agilon health Reports Third Quarter 2024 Results
agilon health reported Q3 2024 results with revenue increasing 28% to $1.45 billion. Medicare Advantage membership grew 37% to 525,000, while total platform members increased 39% to 657,000. The quarter was impacted by challenges including $60 million in prior year development costs, $65 million reduction in 2024 risk adjustment, and $25 million in higher medical expenses. The company reported a gross profit loss of $64 million and a net loss of $118 million. In response, agilon plans to exit two unprofitable partnerships and certain payor contracts by end of 2024. The company updated its full-year 2024 guidance, reflecting Q3 results and revised Q4 cost trends.
Agilon Health ha riportato i risultati del terzo trimestre 2024, con ricavi in crescita del 28%, arrivando a 1,45 miliardi di dollari. L'adesione al programma Medicare Advantage è aumentata del 37%, raggiungendo 525.000 membri, mentre il numero totale dei membri della piattaforma è aumentato del 39%, arrivando a 657.000. Il trimestre è stato colpito da sfide, tra cui 60 milioni di dollari in costi di sviluppo dell'anno precedente, una riduzione di 65 milioni di dollari nell'aggiustamento del rischio per il 2024 e 25 milioni di dollari in spese mediche più elevate. L'azienda ha registrato una perdita di profitto lordo di 64 milioni di dollari e una perdita netta di 118 milioni di dollari. In risposta, Agilon prevede di uscire da due partnership non redditizie e da alcuni contratti con i pagatori entro la fine del 2024. L'azienda ha aggiornato le proprie previsioni per l'intero anno 2024, riflettendo i risultati del terzo trimestre e le tendenze dei costi del quarto trimestre riviste.
Agilon Health reportó resultados del tercer trimestre de 2024, con ingresos que aumentaron un 28%, alcanzando 1.45 mil millones de dólares. La membresía de Medicare Advantage creció un 37%, llegando a 525,000 miembros, mientras que el número total de miembros de la plataforma aumentó un 39%, alcanzando 657,000. El trimestre se vio afectado por desafíos, incluidos 60 millones de dólares en costos de desarrollo del año anterior, una reducción de 65 millones de dólares en el ajuste de riesgo para 2024 y 25 millones de dólares en mayores gastos médicos. La compañía reportó una pérdida de utilidad bruta de 64 millones de dólares y una pérdida neta de 118 millones de dólares. En respuesta, Agilon planea salir de dos asociaciones no rentables y ciertos contratos con pagadores para finales de 2024. La compañía actualizó su guía para todo el año 2024, reflejando los resultados del tercer trimestre y las tendencias de costos revisadas del cuarto trimestre.
Agilon Health는 2024년 3분기 결과를 보고하며 수익이 28% 증가하여 14억 5천만 달러에 도달했다고 발표했습니다. Medicare Advantage 회원 수는 37% 증가하여 525,000명이 되었고, 플랫폼의 총 회원 수는 39% 증가하여 657,000명이 되었습니다. 이번 분기는 지난해 발전 비용 6천만 달러, 2024년 위험 조정 6천5백만 달러 감소, 의료비 증가 2천5백만 달러 등으로 어려움이 있었습니다. 회사는 6천4백만 달러의 총 이익 손실과 1억 1천8백만 달러의 순 손실을 기록했습니다. 이에 따라 Agilon은 2024년 말까지 두 개의 수익성이 없는 파트너십과 일부 지급자 계약을 종료할 계획입니다. 이 회사는 3분기 결과와 4분기 비용 트렌드 수정 내용을 반영하여 2024년 전체 연도 가이드를 업데이트했습니다.
Agilon Health a annoncé ses résultats du troisième trimestre 2024, avec des revenus en hausse de 28 %, atteignant 1,45 milliard de dollars. L'adhésion au programme Medicare Advantage a augmenté de 37 %, atteignant 525 000 membres, tandis que le nombre total de membres de la plateforme a augmenté de 39 %, atteignant 657 000. Le trimestre a été impacté par des défis, notamment 60 millions de dollars de frais de développement de l'année précédente, une réduction de 65 millions de dollars dans l'ajustement du risque pour 2024 et 25 millions de dollars de dépenses médicales accrues. La société a enregistré une perte de bénéfice brut de 64 millions de dollars et une perte nette de 118 millions de dollars. En réponse, Agilon prévoit de sortir de deux partenariats non rentables et de certains contrats de payeurs d'ici la fin de 2024. L'entreprise a mis à jour ses prévisions pour l'année entière 2024, reflétant les résultats du troisième trimestre et les tendances des coûts révisées du quatrième trimestre.
Agilon Health berichtete über die Ergebnisse des dritten Quartals 2024, mit einem Umsatzanstieg von 28 % auf 1,45 Milliarden Dollar. Die Mitgliedschaft im Medicare Advantage-Programm wuchs um 37 % auf 525.000, während die Gesamtzahl der Plattformmitglieder um 39 % auf 657.000 anstieg. Das Quartal war von Herausforderungen geprägt, darunter 60 Millionen Dollar an Entwicklungskosten aus dem Vorjahr, eine Reduzierung von 65 Millionen Dollar bei der Risikoeinstellung für 2024 und 25 Millionen Dollar an höheren medizinischen Ausgaben. Das Unternehmen meldete einen Verlust beim Bruttogewinn von 64 Millionen Dollar und einen Nettoverlust von 118 Millionen Dollar. Als Reaktion plant Agilon, bis Ende 2024 aus zwei unrentablen Partnerschaften und bestimmten Zahlungsgeberverträgen auszusteigen. Das Unternehmen aktualisierte seine Jahresprognose für 2024, um die Ergebnisse des dritten Quartals und die überarbeiteten Kostentrends für das vierte Quartal zu berücksichtigen.
- Revenue growth of 28% YoY to $1.45 billion
- Medicare Advantage membership increased 37% YoY
- Total platform members grew 39% to 657,000
- Strong cash position with $399 million in cash and marketable securities
- Q3 gross profit loss of $64 million compared to $37 million profit in Q3 2023
- Net loss increased to $118 million from $31 million in Q3 2023
- $60 million negative prior year development costs
- $65 million reduction in 2024 risk adjustment estimates
- $25 million increase in current year medical expenses
- Downward revision of full-year 2024 guidance
- Planning to exit two unprofitable partnerships
Insights
The Q3 results reveal significant operational challenges at agilon health.
Three major headwinds impacted performance:
The decision to exit unprofitable partnerships indicates structural issues in their business model. While membership growth remains strong at
The results highlight broader challenges in the Medicare Advantage space. Despite growing their member base to 525,000 MA members, agilon's struggles with risk adjustment and medical costs point to industry-wide pressures. The substantial downward revision in full-year medical margin guidance from
The strategic decision to exit certain partnerships and contracts demonstrates the difficulties in achieving profitability in full-risk Medicare Advantage models. This restructuring, while painful short-term, could help stabilize operations for 2025, though execution risks remain high given the challenging Medicare Advantage environment.
Revenue increased
Third quarter results were affected by lower-than-expected 2024 risk adjustment, negative prior year development mainly from risk adjustment and Part D, and higher current year medical expenses
Adjusted full year guidance reflects Q3 results and updated Q4 cost trends
“Our full-risk model enables primary care physicians to deliver high-quality care to their senior patients. Our Q3 results show that our membership is growing across our 26 partnerships, and it also highlights why we are taking necessary actions to strengthen execution within our platform and proactively manage the challenging Medicare Advantage environment,” said Steve Sell, chief executive officer. “Against that backdrop, we have initiated steps with select partners to exit two unprofitable partnerships and other payor contracts by the end of 2024. While the overall Medicare Advantage environment will eventually realign, it is important that we take these actions in the interim to strengthen the run-rate for our business into 2025 and better position our platform and network for long-term success.”
Third Quarter 2024 Results:
-
Compared to previous guidance, third quarter 2024 gross profit and medical margin was negatively impacted as a result of additional information received from payors in the third quarter. This included prior year development of
primarily related to risk adjustment revenue and Part D medical expense; a reduction of estimated 2024 risk adjustment of$60 million ; and higher current year medical expense of$65 million primarily in the third quarter.$25 million -
Total members on the agilon platform increased to 657,000 as of September 30, 2024, comprising 525,000 Medicare Advantage members and 132,000 ACO model beneficiaries. Medicare Advantage membership increased
37% year-over-year, with4.8% growth in same-partner geographies. -
Total revenue of
in the third quarter 2024 increased$1.45 billion 28% compared to in the third quarter 2023. Year-over-year total revenue growth was primarily driven by membership growth in new markets and same geography growth.$1.14 billion -
Gross profit was negative
in the third quarter 2024 compared to positive$64 million in the third quarter 2023. Net loss was$37 million in the third quarter 2024 compared to a net loss of$118 million in the third quarter 2023. The year-over-year reduction in gross profit and higher net losses resulted from the factors discussed above.$31 million -
Medical margin was negative
during the third quarter 2024, compared to$58 million for the same period 2023. The$111 million year-over-year medical margin reduction also resulted from the factors mentioned above.$169 million -
Adjusted EBITDA loss was
in the third quarter 2024 compared to positive$96 million for the same period in 2023. The year-over-year change is attributable to the factors discussed above.$6 million
Key Financial and Operating Metrics ($M): (Third Quarter 2024 vs. 2023) |
|||||
|
Three Months
|
|
Change |
||
|
2024 |
|
2023 |
|
% YoY |
Medicare Advantage Members1 |
525,000 |
|
384,000 |
|
|
ACO Model Members1, 2 |
132,000 |
|
88,000 |
|
|
Total Members Live on Platform1, 2 |
657,000 |
|
472,000 |
|
|
Avg. Medicare Advantage Members |
535,000 |
|
389,000 |
|
|
Total revenues |
|
|
|
|
|
Gross Profit |
( |
|
|
|
NM |
Medical Margin |
( |
|
|
|
( |
Net (Loss) Income |
( |
|
( |
|
NM |
Adjusted EBITDA3 |
( |
|
|
|
NM |
Geography Entry Costs |
|
|
|
|
( |
- Membership metrics reflect end of period results.
- agilon’s ACO model entities are not included within its consolidated financial results.
-
agilon’s ACO model entities contributed
to Adjusted EBITDA during the third quarter 2024 and$12 million in third quarter 2023.$18 million
Capital Position and Balance Sheet:
agilon health’s balance sheet as of September 30, 2024 included cash, cash equivalents and marketable securities of
Outlook for Fiscal Year 2024 ($M):
Guidance below includes results from the third quarter 2024 and updated cost trends for the fourth quarter 2024. Medical margin guidance below includes approximately
Year Ended December 31, 2024 |
|||||||
Updated Guidance |
Previous Guidance |
||||||
Low |
High |
Low |
High |
||||
Medicare Advantage Members1 |
526,000 |
|
528,000 |
|
518,000 |
|
520,000 |
ACO Model Members1,2 |
127,000 |
|
129,000 |
|
123,000 |
|
128,000 |
Total Members Live on Platform1 |
653,000 |
|
657,000 |
|
641,000 |
|
648,000 |
Avg. Medicare Advantage Members |
522,000 |
|
522,000 |
|
513,000 |
|
514,000 |
Total Revenues |
|
|
|
|
|
|
|
Medical Margin |
|
|
|
|
|
|
|
Adjusted EBITDA3 |
( |
|
( |
|
( |
|
( |
Geography Entry Costs4 |
|
|
|
|
|
|
|
- Membership reflects management’s outlook for end of period.
- agilon’s partnered ACO model entities are not consolidated within its financial results.
-
Adjusted EBITDA contribution from ACO model is expected to be approximately
for fiscal year 2024.$38 million - Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for adjusted EBITDA.
Outlook for Fourth Quarter 2024 ($M):
|
Quarter Ended
|
||
Low |
High |
||
Medicare Advantage Members1 |
526,000 |
|
528,000 |
ACO Model Members1,2 |
127,000 |
|
129,000 |
Total Members Live on Platform1 |
653,000 |
|
657,000 |
Avg. Medicare Advantage Members |
526,000 |
|
527,000 |
Total Revenues |
|
|
|
Medical Margin |
|
|
|
Adjusted EBITDA3 |
( |
|
( |
Geography Entry Costs4 |
|
|
|
- Membership reflects management’s outlook for end of period.
- agilon’s partnered ACO model entities are not consolidated within its financial results.
-
Adjusted EBITDA contribution from ACO model is expected to be approximately
for the fourth quarter 2024.$5 million - Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for adjusted EBITDA.
The Company has not reconciled guidance for medical margin to gross profit or adjusted EBITDA to net income (loss), the most comparable GAAP measures, and has 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 third quarter 2024 results on Thursday, November 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 2,800+ 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 our expectations related to operating and financial results, our ability to negotiate more favorable economic terms in our payor contracts, the value of and demand for our full-risk model for primary care physicians, the strengthening of our value proposition to physicians and payers, our ability to efficiently exit unprofitable markets, and our long-term opportunities and strategic growth plans and alignment with the macro environment, 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 third 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 ability 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; our ability to navigate the changing healthcare payor market 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 with 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 December 31, 2023, 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. Condensed Consolidated Balance Sheets In thousands, except per share data |
|||||||
|
September 30,
|
|
December 31,
|
||||
|
(unaudited) |
|
|
||||
ASSETS |
|
|
|
||||
Current assets: |
|
|
|
||||
Cash and cash equivalents |
$ |
148,161 |
|
|
$ |
107,570 |
|
Restricted cash and equivalents |
|
5,629 |
|
|
|
6,759 |
|
Marketable securities |
|
244,766 |
|
|
|
380,773 |
|
Receivables, net |
|
1,368,349 |
|
|
|
942,461 |
|
Prepaid expenses and other current assets, net |
|
44,854 |
|
|
|
42,513 |
|
Total current assets |
|
1,811,759 |
|
|
|
1,480,076 |
|
Property and equipment, net |
|
28,194 |
|
|
|
27,576 |
|
Intangible assets, net |
|
73,412 |
|
|
|
63,769 |
|
Goodwill |
|
24,133 |
|
|
|
24,133 |
|
Other assets |
|
153,913 |
|
|
|
145,312 |
|
Total assets |
$ |
2,091,411 |
|
|
$ |
1,740,866 |
|
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT) |
|
|
|
||||
Current liabilities: |
|
|
|
||||
Medical claims and related payables |
$ |
1,190,665 |
|
|
$ |
737,724 |
|
Accounts payable, accrued expenses and other |
|
218,492 |
|
|
|
239,432 |
|
Total current liabilities |
|
1,409,157 |
|
|
|
977,156 |
|
Long-term debt, net of current portion |
|
34,884 |
|
|
|
32,308 |
|
Other liabilities |
|
72,498 |
|
|
|
70,381 |
|
Total liabilities |
|
1,516,539 |
|
|
|
1,079,845 |
|
|
|
|
|
||||
Commitments and contingencies |
|
|
|
||||
|
|
|
|
||||
Stockholders' equity (deficit): |
|
|
|
||||
Common stock, |
|
4,120 |
|
|
|
4,064 |
|
Additional paid-in capital |
|
2,051,638 |
|
|
|
1,986,899 |
|
Accumulated deficit |
|
(1,481,187 |
) |
|
|
(1,326,826 |
) |
Accumulated other comprehensive income (loss) |
|
301 |
|
|
|
(2,298 |
) |
Total agilon health, inc. stockholders' equity (deficit) |
|
574,872 |
|
|
|
661,839 |
|
Noncontrolling interests |
|
— |
|
|
|
(818 |
) |
Total stockholders’ equity (deficit) |
|
574,872 |
|
|
|
661,021 |
|
Total liabilities and stockholders’ equity (deficit) |
$ |
2,091,411 |
|
|
$ |
1,740,866 |
|
agilon health, inc. Condensed Consolidated Statements of Operations In thousands, except per share data (unaudited) |
|||||||||||||||
|
Three Months Ended
|
|
Nine Months Ended
|
||||||||||||
|
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
|
|
|
|
|
|
|
|
||||||||
Revenues: |
|
|
|
|
|
|
|
||||||||
Medical services revenue |
$ |
1,447,697 |
|
|
$ |
1,133,457 |
|
|
$ |
4,528,471 |
|
|
$ |
3,253,810 |
|
Other operating revenue |
|
3,235 |
|
|
|
3,406 |
|
|
|
9,573 |
|
|
|
6,480 |
|
Total revenues |
|
1,450,932 |
|
|
|
1,136,863 |
|
|
|
4,538,044 |
|
|
|
3,260,290 |
|
Expenses: |
|
|
|
|
|
|
|
||||||||
Medical services expense |
|
1,505,950 |
|
|
|
1,022,871 |
|
|
|
4,323,852 |
|
|
|
2,853,266 |
|
Other medical expenses |
|
9,149 |
|
|
|
77,153 |
|
|
|
171,096 |
|
|
|
242,486 |
|
General and administrative (including noncash stock-based compensation expense of |
|
63,123 |
|
|
|
72,058 |
|
|
|
209,157 |
|
|
|
221,064 |
|
Depreciation and amortization |
|
6,218 |
|
|
|
4,075 |
|
|
|
17,969 |
|
|
|
11,308 |
|
Total expenses |
|
1,584,440 |
|
|
|
1,176,157 |
|
|
|
4,722,074 |
|
|
|
3,328,124 |
|
Income (loss) from operations |
|
(133,508 |
) |
|
|
(39,294 |
) |
|
|
(184,030 |
) |
|
|
(67,834 |
) |
Other income (expense): |
|
|
|
|
|
|
|
||||||||
Income (loss) from equity method investments |
|
2,047 |
|
|
|
14,659 |
|
|
|
17,686 |
|
|
|
24,507 |
|
Other income (expense), net |
|
16,061 |
|
|
|
5,423 |
|
|
|
26,794 |
|
|
|
20,402 |
|
Interest expense |
|
(1,622 |
) |
|
|
(1,617 |
) |
|
|
(4,603 |
) |
|
|
(4,665 |
) |
Income (loss) before income taxes |
|
(117,022 |
) |
|
|
(20,829 |
) |
|
|
(144,153 |
) |
|
|
(27,590 |
) |
Income tax benefit (expense) |
|
590 |
|
|
|
(1,210 |
) |
|
|
306 |
|
|
|
(524 |
) |
Income (loss) from continuing operations |
|
(116,432 |
) |
|
|
(22,039 |
) |
|
|
(143,847 |
) |
|
|
(28,114 |
) |
Discontinued operations: |
|
|
|
|
|
|
|
||||||||
Income (loss) before gain (loss) on sales |
|
(1,183 |
) |
|
|
(9,444 |
) |
|
|
(1,701 |
) |
|
|
(4,205 |
) |
Gain (loss) on sales of assets, net |
|
— |
|
|
|
— |
|
|
|
(8,763 |
) |
|
|
— |
|
Total discontinued operations |
|
(1,183 |
) |
|
|
(9,444 |
) |
|
|
(10,464 |
) |
|
|
(4,205 |
) |
Net income (loss) |
|
(117,615 |
) |
|
|
(31,483 |
) |
|
|
(154,311 |
) |
|
|
(32,319 |
) |
Noncontrolling interests’ share in (earnings) loss |
|
— |
|
|
|
47 |
|
|
|
(50 |
) |
|
|
156 |
|
Net income (loss) attributable to common shares |
$ |
(117,615 |
) |
|
$ |
(31,436 |
) |
|
$ |
(154,361 |
) |
|
$ |
(32,163 |
) |
|
|
|
|
|
|
|
|
||||||||
Net income (loss) per common share, basic and diluted |
|
|
|
|
|
|
|
||||||||
Continuing operations |
$ |
(0.29 |
) |
|
$ |
(0.06 |
) |
|
$ |
(0.35 |
) |
|
$ |
(0.07 |
) |
Discontinued operations |
$ |
— |
|
|
$ |
(0.02 |
) |
|
$ |
(0.03 |
) |
|
$ |
(0.01 |
) |
Weighted average shares outstanding |
|
|
|
|
|
|
|
||||||||
Basic |
|
411,591 |
|
|
|
405,787 |
|
|
|
410,604 |
|
|
|
412,077 |
|
Diluted |
|
411,591 |
|
|
|
405,787 |
|
|
|
410,604 |
|
|
|
412,077 |
|
agilon health, inc. Condensed Consolidated Statements of Cash Flows In thousands (unaudited) |
|||||||
|
Nine Months Ended September 30, |
||||||
|
2024 |
|
2023 |
||||
Cash flows from operating activities: |
|
|
|
||||
Net income (loss) |
$ |
(154,311 |
) |
|
$ |
(32,319 |
) |
Adjustments to reconcile net income (loss) to net cash used in operating activities: |
|
|
|
||||
Depreciation and amortization |
|
17,969 |
|
|
|
15,014 |
|
Stock-based compensation expense |
|
48,375 |
|
|
|
53,980 |
|
Loss (income) from equity method investments |
|
(17,686 |
) |
|
|
(24,507 |
) |
Distributions of earnings from equity method investments |
|
3,340 |
|
|
|
— |
|
(Gain) loss on sale of assets, net |
|
3,784 |
|
|
|
— |
|
Other noncash items |
|
(491 |
) |
|
|
(1,511 |
) |
Changes in operating assets and liabilities: |
|
24,824 |
|
|
|
(105,690 |
) |
Net cash provided by (used in) operating activities |
|
(74,196 |
) |
|
|
(95,033 |
) |
Cash flows from investing activities: |
|
|
|
||||
Purchase of property and equipment |
|
(9,985 |
) |
|
|
(11,898 |
) |
Purchase of intangible assets |
|
(18,877 |
) |
|
|
(3,535 |
) |
Investment in loans receivable and other |
|
(9,742 |
) |
|
|
(8,778 |
) |
Investments in marketable securities |
|
(12,006 |
) |
|
|
(107,020 |
) |
Proceeds from maturities of marketable securities and other |
|
166,828 |
|
|
|
133,894 |
|
Net cash paid in business combination |
|
— |
|
|
|
(44,479 |
) |
Net cash provided by (used in) investing activities |
|
116,218 |
|
|
|
(41,816 |
) |
Cash flows from financing activities: |
|
|
|
||||
Proceeds from equity issuances, net |
|
1,189 |
|
|
|
11,462 |
|
Common stock repurchase |
|
— |
|
|
|
(200,000 |
) |
Repayments of long-term debt |
|
(3,750 |
) |
|
|
(3,750 |
) |
Net cash provided by (used in) financing activities |
|
(2,561 |
) |
|
|
(192,288 |
) |
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents |
|
39,461 |
|
|
|
(329,137 |
) |
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 |
|
153,790 |
|
|
|
169,660 |
|
Cash, cash equivalents and restricted cash and equivalents from discontinued operations, end of period |
|
— |
|
|
|
8,883 |
|
Cash, cash equivalents and restricted cash and equivalents, end of period |
$ |
153,790 |
|
|
$ |
178,543 |
agilon health, inc. Key Operating Metrics In thousands (unaudited) |
|||||||||||||||
GROSS PROFIT |
|||||||||||||||
|
Three Months Ended
|
|
Nine Months Ended
|
||||||||||||
|
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Total revenues |
$ |
1,450,932 |
|
|
$ |
1,136,863 |
|
|
$ |
4,538,044 |
|
|
$ |
3,260,290 |
|
Medical services expense |
|
(1,505,950 |
) |
|
|
(1,022,871 |
) |
|
|
(4,323,852 |
) |
|
|
(2,853,266 |
) |
Other medical expenses(1) |
|
(9,149 |
) |
|
|
(77,153 |
) |
|
|
(171,096 |
) |
|
|
(242,486 |
) |
Gross profit |
$ |
(64,167 |
) |
|
$ |
36,839 |
|
|
$ |
43,096 |
|
|
$ |
164,538 |
|
______________________________________________________________ |
||
(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 September 30, 2024 and 2023, costs incurred in implementing geographies were |
GENERAL AND ADMINISTRATIVE COSTS, INCLUDING PLATFORM SUPPORT COSTS |
|||||||||||
|
Three Months Ended
|
|
Nine Months Ended
|
||||||||
|
2024 |
|
2023 |
|
2024 |
|
2023 |
||||
Platform support costs |
$ |
42,353 |
|
$ |
41,590 |
|
$ |
129,752 |
|
$ |
126,923 |
Geography entry costs(1) |
|
5,857 |
|
|
8,064 |
|
|
21,182 |
|
|
28,620 |
Severance and related costs |
|
1,453 |
|
|
— |
|
|
4,736 |
|
|
188 |
Stock-based compensation expense |
|
13,259 |
|
|
20,619 |
|
|
48,375 |
|
|
53,650 |
Other(2) |
|
201 |
|
|
1,785 |
|
|
5,112 |
|
|
11,683 |
General and administrative |
$ |
63,123 |
|
$ |
72,058 |
|
$ |
209,157 |
|
$ |
221,064 |
______________________________________________________________ |
||
(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
|
|
Nine Months Ended
|
||||||||||||
|
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Gross profit(1) |
$ |
(64,167 |
) |
|
$ |
36,839 |
|
|
$ |
43,096 |
|
|
$ |
164,538 |
|
Other operating revenue |
|
(3,235 |
) |
|
|
(3,406 |
) |
|
|
(9,573 |
) |
|
|
(6,480 |
) |
Other medical expenses |
|
9,149 |
|
|
|
77,153 |
|
|
|
171,096 |
|
|
|
242,486 |
|
Medical margin |
$ |
(58,253 |
) |
|
$ |
110,586 |
|
|
$ |
204,619 |
|
|
$ |
400,544 |
|
______________________________________________________________ |
||
(1) | Gross profit is defined as total revenues less medical services expense and other medical expenses. |
ADJUSTED EBITDA |
|||||||||||||||
|
Three Months Ended
|
|
Nine Months Ended
|
||||||||||||
|
2024 |
|
2023 |
|
2024 |
|
2023 |
||||||||
Net income (loss)(1) |
$ |
(117,615 |
) |
|
$ |
(31,483 |
) |
|
$ |
(154,311 |
) |
|
$ |
(32,319 |
) |
(Income) loss from discontinued operations, net of income taxes |
|
1,183 |
|
|
|
9,444 |
|
|
|
10,464 |
|
|
|
4,205 |
|
Interest expense |
|
1,622 |
|
|
|
1,617 |
|
|
|
4,603 |
|
|
|
4,665 |
|
Income tax expense (benefit) |
|
(590 |
) |
|
|
1,210 |
|
|
|
(306 |
) |
|
|
524 |
|
Depreciation and amortization |
|
6,218 |
|
|
|
4,075 |
|
|
|
17,969 |
|
|
|
11,308 |
|
Severance and related costs |
|
1,453 |
|
|
|
— |
|
|
|
4,736 |
|
|
|
188 |
|
Stock-based compensation expense |
|
13,259 |
|
|
|
20,619 |
|
|
|
48,375 |
|
|
|
53,650 |
|
EBITDA adjustments related to equity method investments(2) |
|
9,719 |
|
|
|
3,702 |
|
|
|
15,025 |
|
|
|
8,426 |
|
Other(3) |
|
(11,718 |
) |
|
|
(3,631 |
) |
|
|
(16,800 |
) |
|
|
(8,587 |
) |
Adjusted EBITDA |
$ |
(96,469 |
) |
|
$ |
5,553 |
|
|
$ |
(70,245 |
) |
|
$ |
42,060 |
|
______________________________________________________________ |
||
(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 September 30, 2024 and 2023, (i) |
|
(2) | Includes elimination of certain administrative services provided by agilon health, inc. to equity method investments. |
|
(3) | Includes interest income, transaction-related costs and elimination of certain administrative services provided by agilon health, inc. to equity method investments. |
agilon health, inc. Supplemental Financial Information In thousands (unaudited) |
|||||||||||||||
|
Three Months Ended
|
|
Nine Months Ended
|
||||||||||||
|
Medicare
|
|
CMS ACO Models
|
|
Medicare
|
|
CMS ACO Models
|
||||||||
Medical services revenue |
$ |
1,447,697 |
|
|
$ |
454,410 |
|
|
$ |
4,528,471 |
|
|
$ |
1,341,484 |
|
Other operating revenue |
|
3,235 |
|
|
|
— |
|
|
|
9,573 |
|
|
|
— |
|
Total revenues |
|
1,450,932 |
|
|
|
454,410 |
|
|
|
4,538,044 |
|
|
|
1,341,484 |
|
Medical services expense |
|
(1,505,950 |
) |
|
|
(413,189 |
) |
|
|
(4,323,852 |
) |
|
|
(1,218,902 |
) |
Other medical expenses |
|
(9,149 |
) |
|
|
(23,817 |
) |
|
|
(171,096 |
) |
|
|
(71,490 |
) |
Gross profit |
|
(64,167 |
) |
|
|
17,404 |
|
|
|
43,096 |
|
|
|
51,092 |
|
Other operating revenue |
|
(3,235 |
) |
|
|
— |
|
|
|
(9,573 |
) |
|
|
— |
|
Other medical expenses |
|
9,149 |
|
|
|
23,817 |
|
|
|
171,096 |
|
|
|
71,490 |
|
Medical margin |
$ |
(58,253 |
) |
|
$ |
41,221 |
|
|
$ |
204,619 |
|
|
$ |
122,582 |
|
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 September 30, 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/20241107938098/en/
Investor Contact
Leland Thomas
Investor Relations
investors@agilonhealth.com
Media Contact
Maureen Merkle
Communications
media@agilonhealth.com
Source: agilon health, inc.
FAQ
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