WCG
#That's a good question, and we really can't answer that until we see the totality of the rate picture.
Because there's, as you know, more than half a dozen pretty critical factors that go into the overall rate build up.
And so we'll have to look at that carefully, especially if it's merely a one-year moratorium in that rate.
And about $80 million to $85 million of our 2016 ACA fee would be attributable to the Medicare Advantage and PDP businesses.
The balance of that, to balance out to our midpoint of $228 million is Medicaid, which is effectively reimbursed by the states, grossed up for taxes.
Sure, <UNK>.
The change was really to bring more focus to our initiatives.
So we've got three medical directors, one of whom is spending literally all of his time focusing on our quality program and the initiatives that we have both at headquarters and then in all of our local markets.
So we're syncing that up, and it's a much tighter execution than we had previously.
We have another medical director that's focused on utilization management, and we've seen a real lift.
So to your question about when you expect to see, I would say we're already seeing some improvement.
And then our third is really going to be focused on the care management program that we implement and execute at both a national level and out in the local markets.
So it was really about improving the focus of our activity and leveraging some of the existing strength that we had with our current medical directors.
Yes.
Yes, we covered this a while ago, but it's a good question to reflect on 2015 and then think about 2016.
Obviously we don't give quarterly guidance, but in a similar progression, at least macro.
The first quarter and the fourth quarter should be lower than the average, given PDP in the first quarter and the ramping we all know in terms of the MBR.
And then a heavier SG&A load in the fourth quarter with the two quarters in the middle, Q2, Q3, as a whole above average.
And SG&A should ramp through the year and then as you saw in Q4, maybe not as severe depending on discretionary spending in 2016, but a step up in Q4 from that average as well.
But that should largely ramp as well.
Well, if you think about two of those items that were in the fourth quarter, they're singular event driven.
Both Iowa which those costs should taper down quickly into Q1 one way or the other, as well as the PBM conversion which is completed ---+ successfully completed.
And there's some cleanup of that, ongoing costs in Q1 of this year.
But some of it's ---+ it'll be what it'll be, so it's not quite estimable, but we should be through the lion's share of both the PBM costs as well as the culled out expenses for Iowa.
And then Sterling should be pretty immaterial.
It's just the ongoing transition to the buyer and any resulting wind down cost of expenses we're left with.
But that should trickle away as well.
Yes.
We're focused on net income percentages, because that ultimately is what becomes EPS and makes it to shareholder value.
Because the pretax and EBITDA percentages can be misleading, given the ACA fee and the lack of tax deductibility.
So we framed not just our targets, but also our compensation internally in terms of net income margins.
I would point you to the MBRs because that's the best indicator of progression as opposed to getting into the SG&L locations.
And the 87.2% in 2015, I mean effectively that needs to get to low- to mid-80%s in order to achieve a 2% after-tax margin.
And clearly we're making progress on that if we deliver on 2016 and then would expect that to continue into 2017 and beyond.
