Shares of Molina Healthcare Inc. (MOH) plummeted over 10% on Thursday's pre-market session after the health insurer reported mixed fourth-quarter results and issued underwhelming earnings guidance for 2025, overshadowing a revenue beat.

For the fourth quarter of 2024, Molina reported revenue of $10.499 billion, surpassing analysts' estimates of $10.32 billion. However, the company's adjusted earnings per share (EPS) of $5.05 fell short of the consensus estimate of $5.72.

Molina attributed the earnings miss to higher-than-expected medical costs, particularly in its Medicaid business. The company's medical care ratio (MCR), which measures medical costs as a percentage of premium revenue, stood at 90.2% in Q4, up from 89.1% a year earlier. The Medicaid MCR was 90.3%, reflecting the impact of redetermination-related acuity shifts and higher utilization.

Looking ahead, Molina forecasts 2025 revenue of approximately $44 billion, ahead of analysts' expectations of $43.4 billion. However, the company's adjusted EPS guidance of at least $24.50 fell short of the consensus estimate of around $26.07, owing to anticipated costs related to recent contract wins and acquisitions.

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