September 30, 2007 from $23.6 million as of June 30,
2007 was primarily due to the timing of claims paid by our HMO affiliates. The decrease in the
liability for IBNR of $1.5 million or 10.7% to $12.7 million as of September 30, 2006 from $14.2
million as of June 30, 2006 was primarily due to the timing of claims paid by one of our HMO
affiliates.
14
Consideration of Impairment Related to Goodwill and Other Intangible Assets
Our balance sheet includes intangible assets, including goodwill and other separately
identifiable intangible assets, which represented approximately 68% of our total assets at
September 30, 2007. The most significant component of the intangible assets consists of the
intangible assets recorded in connection with the MDHC Acquisition. The purchase price, including
acquisition costs, of approximately $66.2 million was allocated to the estimated fair value of
acquired tangible assets of $13.9 million, identifiable intangible assets of $8.7 million and
assumed liabilities of $15.3 million as of October 1, 2006, resulting in goodwill totaling $58.9
million.
Under Statement of Financial Accounting Standards No. 142, Goodwill and Other Intangible
Assets, goodwill and intangible assets with indefinite useful lives are no longer amortized, but
are reviewed for impairment on an annual basis or more frequently if certain indicators of
permanent impairment arise. Intangible assets with definite useful lives are amortized over their
respective useful lives to their estimated residual values and also reviewed for impairment
annually, or more frequently if certain indicators of permanent impairment arise. Indicators of a
permanent impairment include, among other things, a significant adverse change in legal factors or
the business climate, the loss of a key HMO contract, an adverse action by a regulator,
unanticipated competition, and the loss of key personnel or allocation of goodwill to a portion of
business that is to be sold.
Because we operate in a single segment of business, we have determined that we have a single
reporting unit and we perform our impairment test for goodwill on an enterprise level. In
performing the impairment test, we compare the total current market value of all of our outstanding
common stock, to the current carrying value of our total net assets, including goodwill and
intangible assets. Depending on the market value of our common stock at the time that an
impairment test is required, there is a risk that a portion of our intangible assets would be
considered impaired and must be written-off during that period. We completed our annual impairment
test as of May 1, 2007 and determined that no indicators of impairment existed. In addition, no
indicators of impairment were noted for the three-month period ended September 30, 2007 and,
accordingly, no impairment charges were recognized. Should we later determine that an indicator of
impairment exists, we would be required to perform an additional impairment test.
Realization of Deferred Tax Assets
We account for income taxes in accordance with SFAS No. 109, Accounting for Income Taxes
(SFAS 109) which requires that deferred tax assets and liabilities be recognized using enacted
tax rates for the effect of temporary differences between the book and tax bases of recorded assets
and liabilities. SFAS No. 109 also requires that deferred tax assets be reduced by a valuation
allowance if it is more likely than not that some portion or all of the deferred tax asset will not
be realized.
As part of the process of preparing our consolidated financial statements, we estimate our
income taxes based on our actual current tax exposure together with assessing temporary differences
resulting from differing treatment of items for tax and accounting purposes. We also recognize as
deferred tax assets the future tax benefits from net operating loss carryforwards. We evaluate the
realizability of these deferred tax assets by assessing their valuation allowances and by adjusting
the amount of such allowances, if necessary. Among the factors used to assess the likelihood of
realization are our projections of future taxable income streams, the expected timing of the
reversals of existing temporary differences, and the impact of tax planning strategies that could
be implemented to avoid the potential loss of future tax benefits. However, changes in tax codes,
statutory tax rates or future taxable income levels could materially impact our valuation of tax
accruals and assets and could cause our provision for income taxes to vary significantly from
period to period. At September 30, 2007, we had deferred tax liabilities in excess of deferred tax assets of
approximately $3.4 million.
15
Stock-Based Compensation Expense
We use the modified prospective transition
method under SFAS 123(R). SFAS 123(R) requires us to recognize compensation costs in our financial statements related to
our share-based payment transactions with employees and directors. SFAS 123(R) requires us to
calculate this cost based on the grant date fair value of the equity instrument. As a result of
adopting SFAS No. 123(R), we recognized share-based compensation expense of $0.3 million for each
of the three-month periods ended September 30, 2007 and 2006.
For the three-month period ended September 30, 2007, the
Company had no excess tax benefits resulting from the exercise of stock options. For the
three-month period ended September 30, 2006, the Company recognized excess tax benefits of
approximately $0.1 million resulting from the exercise of stock options. The excess tax benefits
had a positive effect on cash flow from financing activities with a corresponding reduction in cash
flow from operating activities for the three-month period ended September 30, 2006 of $0.1 million.
Consistent with our practices prior to adopting SFAS 123(R), we have elected to calculate the
fair value of our employee stock options using the Black-Scholes option pricing model. Using this
model we calculated the fair value for employee stock options granted during the three-month
periods ended September 30, 2007 and 2006 based on the following assumptions: risk-free interest
rate ranging from 3.71% to 4.22% and 5.08% to 5.16%, respectively; dividend yield of 0%;
weighted-average volatility factor of the expected market price of our common stock of 59.5% and
64.9%, respectively, and weighted-average expected life of the options ranging from 3 to 6 years
depending on the vesting provisions of each option. The expected life of the options is based on
the historical exercise behavior of our employees. The expected volatility factor is based on the
historical volatility of the market price of our common stock as adjusted for certain events that
management deemed to be non-recurring and non-indicative of future events.
SFAS 123(R) does not require the use of any particular option valuation model. Because our
stock options have characteristics significantly different from traded options and because changes
in the subjective input assumptions can materially affect the fair value estimate, in managements
opinion, it is possible that existing models may not necessarily provide a reliable measure of the
fair value of our employee stock options. We selected the Black-Scholes model based on our prior
experience with it, its wide use by issuers comparable to us, and our review of alternate option
valuation models. Based on these factors, we believe that the Black-Scholes model and the
assumptions we made in applying it provide a reasonable estimate of the fair value of our employee
stock options.
The effect of applying the fair value method of accounting for stock options on reported net
income for any period may not be representative of the effects for future periods because our
outstanding options typically vest over a period of several years and additional awards may be made
in future periods.
RESULTS OF OPERATIONS
The following discussion and analysis should be read in conjunction with the unaudited
condensed consolidated financial statements and notes thereto appearing elsewhere in this Form
10-Q.
COMPARISON OF THE THREE-MONTH PERIOD ENDED SEPTEMBER 30, 2007 TO THE THREE- MONTH PERIOD ENDED SEPTEMBER 30, 2006
Revenue
Revenue increased by $25.0 million, or 69.5%, to $60.9 million for the three-month period
ended September 30, 2007 from $35.9 million for the three-month period ended September 30, 2006 due
primarily to increases in our Medicare revenue.
16
The most significant component of our revenue is the revenue we generate from Medicare
patients under risk arrangements which increased by $20.0 million, or 58.5%, during the three-month
period ended September 30, 2007. During the three-month period ended September 30, 2007, revenue
generated by our Medicare risk arrangements increased approximately 11.1% on a per patient per
month basis and Medicare patient months increased by approximately 42.6% over the comparable period
of Fiscal 2007. The increase in Medicare patient months was primarily due to the Acquisition of
the MDHC Companies effective October 1, 2006. The increase in the per member per month Medicare
revenue was primarily due to a rate increase in the Medicare premiums and the increased phase-in of
the Medicare risk adjustment program. Under the Medicare risk adjustment program, the health
status and demographic factors of Medicare Advantage participants are taken into account in
determining premiums paid for each participant. CMS periodically recomputes the premiums to be
paid to the HMOs based on the updated health status and demographic factors of the Medicare
Advantage participants. In addition, the premiums paid to the HMOs for their Medicare Prescription
Drug Plan are subject to periodic adjustment based upon CMSs risk corridor adjustment methodology.
The net effect of these premium adjustments included in revenue for the three-month periods ended
September 30, 2007 and 2006 were unfavorable retroactive Medicare adjustments of $0.5 million and
favorable retroactive Medicare adjustments of $0.6 million, respectively. Future Medicare risk
adjustments may result in reductions of revenue depending on the future health status and
demographic factors of our patients as well as the application of CMSs risk corridor methodology
to the HMOs Medicare Prescription Drug Programs.
During the three-month period ended September 30, 2007, we received payments and recorded
amounts due from our HMO affiliates of approximately $0.5 million related primarily to Medicare
risk adjustments relating to the operations of the MDHC Companies for periods prior to completion
of the Acquisition. While these transactions ordinarily are reflected in our results of
operations, since they related to periods prior to our acquisition of the MDHC Companies, they were
instead recorded as purchase accounting adjustments which decreased the amount of goodwill we
recorded for the Acquisition.
Revenue generated by our managed care entities under contracts with Humana accounted for
approximately 71% and 80% of our total revenue for the three-month periods ended September 30, 2007
and 2006, respectively. Revenue generated by our managed care entities under contracts with Vista
accounted for approximately 20% and 19% of our total revenue for the three-month periods ended
September 30, 2007 and 2006, respectively.
Operating Expenses
Medical services expenses are comprised of medical claims expense and other direct costs
related to the provision of medical services to our patients. Because our risk contracts with HMOs
provide that we are financially responsible for the cost of substantially all medical services
provided to our patients under those contracts, our medical claims expense includes the costs of
prescription drugs our patients receive as well as medical services provided to patients under our
risk contracts by providers other than us. Other direct costs consist primarily of salaries,
taxes and benefits of our health professionals providing primary care services including a portion
of our stock-based compensation expense, medical malpractice insurance costs, capitation payments
to our IPA physicians and fees paid to independent contractors providing medical services to our
patients.
Medical services expenses for the three-month period ended September 30, 2007 increased by
$21.1 million, or 69.5%, to $51.5 million from $30.4 million for the three-month period ended
September 30, 2006. Medical claims expense, which is the largest component of medical services
expense, increased by $17.8 million, or 65.8%, to $44.9 million for the three-month period ended
September 30, 2007 from $27.1 million for the three-month period ended September 30, 2006 primarily
due to an increase in Medicare claims expense of $14.6 million, or 56.6%, resulting from a 9.9%
increase on a per patient per month basis in medical claims expenses related to our Medicare
patients and a 42.6% increase in Medicare patient months. The increase in Medicare per patient per
month medical claims expense is primarily attributable to inflationary trends in the health care
industry. The increase in Medicare patient months is primarily attributable to the acquisition of
the MDHC Companies.
As a percentage of revenue, medical services expenses remained unchanged at 84.5% of revenue
for the three-month periods ended September 30, 2007 and 2006. Our claims loss ratio (medical
claims expense as a percentage of revenue) decreased to 73.7% for the three-month ended September
30, 2007 from 75.3% for the three-month period ended September 30, 2006. This decrease was
primarily due to an increase in Medicare revenue at a greater rate than the increase in Medicare
claims expense on a per patient per month basis. HMOs, however, are under continuous competitive
pressure to offer enhanced, and possibly more expensive, benefits to their Medicare Advantage
members. The premiums CMS pays to HMOs for Medicare Advantage members are generally not increased
as a result of those benefit enhancements. This could increase our claims loss ratio in future
periods, which could reduce our profitability and cash flows.
17
Other direct costs increased by $3.3 million, or 99.1%, to $6.6 million for the three-month
period ended September 30, 2007 from $3.3 million for the three-month period ended September 30,
2006. As a percentage of revenue, other direct costs increased to 10.8% for the three-month
period ended September 30, 2007 from 9.2% for the three-month period ended September 30, 2006. The
increase in the amount of other direct costs was primarily due to the expenses related to the
operations of the MDHC Companies.
Administrative payroll and employee benefits expense increased by $1.1 million, or 68.2%, to
$2.7 million for the three-month period ended September 30, 2007 from $1.6 million for the
three-month period ended September 30, 2006. As a percentage of revenue, administrative payroll
and employee benefits expense remained unchanged at 4.5% for the three-month periods ended
September 30, 2007 and 2006. The increase in administrative payroll and employee benefits expense
was primarily due to an increase in personnel in connection with the acquisition of the MDHC
Companies.
General and administrative expenses increased by $2.0 million, or 105.5%, to $3.8 million for
the three-month period ended September 30, 2007 from $1.8 million for the three-month period ended
September 30, 2006. As a percentage of revenue, general and administrative expenses increased to
6.2% for the three-month period ended September 30, 2007 from 5.1% for the three-month period ended
September 30, 2006. The increase in general and administrative expenses was primarily due to
expenses related to the operations of the MDHC Companies, an increase in professional fees and an
increase in amortization expense resulting from the intangible assets recorded in connection with
the acquisition of the MDHC Companies.
Income from Operations
Income from operations for the three-month period ended September 30, 2007 increased by $0.8
million to $2.9 million from $2.1 million for the three-month period ended September 30, 2006.
Taxes
An income tax provision of $1.2 million and $0.9 million was recorded for the three-month
periods ended September 30, 2007 and 2006, respectively. The effective income tax rate was 37.9%
for the three-month periods ended September 30, 2007 and 2006.
Net Income
Net income for the three-month period ended September 30, 2007 increased by $0.5 million, or
37.5%, to $1.9 million from $1.4 million for the three-month period ended September 30, 2006.
LIQUIDITY AND CAPITAL RESOURCES
At September 30, 2007, working capital was $20.0 million, an increase of $2.5 million from
$17.5 million at June 30, 2007. The increase in working capital for the three-month period ended
September 30, 2007 was primarily due to income before income tax provision of $3.1 million. Cash
and cash equivalents increased by $6.9 million to $14.2 million at September 30, 2007 compared to
$7.3 million at June 30, 2007 due primarily to the collection of favorable Medicare premium
adjustments.
Net cash of $7.7 million was provided by operating activities from continuing operations for
the three-month period ended September 30, 2007 compared to $1.7 million for the three-month period
ended September 30, 2006. This $6.0 million increase in cash provided by operating activities was
primarily due to a decrease in amounts due from HMOs of $4.2 million resulting primarily from the
collection of favorable Medicare premium adjustments.
18
Net cash of approximately $0.3 million was used for investing activities for the three-month
period ended September 30, 2007 compared to approximately $0.5 million for the three-month period
ended September 30, 2006. The $0.2 million decrease in net cash used for investing activities primarily related to
acquisition costs related to the MDHC Companies incurred during the three-months ended September
30, 2006.
Net cash of approximately $0.5 million was used for financing activities for the three-month
period ended September 30, 2007 compared to net cash provided by financing activities of $0.1
million for the three-month period ended September 30, 2006. The $0.6 million increase in cash
used for financing activities for the three-month period ended September 30, 2007 was primarily due
to $0.5 million of cash used for the repurchase of common stock.
Pursuant to the terms under our managed care agreements with certain of our HMO affiliates, we
posted irrevocable standby letters of credit amounting to $1.1 million to secure our payment
obligations to those HMOs. We are required to maintain these letters of credit throughout the term
of the managed care agreements.
In May 2005, our Board of Directors increased our previously announced program to repurchase
shares of our common stock to a total of 2,500,000 shares. Any such repurchases will be made from
time to time at the discretion of our management in the open market or in privately negotiated
transactions subject to market conditions and other factors. We anticipate that any such
repurchases of shares will be funded through cash from operations. During the three-month period
ended September 30, 2007, we repurchased 182,500 shares of our common stock for approximately $0.5
million. As of October 31, 2007, we had repurchased 1,339,967 shares of our common stock for
approximately $3.4 million.
Pursuant to the terms of the MDHC Acquisition, we paid the principal owners of the MDHC
Companies an additional $1.0 million in cash in October 2007. We will also make certain other
payments to the principal owners of the MDHC Companies not expected to exceed $0.1 million
depending on the collection of certain receivables that were fully reserved on the books of the
MDHC Companies as of December 31, 2005.
We believe that we will be able to fund our capital commitments and our anticipated operating
cash requirements for the foreseeable future and satisfy any remaining obligations from our working
capital, anticipated cash flows from operations, our Credit Facility, and our Term Loans. At
September 30, 2007, approximately $10.4 million was available for future borrowing under the Term
Loans and the Credit Facility.
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
At September 30, 2007, we had only certificates of deposit and cash equivalents invested in
high grade, short-term securities, which are not typically subject to material market risk. At
September 30, 2007, we had capital lease obligations outstanding at fixed rates. For loans with
fixed interest rates, a hypothetical 10% change in interest rates would have no material impact on our
future earnings and cash flows related to these instruments and would have an immaterial impact on
the fair value of these instruments. Our Term Loans and Credit Facility accrue interest at
variable rates and are therefore interest rate sensitive, however, we had no amount outstanding
under these facilities at September 30, 2007. We have no material risk associated with foreign
currency exchange rates or commodity prices.
ITEM 4. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our Chief Executive Officer and Chief Financial
Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in
Exchange Act Rules 13a-15(e) or Rule 15d-15(e)) as of the end of the period covered by this report.
Based on that evaluation, our Chief Executive Officer and Chief Financial Officer have concluded
that, as of September 30, 2007, our disclosure controls and procedures were effective to ensure
that information required to be disclosed by us in the reports that we file or submit under the
Exchange Act (i) is recorded, processed, summarized and reported, within the time periods specified
in the SECs rules and forms and (ii) is accumulated and communicated to our management, including
our Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions
regarding required disclosure.
19
Our Chief Executive Officers and Chief Financial Officers conclusion regarding the
effectiveness of our disclosure controls and procedures should be considered in light of the
following limitations on the effectiveness of our disclosure controls and procedures, some of which
pertain to most, if not all, business enterprises, and some of which arise as a result of the
nature of our business. Our management, including our Chief Executive Officer and our Chief
Financial Officer, does not expect that our disclosure controls and procedures will prevent all
errors or improper conduct. A control system, no matter how well conceived and operated, can
provide only reasonable, but not absolute, assurance that the objectives of the control system will
be met. Further, the design of a control system must reflect the fact that there are resource
constraints, and the benefits of controls must be considered relative to their costs. Because of
the inherent limitations in all control systems, no evaluation of controls can provide absolute
assurance that all control issues and instances of improper conduct, if any, will be detected.
These inherent limitations include the realities that judgments in decision-making can be faulty
and that breakdowns can occur because of simple error or mistake. Additionally, controls can be
circumvented by the individual acts of some persons, by collusion of two or more people or by
management override of the controls. Further, the design of any control system is based, in part,
upon assumptions about the likelihood of future events, and there can be no assurance that any
control system design will succeed in achieving its stated goals under all potential future
conditions. Additionally, over time, controls may become inadequate because of changes in
conditions or the degree of compliance with the policies or procedures may deteriorate. Because of
the inherent limitations in a cost-effective control system, misstatements due to error or fraud
may occur and not be detected. In addition, we depend on our HMO affiliates for certain financial
and other information that we receive concerning the revenue and expenses that we earn and incur.
Because our HMO affiliates generate that information for us, we have less control over the manner
in which that information is generated.
Changes in Internal Control over Financial Reporting
In connection with its evaluation of the effectiveness of our internal control over financial
reporting, our management did not identify any changes in our internal control over financial
reporting that occurred during our most recent fiscal quarter that has materially affected, or is
reasonably likely to materially affect, our internal control over financial reporting.
Section 302 Certifications
Provided with this report are certifications of our Chief Executive Officer and Chief
Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 and the SECs
implementing regulations. This Item 4 contains the information concerning the evaluations referred
to in those certifications, and you should read this information in conjunction with those
certifications for a more complete understanding of the topics presented.
PART II OTHER INFORMATION
ITEM 1. LEGAL PROCEEDINGS
See Note 9 of our Condensed Consolidated Financial Statements.
ITEM 1A. RISK FACTORS
There have been no material changes to the risk factors previously disclosed in our Form 10-K
for Fiscal 2007 and in other reports filed from time to time with the SEC since the date we filed
our Form 10-K. Readers are urged to carefully review our risk factors since they may cause our
results to differ from the forward-looking statements made in this report or otherwise made by or
on our behalf. Those risk factors are not the only ones we face. Additional risks not presently
known to us or other factors not perceived by us to present significant risks to our business at
this time also may impair our business operation. We do not undertake to update any of these
forward-looking statements or to announce the results of any revisions to these forward-looking
statements except as required by law.
20
ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
In May 2005, we announced that we had increased our previously announced stock
repurchase program to authorize the buy back of up to 2,500,000 shares of our common stock. Any
such repurchases will be made from time to time at the discretion of our management in the open
market or in privately negotiated transactions subject to market conditions and other factors. We
anticipate that any such repurchases of shares will be funded through cash from operations. There
is no expiration date specified for this program. The following table provides information with
respect to our stock repurchases during the first quarter of Fiscal 2008:
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Total Number of |
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Maximum Number of |
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Total Number of |
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Shares Purchased as |
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Shares that May Yet |
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Shares |
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Average Price |
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Part of Publicly |
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Be Purchased Under |
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Period |
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Purchased |
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Paid per Share |
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Announced Plan |
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the Plan |
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July 1 to July 31, 2007 |
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|
|
|
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N/A |
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|
|
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1,342,533 |
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August 1 to August 31, 2007 |
|
|
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|
|
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N/A |
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|
|
|
|
|
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1,342,533 |
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September 1 to September
30, 2007 |
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182,500 |
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$ |
2.57 |
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182,500 |
|
|
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1,160,033 |
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Totals |
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182,500 |
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$ |
2.57 |
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182,500 |
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ITEM 3. DEFAULTS UPON SENIOR SECURITIES
Not Applicable
ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS
Not Applicable
ITEM 5. OTHER INFORMATION
Not Applicable
ITEM 6. EXHIBITS
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Exhibits |
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31.1
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Section 302 Certification of the Chief Executive Officer. |
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31.2
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Section 302 Certification of the Chief Financial Officer. |
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32.1
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Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to
Section 906 of the Sarbanes-Oxley Act of 2002. |
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32.2
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Certification Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to
Section 906 of the Sarbanes-Oxley Act of 2002. |
21
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the
registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly
authorized.
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CONTINUCARE CORPORATION
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Dated: November 7, 2007 |
By: |
/s/ Richard C. Pfenniger, Jr.
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Richard C. Pfenniger, Jr. |
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Chairman of the Board, Chief Executive
Officer and President |
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By: |
/s/ Fernando L. Fernandez
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Fernando L. Fernandez |
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Senior Vice President Finance, Chief Financial
Officer, Treasurer and Secretary |
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22