While larger insurers like UnitedHealthcare and Aetna have complained of losing hundreds of millions of dollars on the Affordable Care Act’s exchanges, Molina Healthcare has turned a slim profit by applying its Medicaid management strategies to the new marketplace.

The Wall Street Journal reported on one Molina customer’s story which is common for many under their plans: initially, they’re concerned about the limitations of the health maintenance organization plan, but “when we had to make the first premium payment, we got over that quickly,” said 56-year-old Elizabeth Wolfe.

Wolfe pays $52 per month for a Molina plan which covers her and her husband, with federal subsidies picking up some of the cost.

Molina’s profit margins on its exchange business are slim—somewhere in the 1.5 to 2 percent range—but they’re in the black, unlike many other exchange participants. It’s winning strategy is similar to how they’ve managed Medicaid patients for years: using narrow provider networks, rigorous cost control and close management of patients’ health.

“We are attracting and managing a similar population to what we have managed for the last 36 years” in Medicaid plans, Lisa Rubino, a Molina senior vice president, said to the Journal. “Making our products affordable at the premium level is job No. 1.”

For more on how other insurers could walk a similar path towards profitability on the exchanges, click on the link below: