agilon health Reports First Quarter 2024 Results
Agilon health reported strong financial and operational results for the first quarter of 2024, with revenue increasing by 52% to $1.6 billion and Medicare Advantage membership growing by 43% to 523,000. The company continues to focus on driving profitability and enhancing operating efficiency while maintaining its full-year guidance for Medical Margin and Adjusted EBITDA. Agilon health is making progress on its performance action plan to improve performance and support growth in Adjusted EBITDA in 2024 and beyond. The company also announced new partnerships with leading physician groups, expanding its presence in several states. With a solid capital position and positive outlook for the fiscal year, agilon health is poised for continued success.
Revenue increased by 52% to $1.6 billion, showcasing strong financial growth.
Medicare Advantage membership grew by 43% to 523,000, indicating increased market presence.
Total members on the agilon platform reached 654,000, demonstrating continued expansion.
Adjusted EBITDA increased by 21% to $29 million, reflecting improved operational efficiency.
New partnerships with leading physician groups will enhance agilon's presence in key states.
Net loss of $6 million in the first quarter of 2024 compared to net income of $16 million in the same period last year.
Gross profit saw only a slight increase, rising from $73 million to $75 million.
Exiting unprofitable payor contracts may impact short-term financial performance.
Insights
The substantial 52% increase in revenue to $1.6 billion that agilon health reported for Q1 2024 represents a notable expansion of their business, indicating the company's ability to grow its customer base and increase its operational scale. However, the report also indicates a net loss of $6 million, which contrasts last year’s net income of $16 million, signaling potential concerns over profitability despite top-line growth. The slight increase in Medical Margin by 1% to $157 million, juxtaposed against the significant revenue increase, suggests that the company may be facing pressure on margins or increasing costs that are not scaling proportionately with revenue.
The maintenance of full-year 2024 guidance for Medical Margin and Adjusted EBITDA suggests management confidence in their strategy and operational control. The guidance for Adjusted EBITDA to remain relatively flat despite aggressive growth ambitions may disappoint investors looking for improvements in profitability scaled to revenue growth. The balanced capital position, with $426 million in cash against $37 million in total debt, provides financial stability but it will be key to monitor how these resources are deployed to support growth initiatives and improve profitability.
For retail investors, the critical takeaway is the juxtaposition of robust top-line growth against the backdrop of a net loss, requiring a keen eye on future profitability metrics and the effectiveness of the performance action plan laid out by management.
Agilon health's growth in Medicare Advantage membership by 43% and the expansion of their overall membership base indicates a successful penetration in the Medicare Advantage market. Their strategic focus on this segment is pertinent as Medicare Advantage continues to represent a growing portion of the healthcare coverage landscape. This demographic tailwind could be a long-term driver of growth for agilon.
The execution of their performance action plan, including refining payer relationships and enhancing physician onboarding, speaks to efforts to improve operational efficiencies and physician engagement – which are critical for success in value-based care models. However, the decision to exit unprofitable payor contracts could be a double-edged sword, potentially improving margins but also affecting short-term growth rates.
From the perspective of healthcare dynamics, agilon’s growing traction with ACO model beneficiaries, which saw a 48% increase, is significant. ACOs (Accountable Care Organizations) are designed to improve patient care coordination and can provide cost savings over time, which may enhance agilon’s value proposition in the market. The emphasis on adding primary care physicians to its network is a strategic advantage, enabling agilon to potentially capitalize on value-based care paradigms.
Revenue increased
Continued progress executing performance action plan with focus on driving profitability and enhancing operating efficiency
Maintaining full year 2024 guidance for Medical Margin and Adjusted EBITDA
“Our first quarter results were in-line with our guidance,” said Steve Sell, chief executive officer. “We continue to make tangible progress executing our performance action plan. As payors adjust to the current funding environment for Medicare Advantage, we remain well positioned as our value proposition to primary care doctors and payors is increasingly important and well-recognized.”
First Quarter 2024 Results:
-
Total members on the agilon platform increased to 654,000 as of March 31, 2024, including 523,000 Medicare Advantage members and 131,000 ACO model beneficiaries. Medicare Advantage membership increased
43% , with7% growth in same partner geographies. -
Total revenue of
$1.60 billion 52% compared to$1.05 billion -
Gross profit of
$75 million $73 million $6 million $16 million -
Medical margin of
$157 million $156 million $8.7 million $16.5 million $7.8 million -
Adjusted EBITDA of
$29 million 21% compared to$24 million
Key Financial and Operating Metrics ($M):
(First Quarter 2024 vs. 2023)
|
Three Months Ended March 31, |
|
Change |
||
|
2024 |
|
2023 |
|
% YoY |
Medicare Advantage Members1 |
522,800 |
|
365,700 |
|
|
ACO Model Members1, 2 |
131,000 |
|
88,700 |
|
|
Total Members Live on Platform1, 2 |
653,800 |
|
454,400 |
|
|
Avg. Medicare Advantage Members |
518,400 |
|
363,400 |
|
|
Total revenues |
|
|
|
|
|
Gross Profit |
|
|
|
|
|
Medical Margin |
|
|
|
|
|
Net (Loss) Income |
( |
|
|
|
NM |
Adjusted EBITDA3 |
|
|
|
|
|
Geography Entry Costs |
|
|
|
|
( |
| 1. | Membership metrics reflect end of period results. |
| 2. | agilon’s ACO model entities are not included within its consolidated financial results. |
| 3. |
agilon’s ACO model entities contributed |
Continued Progress on Performance Action Plan
agilon health continues to make progress executing its targeted action plan to improve performance. This plan includes refining payor relationships, expanding onboarding support for newer primary care physicians, improving data visibility and analytics, and accelerating operating efficiency. Management anticipates these actions will support growth in Adjusted EBITDA in 2024 and beyond.
During the first quarter, agilon health reached agreements with certain payors to mitigate 2023 medical margin losses and made the decision to exit certain unprofitable payor contracts effective during the second quarter 2024. The company continues to deploy structured training and education resources to physician partners with
Class of 2025 New Partnership Announcement
On May 7, agilon health announced the formation of long-term partnerships with five leading physician groups: Graves Gilbert Clinic in
With the addition of the Class of 2025, agilon’s Physician Network will include over 3,000 primary care physicians (PCPs) who are delivering value-based care to more than 700,000 senior patients in 30+ communities. The Class of 2025 is expected to add more than 60,000 Medicare Advantage members to the agilon platform.
Capital Position and Balance Sheet:
agilon health’s balance sheet as of March 31, 2024 included cash, cash equivalents and marketable securities of
Outlook for Fiscal Year 2024 ($M):
Year Ended December 31, 2024 |
|||||||
Updated Guidance |
|
Previous Guidance |
|||||
Low |
|
High |
|
Low |
|
High |
|
Medicare Advantage Members1 |
510,000 |
|
515,000 |
|
540,00 |
|
550,000 |
ACO Model Members1,2 |
120,000 |
|
125,000 |
|
120,00 |
|
125,000 |
Total Members Live on Platform1 |
630,000 |
|
640,000 |
|
660,00 |
|
675,000 |
Avg. Medicare Advantage Members |
510,000 |
|
514,000 |
|
527,00 |
|
536,000 |
Total Revenues |
|
|
|
|
|
|
|
Medical Margin |
|
|
|
|
|
|
|
Adjusted EBITDA3 |
( |
|
( |
|
( |
|
( |
Geography Entry Costs4 |
|
|
|
|
|
|
|
| 1. | Membership reflects management’s outlook for end of period. |
| 2. | agilon’s partnered ACO model entities are not consolidated within its financial results. |
| 3. |
Adjusted EBITDA contribution from ACO model is expected to be approximately |
| 4. | Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for Adjusted EBITDA. |
Outlook for Second Quarter 2024 ($M):
|
Quarter Ended June 30, 2024 |
||
Low |
|
High |
|
Medicare Advantage Members1 |
513,000 |
|
518,000 |
ACO Model Members1,2 |
123,000 |
|
128,000 |
Total Members Live on Platform1 |
636,000 |
|
646,000 |
Avg. Medicare Advantage Members |
514,000 |
|
519,000 |
Total Revenues |
|
|
|
Medical Margin |
|
|
|
Adjusted EBITDA3 |
( |
|
|
Geography Entry Costs4 |
|
|
|
| 1. | Membership reflects management’s outlook for end of period. |
| 2. | agilon’s partnered ACO model entities are not consolidated within its financial results. |
| 3. |
Adjusted EBITDA contribution from ACO model is expected to be approximately |
| 4. | Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for Adjusted EBITDA. |
We have not reconciled guidance for Medical Margin to Gross Profit or Adjusted EBITDA to net income (loss), the most comparable GAAP measures, and have not provided forward-looking guidance for net income (loss) in each case because of the uncertainty around certain items that may impact Gross Profit or net income (loss), including non-cash stock-based compensation.
Webcast and Conference Call:
agilon health will host a conference call to discuss first quarter 2024 results on Tuesday, May 7, 2024 at 4:30 PM Eastern Time. The conference call can be accessed by dialing (833) 470-1428 for
About agilon health
agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 3,000+ PCPs that allow its physician partners to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30+ diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit www.agilonhealth.com and connect with us on Instagram, LinkedIn and YouTube.
Forward-Looking Statements
Statements in this release that are not historical factual statements are “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among other things, statements regarding our and our officers’ intent, belief or expectation as identified by the use of words such as “believes,” “expects,” “may,” “will,” “shall,” “should,” “would,” “could,” “seeks,” “aims,” “projects,” “is optimistic,” “intends,” “plans,” “estimates,” “anticipates” or the negative versions of these words or other comparable terms. Examples of forward-looking statements include, among other things: statements regarding timing, outcomes and other details relating to current, pending or contemplated new markets, growth opportunities, ability to deliver sustainable long-term value, business environment, long-term opportunities and strategic growth plans, expected revenue, medical costs, net income and gross profit, total and average membership, Adjusted EBITDA, Medical Margin, geography entry costs and other financial projections and assumptions, including our fiscal year and first quarter 2024 guidance. Forward-looking statements reflect our current expectations and views about future events and are subject to risks and uncertainties that could significantly affect our future financial condition and results of operations. While forward-looking statements reflect our good faith belief and assumptions we believe to be reasonable based upon current information, we can give no assurance that our expectations or forecasts will be attained. Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be outside our control. These risks and uncertainties that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, but are not limited to: our history of net losses and the expectation that our expenses will increase in the future; failure to identify and develop successful new geographies, physician partners and payors, or execute upon our growth initiatives; success in executing our operating strategies or achieving results consistent with our historical performance; medical expenses incurred on behalf of our members may exceed revenues we receive; our ability to secure contracts with Medicare Advantage payors; our ability to grow new physician partner relationships sufficient to recover startup costs; availability of additional capital, on acceptable terms or at all, to support our business in the future; significant reduction in our membership; transition to a Total Care Model may be challenging for physician partners; public health crises, such as COVID-19, could adversely affect us; inaccuracy in estimates of our members’ risk adjustment factors, medical services expense, incurred but not reported claims, and earnings pursuant to payor contracts; the impact of restrictive clauses or exclusivity provisions in some of our contracts with physician partners; our to hire and retain qualified personnel; our ability to realize the full value of our intangible assets; security breaches, cybersecurity attacks, loss of data and other disruptions to our information systems; our ability to protect the confidentiality of our know-how and other proprietary and internally developed information; reliance on our subsidiaries; Environmental, Social, and Governance issues; reliance on a limited number of key payors; the limited terms of contracts with our payors and our ability to renew them upon expiration; reliance on our payors, physician partners and other providers to operate our business; our ability to obtain accurate and complete diagnosis data; reliance on third-party software, data, infrastructure and bandwidth; consolidation and competition in the healthcare industry; the impact of changes to, and dependence on, federal government healthcare programs; uncertain or adverse economic and macroeconomic conditions, including a downturn or decrease in government expenditures; regulation of the healthcare industry and our and our physician partners’ ability to comply such laws and regulations; federal and state investigations, audits and enforcement actions; repayment obligations arising out of payor audits; negative publicity regarding the managed healthcare industry generally; our use, disclosure and processing of personally identifiable information, protected health information, and de-identified data; failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization; lawsuits not covered by insurance; changes in tax laws and regulations, or changes in related judgments or assumptions; our indebtedness and our potential to incur more debt; dependence on our subsidiaries for cash to fund all of our operations and expenses; provisions in our governing documents; ability to achieve a return on your investment depends on appreciation in the price of our common stock; the material weakness in our internal control over financial reporting and our ability to remediate such material weakness; and risks related to other factors discussed in our filings with the Securities and Exchange Commission (the “SEC”), including the factors discussed under “Risk Factors” in our Annual Report on Form 10-K for the fiscal year ended March 31, 2024, which can be found at the SEC’s website at www.sec.gov. Except as required by law, we do not undertake, and hereby disclaim, any obligation to update any forward-looking statements, which speak only as of the date on which they are made.
agilon health, inc. Consolidated Balance Sheets In thousands, except per share data |
|||||||
|
|
|
|
||||
|
March 31,
|
|
December 31,
|
||||
|
(unaudited) |
|
|
||||
ASSETS |
|
|
|
||||
Current assets: |
|
|
|
||||
Cash and cash equivalents |
$ |
111,706 |
|
|
$ |
107,570 |
|
Restricted cash and equivalents |
|
6,844 |
|
|
|
6,759 |
|
Marketable securities |
|
307,359 |
|
|
|
380,773 |
|
Receivables, net |
|
1,571,143 |
|
|
|
942,461 |
|
Prepaid expenses and other current assets, net |
|
39,757 |
|
|
|
42,513 |
|
Total current assets |
|
2,036,809 |
|
|
|
1,480,076 |
|
Property and equipment, net |
|
27,539 |
|
|
|
27,576 |
|
Intangible assets, net |
|
72,076 |
|
|
|
63,769 |
|
Goodwill |
|
24,133 |
|
|
|
24,133 |
|
Other assets |
|
155,906 |
|
|
|
145,312 |
|
Total assets |
$ |
2,316,463 |
|
|
$ |
1,740,866 |
|
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT) |
|
|
|
||||
Current liabilities: |
|
|
|
||||
Medical claims and related payables |
$ |
1,266,651 |
|
|
$ |
737,724 |
|
Accounts payable and accrued expenses |
|
252,497 |
|
|
|
233,182 |
|
Current portion of long-term debt |
|
7,500 |
|
|
|
6,250 |
|
Total current liabilities |
|
1,526,648 |
|
|
|
977,156 |
|
Long-term debt, net of current portion |
|
29,834 |
|
|
|
32,308 |
|
Other liabilities |
|
71,495 |
|
|
|
70,381 |
|
Total liabilities |
|
1,627,977 |
|
|
|
1,079,845 |
|
|
|
|
|
||||
Commitments and contingencies |
|
|
|
||||
|
|
|
|
||||
Stockholders' equity (deficit): |
|
|
|
||||
Common stock, |
|
4,108 |
|
|
|
4,064 |
|
Additional paid-in capital |
|
2,020,803 |
|
|
|
1,986,899 |
|
Accumulated deficit |
|
(1,332,890 |
) |
|
|
(1,326,826 |
) |
Accumulated other comprehensive income (loss) |
|
(2,747 |
) |
|
|
(2,298 |
) |
Total agilon health, inc. stockholders' equity (deficit) |
|
689,274 |
|
|
|
661,839 |
|
Noncontrolling interests |
|
(788 |
) |
|
|
(818 |
) |
Total stockholders’ equity (deficit) |
|
688,486 |
|
|
|
661,021 |
|
Total liabilities and stockholders’ equity (deficit) |
$ |
2,316,463 |
|
|
$ |
1,740,866 |
|
agilon health, inc. Consolidated Statements of Operations In thousands, except per share data (unaudited) |
|||||||
|
Three Months Ended
|
||||||
|
|
2024 |
|
|
|
2023 |
|
|
|
|
|
||||
Revenues: |
|
|
|
||||
Medical services revenue |
$ |
1,601,195 |
|
|
$ |
1,053,119 |
|
Other operating revenue |
|
3,159 |
|
|
|
1,193 |
|
Total revenues |
|
1,604,354 |
|
|
|
1,054,312 |
|
Expenses: |
|
|
|
||||
Medical services expense |
|
1,443,842 |
|
|
|
897,572 |
|
Other medical expenses |
|
85,424 |
|
|
|
83,617 |
|
General and administrative (including noncash stock-based compensation expense of |
|
76,422 |
|
|
|
69,752 |
|
Depreciation and amortization |
|
5,844 |
|
|
|
2,954 |
|
Total expenses |
|
1,611,532 |
|
|
|
1,053,895 |
|
Income (loss) from operations |
|
(7,178 |
) |
|
|
417 |
|
Other income (expense): |
|
|
|
||||
Income (loss) from equity method investments |
|
5,684 |
|
|
|
1,376 |
|
Other income (expense), net |
|
5,892 |
|
|
|
7,892 |
|
Interest expense |
|
(1,284 |
) |
|
|
(1,493 |
) |
Income (loss) before income taxes |
|
3,114 |
|
|
|
8,192 |
|
Income tax benefit (expense) |
|
133 |
|
|
|
1,759 |
|
Income (loss) from continuing operations |
|
3,247 |
|
|
|
9,951 |
|
Discontinued operations: |
|
|
|
||||
Income (loss) before gain (loss) on sales |
|
(518 |
) |
|
|
6,008 |
|
Gain (loss) on sales of assets, net |
|
(8,763 |
) |
|
|
— |
|
Total discontinued operations |
|
(9,281 |
) |
|
|
6,008 |
|
Net income (loss) |
|
(6,034 |
) |
|
|
15,959 |
|
Noncontrolling interests’ share in (earnings) loss |
|
(30 |
) |
|
|
63 |
|
Net income (loss) attributable to common shares |
$ |
(6,064 |
) |
|
$ |
16,022 |
|
|
|
|
|
||||
Net income (loss) per common share, basic and diluted |
|
|
|
||||
Continuing operations |
$ |
0.01 |
|
|
$ |
0.02 |
|
Discontinued operations |
$ |
(0.02 |
) |
|
$ |
0.02 |
|
Weighted average shares outstanding |
|
|
|
||||
Basic |
|
408,938 |
|
|
|
413,136 |
|
Diluted |
|
413,437 |
|
|
|
426,586 |
|
agilon health, inc. Consolidated Statements of Cash Flows In thousands (unaudited) |
|||||||
|
Three Months Ended March 31, |
||||||
|
|
2024 |
|
|
|
2023 |
|
Cash flows from operating activities: |
|
|
|
||||
Net income (loss) |
$ |
(6,034 |
) |
|
$ |
15,959 |
|
Adjustments to reconcile net income (loss) to net cash used in operating activities: |
|
|
|
||||
Depreciation and amortization |
|
5,844 |
|
|
|
4,189 |
|
Stock-based compensation expense |
|
16,909 |
|
|
|
13,672 |
|
Loss (income) from equity method investments |
|
(5,684 |
) |
|
|
(1,376 |
) |
(Gain) loss on sale of assets, net |
|
4,996 |
|
|
|
— |
|
Other noncash items |
|
(472 |
) |
|
|
(1,785 |
) |
Changes in operating assets and liabilities: |
|
(63,335 |
) |
|
|
(91,470 |
) |
Net cash provided by (used in) operating activities |
|
(47,776 |
) |
|
|
(60,811 |
) |
Cash flows from investing activities: |
|
|
|
||||
Purchase of property and equipment |
|
(3,139 |
) |
|
|
(3,717 |
) |
Purchase of intangible assets |
|
(11,438 |
) |
|
|
— |
|
Funding of loans receivable and other |
|
(8,508 |
) |
|
|
(1,301 |
) |
Investments in marketable securities |
|
— |
|
|
|
(29,969 |
) |
Proceeds from maturities of marketable securities and other |
|
74,523 |
|
|
|
28,540 |
|
Net cash paid in business combination |
|
— |
|
|
|
(44,367 |
) |
Net cash provided by (used in) investing activities |
|
51,438 |
|
|
|
(50,814 |
) |
Cash flows from financing activities: |
|
|
|
||||
Proceeds from equity issuances, net |
|
1,809 |
|
|
|
9,589 |
|
Repayments of long-term debt |
|
(1,250 |
) |
|
|
(1,250 |
) |
Net cash provided by (used in) financing activities |
|
559 |
|
|
|
8,339 |
|
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents |
|
4,221 |
|
|
|
(103,286 |
) |
Cash, cash equivalents and restricted cash and equivalents from continuing operations, beginning of period |
|
114,329 |
|
|
|
475,912 |
|
Cash, cash equivalents and restricted cash and equivalents from discontinued operations, beginning of period |
|
— |
|
|
|
31,768 |
|
Cash, cash equivalents and restricted cash and equivalents, beginning of period |
|
114,329 |
|
|
|
507,680 |
|
Cash, cash equivalents and restricted cash and equivalents from continuing operations, end of period |
|
118,550 |
|
|
|
397,023 |
|
Cash, cash equivalents and restricted cash and equivalents from discontinued operations, end of period |
|
— |
|
|
|
7,371 |
|
Cash, cash equivalents and restricted cash and equivalents, end of period |
$ |
118,550 |
|
|
$ |
404,394 |
|
agilon health, inc. |
|||||||
Key Operating Metrics |
|||||||
In thousands |
|||||||
(unaudited) |
|||||||
GROSS PROFIT |
|||||||
|
Three Months Ended
|
||||||
|
|
2024 |
|
|
|
2023 |
|
Total revenues |
$ |
1,604,354 |
|
|
$ |
1,054,312 |
|
Medical services expense |
|
(1,443,842 |
) |
|
|
(897,572 |
) |
Other medical expenses(1) |
|
(85,424 |
) |
|
|
(83,617 |
) |
Gross profit |
$ |
75,088 |
|
|
$ |
73,123 |
|
______________________________________________________________
(1) |
Represents physician compensation expense related to surplus sharing and other care management expenses that help to create medical cost efficiency. Includes costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended March 31, 2024 and 2023, costs incurred in implementing geographies were |
GENERAL AND ADMINISTRATIVE COSTS, INCLUDING PLATFORM SUPPORT COSTS |
|||||||
|
Three Months Ended
|
||||||
|
|
2024 |
|
|
2023 |
||
Platform support costs |
$ |
45,712 |
|
$ |
43,292 |
||
Geography entry costs(1) |
|
10,459 |
|
|
9,250 |
||
Severance and related costs |
|
2,415 |
|
|
188 |
||
Stock-based compensation expense |
|
16,909 |
|
|
13,585 |
||
Other(2) |
|
927 |
|
|
3,437 |
||
General and administrative |
$ |
76,422 |
|
$ |
69,752 |
||
______________________________________________________________
(1) |
Represents direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. |
(2) |
Includes transaction-related costs. |
Our platform support costs, which include regionally-based support personnel and other operating costs to support our geographies, are expected to decrease over time as a percentage of revenue as our physician partners add members and our revenue grows. Our operating expenses at the enterprise level include resources and technology to support payor contracting, clinical program development, quality, data management, finance, and legal and compliance functions.
agilon health, inc. |
|||||||
Non-GAAP Financial Measures |
|||||||
In thousands |
|||||||
(unaudited) |
|||||||
MEDICAL MARGIN |
|||||||
|
Three Months Ended
|
||||||
|
|
2024 |
|
|
|
2023 |
|
Gross profit(1) |
$ |
75,088 |
|
|
$ |
73,123 |
|
Other operating revenue |
|
(3,159 |
) |
|
|
(1,193 |
) |
Other medical expenses |
|
85,424 |
|
|
|
83,617 |
|
Medical margin |
$ |
157,353 |
|
|
$ |
155,547 |
|
______________________________________________________________
| (1) | Gross profit is defined as total revenues less medical services expense and other medical expenses. |
ADJUSTED EBITDA |
|||||||
|
Three Months Ended
|
||||||
|
|
2024 |
|
|
|
2023 |
|
Net income (loss)(1) |
$ |
(6,034 |
) |
|
$ |
15,959 |
|
(Income) loss from discontinued operations, net of income taxes |
|
9,281 |
|
|
|
(6,008 |
) |
Interest expense |
|
1,284 |
|
|
|
1,493 |
|
Income tax expense (benefit) |
|
(133 |
) |
|
|
(1,759 |
) |
Depreciation and amortization |
|
5,844 |
|
|
|
2,954 |
|
Severance and related costs |
|
2,415 |
|
|
|
188 |
|
Stock-based compensation expense |
|
16,909 |
|
|
|
13,585 |
|
EBITDA adjustments related to equity method investments |
|
3,902 |
|
|
|
1,967 |
|
Other(2) |
|
(4,414 |
) |
|
|
(4,341 |
) |
Adjusted EBITDA |
$ |
29,054 |
|
|
$ |
24,038 |
|
______________________________________________________________
(1) |
Includes direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended March 31, 2024 and 2023, (i) |
(2) |
Includes interest income and transaction-related costs. |
agilon health, inc. Supplemental Financial Information In thousands (unaudited) |
|||||||
|
Three Months Ended
|
||||||
|
Medicare Advantage (Consolidated) |
|
CMS ACO Models (Unconsolidated) |
||||
Medical services revenue |
$ |
1,601,195 |
|
|
$ |
440,160 |
|
Other operating revenue |
|
3,159 |
|
|
|
— |
|
Total revenues |
|
1,604,354 |
|
|
|
440,160 |
|
Medical services expense |
|
(1,443,842 |
) |
|
|
(398,792 |
) |
Other medical expenses |
|
(85,424 |
) |
|
|
(25,405 |
) |
Gross profit |
|
75,088 |
|
|
|
15,963 |
|
Other operating revenue |
|
(3,159 |
) |
|
|
— |
|
Other medical expenses |
|
85,424 |
|
|
|
25,405 |
|
Medical margin |
$ |
157,353 |
|
|
$ |
41,368 |
|
Certain of our operations are not consolidated for the period presented because we do not have the ability to control certain activities due to another party’s control of the entities’ board of directors. Although revenues of the unconsolidated operations are not recorded as revenues by us, income (loss) from equity method investments is nonetheless a significant portion of our overall earnings. See Note 14 to the Condensed Consolidated Financial Statements in the Quarterly Report on Form 10-Q for the period ending March 31, 2024 for additional discussion on our equity method investments.
In addition to providing results that are determined in accordance with GAAP, we present Medical Margin and Adjusted EBITDA, which are non-GAAP financial measures.
We define Medical Margin as medical services revenue after medical services expense is deducted. Medical services expense represents costs incurred for medical services provided to our members. As our platform matures over time, we expect Medical Margin to increase in absolute dollars. However, Medical Margin per member per month (PMPM) may vary as the percentage of new members brought onto our platform fluctuates. New membership added to the platform is typically dilutive to Medical Margin PMPM. We believe this metric provides insight into the economics of our capitation arrangements as it includes all medical services expense directly associated with our members’ care.
We define Adjusted EBITDA as net income (loss) adjusted to exclude: (i) income (loss) from discontinued operations, net of income taxes, (ii) interest expense, (iii) income tax expense (benefit), (iv) depreciation and amortization, (v) stock-based compensation expense, (vi) severance and related costs, and (vii) certain other items that are not considered by us in the evaluation of ongoing operating performance. We reflect our share of Adjusted EBITDA for equity method investments by applying our actual ownership percentage for the period to the applicable reconciling items on an entity-by-entity basis.
Gross profit is the most directly comparable GAAP measure to Medical Margin. Net income (loss) is the most directly comparable GAAP measure to Adjusted EBITDA.
We believe Medical Margin and Adjusted EBITDA help identify underlying trends in our business and facilitate evaluation of period-to-period operating performance of our operations by eliminating items that are variable in nature and not considered by us in the evaluation of ongoing operating performance, allowing comparison of our recurring core business operating results over multiple periods. We also believe Medical Margin and Adjusted EBITDA provide useful information about our operating results, enhance the overall understanding of our past performance and future prospects, and allow for greater transparency with respect to key metrics we use for financial and operational decision-making. We believe Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in our industry as a measure of financial performance. Other companies may calculate Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures differently from the way we calculate these metrics. As a result, our presentation of Medical Margin and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures.
View source version on businesswire.com: https://www.businesswire.com/news/home/20240507422238/en/
Investor Contact
Matthew Gillmor
VP, Investor Relations
investors@agilonhealth.com
Media Contact
Maureen Merkle
Communications & Public Affairs
media@agilonhealth.com
Source: agilon health
FAQ
What was agilon health's revenue in the first quarter of 2024?
How much did Medicare Advantage membership grow by in the first quarter of 2024?
What was agilon health's net loss in the first quarter of 2024?
What is agilon health's stock symbol?
How many physician groups did agilon health partner with in May 2025?
