Form 10-Q - Quarterly report [Sections 13 or 15(d)]

Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

_______________________________________________________

FORM 10-Q

_______________________________________________________

(Mark One)


x			QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.

For the quarterly period ended September 30, 2023


o			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to

Commission file number 001-40332

_______________________________________________________

agilon health, inc.

(Exact name of registrant as specified in its charter)


Delaware			37-1915147
(State or other jurisdiction of incorporation or organization)			(I.R.S. Employer Identification No.)

6210 E Hwy 290, Suite 450

Austin, TX 78723

(Address of principal executive offices)

(562) 256-3800

(Registrant’s telephone number, including area code)

(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:


Title of each class	Trading symbol(s)	Name of each exchange on which registered
Common stock, $0.01 par value	AGL	New York Stock Exchange

_______________________________________________________

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x NO o

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or such shorter period that the registrant was required to submit such files). Yes x No o

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large Accelerated Filer

Accelerated Filer

Non-accelerated Filer

Smaller Reporting Company

Emerging Growth Company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act) YES o NO x

At October 27, 2023, there were 406,040,924 shares of the registrant’s $0.01 par value common stock outstanding.

Table of Contents

agilon health, inc.

INDEX


PART I. FINANCIAL INFORMATION

Item 1.	Financial Statements:

	Condensed Consolidated Balance Sheets as of September 30, 2023 and December 31, 2022	3

	Condensed Consolidated Statements of Operations for the Three and Nine Months Ended September 30, 2023 and 2022	4

	Condensed Consolidated Statements of Comprehensive Income (Loss) for the Three and Nine Months Ended September 30, 2023 and 2022	5

	Condensed Consolidated Statements of Stockholders’ Equity (Deficit) for the Three and Nine Months Ended September 30, 2023 and 2022	6

	Condensed Consolidated Statements of Cash Flows for the Nine Months Ended September 30, 2023 and 2022	8

	Notes to the Condensed Consolidated Financial Statements	9

Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	20

Item 3.	Quantitative and Qualitative Disclosures About Market Risk	37

Item 4.	Controls and Procedures	37

PART II. OTHER INFORMATION

Item 1.	Legal Proceedings	39

Item 1A.	Risk Factors	39

Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	39

Item 5 .	Other Information	39

Item 6.	Exhibits	40

Signatures		41

Table of Contents

PART I. FINANCIAL INFORMATION

Item 1. Financial Statements

agilon health, inc.

CONDENSED CONSOLIDATED BALANCE SHEETS

(in thousands, except per share data)


	September 30, 2023		December 31, 2022
	(unaudited)
ASSETS
Current assets:
Cash and cash equivalents	$	168,339	$	497,070
Restricted cash and equivalents	10,204		10,610
Marketable securities	395,878		411,901
Receivables, net	1,345,711		497,574
Prepaid expenses and other current assets	36,512		34,119
Total current assets	1,956,644		1,451,274
Property and equipment, net	26,203		20,050
Intangible assets, net	92,657		67,680
Goodwill	62,387		41,540
Other assets, net	140,184		116,924
Total assets	$	2,278,075	$	1,697,468
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)
Current liabilities:
Medical claims and related payables	$	1,005,762	$	346,727
Accounts payable and accrued expenses	290,563		183,364
Current portion of long-term debt	5,000		5,000
Total current liabilities	1,301,325		535,091
Long-term debt, net of current portion	34,780		38,482
Other liabilities	70,370		83,286
Total liabilities	1,406,475		656,859

Commitments and contingencies

Stockholders' equity (deficit):
Common stock, $0.01 par value: $2,000,000 shares authorized; 405,980 and 412,385 shares issued and outstanding, respectively	4,060		4,124
Additional paid-in capital	1,970,930		2,106,886
Accumulated deficit	(1,096,393)		(1,064,230)
Accumulated other comprehensive income (loss)	(6,230)		(5,560)
Total agilon health, inc. stockholders' equity (deficit)	872,367		1,041,220
Noncontrolling interests	(767)		(611)
Total stockholders’ equity (deficit)	871,600		1,040,609
Total liabilities and stockholders’ equity (deficit)	$	2,278,075	$	1,697,468

The condensed consolidated balance sheets include assets and liabilities of consolidated variable interest entities (“VIEs”) as agilon health, inc., together with its consolidated subsidiaries and variable interest entities (the “Company”), is the primary beneficiary of these VIEs. The condensed consolidated balance sheets include total assets that can only be used to settle obligations of the Company’s consolidated VIEs totaling $1.48 billion and $703.30 million as of September 30, 2023 and December 31, 2022, respectively, and total liabilities of the Company’s consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $1.23 billion and $462.40 million as of September 30, 2023 and December 31, 2022, respectively. See Note 14 for additional details.

See accompanying Notes to the Condensed Consolidated Financial Statements.

Table of Contents

agilon health, inc.

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

(in thousands, except per share data)

(unaudited)


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Revenues:
Medical services revenue	$	1,212,132	$	693,934	$	3,494,006	$	2,015,541
Other operating revenue	3,528		924		6,853		2,896
Total revenues	1,215,660		694,858		3,500,859		2,018,437
Expenses:
Medical services expense	1,104,396		618,287		3,085,957		1,771,635
Other medical expenses	80,787		50,659		249,936		144,512
General and administrative (including noncash stock-based compensation expense of $20,736, $7,907, $53,980 and $18,430, respectively)	74,138		51,980		222,483		143,738
Depreciation and amortization	5,310		3,450		15,014		9,865
Total expenses	1,264,631		724,376		3,573,390		2,069,750
Income (loss) from operations	(48,971)		(29,518)		(72,531)		(51,313)
Other income (expense):
Income (loss) from equity method investments	14,659		(4,314)		24,507		3,473
Other income (expense), net	5,690		4,888		21,001		6,367
Gain (loss) on lease terminations	—		—		—		(5,458)
Interest expense	(1,651)		(1,000)		(4,772)		(2,816)
Income (loss) before income taxes	(30,273)		(29,944)		(31,795)		(49,747)
Income tax benefit (expense)	(1,210)		(559)		(524)		(1,068)
Income (loss) from continuing operations	(31,483)		(30,503)		(32,319)		(50,815)
Discontinued operations:
Income (loss) before income taxes	—		(224)		—		526
Income tax benefit (expense)	—		(12)		—		(26)
Total discontinued operations	—		(236)		—		500
Net income (loss)	(31,483)		(30,739)		(32,319)		(50,315)
Noncontrolling interests’ share in (earnings) loss	47		71		156		228
Net income (loss) attributable to common shares	$	(31,436)	$	(30,668)	$	(32,163)	$	(50,087)

Net income (loss) per common share, basic and diluted
Continuing operations	$	(0.08)	$	(0.07)	$	(0.08)	$	(0.12)
Discontinued operations	$	—	$	—	$	—	$	—
Weighted average shares outstanding
Basic	405,787		411,065		412,077		406,823
Diluted	405,787		411,065		412,077		406,823

See accompanying Notes to the Condensed Consolidated Financial Statements.

Table of Contents

agilon health, inc.

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)

(in thousands)

(unaudited)


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Net income (loss)	$	(31,483)	$	(30,739)	$	(32,319)	$	(50,315)
Other comprehensive income (loss):
Net unrealized gain (loss) on marketable securities, net of tax	114		(5,611)		(758)		(5,098)
Foreign currency translation adjustment	25		—		88		—
Total comprehensive income (loss)	(31,344)		(36,350)		(32,989)		(55,413)
Comprehensive (income) loss attributable to noncontrolling interests	47		71		156		228
Total comprehensive income (loss) attributable to agilon health, inc.	$	(31,297)	$	(36,279)	$	(32,833)	$	(55,185)

See accompanying Notes to the Condensed Consolidated Financial Statements.

Table of Contents

agilon health, inc.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

(in thousands)

(unaudited)

For the three months ended September 30, 2023:


	Total Stockholders’ Equity
	Common Stock			Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Income (loss)		Noncontrolling Interest		Total Stockholders’ Equity (Deficit)
	Shares	Amount
July 1, 2023	405,427	$	4,054	$	1,947,438	$	(1,064,957)	$	(6,369)	$	(720)	$	879,446
Net income (loss)	—	—		—		(31,436)		—		(47)		(31,483)
Other comprehensive income (loss)	—	—		—		—		139		—		139
Exercise of stock options	424	5		2,718		—		—		—		2,723
Vesting of restricted stock units	132	1		(1)		—		—		—		—
Shares withheld related to net share settlement	(3)	—		(63)		—		—		—		(63)
Common stock repurchase	—	—		102		—		—		—		102
Stock-based compensation expense	—	—		20,736		—		—		—		20,736
September 30, 2023	405,980	$	4,060	$	1,970,930	$	(1,096,393)	$	(6,230)	$	(767)	$	871,600

For the three months ended September 30, 2022:


	Total Stockholders’ Equity
	Common Stock			Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Income (loss)		Noncontrolling Interest		Total Stockholders’ Equity (Deficit)
	Shares	Amount
July 1, 2022	408,204	$	4,082	$	2,076,329	$	(977,096)	$	513	$	(457)	$	1,103,371
Net income (loss)	—	—		—		(30,668)		—		(71)		(30,739)
Other comprehensive income (loss)	—	—		—		—		(5,611)		—		(5,611)
Exercise of stock options	3,390	33		10,356		—		—		—		10,389
Vesting of restricted stock units	149	2		(2)		—		—		—		—
Shares withheld related to net share settlement	(2)	—		(28)		—		—		—		(28)
Stock-based compensation expense	—	—		7,907		—		—		—		7,907
September 30, 2022	411,741	$	4,117	$	2,094,562	$	(1,007,764)	$	(5,098)	$	(528)	$	1,085,289

Table of Contents

agilon health, inc.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT)

(in thousands)

(unaudited)

For the nine months ended September 30, 2023:


	Total Stockholders’ Equity
	Common Stock			Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Income (loss)		Noncontrolling Interest		Total Stockholders’ Equity (Deficit)
	Shares	Amount
January 1, 2023	412,385	$	4,124	$	2,106,886	$	(1,064,230)	$	(5,560)	$	(611)	$	1,040,609
Net income (loss)	—	—		—		(32,163)		—		(156)		(32,319)
Other comprehensive income (loss)	—	—		—		—		(670)		—		(670)
Exercise of stock options	2,691	27		13,241		—		—		—		13,268
Vesting of restricted stock units	584	6		(6)		—		—		—		—
Shares withheld related to net share settlement	(65)	(1)		(1,805)		—		—		—		(1,806)
Common stock repurchase	(9,615)	(96)		(201,366)		—		—		—		(201,462)
Stock-based compensation expense	—	—		53,980		—		—		—		53,980
September 30, 2023	405,980	$	4,060	$	1,970,930	$	(1,096,393)	$	(6,230)	$	(767)	$	871,600

For the nine months ended September 30, 2022:


	Total Stockholders’ Equity
	Common Stock			Additional Paid-In Capital		Accumulated Deficit		Accumulated Other Comprehensive Income (loss)		Noncontrolling Interests		Total Stockholders’ Equity (Deficit)
	Shares	Amount
January 1, 2022	400,095	$	4,001	$	2,045,572	$	(957,677)	$	—	$	(300)	$	1,091,596
Net income (loss)	—	—		—		(50,087)		—		(228)		(50,315)
Other comprehensive income (loss)	—	—		—		—		(5,098)		—		(5,098)
Exercise of stock options	11,392	113		31,349		—		—		—		31,462
Vesting of restricted stock units	289	3		(3)		—		—		—		—
Shares withheld related to net share settlement	(35)	—		(786)		—		—		—		(786)
Stock-based compensation expense	—	—		18,430		—		—		—		18,430
September 30, 2022	411,741	$	4,117	$	2,094,562	$	(1,007,764)	$	(5,098)	$	(528)	$	1,085,289

See accompanying Notes to the Condensed Consolidated Financial Statements.

Table of Contents

agilon health, inc.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands)

(unaudited)


	Nine Months Ended September 30,
	2023		2022
Cash flows from operating activities:
Net income (loss)	$	(32,319)	$	(50,315)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation and amortization	15,014		9,865
Stock-based compensation expense	53,980		18,430
Loss (income) from equity method investments	(24,507)		(3,473)
Other noncash items	(1,511)		4,261
Changes in operating assets and liabilities	(105,690)		(59,617)
Net cash provided by (used in) operating activities	(95,033)		(80,849)
Cash flows from investing activities:
Purchase of property and equipment, net	(11,898)		(11,937)
Purchase of intangible assets	(3,535)		(12,415)
Investment in loans receivable and other	(8,778)		(4,510)
Investments in marketable securities	(107,020)		(423,183)
Proceeds from maturities and sales of marketable securities and other	133,894		15,127
Net cash paid in business combination	(44,479)		—
Proceeds from sale of business and property, net of cash divested	—		500
Net cash provided by (used in) investing activities	(41,816)		(436,418)
Cash flows from financing activities:
Proceeds from equity issuances, net	11,462		30,676
Common stock repurchase	(200,000)		—
Repayments of long-term debt	(3,750)		(3,750)
Net cash provided by (used in) financing activities	(192,288)		26,926
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents	(329,137)		(490,341)
Cash, cash equivalents and restricted cash and equivalents, beginning of period	507,680		1,054,820
Cash, cash equivalents and restricted cash and equivalents, end of period	$	178,543	$	564,479

See accompanying Notes to the Condensed Consolidated Financial Statements.

Table of Contents

agilon health, inc.

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(Unaudited)


NOTE 1. Business

Description of Business

agilon health, inc., through its partnerships and platform, provides the necessary capabilities, capital, and business model for existing physician groups to create a Medicare-centric, globally capitated line of business. As of September 30, 2023, the Company, through its contracted physician networks, provided care to approximately 420,300 Medicare Advantage members enrolled with private health plans. Beginning January 1, 2023, the Company expanded its operations into: (i) Portland, Maine, (ii) St. Paul, Minnesota, (iii) Detroit, Michigan, (iv) Charleston, South Carolina; (v) Statesville, North Carolina; and (vi) Jackson, Tennessee, along with additional partnerships in the Company’s existing Texas markets.

See Note 14 for additional discussions related to the Company’s involvement with VIEs.

The Company’s largest shareholder is an investment fund associated with Clayton Dubilier & Rice, LLC (“CD&R”), a private equity firm. All funds affiliated with CD&R are considered related parties.

Subsequent Events

On October 27, 2023, the Company entered into a definitive agreement to sell MDX Hawaii, Inc. (“MDX Hawaii”), a wholly-owned subsidiary, and its related operations. Acquired by agilon in 2016, MDX Hawaii is a provider network with fully-delegated risk contracts and management services organization capabilities, including claims processing and utilization management. The sale of MDX Hawaii and its related operations closed on October 31, 2023.


NOTE 2. Summary of Significant Accounting Policies

Basis of Presentation

The accompanying condensed consolidated financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). The condensed consolidated financial statements include the accounts of agilon health, inc., its wholly-owned subsidiaries, and both joint ventures and VIEs that it controls through voting rights or other means. Intercompany transactions and balances have been eliminated upon consolidation. All adjustments (consisting of normal recurring adjustments unless otherwise indicated), which the Company considers necessary to present fairly its financial position, results of operations, and cash flows, have been included. Operating results for the three and nine months ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. The accompanying condensed consolidated financial information should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2022 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission.

Use of Estimates

Management is required to make estimates and assumptions in the preparation of financial statements. These estimates and assumptions affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant estimates can include, among other things, those used to determine revenues and related receivables from risk adjustments, medical services expense and related payables (including the reserve for incurred but not reported (“IBNR”) claims), and valuation of long-lived assets, goodwill and intangible assets (acquired in business combinations and analysis of impairment). Management’s estimates for revenue recognition, medical services expense, and other estimates, judgments, and assumptions, may be materially and adversely different from actual results. These estimates are based on knowledge of current events and anticipated future events, and accordingly, actual results may ultimately differ materially from those estimates.

Table of Contents

Property and Equipment

As of September 30, 2023 and December 31, 2022, the Company’s gross carrying amount of property and equipment was $38.6 million and $29.5 million, with accumulated depreciation of $12.4 million and $9.4 million, respectively. For the three months ended September 30, 2023 and 2022, the Company recognized $2.1 million and $1.4 million, respectively, in depreciation expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations. For the nine months ended September 30, 2023 and 2022, the Company recognized $5.6 million and $2.7 million, respectively, in depreciation expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations.

Income Taxes

The Company determined the income tax provision for interim periods using an estimate of the Company’s annual effective tax rate, applied to year-to-date results, adjusted for discrete items arising in that quarter. In each quarter, the Company updates its estimated annual effective tax rate, and if the estimated annual effective tax rate changes, a cumulative catch-up adjustment is recorded in that quarter. The Company applied the intra-period tax allocation rules to allocate income taxes between continuing operations and discontinued operations as prescribed in U.S. GAAP, where the tax effect of income (loss) before income taxes from continuing operations is computed without regard to the tax effects of income (loss) before income taxes from the other categories.


NOTE 3. Revenue, Receivables, and Concentration of Credit Risk

Medical Services Revenue

Medical services revenue consists of capitation fees under contracts with various Medicare Advantage payors (“payors”). Under the typical capitation arrangement, the Company is entitled to monthly per-member, per-month (“PMPM”) fees to provide a defined range of healthcare services for Medicare Advantage health plan members (“members”) attributed to the Company’s contracted primary care physicians. PMPM fees are determined as a percent of the premium payors receive from the Centers for Medicare & Medicaid Services’ (“CMS”) for these members. The Company generally accepts full financial risk for members attributed to its contracted primary care physicians and therefore is responsible for the cost of all healthcare services required by those members. Fees are generally recorded gross in revenue because the Company is acting as a principal in coordinating and controlling the range of services provided (other than clinical decisions) under its capitation contracts with payors. Capitation contracts with payors are generally multi-year arrangements and have a single performance obligation that constitutes a series, as defined by Accounting Standards Codification (“ASC”) 606, Revenue From Contracts With Customers (“ASC 606”), to stand ready on a monthly basis to provide all aspects of necessary medical care to members for the contracted period. The Company recognizes revenue in the month in which eligible members are entitled to receive healthcare benefits during the contract term.

The transaction price for the Company’s capitation contracts is variable, as the PMPM fees to which the Company is entitled are subject to periodic adjustment under CMS’s risk adjustment payment methodology. CMS deploys a risk adjustment model that determines premiums paid to all payors according to each member’s health status and certain demographic factors. Under this risk adjustment methodology, CMS calculates the risk adjusted premium payment using diagnosis data from various settings. The Company and healthcare providers collect and submit the necessary and available diagnosis data to payors and such data is utilized by the Company to estimate risk adjustment payments to be received in subsequent periods. Risk adjustment-related revenues are estimated using the most likely amount methodology and amounts are only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. PMPM fees are also subject to adjustment for incentives or penalties based on the achievement of certain quality metrics defined in the Company’s contracts with payors. The Company recognizes incentive revenue as earned using the most likely amount methodology and only to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved.

Neither the Company nor any of its affiliates is a registered insurance company because state law in the states in which it operates does not require such registration for risk-bearing providers.

Receivables

Receivables primarily consist of amounts due under capitation contracts with various payors. Receivables due under capitation contracts are recorded monthly based on reports received from payors and management’s estimate of risk

Table of Contents

adjustment payments to be received in subsequent periods for open performance years. Receivables are recorded at the amount expected to be realized.

Concentration

The Company contracts with various payors whereby the Company is entitled to monthly PMPM fees to provide a defined range of healthcare services for members attributed to its contracted primary care physicians. The Company generally accepts full financial risk for such members and therefore is responsible for the cost of all healthcare services required by them. Substantially all of the Company’s receivable balances are from a small number of payors. Revenue from Medicare Advantage payors constitutes substantially all of the Company’s total revenue for the three and nine months ended September 30, 2023 and 2022.

The following table provides the Company’s revenue concentration with respect to major payors as a percentage of the Company’s total revenues:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Payor A	24	%	26	%	24	%	25	%
Payor B	14	%	19	%	15	%	19	%
Payor C	18	%	14	%	17	%	14	%

Payor F	10	%	*		10	%	*

___________________________________________

*Less than 10% of total revenues.

The following table provides the Company’s concentration of credit risk with respect to major payors as a percentage of receivables, net:


	September 30, 2023		December 31, 2022
Payor A	*		13	%
Payor B	18	%	20	%
Payor C	12	%	10	%
Payor D	*		10	%
Payor E	*		11	%
Payor F	26	%	*

___________________________________________

*Less than 10% of total receivables.


NOTE 4. Marketable Securities and Fair Value Measurements

Marketable Securities

The following table summarizes the Company’s marketable securities (in thousands):


	September 30, 2023								December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value		Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Marketable securities:
Corporate debt securities	$	241,723	$	—	$	(3,515)	$	238,208	$	255,613	$	60	$	(3,240)	$	252,433
U.S. Treasury notes	150,473		—		(2,751)		147,722		151,873		—		(2,306)		149,567
Other	10,000		—		(52)		9,948		9,975		—		(74)		9,901
	$	402,196	$	—	$	(6,318)	$	395,878	$	417,461	$	60	$	(5,620)	$	411,901

Table of Contents

At September 30, 2023 and December 31, 2022, marketable securities of $373.3 million and $407.4 million, respectively, were in an unrealized loss position for less than twelve months. The Company’s unrealized losses from marketable securities as of September 30, 2023 and December 31, 2022 were caused primarily by interest rate increases. The Company does not intend to sell marketable securities that are in an unrealized loss position, and it is not more likely than not that the Company will be required to sell the investments before recovery of their amortized cost bases, which may be at maturity. Therefore, the Company believes these losses to be temporary. There was no allowance for credit losses on available-for-sale marketable securities at September 30, 2023 and December 31, 2022.

The following table summarizes the Company’s marketable securities maturity as of September 30, 2023 (in thousands):


Year	Amortized Cost		Fair Value
2023	$	27,922	$	27,826
2024	155,006		153,241
2025	183,796		179,855
2026	35,472		34,956
	$	402,196	$	395,878

Fair Value Measurements

The Company’s financial instruments consist of cash and cash equivalents, restricted cash and cash equivalents, marketable securities, receivables, other liabilities, accounts payable, certain accrued expenses, and borrowings which consist of a term loan and a revolving credit facility. The carrying values of the financial instruments classified as current in the consolidated balance sheets approximate their fair values due to their short-term maturities. The Company's cash and cash equivalents are classified within Level 1 of the fair value hierarchy. The Company may be required, from time to time, to measure its loans to physician partner groups, primarily in connection with taxes payable on shares distributed to them upon completion of the initial public offering ("IPO"), at fair value on a nonrecurring basis. Such measurements are classified within Level 2 of the fair value hierarchy. The carrying values of the term loan and revolving credit facility are a reasonable estimate of fair value because the interest rates on such borrowings approximate market rates as of the reporting date. Such borrowings are classified within Level 2 of the fair value hierarchy. During the three and nine months ended September 30, 2023 and 2022, there were no material transfers of financial assets or liabilities within the fair value hierarchy.

The Company measures and discloses the fair value of nonfinancial and financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy:

•Level 1—quoted prices for identical instruments in active markets;

•Level 2—quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and

•Level 3—fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.

Table of Contents

The table below summarizes the Company’s financial instruments measured at fair value on a recurring basis (in thousands):


	September 30, 2023						December 31, 2022
	Level 1		Level 2		Level 3		Level 1		Level 2		Level 3
Marketable securities:
Corporate debt securities	$	—	$	238,208	$	—	$	—	$	252,433	$	—
U.S. Treasury notes	147,722		—		—		149,567		—		—
Other	9,948		—		—		9,901		—		—
	$	157,670	$	238,208	$	—	$	159,468	$	252,433	$	—


NOTE 5. Other Assets, net

The following table summarizes the Company’s other assets, net (in thousands):


	September 30, 2023		December 31, 2022
Loans to physician partners	$	70,475	$	69,383
Health plan deposits	12,051		11,728
Equity method investments(1)	39,170		17,352
Right-of-use lease assets	14,594		13,029
Other	3,894		5,432
	$	140,184	$	116,924

___________________________________________

(1)See Note 14 for additional discussion related to the Company's equity method investments.

Loans to Physician Partners

Loans to physician partners primarily represent loans in connection with taxes payable on shares distributed to them in connection with the IPO. These loans mature between 2026 and 2031 with nominal interest compounding annually and no prepayment penalties. Such loans are stated at the amount expected to be collected.


NOTE 6. Medical Claims and Related Payables

Medical services expense represents costs incurred for medical services provided to members by physicians, hospitals and other ancillary providers for which the Company is financially responsible and that are paid either directly by the Company or by payors with whom the Company has contracted. Medical services expenses are recognized in the period in which services are provided and include estimates of claims that have been incurred but have either not yet been received, processed, or paid and as such, not reported.

Such estimates are developed using actuarial methods commonly used by health insurance actuaries that include a number of factors and assumptions including medical service utilization trends, changes in membership, observed medical cost trends, historical claim payment patterns and other factors. Generally, for the most recent months, the Company estimates claim costs incurred by applying observed medical cost trend factors to the average PMPM medical costs incurred in prior months for which more complete claims data are available.

Each period, the Company re-examines previously established medical claims payable estimates based on actual claim submissions and other changes in facts and circumstances. As more complete claims information becomes available, the Company adjusts its estimates and recognizes those changes in estimates in the period in which the change is identified. The difference between the estimated liability and the actual settlements of claims is recognized in the period the claims are settled. The Company’s medical claims payable balance represents management’s best estimate of its liability for unpaid medical costs as of September 30, 2023 and 2022. The Company uses judgment to determine the appropriate assumptions for developing the required estimates.

Table of Contents

The following table presents the components of changes in medical claims and related payables (in thousands):


	September 30,
	2023		2022
Medical claims and related payables, beginning of the year	$	339,748	$	239,014
Components of incurred costs related to:
Current year	3,032,501		1,756,943
Prior years	53,456		14,692
Discontinued operations - prior years	—		—
	3,085,957		1,771,635
Claims paid related to:
Current year	(2,046,004)		(1,283,242)
Prior years	(387,161)		(236,413)
Discontinued operations - prior years	—		(154)
	(2,433,165)		(1,519,809)
Medical claims and related payables, end of the period	$	992,540	$	490,840

Medical claims and related payables also include $13.2 million and $7.0 million, as of September 30, 2023 and December 31, 2022, respectively, that is recoverable from other parties under risk sharing arrangements and is presented as prepaid expenses and other current assets, net in the condensed consolidated balance sheets. Medical claims and related payables presented in the periods above include immaterial balances related to claims liabilities associated with certain divested California businesses for which the Company has retained the liability for claims incurred prior to the date of divestiture.


NOTE 7. Other Liabilities

The following table summarizes the Company’s other liabilities (in thousands):


	September 30, 2023		December 31, 2022
Other long-term contingencies	$	49,523	$	62,931
Lease liabilities, long-term	11,975		9,885
Equity method liabilities – ACO REACH	—		4,657
Other	8,872		5,813
	$	70,370	$	83,286

As of September 30, 2023 and December 31, 2022, the Company’s accruals for contingent liabilities related to unasserted claims were $49.5 million and $62.9 million, respectively. The accrued amounts represent the Company’s estimate of probable losses in accordance with ASC Topic 450, Contingencies. The Company’s estimate of the range of reasonably possible losses in excess of such accruals was $0 to $69.1 million as of September 30, 2023.

See Note 14 for equity method liabilities related to the Company's ACO REACH investments.


NOTE 8. Debt

On February 18, 2021, the Company executed a credit facility agreement (as amended by the First Amendment to Credit Agreement, dated as of March 1, 2021 and the Second Amendment to Credit Agreement, dated as of May 25, 2023, the “Credit Facilities”). The Credit Facilities include: (i) a $100.0 million secured term loan (the “Secured Term Loan Facility”) and (ii) a $100.0 million senior secured revolving credit facility (the “Secured Revolving Facility”) with a capacity to issue standby letters of credit in certain circumstances up to a maximum of $100.0 million. Subject to specified conditions and receipt of commitments, the Secured Term Loan Facility may be expanded (or a new term loan facility, revolving credit facility or letter of credit facility added) by up to (i) $50.0 million plus (ii) an additional amount

Table of Contents

determined in accordance with a formula tied to repayment of certain of the Company’s indebtedness. The maturity date of the Credit Facilities is February 18, 2026.

As of September 30, 2023, the Company had $40.0 million outstanding under the Secured Term Loan Facility and availability under the Secured Revolving Facility was $32.9 million, as the Company had outstanding letters of credit totaling $67.1 million, of which $37.2 million was for the Company's ACO REACH investments. The standby letters of credit are automatically extended without amendment for one-year periods, unless the Company notifies the institution in advance of the expiration date that the letter will be terminated. No amounts have been drawn on the outstanding letters of credit as of September 30, 2023.

Effective with the Second Amendment to Credit Agreement on May 25, 2023, the Company transitioned to the Secured Overnight Financing Rate ("SOFR") as a benchmark interest rate used in the Credit Agreement. At the Company’s option, borrowings under the agreement can be either: (i) SOFR Rate Loans, (ii) Daily Simple SOFR Rate Loans, or (iii) Base Rate Loans. Daily Simple SOFR Rate Loans and SOFR Rate Loans bear interest at a rate equal to the sum of 4.00% (stepping down to 3.50% on and following October 1, 2023) and the higher of (a) SOFR, as defined in the credit agreement, and (b) 0%. Base Rate Loans bear interest at a rate equal to the sum of 3.00% (stepping down to 2.50% on and following October 1, 2023) and the highest of: (a) 0.50% in excess of the overnight federal funds rate, (b) the prime rate established by the administrative agent from time to time, (c) the one-month LIBO rate (adjusted for maximum reserves) plus 1.00% and (d) 0%. Additionally, the Company pays a commitment fee on the unfunded 2021 Revolving Credit Facility amount of 0.50% (stepping down to 0.375% on and following October 1, 2023). The Company must also pay customary letter of credit fees. As of September 30, 2023, the effective interest rate on the Secured Term Loan Facility was 9.349%.

The Credit Facilities are guaranteed by certain of the Company’s subsidiaries, including those identified as VIEs, and contain customary covenants including, among other things, limitations on restricted payments including: (i) dividends and distributions from restricted subsidiaries, (ii) requirements of minimum financial ratios, and (iii) limitation on additional borrowings based on certain financial ratios. Failure to meet any of these covenants could result in an event of default under the agreement. If an event of default occurs, the lenders could elect to declare all amounts outstanding under the agreement to be immediately due and payable. As of September 30, 2023, the Company was in compliance with all covenants under the Credit Facilities.


NOTE 9. Commitments and Contingencies

Legal Proceedings

From time to time, the Company is a party to, or has a significant relationship to, legal proceedings, lawsuits, and other claims. The Company is not aware of any legal proceedings or claims that it believes may have, individually or taken together, a material adverse effect on the Company’s financial condition, results of operations or cash flows. The Company’s policy is to expense legal costs as they are incurred.


NOTE 10. Common Stock

Common Stock

2023. During the three months ended September 30, 2023, the Company issued approximately 0.6 million shares of common stock primarily in connection with exercises and vesting of stock-based awards. During the nine months ended September 30, 2023, the Company issued approximately 3.2 million shares of common stock primarily in connection with exercises and vesting of stock-based awards.

On May 18, 2023, the Company repurchased and retired 9.6 million shares of common stock pursuant to an underwritten secondary public offering of 94.6 million shares of its common stock by CD&R. The Company paid approximately $20.80 per share, which is the same per share price paid by the underwriters to CD&R in the offering.

2022. During the three months ended September 30, 2022, the Company issued approximately 3.5 million shares of common stock primarily in connection with exercises and vesting of stock-based awards. During the nine months ended September 30, 2022, the Company issued approximately 11.6 million shares of common stock primarily in connection with exercises and vesting of stock-based awards.

Table of Contents


NOTE 11. Net Income (Loss) Per Common Share

Basic net income (loss) per common share (“EPS”) is computed based upon the weighted average number of common shares outstanding. Diluted net income (loss) per common share is computed based upon the weighted average number of common shares outstanding plus the impact of common shares issuable from the assumed conversion of stock options, certain performance restricted stock units, and unvested restricted stock units. Only those instruments having a dilutive impact on basic net income (loss) per share are included in diluted net income (loss) per share during the periods presented.

The following table illustrates the computation of basic and diluted EPS (in thousands, except per share amounts):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator
Income (loss) from continuing operations	$	(31,483)	$	(30,503)	$	(32,319)	$	(50,815)
Noncontrolling interests’ share in (earnings) loss from continuing operations	47		71		156		228
Net income (loss) attributable to common stockholders before discontinued operations	(31,436)		(30,432)		(32,163)		(50,587)
Income (loss) from discontinued operations	—		(236)		—		500
Net income (loss) attributable to common stockholders	$	(31,436)	$	(30,668)	$	(32,163)	$	(50,087)
Denominator
Weighted average shares outstanding – basic	405,787		411,065		412,077		406,823
Weighted average shares outstanding – diluted	405,787		411,065		412,077		406,823
Net income (loss) per share attributable to common stockholders
Net income (loss) per common share from continuing operations, basic and diluted	$	(0.08)	$	(0.07)	$	(0.08)	$	(0.12)
Net income (loss) per common share from discontinued operations, basic and diluted	$	—	$	—	$	—	$	—

The following table provides the weighted-average potential shares of common stock that were excluded from the calculation of diluted net income (loss) per share attributable to common stockholders because their effect would have been anti-dilutive (in thousands):


	September 30,
	2023	2022
Stock options	17,424	20,474
Restricted stock units	9,183	1,908


NOTE 12. Goodwill and Amortizable Intangible Assets

As of September 30, 2023 and December 31, 2022, the Company’s goodwill balance was $62.4 million and $41.5 million, respectively, of which $39.0 million was allocated to the Company’s Hawaii reporting unit. The carrying value of the Hawaii reporting unit was negative as of September 30, 2023 and December 31, 2022. There were no events or circumstances that warranted an interim impairment test for goodwill during the three and nine months ended September 30, 2023.

As of September 30, 2023 and December 31, 2022, the Company’s gross carrying amount of amortizable intangible assets was $165.1 million and $130.8 million, with accumulated amortization of $72.4 million and $63.1 million, respectively. For the three months ended September 30, 2023 and 2022, the Company recognized $3.2 million and $2.1 million, respectively, in amortization expense, which is included in depreciation and amortization expense in the

Table of Contents

condensed consolidated statements of operations. For the nine months ended September 30, 2023 and 2022, the Company recognized $9.4 million and $7.2 million, respectively, in amortization expense, which is included in depreciation and amortization expense in the condensed consolidated statements of operations.

Acquisition

On February 28, 2023, the Company completed the acquisition of My Personal Health Record Express, Inc. (the “Acquisition”), a leading provider of value-based care technology and interoperability solutions for cash consideration of $44.5 million, net of cash acquired and subject to certain post-closing adjustments. The Company accounted for the Acquisition utilizing the acquisition method of accounting, which requires assets and liabilities to be recognized based on estimates of their acquisition date fair values. The determination of the values of the acquired assets and assumed liabilities, including other intangible assets and deferred taxes, requires significant judgment. While the Company uses its best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, the Company estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, the Company may record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Measurement period adjustments are recorded in the period in which they are determined, as if they had been completed at the acquisition date. Upon the conclusion of the final determination of the values of assets acquired or liabilities assumed, or one year after the date of acquisition, whichever comes first, any subsequent adjustments are recorded within the Company's consolidated results of operations. The following preliminary allocation of the purchase price related to the Acquisition based upon the fair value of assets and liabilities assumed included developed technology intangible assets of $25.7 million, customer relationship intangible assets of $1.9 million, and assumed net liabilities of $3.7 million, with the residual amount being recorded as goodwill of $20.6 million. The intangible assets acquired have a weighted-average life of 10 years.


NOTE 13. Supplemental Cash Flow Information

The following table provides supplemental cash flow information (in thousands):


	Nine Months Ended September 30,
	2023		2022
Supplemental cash flow information:
Interest paid	$	4,519	$	2,878
Income taxes paid	5,156		4,223
Supplemental disclosure of non-cash investing and financing activities:
Right-of-use asset obtained in exchange for new operating lease liability	3,612		7,288
Non-cash investment in unconsolidated subsidiaries	—		190

The following table summarizes cash, cash equivalents and restricted cash equivalents from continuing operations (in thousands):


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	168,339	$	497,070
Restricted cash and equivalents(1)	10,204		10,610
Cash, cash equivalents and restricted cash equivalents	$	178,543	$	507,680

___________________________________________

(1)Restricted cash and equivalents primarily consist of amounts used as collateral to secure letters of credit that the Company is required to maintain pursuant to contracts with payors.

Table of Contents


NOTE 14. Variable Interest Entities

Consolidated Variable Interest Entities

agilon health, inc.’s consolidated assets and liabilities as of September 30, 2023 and December 31, 2022 include certain assets of VIEs that can only be used to settle the liabilities of the related VIE. The VIE creditors do not have recourse to agilon health, inc.

agilon health, inc.’s consolidated assets and liabilities include VIE assets and liabilities as follows (in thousands):


	September 30, 2023		December 31, 2022
Assets
Cash and cash equivalents	$	86,581	$	155,819
Restricted cash equivalents	10,202		10,610
Receivables, net	1,334,394		492,077
Prepaid expenses and other current assets, net	20,781		15,515
Property and equipment, net	1,817		1,567
Intangible assets, net	20,187		17,347
Other assets, net	9,790		10,371
Liabilities
Medical claims and related payables	962,505		300,798
Accounts payable and accrued expenses	259,553		159,526
Other liabilities	4,188		2,059

Risk-bearing Entities. At September 30, 2023, the Company operates 29 wholly-owned risk-bearing entities (“RBEs”) for the purpose of entering into risk-bearing contracts with payors. Each RBE’s equity at risk is considered insufficient to finance its activities without additional support, and, therefore, each RBE is considered a VIE. The Company consolidates the RBEs as it has determined that it is the primary beneficiary because it has: (i) the ability to control the activities that most significantly impact the RBEs’ economic performance; and (ii) the obligation to absorb losses or right to receive benefits that could potentially be significant to the RBEs. Specifically, the Company has the unilateral ability and authority, through the RBE governance and management agreements, to make significant decisions about strategic and operating activities of the RBEs, including negotiating and entering into risk-bearing contracts with payors, and approving the RBEs’ annual operating budgets. The Company also has the obligation to fund losses of the RBEs and the right to receive a significant percentage of any financial surplus generated by the RBEs. The assets of the RBEs primarily consist of cash and cash equivalents, receivables, net, intangible assets, net, and other assets, net; its obligations primarily consist of medical claims and related payables as well as operating expenses of the RBEs (accounts payable and accrued expenses), including incentive compensation obligations to the Company’s physician partners. On February 18, 2021, the Company executed the Credit Facilities, which are guaranteed by certain of the Company’s VIEs. Assets generated by the RBEs (primarily from medical services revenues) may be used, in certain limited circumstances, to settle the Company’s contractual debt obligations.

Unconsolidated Variable Interest Entities

As of September 30, 2023, the Company had nine equity method investments (liabilities) that were deemed to be VIEs. The Company has determined that the activities that most significantly impact the performance of these VIEs consist of the allocation of resources to and other decisions related to clinical activities and provider contracting decisions. Because the Company does not have the ability to control these activities due to another party’s control of the VIEs’ board of directors, the Company has determined that it is not the primary beneficiary of and therefore does not consolidate these VIEs. The Company's maximum loss exposure as a result of the Company’s involvement with the VIEs cannot be quantified as the Company has the obligation to provide ongoing operational support to the unconsolidated VIEs, as needed.

Table of Contents

Equity Method Investments

The following table summarizes the Company’s equity method investments (in thousands):


	September 30, 2023		December 31, 2022
Equity method investments - Other(1)	$	9,114	$	8,329
Equity method investments - ACO REACH(1)	30,056		9,023
Equity method liabilities - ACO REACH(2)	—		(4,657)

___________________________________________

(1)Included in Other assets, net in the condensed consolidated balance sheets.

(2)Included in Other liabilities in the condensed consolidated balance sheets.

The Company is a partner in eight wholly-owned ACO REACH entities in collaboration with 12 of its physician group partners operating in 10 geographies. The combined summarized operating results of the Company’s ACO REACH entities are as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Medical services revenue	$	296,937	$	241,408	$	858,286	$	786,171
Medical services expense	(242,431)		(231,910)		(741,752)		(735,924)
Other medical expenses(1)	(31,970)		(9,215)		(71,138)		(34,019)
Income (loss) from operations	18,330		(3,035)		31,515		6,333
Net income (loss)(2)	14,628		(4,361)		24,388		3,345

___________________________________________

(1)For the three months ended September 30, 2023 and 2022, includes physician incentive expenses of $25.1 million and $2.9 million, respectively. For the nine months ended September 30, 2023 and 2022, includes physician incentive expenses of $51.4 million and $15.0 million, respectively.

(2)Included in Income (loss) from equity method investments in the condensed consolidated statements of operations.

The combined summarized balance sheet of the Company’s ACO REACH entities are as follows (in thousands):


	September 30, 2023		December 31, 2022
Current assets	$	165,257	$	70,625
Noncurrent assets	130		—
Total assets	165,387		70,625
Current and total liabilities	136,285		67,343

Table of Contents

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

All references in this report to “agilon,” “the Company”, “we,” “us” or “our” mean agilon health, inc., together with its consolidated subsidiaries. Unless the context suggests otherwise, references to “agilon health, inc.” mean the parent company without its subsidiaries.

Cautionary Language Regarding Forward-Looking Statements

Statements in this Quarterly Report on Form 10-Q (the “Report”) 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 (the “Exchange Act”). Some of the forward-looking statements can be identified by the use of forward-looking terms 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. Forward-looking statements include, without limitation, all matters that are not historical facts. They appear in a number of places throughout this Report and include, without limitation, statements regarding our intentions, beliefs, assumptions or current expectations concerning, among other things, our financial position, results of operations, cash flows, prospects, and growth strategies.

Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be outside our control. We caution you that forward-looking statements are not guarantees of future performance or outcomes and that actual performance and outcomes, including, without limitation, our actual results of operations, financial condition and liquidity, and the development of the market in which we operate, may differ materially from those made in or suggested by the forward-looking statements contained in this Report. In addition, even if our results of operations, financial condition, and cash flows, and the development of the market in which we operate, are consistent with the forward-looking statements contained in this Report, those results or developments may not be indicative of results or developments in subsequent periods. A number of important factors, including, without limitation, the risks and uncertainties discussed under Part I, Item 1A. “Risk Factors” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022, could cause actual results and outcomes to differ materially from those reflected in the forward-looking statements. As explained in greater detail under Item 9A. “Controls and Procedures” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022, we are undertaking a broad range of remedial procedures to address the material weaknesses in our internal control over financial reporting identified as of December 31, 2022. Our efforts to improve our internal controls are ongoing. Furthermore, new risks and uncertainties emerge from time to time, and it is not possible for us to predict all risks and uncertainties that could have an impact on the forward-looking statements contained in this Report. Factors that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, without limitation:

•our history of net losses, and our ability to achieve or maintain profitability in an environment of increasing expenses;

•our ability to identify and develop successful new geographies, physician partners and health plan payors, and to execute upon our growth initiatives and achieve required operational scale;

•our ability to execute our operating strategies or to achieve results consistent with our historical performance;

•our expectation that our expenses will increase in the future and the risk that medical expenses incurred on behalf of members may exceed the amount of medical revenues we receive;

•our ability to secure contracts with Medicare Advantage (“MA”) payors and to ensure such contracts are on financial terms sufficient to meet our financial targets;

•our ability to recover startup costs incurred during the initial stages of development of our physician partner relationships and program initiatives;

•our ability to obtain additional capital needed to support our business;

•significant reductions in our membership;

•challenges for our physician partners in the transition to our “Total Care Model”;

•inaccuracies in the estimates and assumptions we use to project the size, revenue or medical expense amounts of our target market;

Table of Contents

•the spread of, and response to, COVID-19, potential new variants of COVID-19 and entirely new pandemics, and the inability to predict the ultimate impact of pandemics on us;

•inaccuracies in the estimates and assumptions we use to project our members’ risk adjustment factors, medical services expense, incurred but not reported claims, and earnings under payor contracts;

•the impact of restrictive or exclusivity clauses in some of our contracts with physician partners that may prohibit us from establishing new risk-bearing entities (each, an “RBE”) within certain geographies in the future;

•the impact of restrictive or exclusivity clauses in some of our contracts with physician partners that may subject us to investigations or litigation;

•our ability to retain our management team and key employees or attract qualified personnel in the future;

•our ability to realize the full value of our intangible assets and any negative impact from impairment charges we may record;

•security breaches, loss of data and other disruptions to our data platforms could adversely impact us;

•our ability to protect the confidentiality of our know-how and other proprietary and internally developed information;

•our responsibility for certain liabilities in connection with the disposition of our California operations;

•our subsidiaries’ lack of performance or ability to fund their operations could require us to fund such losses;

•our dependence on a limited number of key health plan payors;

•our contracts with our payors are for limited terms and may not be renewed upon their expiration;

•our reliance on our health plan payors for membership attribution and assignment, data and reporting accuracy, and claims payment;

•our dependence on physician partners and other providers to effectively manage the quality and cost of care, and perform obligations under payor contracts;

•difficulties in obtaining accurate and complete diagnosis data;

•our dependence on physician partners to accurately, timely and sufficiently document their services and potential regulatory or other liability if any diagnosis information or encounter data are inaccurate or incorrect;

•we rely on third party software and data to operate our business and restrictions on the use of third-party resources could adversely affect us;

•our reliance on third parties for internet infrastructure and bandwidth to operate our business and provide services to our members and physician partners;

•consolidation in our industry could adversely impact us;

•reductions in reimbursement rates or methodology applied to derive reimbursement from, or discontinuation of, federal government healthcare programs, from which we derive substantially all of our total revenue;

•uncertain or adverse economic conditions, including a downturn or decrease in government expenditures, including as a result of an inability or failure by the U.S. federal government to fund Medicare;

•our ability to compete in our industry;

•the impact of government performance standards and benchmarks on our compensation and reputation;

•statutory or regulatory changes, administrative rulings, interpretations of policy, and determinations by intermediaries and governmental funding restrictions, and their impact on government funding, program coverage, and reimbursements;

•regulatory proposals directed at containing or lowering the cost of healthcare and our participation in such proposed models;

Table of Contents

•we, our physician partners or affiliates being subject to federal or state investigations, audits and enforcement actions;

•regulatory inquiries and corrective action plans imposed by our health plan payors;

•repayment obligations arising out of payor audits;

•the impact on our revenue of Centers for Medicare & Medicaid Services’ (“CMS”) modifying the methodology used to determine the revenue associated with MA members;

•negative publicity regarding the managed healthcare industry;

•the extensive regulation of the healthcare industry at the federal, state, and local levels;

•if our physician alignment strategies with our physician partners, including the formation of risk and shared savings pools, making downstream payments and joint venture arrangements, are not in compliance with the state and federal fraud and abuse laws, including physician incentive plan laws and regulations, we could be subject to penalties;

•our business development and member engagement activities may implicate laws and regulations regarding marketing, beneficiary inducements, telemarketing and the use of protected health information;

•our physician partners are subject to federal and state healthcare fraud and abuse regulations;

•our use, disclosure and processing of personally identifiable information, personal health information, and de-identified data is subject to HIPAA and state patient confidentiality laws, and our failure to comply with those regulations or to adequately secure the information we hold could adversely impact us;

•our failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization allowing our participation in downstream risk-sharing arrangements with payors could adversely impact us;

•laws regulating the corporate practice of medicine could restrict the manner in which we are permitted to conduct our business, and the failure to comply with such laws, or any changes to such laws or regulations or similar laws or regulations could adversely impact us;

•if we or our physician partners inadvertently employ or contract with an excluded person, we may face government sanctions;

•we may face litigation not covered by insurance;

•our indebtedness and the potential that we may incur additional substantial indebtedness;

•the agreements and instruments governing our indebtedness contain restrictions and limitations that could adversely impact us;

•agilon health is a holding company with no operations of its own, and it depends on its subsidiaries for cash to fund all of its operations and expenses;

•under our Certificate of Incorporation, the CD&R Investor and its affiliates and, in some circumstances, each of our directors and officers who is also a director, officer, employee, member or partner of the CD&R Investor and its affiliates, have no obligation to offer us corporate opportunities;

•anti-takeover provisions in our certificate of incorporation and by-laws could discourage, delay or prevent a change of control of our company and may affect the trading price of our common stock;

•we do not intend to pay dividends on our common stock for the foreseeable future and, consequently, a shareholder’s return on investment depends on appreciation in the price of our common stock;

•our certificate of incorporation designates the Court of Chancery of the State of Delaware as the sole and exclusive forum for certain litigation that may be initiated by our stockholders, which could limit our stockholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers or stockholders;

•we identified material weaknesses in our internal control over financial reporting and, if our remedial measures are insufficient to address the material weaknesses, or if significant deficiencies or material weaknesses in our internal control over financial reporting are discovered or occur in the future, it may adversely affect us; and

Table of Contents

•risks related to other factors discussed under “Risk Factors” in Annual Report on Form 10-K for the fiscal year ended December 31, 2022.

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.

The information set forth in this Item 2 is intended to provide readers with an understanding of our financial condition, changes in financial condition, and results of operations. We will discuss and provide our analysis in the following order:

•Overview and Recent Developments

•Key Financial and Operating Metrics

•Key Components of Our Results of Operations

•Results of Operations

•Non-GAAP Financial Measures

•Liquidity and Capital Resources

•Critical Accounting Policies and Estimates

•Recent Accounting Pronouncements

Overview and Recent Developments

Our business is transforming healthcare by empowering the primary care physicians (“PCPs”) to be the agent for change in the communities they serve. We believe that PCPs, with their intimate patient-physician relationships, are best positioned to drive meaningful change in quality, cost, and patient experience when provided with the right infrastructure and payment model. Through our combination of the agilon platform, a long-term partnership model with existing physician groups and a growing network of like-minded physicians, we are poised to revolutionize healthcare for seniors across communities throughout the United States. Our purpose-built model provides the necessary capabilities, capital, and business model for existing physician groups to create a Medicare-centric, globally capitated line of business. Our model operates by forming RBEs within local geographies, that enter into arrangements with payors providing for monthly payments to manage the total healthcare needs of our physician partners’ attributed patients (or, global capitation arrangements). The RBEs also contract with agilon to perform certain functions and enter into long-term professional service agreements with one or more anchor physician groups pursuant to which the anchor physician groups receive a base compensation rate and share in the savings from successfully improving quality of care and reducing costs.

Our business model is differentiated by its focus on existing community-based physician groups and is built around three key elements: (1) agilon’s platform; (2) agilon’s long-term physician partnership approach; and (3) agilon’s network. With our model, our goal is to remove the barriers that prevent community-based physicians from evolving to a Total Care Model, where the physician is empowered to manage health outcomes and the total healthcare needs of their attributed Medicare patients.

Third Quarter 2023 Results:

•Medicare Advantage members of approximately 420,300 as of September 30, 2023 increased 58% from September 30, 2022.

•ACO REACH attributed beneficiaries of approximately 87,700 as of September 30, 2023 decreased 2% from September 30, 2022.

•Total revenue of $1.22 billion increased 75% from the third quarter of 2022.

•Gross profit of $30 million, compared to $26 million in the third quarter of 2022.

•Medical margin of $108 million, compared to $76 million in the third quarter of 2022.

•Net loss of $31 million, compared to $31 million in the third quarter of 2022.

•Adjusted EBITDA loss of $6 million in the third quarter compared to an Adjusted EBITDA loss of $26 million in the third quarter 2022.

Table of Contents

Year to Date 2023 Results:

•Total revenue of $3.50 billion increased 73% from 2022.

•Gross profit of $165 million, compared to $102 million in 2022.

•Medical margin of $408 million, compared to $244 million in 2022.

•Net loss of $32 million, compared to $50 million in 2022.

•Adjusted EBITDA $28 million compared to an Adjusted EBITDA loss of $20 million in 2022.

Membership Details

Medicare Advantage members increased 58% from September 30, 2022, which includes contributions from new geographies and growth within geographies existing prior to 2023. Total members live on the platform includes 420,300 Medicare Advantage members and 87,700 attributed ACO REACH beneficiaries.

Average Medicare Advantage membership was 425,100 during the third quarter of 2023.

Subsequent Events

On October 27, 2023, we entered into a definitive agreement to sell MDX Hawaii, Inc. (“MDX Hawaii”), a wholly-owned subsidiary, and its related operations. Acquired by agilon in 2016, MDX Hawaii is a provider network with fully-delegated risk contracts and management services organization capabilities, including claims processing and utilization management. The sale of MDX Hawaii and its related operations closed on October 31, 2023.

Key Financial and Operating Metrics

All of our key metrics exclude historical results from our California operations (which are included as discontinued operations in our condensed consolidated financial statements).

We monitor the following key financial and operating metrics to help us evaluate our business, identify trends affecting our business, formulate business plans and make strategic decisions. We believe the following key metrics are useful in evaluating our business (dollars in thousands):


	As of and For the					As of and For the
	Three Months Ended September 30,					Nine Months Ended September 30,
	2023		2022		% Change	2023		2022		% Change
MA members	420,300		266,600		58	420,300		266,600		58
Medical services revenue	$	1,212,132	$	693,934	75	$	3,494,006	$	2,015,541	73
Gross profit	$	30,477	$	25,912	18	$	164,966	$	102,290	61
Medical margin(1)	$	107,736	$	75,647	42	$	408,049	$	243,906	67
Platform support costs	$	46,629	$	34,764	34	$	141,176	$	104,868	35
Net income (loss)	$	(31,483)	$	(30,739)	(2)	$	(32,319)	$	(50,315)	36
Adjusted EBITDA(1)	$	(5,777)	$	(25,839)	78	$	28,342	$	(20,473)	238

___________________________________________

(1)Medical margin and Adjusted EBITDA are non-GAAP financial measures. Gross profit is the most directly comparable financial measure calculated in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) to medical margin. Net income (loss) is the most directly comparable financial measure calculated in accordance with U.S. GAAP to Adjusted EBITDA. See “—Non-GAAP Financial Measures" for additional information.

Medicare Advantage Members

Our MA members include all individuals enrolled in an MA plan that are attributed to the PCPs on our platform at the end of a given period.

Table of Contents

Medical Services Revenue

Our medical services revenue consists of capitation revenue under contracts with various payors. Under the typical capitation arrangement, we are entitled to per member per month ("PMPM") fees to provide a defined range of healthcare services for MA health plan members through our contracted physician partners and affiliated PCPs. Such fees are typically based on a defined percentage of corresponding premium that payors receive from CMS. We recognize capitation revenue over the period eligible members are entitled to receive healthcare services.

Gross Profit

Gross profit represents the amount earned from total revenues less medical services expense and other medical expenses. Total revenues include medical services revenue and other operating revenue. The Company’s costs of revenues consist of medical services expense and other medical expenses, which represents the costs that are directly related to providing the services that generate revenue.

The following table presents our gross profit (dollars in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Total revenues	$	1,215,660	$	694,858	$	3,500,859	$	2,018,437
Medical services expense	(1,104,396)		(618,287)		(3,085,957)		(1,771,635)
Other medical expenses(1)	(80,787)		(50,659)		(249,936)		(144,512)
Gross profit	$	30,477	$	25,912	$	164,966	$	102,290

___________________________________________

(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, 2023 and 2022, costs incurred in implementing geographies were $10.3 million and $7.2 million, respectively. For the nine months ended September 30, 2023 and 2022, costs incurred in implementing geographies were $20.3 million and $10.9 million, respectively.

Medical Margin

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 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.

See “—Non-GAAP Financial Measures” for information regarding our use of medical margin and a reconciliation of gross profit to medical margin.

Platform Support 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 functions.

The table below represents costs to support our live geographies and enterprise functions, which are included in general and administrative expenses (dollars in thousands):


	Three Months Ended September 30,						Nine Months Ended September 30,
	2023			2022			2023			2022
Platform support costs	$	46,629		$	34,764		$	141,176		$	104,868
% of Revenue	4		%	5		%	4		%	5		%

Table of Contents

Net Income (Loss) and Adjusted EBITDA

Net income (loss) is the most directly comparable GAAP measure to Adjusted EBITDA. 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.

See “—Non-GAAP Financial Measures” for information regarding our use of Adjusted EBITDA and a reconciliation of net income (loss) to Adjusted EBITDA.

Key Components of Our Results of Operations

Revenues

Medical Services Revenue

Our medical services revenue consists of capitation revenue under contracts with various payors. Under the typical capitation arrangement, we are entitled to PMPM fees to provide a defined range of healthcare services for MA health plan members through our contracted physician partners and affiliated PCPs. Such fees are typically based on a defined percentage of corresponding premium that payors receive from CMS. We recognize capitation revenue over the period eligible members are entitled to receive healthcare services.

Medical services revenue constitutes substantially all of our total revenue for the three and nine months ended September 30, 2023 and 2022.

Operating Expenses

Medical Services Expense

In each of our geographies, a network of physicians, hospitals, and other healthcare providers provide care to our members. Medical services expense represents costs incurred for medical services provided to our members. Our medical services expense trends primarily relate to changes in per visit costs incurred by our members, along with changes in health system and provider utilization of services. Medical services expenses are recognized in the period in which services are provided and include estimates of our obligations for medical services that have been rendered by third parties but for which claims have either not yet been received, processed, or paid.

Other Medical Expenses

Other medical expenses include: (i) partner physician compensation expense and (ii) other provider costs. Partner physician compensation expense represents obligations to our physician partners corresponding to a portion of the surplus generated in our geographies, which is a function of medical services revenues less the sum of medical services expenses, other provider costs and market operating costs, for the respective geography. Physician payment obligations are reconciled quarterly, and settlement payments are typically issued to providers on an annual basis in arrears, with interim payments issued periodically. Other provider costs include payments to support physician-patient engagement, certain other medical costs, and other care management expenses that help to create medical cost efficiency. Other provider costs include costs incurred for geographies that are in implementation and are not yet generating revenue.

General and Administrative

General and administrative expenses consist of market-based support personnel and other operating costs to support our geographies, personnel and other operating costs to support our enterprise functions, and investments to support development and expansion of our physician partners. Our enterprise functions include salaries and related expenses, stock-based compensation (including shares issued under partner physician group equity agreements), operational support expenses, technology infrastructure, finance, and legal, as well as other costs associated with the continued growth of our platform. For the purposes of calculating physician partner incentive expense, we allocate a portion of our enterprise general and administrative expenses to our geographies. General and administrative expenses also include severance and accruals for unasserted claims.

Table of Contents

Depreciation and Amortization

Depreciation and amortization expenses are associated with our property and equipment and acquired intangible assets. Depreciation includes expenses associated with buildings, computer equipment and software, furniture and fixtures, and leasehold improvements. Amortization primarily includes expenses associated with acquired intangible assets.

Other Income (Expense)

Income (loss) from equity method investments

Income (loss) from equity method investments consists primarily of income associated with our participation in the ACO REACH program.

Other Income (Expense), Net

Other income (expense), net includes the following items:

•Interest income, which consists primarily of interest earned on our cash and cash equivalents, restricted cash and cash equivalents, and marketable securities, including amortization/accretion of discount/premium.

Interest Expense

Interest expense consists primarily of interest expense associated with our outstanding debt, including amortization of debt discounts and costs.

Income Tax Benefit (Expense)

We are subject to corporate U.S. federal, state, and local income taxation. Deferred tax assets are reduced by a valuation allowance to the extent management believes it is not more likely than not to be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income. Management makes estimates and judgments about future taxable income based on assumptions that are consistent with our plans and estimates.

Table of Contents

Results of Operations

The following table summarizes key components of our results of operations (dollars in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Revenues:
Medical services revenue	$	1,212,132	$	693,934	$	3,494,006	$	2,015,541
Other operating revenue	3,528		924		6,853		2,896
Total revenues	1,215,660		694,858		3,500,859		2,018,437
Expenses:
Medical services expense	1,104,396		618,287		3,085,957		1,771,635
Other medical expenses	80,787		50,659		249,936		144,512
General and administrative (including noncash stock-based compensation expense of $20,736, $7,907, $53,980 and $18,430, respectively)	74,138		51,980		222,483		143,738
Depreciation and amortization	5,310		3,450		15,014		9,865
Total expenses	1,264,631		724,376		3,573,390		2,069,750
Income (loss) from operations	(48,971)		(29,518)		(72,531)		(51,313)
Other income (expense):
Income (loss) from equity method investments	14,659		(4,314)		24,507		3,473
Other income (expense), net	5,690		4,888		21,001		6,367
Gain (loss) on lease terminations	—		—		—		(5,458)
Interest expense	(1,651)		(1,000)		(4,772)		(2,816)
Income (loss) before income taxes	(30,273)		(29,944)		(31,795)		(49,747)
Income tax benefit (expense)	(1,210)		(559)		(524)		(1,068)
Income (loss) from continuing operations	(31,483)		(30,503)		(32,319)		(50,815)
Discontinued operations:
Income (loss) before income taxes	—		(224)		—		526
Income tax benefit (expense)	—		(12)		—		(26)
Total discontinued operations	—		(236)		—		500
Net income (loss)	(31,483)		(30,739)		(32,319)		(50,315)
Noncontrolling interests’ share in (earnings) loss	47		71		156		228
Net income (loss) attributable to common shares	$	(31,436)	$	(30,668)	$	(32,163)	$	(50,087)

Table of Contents

The following table summarizes our results of operations as a percentage of total revenues:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Revenues:
Medical services revenue	100	%	100	%	100	%	100	%
Other operating revenue	—		—		—		—
Total revenues	100		100		100		100
Expenses:
Medical services expense	91		89		88		88
Other medical expenses	7		7		7		7
General and administrative (including noncash stock-based compensation expense of 2%, 1%, 1% and 1%, respectively)	6		7		6		7
Depreciation and amortization	—		—		—		—
Total expenses	104		104		102		102
Income (loss) from operations	(4)		(4)		(2)		(2)
Other income (expense):
Income (loss) from equity method investments	1		(1)		1		—
Other income (expense), net	—		1		1		—
Gain (loss) on lease terminations	—		—		—		—
Interest expense	—		—		—		—
Income (loss) before income taxes	(2)		(4)		(1)		(2)
Income tax benefit (expense)	—		—		—		—
Income (loss) from continuing operations	(2)		(4)		(1)		(2)
Discontinued operations:
Income (loss) before income taxes	—		—		—		—
Income tax benefit (expense)	—		—		—		—
Total discontinued operations	—		—		—		—
Net income (loss)	(2)		(4)		(1)		(2)
Noncontrolling interests’ share in (earnings) loss	—		—		—		—
Net income (loss) attributable to common shares	(2)	%	(4)	%	(1)	%	(2)	%

Comparison of the Three and Nine Months Ended September 30, 2023 to the Three and Nine Months Ended September 30, 2022

Medical Services Revenue


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Medical services revenue	$	1,212,132		$	693,934		$	518,198	75	%
% of total revenues	100		%	100		%

Medical services revenue increased for the three months ended September 30, 2023 due primarily to growth in average membership of 57%, which was attributable to eight new geographies that began to generate revenue in 2023 and

Table of Contents

growth in our existing geographies. The increase in medical services revenue for the three months ended September 30, 2023 was also driven, to a lesser extent, by an increase in PMPM capitation rates of 11%.


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Medical services revenue	$	3,494,006		$	2,015,541		$	1,478,465	73	%
% of total revenues	100		%	100		%

Medical services revenue increased for the nine months ended September 30, 2023 due primarily to growth in average membership of 58%, which was attributable to eight new geographies that began to generate revenue in 2023 and growth in our existing geographies. The increase in medical services revenue for the nine months ended September 30, 2023 was also driven, to a lesser extent, by an increase in PMPM capitation rates of 10%.

Medical Services Expense


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Medical services expense	$	1,104,396		$	618,287		$	486,109	79	%
% of total revenues	91		%	89		%

Medical services expense increased for the three months ended September 30, 2023 due primarily to growth in average membership of 57%, which was attributable to eight new geographies that became operational in 2023 and growth in our existing geographies. The increase in medical services expense for the three months ended September 30, 2023 was also driven, to a lesser extent, by an increase in average medical services expense per member of 13%.


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Medical services expense	$	3,085,957		$	1,771,635		$	1,314,322	74	%
% of total revenues	88		%	88		%

Medical services expense increased for the nine months ended September 30, 2023 due primarily to growth in average membership of 58%, which was attributable to eight new geographies that became operational in 2023 and growth in our existing geographies. The increase in medical services expense for the nine months ended September 30, 2023 was also driven, to a lesser extent, by an increase in average medical services expense per member of 11%.

Other Medical Expenses


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Other medical expenses	$	80,787		$	50,659		$	30,128	59	%
% of total revenues	7		%	7		%

Other medical expenses increased by $30.1 million, or 59%, for the three months ended September 30, 2023 compared to 2022. Partner physician incentive expense increased by $16.5 million to $38.5 million in 2023 compared to $22.0 million in 2022. Other provider costs increased by $13.6 million to $42.2 million in 2023 compared to $28.6 million in 2022, resulting from the increase in the number of geographies and members on our platform. Other provider costs for the three months ended September 30, 2023 include $10.3 million of costs related to geographies that will become operational in January 2024, while other provider costs for the three months ended September 30, 2022 include $7.2 million of costs related to geographies that became operational in 2023.

Table of Contents


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Other medical expenses	$	249,936		$	144,512		$	105,424	73	%
% of total revenues	7		%	7		%

Other medical expenses increased by $105.4 million, or 73%, for the nine months ended September 30, 2023 compared to 2022. Partner physician incentive expense increased by $65.1 million to $140.9 million in 2023 compared to $75.8 million in 2022. Other provider costs increased by $40.3 million to $109.0 million in 2023 compared to $68.7 million in 2022, resulting from the increase in the number of geographies and members on our platform. Other provider costs for the nine months ended September 30, 2023 include $20.3 million of costs related to geographies that will become operational in January 2024, while other provider costs for the nine months ended September 30, 2022 include $10.9 million of costs related to geographies that became operational in 2023.

General and Administrative


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
General and administrative	$	74,138		$	51,980		$	22,158	43	%
% of total revenues	6		%	7		%

General and administrative expenses increased $22.2 million, or 43%, for the three months ended September 30, 2023 compared to 2022. Operating costs to support our live geographies and enterprise functions (platform support costs) increased by $11.8 million to $46.6 million in 2023 compared to $34.8 million in 2022 due primarily to growth in operating costs incurred to support geographies that became operational in 2023. Operating costs to support our live geographies and enterprise functions as a percentage of revenue decreased to 4% for the three months ended September 30, 2023 compared to 5% for the same period in 2022. Investments to support geography entry declined to $8.0 million in 2023, compared to $14.1 million in 2022 due to increased costs associated with our geographies that become operational in the following calendar year and expansion into existing geographies. Stock-based compensation expense increased $12.9 million in 2023 primarily due to the granting of certain stock-based instruments to third parties after the third quarter of 2022.


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
General and administrative	$	222,483		$	143,738		$	78,745	55	%
% of total revenues	6		%	7		%

General and administrative expenses increased $78.7 million, or 55%, for the nine months ended September 30, 2023 compared to 2022. Operating costs to support our live geographies and enterprise functions (platform support costs) increased by $36.3 million to $141.2 million in 2023 compared to $104.9 million in 2022 due primarily to growth in operating costs incurred to support geographies that became operational in 2023. Operating costs to support our live geographies and enterprise functions as a percentage of revenue decreased to 4% for the nine months ended September 30, 2023 compared to 5% for the same period in 2022. Investments to support geography entry increased to $28.6 million in 2023, compared to $24.5 million in 2022 due to increased costs associated with our geographies that become operational in the following calendar year and expansion into existing geographies. Stock-based compensation expense increased $35.6 million in 2023 primarily due to the granting of certain stock-based instruments to third parties after the third quarter of 2022.

Table of Contents

Income (loss) from equity method investments


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Income (loss) from equity method investments	$	14,659		$	(4,314)		$	18,973	440	%
% of total revenues	1		%	(1)		%

Income (loss) from equity method investments increased $19.0 million, or 440%, for the three months ended September 30, 2023 compared to 2022 primarily from our ACO REACH equity investments as a result of stronger performance driven primarily by increased PMPM capitation rates during 2023 compared to 2022.


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Income (loss) from equity method investments	$	24,507		$	3,473		$	21,034	606	%
% of total revenues	1		%	—		%

Income (loss) from equity method investments increased $21.0 million, or 606%, for the nine months ended September 30, 2023 compared to 2022 primarily from our ACO REACH equity investments as a result of stronger performance driven primarily by increased PMPM capitation rates during 2023 compared to 2022.

Other income (expense), net


	Three Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Other income (expense), net	$	5,690		$	4,888		$	802	16	%
% of total revenues	1		%	1		%

Other income (expense), net increased $0.8 million, or 16%, for the three months ended September 30, 2023 compared to 2022 primarily from interest income as a result of our marketable securities investments, which were made at the end of the first quarter of 2022.


	Nine Months Ended September 30,						Change
(dollars in thousands)	2023			2022			$		%
Other income (expense), net	$	21,001		$	6,367		$	14,634	230	%
% of total revenues	1		%	—		%

Other income (expense), net increased $14.6 million, or 230%, for the nine months ended September 30, 2023 compared to 2022 primarily from interest income as a result of our marketable securities investments, which were made at the end of the first quarter of 2022.

Non-GAAP Financial Measures

In addition to providing results that are determined in accordance with U.S. GAAP, we present medical margin and Adjusted EBITDA, which are non-GAAP financial measures.

Table of Contents

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.

Adjusted EBITDA is not considered a measure of financial performance under U.S. GAAP, and the items excluded therefrom are significant components in understanding and assessing our financial performance. Adjusted EBITDA has limitations as an analytical tool and should not be considered in isolation or as an alternative to such U.S. GAAP measures as net income (loss), cash flows provided by or used in operating, investing, or financing activities or other financial statement data presented in our consolidated financial statements as an indicator of financial performance or liquidity. Some of these limitations are:

•Adjusted EBITDA does not reflect changes in, or cash requirements for, working capital needs;

•Adjusted EBITDA does not reflect interest expense or the requirements necessary to service interest or principal payments on debt;

•Adjusted EBITDA does not reflect income tax expense (benefit) or the cash requirements to pay taxes;

•Adjusted EBITDA does not reflect historical cash expenditures or future requirements for capital expenditures or contractual commitments;

•Although depreciation and amortization charges are non-cash charges, the assets being depreciated and amortized will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements; and

•The expenses and other items that we exclude in our calculation of Adjusted EBITDA may differ from the expenses and other items, if any, that other companies may exclude from similarly titled non-GAAP financial measures.

Table of Contents

The following table sets forth a reconciliation of gross profit to medical margin using data derived from our condensed consolidated financial statements for the periods indicated (dollars in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Gross profit(1)	$	30,477	$	25,912	$	164,966	$	102,290
Other operating revenue	(3,528)		(924)		(6,853)		(2,896)
Other medical expenses	80,787		50,659		249,936		144,512
Medical margin	$	107,736	$	75,647	$	408,049	$	243,906

___________________________________________

(1)Gross profit is defined as total revenues less medical services expense and other medical expenses.

The following table sets forth a reconciliation of net income (loss) to Adjusted EBITDA using data derived from our condensed consolidated financial statements for the periods indicated (dollars in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Net income (loss)	$	(31,483)	$	(30,739)	$	(32,319)	$	(50,315)
(Income) loss from discontinued operations, net of income taxes	—		236		—		(500)
Interest expense	1,651		1,000		4,772		2,816
Income tax expense (benefit)	1,210		559		524		1,068
Depreciation and amortization	5,310		3,450		15,014		9,865
(Gain) loss on lease terminations	—		—		—		5,458
Severance and related costs(1)	—		512		188		2,470
Stock-based compensation expense	20,736		7,907		53,980		18,430
EBITDA adjustments related to equity method investments	3,702		1,325		8,426		2,988
Other(2)	(6,903)		(10,089)		(22,243)		(12,753)
Adjusted EBITDA(3)	$	(5,777)	$	(25,839)	$	28,342	$	(20,473)

___________________________________________

(1)For the three and nine months ended September 30, 2022, includes taxes and related costs on stock option exercises for departed executives of $0.6 million and $2.0 million.

(2)Includes interest income, non-cash accruals for unasserted claims and contingent liabilities, and transaction-related costs.

(3)Effective 2023, we no longer exclude geography entry costs from our computation of Adjusted EBITDA. Adjusted EBITDA for the prior period presented has been restated to the current period computation methodology.

Liquidity and Capital Resources

We have historically financed our operations primarily through funds generated from our capitation arrangements with payors, issuances of equity securities, and borrowings under credit agreements. We generally invest any excess cash in money market accounts, which are classified as cash equivalents, and marketable securities. Our investment strategies are designed to provide safety and preservation of capital, sufficient liquidity to meet the cash flow needs of our business operations, and attainment of a competitive return. As of September 30, 2023, we had cash and cash equivalents and restricted cash and equivalents of $178.5 million and investments in marketable securities of $395.9 million.

We expect to continue to incur operating losses and generate negative cash flows from operations for the foreseeable future due to the investments we intend to continue to make in expanding our business and additional general and administrative costs we expect to incur related to our operation as a public company. As a result, we may require additional capital resources in the future to execute strategic initiatives to grow our business.

Our primary uses of cash include payments for medical claims and other medical expenses, general and administrative expenses, costs associated with the development of new geographies and expansion of existing geographies,

Table of Contents

debt service, and capital expenditures. Final reconciliation and receipt of amounts due from payors are typically settled in arrears, following completion of the contractual program year.

Based on our planned operations, we believe that our existing cash and cash equivalents, investments in marketable securities, as well as available borrowing capacity under the credit facilities, will be sufficient to meet our working capital and capital expenditure needs over at least the next 12 months, though we may require additional capital resources in the future. We have based these estimates on assumptions that may prove to be wrong and we could utilize our available capital resources sooner than we expect.

We may require additional financing in the future to fund working capital and pay our obligations. We may seek to raise any necessary additional capital through a combination of public or private equity offerings and/or debt financings. There can be no assurance that we will be successful in acquiring additional funding at levels sufficient to fund our operations or on terms favorable to us, if at all. If adequate funds are not available on acceptable terms when needed, we may be required to significantly reduce operating expenses, which may have a material adverse effect on our business, financial condition, cash flows, and results of operations. If we do raise additional capital through public or private equity, the ownership interest of our existing stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect our existing stockholders’ rights. If we raise additional capital through debt financing, we may be subject to covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures, or declaring dividends.

Our ability to pay dividends to holders of our common stock is significantly limited as a practical matter by our growth plans as well as our credit facilities insofar as we may seek to pay dividends out of funds made available to us by agilon health management, inc. (“agilon management”) or its subsidiaries because our credit facilities restrict agilon management’s ability to pay dividends or make loans to us. The borrower on our credit facilities is agilon management, our wholly-owned subsidiary. Our credit facilities are guaranteed by certain of our subsidiaries, including those identified as variable interest entities, and contain customary covenants including, among other things, limitations on restricted payments including: (i) dividends and distributions from restricted subsidiaries, (ii) requirements of minimum financial ratios, and (iii) limitation on additional borrowings based on certain financial ratios.

Cash Flows

The following summary discussion of our cash flows is based on the condensed consolidated statements of cash flows. The following table sets forth changes in cash flows (dollars in thousands):


	Nine Months Ended September 30,
	2023		2022		Change
Net cash provided by (used in) operating activities	$	(95,033)	$	(80,849)	$	(14,184)
Net cash provided by (used in) investing activities	(41,816)		(436,418)		394,602
Net cash provided by (used in) financing activities	(192,288)		26,926		(219,214)

Net Cash Provided By (Used In) Operating Activities

Net cash used in operating activities was $95.0 million for the nine months ended September 30, 2023 compared to $80.8 million for the nine months ended September 30, 2022. The increase in net cash used in operating activities was primarily as a result of increased provider costs, including partner physician incentive expenses, and the timing of settlements with payors from new and existing geographies, partially offset by the increase in gross profit contributed from new and existing geographies. Our cash flow from operations is dependent upon the number of members on our platform, the timing of settlements with payors, and the level of operating and general and administrative expenses necessary to operate and grow our business, among other factors.

Net Cash Provided By (Used In) Investing Activities

Net cash used in investing activities was $41.8 million for the nine months ended September 30, 2023 compared to $436.4 million for the nine months ended September 30, 2022. During the nine months ended September 30, 2023, we completed the acquisition of My Personal Health Record Express, Inc. for $44.4 million and made investments in marketable securities of $107.0 million, which were partially offset by proceeds from the maturity of marketable securities

Table of Contents

of $133.9 million. During the nine months ended September 30, 2022, we made investments in marketable securities of $423.2 million.

Net Cash Provided By (Used In) Financing Activities

Net cash used in financing activities was $192.3 million for the nine months ended September 30, 2023 compared to net cash provided by financing activities of $26.9 million for the nine months ended September 30, 2022. During the nine months ended September 30, 2023, we used $200.0 million to repurchase common stock. During the nine months ended September 30, 2023, we received net proceeds of $11.5 million from the exercise of stock options compared to $30.7 million for the nine months ended September 30, 2022.

Debt Obligations

On February 18, 2021, we executed a credit facility agreement (as amended by the First Amendment to Credit Agreement, dated as of March 1, 2021 and the Second Amendment to Credit Agreement, dated as of May 25, 2023, the “Credit Facilities”). The Credit Facilities include: (i) a $100.0 million senior secured term loan (the “Secured Term Loan Facility”) and (ii) a $100.0 million senior secured revolving credit facility (the “Secured Revolving Facility”) with a capacity to issue standby letters of credit in certain circumstances up to a maximum of $100.0 million. Subject to specified conditions and receipt of commitments, the Secured Term Loan Facility may be expanded (or a new term loan facility, revolving credit facility or letter of credit facility added) by up to (i) $50.0 million plus (ii) an additional amount determined in accordance with a formula tied to repayment of certain of our indebtedness. The maturity date of the Credit Facilities was extended to February 18, 2026.

Effective with the Second Amendment to Credit Agreement on May 25, 2023, we transitioned to the Secured Overnight Financing Rate ("SOFR") as a benchmark interest rate used in the Credit Agreement. At our option, borrowings under the Credit Facilities, as defined in the credit agreement, can be either: (i) SOFR Rate Loans, (ii) Daily Simple SOFR Rate Loans, or (iii) Base Rate Loans. Daily Simple SOFR Rate Loans and SOFR Rate Loans bear interest at a rate equal to the sum of 4.00% (stepping down to 3.50% on and following October 1, 2023) and the higher of (a) SOFR, as defined in the credit agreement, and (b) 0%. Base Rate Loans bear interest at a rate equal to the sum of 3.00% (stepping down to 2.50% on and following October 1, 2023) and the highest of: (a) 0.50% in excess of the overnight federal funds rate, (b) the prime rate established by the administrative agent from time to time, (c) the one-month SOFR rate (adjusted for maximum reserves) plus 1.00% and (d) 0%. Additionally, we pay a commitment fee on the unfunded 2021 Revolving Credit Facility amount of 0.50% (stepping down to 0.375% on and following October 1, 2023). We must also pay customary letter of credit fees.

The Credit Facilities contain customary covenants including, among other things, limitations on restricted payments including: (i) dividends and distributions from restricted subsidiaries, (ii) requirements of minimum financial ratios, and (iii) limitation on additional borrowings based on certain financial ratios.

For additional discussion on our debt obligations, see Note 8 to the Condensed Consolidated Financial Statements for additional information about our outstanding debt.

Equity

As of September 30, 2023, we had 406.0 million shares of common stock outstanding. See Note 10 to the Condensed Consolidated Financial Statements for additional information about our equity transactions.

Critical Accounting Policies and Estimates

Management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been prepared in accordance with U.S. GAAP. The preparation of financial statements in conformity with U.S. GAAP requires us to use judgment in the application of accounting policies, including making estimates and assumptions. We base estimates on the best information available to us at the time, our historical experience, known trends and events, and various other assumptions that we believe are reasonable under the circumstances. These estimates affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. If our judgment or interpretation of the facts and circumstances relating to various transactions or other matters had been different, it is possible that different accounting would have been applied, resulting in a different presentation of our condensed consolidated financial statements. From time to time, we re-evaluate our estimates and assumptions. In the event estimates

Table of Contents

or assumptions prove to be different from actual results, adjustments are made in subsequent periods to reflect more current estimates and assumptions about matters that are inherently uncertain. A summary of our critical accounting policies is included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022 in “Management’s Discussion and Analysis of Financial Conditions and Results of Operations - Critical Accounting Policies” and Note 2 to the Condensed Consolidated Financial Statements. There have been no significant changes to our critical accounting policies during 2023.

Recent Accounting Pronouncements

There are no new accounting standards that have been issued and we have not adopted that are material to us as of September 30, 2023.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates. We do not use derivative financial instruments in the normal course of business or for speculative or trading purposes.

Our exposures to market risk for changes in interest expense relate primarily to the Credit Facilities. Indebtedness under the Credit Facilities is floating rate debt and is carried at amortized cost. Therefore, fluctuations in interest rates will impact our consolidated financial statements. A rising interest rate environment will increase the amount of interest paid on this debt. A hypothetical 100 basis point change in interest rates would not have a material impact on our interest expense.

We held cash, cash equivalents, restricted cash equivalents, and marketable securities of $574.4 million and $919.6 million as of September 30, 2023 and December 31, 2022, respectively, consisting of bank deposits, certificates of deposits, money market funds, U.S. Treasury notes, and corporate debt securities. Such interest-earning instruments carry a degree of interest rate risk. A hypothetical 100 basis point change in interest rates would not have a material impact on the fair value of our marketable securities. Declines in interest rates over time will reduce our investment income. The goals of our investment policy are liquidity and capital preservation. We do not enter into investments for trading or speculative purposes.

Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures. Our Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”), with the assistance of other members of management, have evaluated the effectiveness of our disclosure controls and procedures (as defined in Rule 13a-15(e) under the Exchange Act) as of the end of the period covered by this report. Our disclosure controls and procedures are intended to ensure that information required to be disclosed by us in the reports we file or submit under the Exchange Act is (1) recorded, processed, summarized and reported, within the time periods specified in the Securities and Exchange Commission’s rules and forms and (2) accumulated and communicated to our management, including our CEO and CFO, as appropriate to allow timely decisions regarding required disclosure. Based on this review, although we continue to work to remediate the material weaknesses in internal control over financial reporting as described in our Annual Report on Form 10-K for the year ended December 31, 2022, and progress has been made to date, our CEO and CFO have concluded that the disclosure controls and procedures related to these material weaknesses were not effective as of September 30, 2023.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect every misstatement. An evaluation of effectiveness is subject to the risk that the controls may become inadequate because of changes in conditions, or that the degree of compliance with policies or procedures may decrease over time.

Changes in Internal Control Over Financial Reporting. Under applicable SEC rules (Exchange Act Rules 13a-15(d) and 15d-15(d)), management is required to evaluate any change in internal control over financial reporting that occurred during each fiscal quarter that had materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

As explained in greater detail under Part II, Item 9A. “Controls and Procedures” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022, we are undertaking a broad range of remedial procedures to address the material weaknesses in our internal control over financial reporting identified as of December 31, 2022. Our efforts to improve our internal controls are ongoing. Therefore, while we determined, with the participation of our CEO and CFO, that there have been no changes in our internal control over financial reporting in the three-month period ended

Table of Contents

September 30, 2023, that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting, we continue to monitor the operation of these remedial measures through the date of this report.

Table of Contents

PART II. OTHER INFORMATION

Item 1. Legal Proceedings

See the “Legal Proceedings” section of Note 9 to the Condensed Consolidated Financial Statements for information regarding legal proceedings, which information is incorporated by reference in this Item 1.

Item 1A. Risk Factors

In addition to the information set forth in this Form 10-Q, you should carefully consider the risk factors disclosed in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022. There have been no material changes to the risk factors disclosed in the Form 10-K.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

(a)

None.

(b)

None.

(c)

None.

Item 5. Other Information

On August 15, 2023, Veeral Desai, the registrant’s Chief Strategy and Development Officer, adopted a Rule 10b5-1 plan intended to satisfy the affirmative defense of Commission Rule 10b5-1(c). The trading plan commences November 20, 2023, ends June 7, 2024 and covers 1,307,441 options to purchase common stock of the registrant.

Table of Contents

Item 6. Exhibits


Exhibit Number						Description
31.1						Certification by Steven J. Sell, agilon’s Principal Executive Officer, Pursuant to Securities Exchange Act Rule 13a-14(a).*

31.2						Certification by Timothy S. Bensley, agilon’s Principal Financial Officer, Pursuant to Securities Exchange Act Rule 13a-14(a).*

32.1						Certification by Steven J. Sell, agilon’s Principal Executive Officer, Pursuant to Securities Exchange Act Rule 13a-14(b) and 18 U.S.C. Section 1350.**

32.2						Certification by Timothy S. Bensley, agilon’s Principal Financial Officer, Pursuant to Securities Exchange Act Rule 13a-14(b) and 18 U.S.C. Section 1350.**

101.INS						Inline XBRL Instance Document – the instance document does not appear in the Interactive Data File because XBRL tags are embedded within the Inline XBRL document.*

101.SCH						Inline XBRL Taxonomy Extension Schema Document.*

101.CAL						Inline XBRL Taxonomy Extension Calculation Linkbase Document.*

101.DEF						Inline XBRL Taxonomy Extension Definition Linkbase Document.*

101.LAB						Inline XBRL Taxonomy Extension Label Linkbase Document.*

101.PRE						Inline XBRL Taxonomy Extension Presentation Linkbase Document.*

104						Cover Page Interactive Data File (embedded within the Inline XBRL document).*

___________________________________________

*Filed herewith.

**Furnished herewith.

Table of Contents

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.


Date: November 2, 2023						agilon health, inc.

						(Registrant)

						/s/ TIMOTHY S. BENSLEY
						Timothy S. Bensley
						Chief Financial Officer
						(Principal Financial Officer)

Exhibit 31.1

CERTIFICATION PURSUANT TO

RULES 13a-14(a) AND 15d-14(a) UNDER THE SECURITIES EXCHANGE ACT OF 1934,

AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Steven J. Sell, certify that:

1.I have reviewed this quarterly report on Form 10-Q of agilon health, inc. for the period ended September 30, 2023;

2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.The registrant's other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

(a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

(b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.


Date: November 2, 2023	By:	/s/ STEVEN J. SELL
		Steven J. Sell
		Chief Executive Officer
		(Principal Executive Officer)

Exhibit 31.2

CERTIFICATION PURSUANT TO

RULES 13a-14(a) AND 15d-14(a) UNDER THE SECURITIES EXCHANGE ACT OF 1934,

AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Timothy S. Bensley, certify that:

1.I have reviewed this quarterly report on Form 10-Q of agilon health, inc. for the period ended September 30, 2023;

(b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.


Date: November 2, 2023	By:	/s/ TIMOTHY S. BENSLEY
		Timothy S. Bensley
		Chief Financial Officer
		(Principal Financial Officer)

Exhibit 32.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of agilon health, inc. (the “Company”) on Form 10-Q for the period ending September 30, 2023 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Steven J. Sell, Chief Executive Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:

(1)The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

(2)The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.


Date: November 2, 2023	By:	/s/ STEVEN J. SELL
		Steven J. Sell
		Chief Executive Officer
		(Principal Executive Officer)

Exhibit 32.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of agilon health, inc. (the “Company”) on Form 10-Q for the period ending September 30, 2023 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Timothy S. Bensley, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that:

(1)The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and

(2)The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.


Date: November 2, 2023	By:	/s/ TIMOTHY S. BENSLEY
		Timothy S. Bensley
		Chief Financial Officer
		(Principal Financial Officer)

Cover - shares	9 Months Ended
Cover - shares	Sep. 30, 2023	Oct. 27, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-40332
Entity Registrant Name	agilon health, inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	37-1915147
Entity Address, Address Line One	6210 E Hwy 290
Entity Address, Address Line Two	Suite 450
Entity Address, City or Town	Austin
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	78723
City Area Code	(562)
Local Phone Number	256-3800
Title of 12(b) Security	Common stock, $0.01 par value
Trading Symbol	AGL
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		406,040,924
Entity Central Index Key	0001831097
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 168,339	$ 497,070
Restricted cash and equivalents	10,204	10,610
Marketable securities	395,878	411,901
Receivables, net	1,345,711	497,574
Prepaid expenses and other current assets	36,512	34,119
Total current assets	1,956,644	1,451,274
Property and equipment, net	26,203	20,050
Intangible assets, net	92,657	67,680
Goodwill	62,387	41,540
Other assets, net	140,184	116,924
Total assets	2,278,075	1,697,468
Current liabilities:
Medical claims and related payables	1,005,762	346,727
Accounts payable and accrued expenses	290,563	183,364
Current portion of long-term debt	5,000	5,000
Total current liabilities	1,301,325	535,091
Long-term debt, net of current portion	34,780	38,482
Other liabilities	70,370	83,286
Total liabilities	1,406,475	656,859
Commitments and contingencies
Stockholders' equity (deficit):
Common stock, $0.01 par value: $2,000,000 shares authorized; 405,980 and 412,385 shares issued and outstanding, respectively	4,060	4,124
Additional paid-in capital	1,970,930	2,106,886
Accumulated deficit	(1,096,393)	(1,064,230)
Accumulated other comprehensive income (loss)	(6,230)	(5,560)
Total agilon health, inc. stockholders' equity (deficit)	872,367	1,041,220
Noncontrolling interests	(767)	(611)
Total stockholders’ equity (deficit)	871,600	1,040,609
Total liabilities and stockholders’ equity (deficit)	$ 2,278,075	$ 1,697,468

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	2,000,000,000	2,000,000,000
Common stock, shares issued (in shares)	405,980,000	412,385,000
Common stock, shares outstanding (in shares)	405,980,000	412,385,000
Assets	$ 2,278,075	$ 1,697,468
Liabilities	1,406,475	656,859
Variable Interest Entity, Primary Beneficiary
Assets	1,480,000	703,300
Liabilities	$ 1,230,000	$ 462,400

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Revenues:
Revenues	$ 1,215,660	$ 694,858	$ 3,500,859	$ 2,018,437
Expenses:
General and administrative (including noncash stock-based compensation expense of $20,736, $7,907, $53,980 and $18,430, respectively)	74,138	51,980	222,483	143,738
Depreciation and amortization	5,310	3,450	15,014	9,865
Total expenses	1,264,631	724,376	3,573,390	2,069,750
Income (loss) from operations	(48,971)	(29,518)	(72,531)	(51,313)
Other income (expense):
Income (loss) from equity method investments	14,659	(4,314)	24,507	3,473
Other income (expense), net	5,690	4,888	21,001	6,367
Gain (loss) on lease terminations	0	0	0	(5,458)
Interest expense	(1,651)	(1,000)	(4,772)	(2,816)
Income (loss) before income taxes	(30,273)	(29,944)	(31,795)	(49,747)
Income tax benefit (expense)	(1,210)	(559)	(524)	(1,068)
Income (loss) from continuing operations	(31,483)	(30,503)	(32,319)	(50,815)
Discontinued operations:
Income (loss) before income taxes	0	(224)	0	526
Income tax benefit (expense)	0	(12)	0	(26)
Total discontinued operations	0	(236)	0	500
Net income (loss)	(31,483)	(30,739)	(32,319)	(50,315)
Noncontrolling interests’ share in (earnings) loss	47	71	156	228
Net income (loss) attributable to common shares	$ (31,436)	$ (30,668)	$ (32,163)	$ (50,087)
Net income (loss) per common share, basic and diluted
Continuing operations, basic (in dollars per share)	$ (0.08)	$ (0.07)	$ (0.08)	$ (0.12)
Continuing operations, diluted (in dollars per share)	(0.08)	(0.07)	(0.08)	(0.12)
Discontinued operations, basic (in dollars per share)	0	0	0	0
Discontinued operations, diluted (in dollars per share)	$ 0	$ 0	$ 0	$ 0
Weighted average shares outstanding
Basic (in shares)	405,787	411,065	412,077	406,823
Diluted (in shares)	405,787	411,065	412,077	406,823
Medical services revenue
Revenues:
Revenues	$ 1,212,132	$ 693,934	$ 3,494,006	$ 2,015,541
Expenses:
Expenses	1,104,396	618,287	3,085,957	1,771,635
Other operating revenue
Revenues:
Revenues	3,528	924	6,853	2,896
Expenses:
Expenses	$ 80,787	$ 50,659	$ 249,936	$ 144,512

CONSOLIDATED STATEMENTS OF OPERATIONS (Parenthetical) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Stock-based compensation expense	$ 20,736	$ 7,907	$ 53,980	$ 18,430

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ (31,483)	$ (30,739)	$ (32,319)	$ (50,315)
Other comprehensive income (loss):
Net unrealized gain (loss) on marketable securities, net of tax	114	(5,611)	(758)	(5,098)
Foreign currency translation adjustment	25	0	88	0
Total comprehensive income (loss)	(31,344)	(36,350)	(32,989)	(55,413)
Comprehensive (income) loss attributable to noncontrolling interests	47	71	156	228
Total comprehensive income (loss) attributable to agilon health, inc.	$ (31,297)	$ (36,279)	$ (32,833)	$ (55,185)

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Accumulated Other Comprehensive Income (loss)	Noncontrolling Interest
Beginning balance (in shares) at Dec. 31, 2021		400,095,000
Beginning balance at Dec. 31, 2021	$ 1,091,596	$ 4,001	$ 2,045,572	$ (957,677)		$ (300)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(50,315)			(50,087)		(228)
Other comprehensive income (loss)	(5,098)				$ (5,098)
Exercise of stock options (in shares)		11,392,000
Exercise of stock options	31,462	$ 113	31,349
Vesting of restricted stock units (in shares)		289,000
Vesting of restricted stock units	0	$ 3	(3)
Shares withheld related to net share settlement (in shares)		(35,000)
Shares withheld related to net share settlement	(786)		(786)
Stock-based compensation expense	18,430		18,430
Ending balance, (in shares) at Sep. 30, 2022		411,741,000
Ending balance at Sep. 30, 2022	1,085,289	$ 4,117	2,094,562	(1,007,764)	(5,098)	(528)
Beginning balance (in shares) at Jun. 30, 2022		408,204,000
Beginning balance at Jun. 30, 2022	1,103,371	$ 4,082	2,076,329	(977,096)	513	(457)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(30,739)			(30,668)		(71)
Other comprehensive income (loss)	(5,611)				(5,611)
Exercise of stock options (in shares)		3,390,000
Exercise of stock options	10,389	$ 33	10,356
Vesting of restricted stock units (in shares)		149,000
Vesting of restricted stock units	0	$ 2	(2)
Shares withheld related to net share settlement (in shares)		(2,000)
Shares withheld related to net share settlement	(28)		(28)
Stock-based compensation expense	7,907		7,907
Ending balance, (in shares) at Sep. 30, 2022		411,741,000
Ending balance at Sep. 30, 2022	$ 1,085,289	$ 4,117	2,094,562	(1,007,764)	(5,098)	(528)
Beginning balance (in shares) at Dec. 31, 2022	412,385,000	412,385,000
Beginning balance at Dec. 31, 2022	$ 1,040,609	$ 4,124	2,106,886	(1,064,230)	(5,560)	(611)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(32,319)			(32,163)		(156)
Other comprehensive income (loss)	(670)				(670)
Exercise of stock options (in shares)		2,691,000
Exercise of stock options	13,268	$ 27	13,241
Vesting of restricted stock units (in shares)		584,000
Vesting of restricted stock units	0	$ 6	(6)
Shares withheld related to net share settlement (in shares)		(65,000)
Shares withheld related to net share settlement	(1,806)	$ (1)	(1,805)
Common stock repurchase (in shares)		(9,615,000)
Common stock repurchase	(201,462)	$ (96)	(201,366)
Stock-based compensation expense	$ 53,980		53,980
Ending balance, (in shares) at Sep. 30, 2023	405,980,000	405,980,000
Ending balance at Sep. 30, 2023	$ 871,600	$ 4,060	1,970,930	(1,096,393)	(6,230)	(767)
Beginning balance (in shares) at Jun. 30, 2023		405,427,000
Beginning balance at Jun. 30, 2023	879,446	$ 4,054	1,947,438	(1,064,957)	(6,369)	(720)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(31,483)			(31,436)		(47)
Other comprehensive income (loss)	139				139
Exercise of stock options (in shares)		424,000
Exercise of stock options	2,723	$ 5	2,718
Vesting of restricted stock units (in shares)		132,000
Vesting of restricted stock units	0	$ 1	(1)
Shares withheld related to net share settlement (in shares)		(3,000)
Shares withheld related to net share settlement	(63)		(63)
Common stock repurchase	102		102
Stock-based compensation expense	$ 20,736		20,736
Ending balance, (in shares) at Sep. 30, 2023	405,980,000	405,980,000
Ending balance at Sep. 30, 2023	$ 871,600	$ 4,060	$ 1,970,930	$ (1,096,393)	$ (6,230)	$ (767)

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net income (loss)	$ (32,319)	$ (50,315)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation and amortization	15,014	9,865
Stock-based compensation expense	53,980	18,430
Loss (income) from equity method investments	(24,507)	(3,473)
Other noncash items	(1,511)	4,261
Changes in operating assets and liabilities	(105,690)	(59,617)
Net cash provided by (used in) operating activities	(95,033)	(80,849)
Cash flows from investing activities:
Purchase of property and equipment, net	(11,898)	(11,937)
Purchase of intangible assets	(3,535)	(12,415)
Investment in loans receivable and other	(8,778)	(4,510)
Investments in marketable securities	(107,020)	(423,183)
Proceeds from maturities and sales of marketable securities and other	133,894	15,127
Net cash paid in business combination	(44,479)	0
Proceeds from sale of business and property, net of cash divested	0	500
Net cash provided by (used in) investing activities	(41,816)	(436,418)
Cash flows from financing activities:
Proceeds from equity issuances, net	11,462	30,676
Common stock repurchase	(200,000)	0
Repayments of long-term debt	(3,750)	(3,750)
Net cash provided by (used in) financing activities	(192,288)	26,926
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents	(329,137)	(490,341)
Cash, cash equivalents and restricted cash and equivalents, beginning of period	507,680	1,054,820
Cash, cash equivalents and restricted cash and equivalents, end of period	$ 178,543	$ 564,479

Business

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business


NOTE 1. Business

Description of Business

See Note 14 for additional discussions related to the Company’s involvement with VIEs.

Subsequent Events

Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies


NOTE 2. Summary of Significant Accounting Policies

Basis of Presentation

Use of Estimates

Property and Equipment

Income Taxes

Revenue, Receivables, and Concentration of Credit Risk

9 Months Ended

Sep. 30, 2023

Risks and Uncertainties [Abstract]

Revenue, Receivables, and Concentration of Credit Risk


NOTE 3. Revenue, Receivables, and Concentration of Credit Risk

Medical Services Revenue

Neither the Company nor any of its affiliates is a registered insurance company because state law in the states in which it operates does not require such registration for risk-bearing providers.

Receivables

adjustment payments to be received in subsequent periods for open performance years. Receivables are recorded at the amount expected to be realized.

Concentration

The following table provides the Company’s revenue concentration with respect to major payors as a percentage of the Company’s total revenues:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Payor A	24	%	26	%	24	%	25	%
Payor B	14	%	19	%	15	%	19	%
Payor C	18	%	14	%	17	%	14	%

Payor F	10	%	*		10	%	*

___________________________________________

*Less than 10% of total revenues.

The following table provides the Company’s concentration of credit risk with respect to major payors as a percentage of receivables, net:


	September 30, 2023		December 31, 2022
Payor A	*		13	%
Payor B	18	%	20	%
Payor C	12	%	10	%
Payor D	*		10	%
Payor E	*		11	%
Payor F	26	%	*

___________________________________________

*Less than 10% of total receivables.

Marketable Securities and Fair Value Measurements

9 Months Ended

Sep. 30, 2023

Debt Securities [Abstract]

Marketable Securities and Fair Value Measurements


NOTE 4. Marketable Securities and Fair Value Measurements

Marketable Securities

The following table summarizes the Company’s marketable securities (in thousands):


	September 30, 2023								December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value		Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Marketable securities:
Corporate debt securities	$	241,723	$	—	$	(3,515)	$	238,208	$	255,613	$	60	$	(3,240)	$	252,433
U.S. Treasury notes	150,473		—		(2,751)		147,722		151,873		—		(2,306)		149,567
Other	10,000		—		(52)		9,948		9,975		—		(74)		9,901
	$	402,196	$	—	$	(6,318)	$	395,878	$	417,461	$	60	$	(5,620)	$	411,901

The following table summarizes the Company’s marketable securities maturity as of September 30, 2023 (in thousands):


Year	Amortized Cost		Fair Value
2023	$	27,922	$	27,826
2024	155,006		153,241
2025	183,796		179,855
2026	35,472		34,956
	$	402,196	$	395,878

Fair Value Measurements

•Level 1—quoted prices for identical instruments in active markets;

•Level 3—fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable.

The table below summarizes the Company’s financial instruments measured at fair value on a recurring basis (in thousands):


	September 30, 2023						December 31, 2022
	Level 1		Level 2		Level 3		Level 1		Level 2		Level 3
Marketable securities:
Corporate debt securities	$	—	$	238,208	$	—	$	—	$	252,433	$	—
U.S. Treasury notes	147,722		—		—		149,567		—		—
Other	9,948		—		—		9,901		—		—
	$	157,670	$	238,208	$	—	$	159,468	$	252,433	$	—

Other Assets, net

9 Months Ended

Sep. 30, 2023

Other Assets [Abstract]

Other Assets, net


NOTE 5. Other Assets, net

The following table summarizes the Company’s other assets, net (in thousands):


	September 30, 2023		December 31, 2022
Loans to physician partners	$	70,475	$	69,383
Health plan deposits	12,051		11,728
Equity method investments(1)	39,170		17,352
Right-of-use lease assets	14,594		13,029
Other	3,894		5,432
	$	140,184	$	116,924

___________________________________________

(1)See Note 14 for additional discussion related to the Company's equity method investments.

Loans to Physician Partners

Medical Claims and Related Payables

9 Months Ended

Sep. 30, 2023

Insurance [Abstract]

Medical Claims and Related Payables


NOTE 6. Medical Claims and Related Payables

The following table presents the components of changes in medical claims and related payables (in thousands):


	September 30,
	2023		2022
Medical claims and related payables, beginning of the year	$	339,748	$	239,014
Components of incurred costs related to:
Current year	3,032,501		1,756,943
Prior years	53,456		14,692
Discontinued operations - prior years	—		—
	3,085,957		1,771,635
Claims paid related to:
Current year	(2,046,004)		(1,283,242)
Prior years	(387,161)		(236,413)
Discontinued operations - prior years	—		(154)
	(2,433,165)		(1,519,809)
Medical claims and related payables, end of the period	$	992,540	$	490,840

Other Liabilities

9 Months Ended

Sep. 30, 2023

Other Liabilities [Abstract]

Other Liabilities


NOTE 7. Other Liabilities

The following table summarizes the Company’s other liabilities (in thousands):


	September 30, 2023		December 31, 2022
Other long-term contingencies	$	49,523	$	62,931
Lease liabilities, long-term	11,975		9,885
Equity method liabilities – ACO REACH	—		4,657
Other	8,872		5,813
	$	70,370	$	83,286

See Note 14 for equity method liabilities related to the Company's ACO REACH investments.

Debt

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Debt


NOTE 8. Debt

determined in accordance with a formula tied to repayment of certain of the Company’s indebtedness. The maturity date of the Credit Facilities is February 18, 2026.

Commitments and Contingencies

9 Months Ended

Sep. 30, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies


NOTE 9. Commitments and Contingencies

Legal Proceedings

Common Stock

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Common Stock


NOTE 10. Common Stock

Common Stock

Net Income (Loss) Per Common Share

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Net Income (Loss) Per Common Share


NOTE 11. Net Income (Loss) Per Common Share

The following table illustrates the computation of basic and diluted EPS (in thousands, except per share amounts):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator
Income (loss) from continuing operations	$	(31,483)	$	(30,503)	$	(32,319)	$	(50,815)
Noncontrolling interests’ share in (earnings) loss from continuing operations	47		71		156		228
Net income (loss) attributable to common stockholders before discontinued operations	(31,436)		(30,432)		(32,163)		(50,587)
Income (loss) from discontinued operations	—		(236)		—		500
Net income (loss) attributable to common stockholders	$	(31,436)	$	(30,668)	$	(32,163)	$	(50,087)
Denominator
Weighted average shares outstanding – basic	405,787		411,065		412,077		406,823
Weighted average shares outstanding – diluted	405,787		411,065		412,077		406,823
Net income (loss) per share attributable to common stockholders
Net income (loss) per common share from continuing operations, basic and diluted	$	(0.08)	$	(0.07)	$	(0.08)	$	(0.12)
Net income (loss) per common share from discontinued operations, basic and diluted	$	—	$	—	$	—	$	—


	September 30,
	2023	2022
Stock options	17,424	20,474
Restricted stock units	9,183	1,908

Goodwill and Amortizable Intangible Assets

9 Months Ended

Sep. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Amortizable Intangible Assets


NOTE 12. Goodwill and Amortizable Intangible Assets

Acquisition

Supplemental Cash Flow Information

9 Months Ended

Sep. 30, 2023

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information


NOTE 13. Supplemental Cash Flow Information

The following table provides supplemental cash flow information (in thousands):


	Nine Months Ended September 30,
	2023		2022
Supplemental cash flow information:
Interest paid	$	4,519	$	2,878
Income taxes paid	5,156		4,223
Supplemental disclosure of non-cash investing and financing activities:
Right-of-use asset obtained in exchange for new operating lease liability	3,612		7,288
Non-cash investment in unconsolidated subsidiaries	—		190

The following table summarizes cash, cash equivalents and restricted cash equivalents from continuing operations (in thousands):


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	168,339	$	497,070
Restricted cash and equivalents(1)	10,204		10,610
Cash, cash equivalents and restricted cash equivalents	$	178,543	$	507,680

___________________________________________

(1)Restricted cash and equivalents primarily consist of amounts used as collateral to secure letters of credit that the Company is required to maintain pursuant to contracts with payors.

Variable Interest Entities

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Variable Interest Entities


NOTE 14. Variable Interest Entities

Consolidated Variable Interest Entities

agilon health, inc.’s consolidated assets and liabilities include VIE assets and liabilities as follows (in thousands):


	September 30, 2023		December 31, 2022
Assets
Cash and cash equivalents	$	86,581	$	155,819
Restricted cash equivalents	10,202		10,610
Receivables, net	1,334,394		492,077
Prepaid expenses and other current assets, net	20,781		15,515
Property and equipment, net	1,817		1,567
Intangible assets, net	20,187		17,347
Other assets, net	9,790		10,371
Liabilities
Medical claims and related payables	962,505		300,798
Accounts payable and accrued expenses	259,553		159,526
Other liabilities	4,188		2,059

Unconsolidated Variable Interest Entities

Equity Method Investments

The following table summarizes the Company’s equity method investments (in thousands):


	September 30, 2023		December 31, 2022
Equity method investments - Other(1)	$	9,114	$	8,329
Equity method investments - ACO REACH(1)	30,056		9,023
Equity method liabilities - ACO REACH(2)	—		(4,657)

___________________________________________

(1)Included in Other assets, net in the condensed consolidated balance sheets.

(2)Included in Other liabilities in the condensed consolidated balance sheets.


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Medical services revenue	$	296,937	$	241,408	$	858,286	$	786,171
Medical services expense	(242,431)		(231,910)		(741,752)		(735,924)
Other medical expenses(1)	(31,970)		(9,215)		(71,138)		(34,019)
Income (loss) from operations	18,330		(3,035)		31,515		6,333
Net income (loss)(2)	14,628		(4,361)		24,388		3,345

___________________________________________

(2)Included in Income (loss) from equity method investments in the condensed consolidated statements of operations.

The combined summarized balance sheet of the Company’s ACO REACH entities are as follows (in thousands):


	September 30, 2023		December 31, 2022
Current assets	$	165,257	$	70,625
Noncurrent assets	130		—
Total assets	165,387		70,625
Current and total liabilities	136,285		67,343

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income (loss)	$ (31,436)	$ (30,668)	$ (32,163)	$ (50,087)

Insider Trading Arrangements	3 Months Ended	9 Months Ended
Insider Trading Arrangements	Sep. 30, 2023 shares	Sep. 30, 2023 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On August 15, 2023, Veeral Desai, the registrant’s Chief Strategy and Development Officer, adopted a Rule 10b5-1 plan intended to satisfy the affirmative defense of Commission Rule 10b5-1(c). The trading plan commences November 20, 2023, ends June 7, 2024 and covers 1,307,441 options to purchase common stock of the registrant.
Rule 10b5-1 Arrangement Adopted	true
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Veeral Desai [Member]
Trading Arrangements, by Individual
Name	Veeral Desai
Title	Chief Strategy and Development Officer
Adoption Date	August 15, 2023
Arrangement Duration	200 days
Aggregate Available	1,307,441	1,307,441

Summary of Significant Accounting Policies (Policies)	9 Months Ended
Summary of Significant Accounting Policies (Policies)	Sep. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of PresentationThe accompanying condensed consolidated financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). The condensed consolidated financial statements include the accounts of agilon health, inc., its wholly-owned subsidiaries, and both joint ventures and VIEs that it controls through voting rights or other means. Intercompany transactions and balances have been eliminated upon consolidation. All adjustments (consisting of normal recurring adjustments unless otherwise indicated), which the Company considers necessary to present fairly its financial position, results of operations, and cash flows, have been included.
Use of Estimates	Use of Estimates Management is required to make estimates and assumptions in the preparation of financial statements. These estimates and assumptions affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant estimates can include, among other things, those used to determine revenues and related receivables from risk adjustments, medical services expense and related payables (including the reserve for incurred but not reported (“IBNR”) claims), and valuation of long-lived assets, goodwill and intangible assets (acquired in business combinations and analysis of impairment). Management’s estimates for revenue recognition, medical services expense, and other estimates, judgments, and assumptions, may be materially and adversely different from actual results. These estimates are based on knowledge of current events and anticipated future events, and accordingly, actual results may ultimately differ materially from those estimates.
Income Taxes	Income Taxes The Company determined the income tax provision for interim periods using an estimate of the Company’s annual effective tax rate, applied to year-to-date results, adjusted for discrete items arising in that quarter. In each quarter, the Company updates its estimated annual effective tax rate, and if the estimated annual effective tax rate changes, a cumulative catch-up adjustment is recorded in that quarter. The Company applied the intra-period tax allocation rules to allocate income taxes between continuing operations and discontinued operations as prescribed in U.S. GAAP, where the tax effect of income (loss) before income taxes from continuing operations is computed without regard to the tax effects of income (loss) before income taxes from the other categories.
Revenue from Contract with Customer	Medical Services Revenue Medical services revenue consists of capitation fees under contracts with various Medicare Advantage payors (“payors”). Under the typical capitation arrangement, the Company is entitled to monthly per-member, per-month (“PMPM”) fees to provide a defined range of healthcare services for Medicare Advantage health plan members (“members”) attributed to the Company’s contracted primary care physicians. PMPM fees are determined as a percent of the premium payors receive from the Centers for Medicare & Medicaid Services’ (“CMS”) for these members. The Company generally accepts full financial risk for members attributed to its contracted primary care physicians and therefore is responsible for the cost of all healthcare services required by those members. Fees are generally recorded gross in revenue because the Company is acting as a principal in coordinating and controlling the range of services provided (other than clinical decisions) under its capitation contracts with payors. Capitation contracts with payors are generally multi-year arrangements and have a single performance obligation that constitutes a series, as defined by Accounting Standards Codification (“ASC”) 606, Revenue From Contracts With Customers (“ASC 606”), to stand ready on a monthly basis to provide all aspects of necessary medical care to members for the contracted period. The Company recognizes revenue in the month in which eligible members are entitled to receive healthcare benefits during the contract term. The transaction price for the Company’s capitation contracts is variable, as the PMPM fees to which the Company is entitled are subject to periodic adjustment under CMS’s risk adjustment payment methodology. CMS deploys a risk adjustment model that determines premiums paid to all payors according to each member’s health status and certain demographic factors. Under this risk adjustment methodology, CMS calculates the risk adjusted premium payment using diagnosis data from various settings. The Company and healthcare providers collect and submit the necessary and available diagnosis data to payors and such data is utilized by the Company to estimate risk adjustment payments to be received in subsequent periods. Risk adjustment-related revenues are estimated using the most likely amount methodology and amounts are only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. PMPM fees are also subject to adjustment for incentives or penalties based on the achievement of certain quality metrics defined in the Company’s contracts with payors. The Company recognizes incentive revenue as earned using the most likely amount methodology and only to the extent that it is probable that a significant reversal of cumulative revenue will not occur once any uncertainty is resolved. Neither the Company nor any of its affiliates is a registered insurance company because state law in the states in which it operates does not require such registration for risk-bearing providers.
Receivables	Receivables Receivables primarily consist of amounts due under capitation contracts with various payors. Receivables due under capitation contracts are recorded monthly based on reports received from payors and management’s estimate of risk adjustment payments to be received in subsequent periods for open performance years. Receivables are recorded at the amount expected to be realized.

Revenue, Receivables, and Concentration of Credit Risk (Tables)

9 Months Ended

Sep. 30, 2023

Risks and Uncertainties [Abstract]

Schedules of Concentration of Risk as a Percentage of Revenues and Receivables

The following table provides the Company’s revenue concentration with respect to major payors as a percentage of the Company’s total revenues:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Payor A	24	%	26	%	24	%	25	%
Payor B	14	%	19	%	15	%	19	%
Payor C	18	%	14	%	17	%	14	%

Payor F	10	%	*		10	%	*

___________________________________________

*Less than 10% of total revenues.

The following table provides the Company’s concentration of credit risk with respect to major payors as a percentage of receivables, net:


	September 30, 2023		December 31, 2022
Payor A	*		13	%
Payor B	18	%	20	%
Payor C	12	%	10	%
Payor D	*		10	%
Payor E	*		11	%
Payor F	26	%	*

___________________________________________

*Less than 10% of total receivables.

Marketable Securities and Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2023

Debt Securities [Abstract]

Summary of Marketable Securities

The following table summarizes the Company’s marketable securities (in thousands):


	September 30, 2023								December 31, 2022
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value		Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Marketable securities:
Corporate debt securities	$	241,723	$	—	$	(3,515)	$	238,208	$	255,613	$	60	$	(3,240)	$	252,433
U.S. Treasury notes	150,473		—		(2,751)		147,722		151,873		—		(2,306)		149,567
Other	10,000		—		(52)		9,948		9,975		—		(74)		9,901
	$	402,196	$	—	$	(6,318)	$	395,878	$	417,461	$	60	$	(5,620)	$	411,901

The following table summarizes the Company’s marketable securities maturity as of September 30, 2023 (in thousands):


Year	Amortized Cost		Fair Value
2023	$	27,922	$	27,826
2024	155,006		153,241
2025	183,796		179,855
2026	35,472		34,956
	$	402,196	$	395,878

Summary of Fair Value Assets Measured on Recurring Basis

The table below summarizes the Company’s financial instruments measured at fair value on a recurring basis (in thousands):


	September 30, 2023						December 31, 2022
	Level 1		Level 2		Level 3		Level 1		Level 2		Level 3
Marketable securities:
Corporate debt securities	$	—	$	238,208	$	—	$	—	$	252,433	$	—
U.S. Treasury notes	147,722		—		—		149,567		—		—
Other	9,948		—		—		9,901		—		—
	$	157,670	$	238,208	$	—	$	159,468	$	252,433	$	—

Other Assets, net (Tables)

9 Months Ended

Sep. 30, 2023

Other Assets [Abstract]

Schedule of Other Assets, Net

The following table summarizes the Company’s other assets, net (in thousands):


	September 30, 2023		December 31, 2022
Loans to physician partners	$	70,475	$	69,383
Health plan deposits	12,051		11,728
Equity method investments(1)	39,170		17,352
Right-of-use lease assets	14,594		13,029
Other	3,894		5,432
	$	140,184	$	116,924

___________________________________________

(1)See Note 14 for additional discussion related to the Company's equity method investments.

Medical Claims and Related Payables (Tables)

9 Months Ended

Sep. 30, 2023

Insurance [Abstract]

Summary Changes in Medical Claims and Related Payables

The following table presents the components of changes in medical claims and related payables (in thousands):


	September 30,
	2023		2022
Medical claims and related payables, beginning of the year	$	339,748	$	239,014
Components of incurred costs related to:
Current year	3,032,501		1,756,943
Prior years	53,456		14,692
Discontinued operations - prior years	—		—
	3,085,957		1,771,635
Claims paid related to:
Current year	(2,046,004)		(1,283,242)
Prior years	(387,161)		(236,413)
Discontinued operations - prior years	—		(154)
	(2,433,165)		(1,519,809)
Medical claims and related payables, end of the period	$	992,540	$	490,840

Other Liabilities (Tables)

9 Months Ended

Sep. 30, 2023

Other Liabilities [Abstract]

Summary of Other Liabilities

The following table summarizes the Company’s other liabilities (in thousands):


	September 30, 2023		December 31, 2022
Other long-term contingencies	$	49,523	$	62,931
Lease liabilities, long-term	11,975		9,885
Equity method liabilities – ACO REACH	—		4,657
Other	8,872		5,813
	$	70,370	$	83,286

Net Income (Loss) Per Common Share (Tables)

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Summery of Net Income (Loss) Per Share Attributable to Common Stockholder

The following table illustrates the computation of basic and diluted EPS (in thousands, except per share amounts):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Numerator
Income (loss) from continuing operations	$	(31,483)	$	(30,503)	$	(32,319)	$	(50,815)
Noncontrolling interests’ share in (earnings) loss from continuing operations	47		71		156		228
Net income (loss) attributable to common stockholders before discontinued operations	(31,436)		(30,432)		(32,163)		(50,587)
Income (loss) from discontinued operations	—		(236)		—		500
Net income (loss) attributable to common stockholders	$	(31,436)	$	(30,668)	$	(32,163)	$	(50,087)
Denominator
Weighted average shares outstanding – basic	405,787		411,065		412,077		406,823
Weighted average shares outstanding – diluted	405,787		411,065		412,077		406,823
Net income (loss) per share attributable to common stockholders
Net income (loss) per common share from continuing operations, basic and diluted	$	(0.08)	$	(0.07)	$	(0.08)	$	(0.12)
Net income (loss) per common share from discontinued operations, basic and diluted	$	—	$	—	$	—	$	—

Schedule of Antidilutive Securities


	September 30,
	2023	2022
Stock options	17,424	20,474
Restricted stock units	9,183	1,908

Supplemental Cash Flow Information (Tables)

9 Months Ended

Sep. 30, 2023

Supplemental Cash Flow Elements [Abstract]

Summary of Supplemental Cash Flow Information

The following table provides supplemental cash flow information (in thousands):


	Nine Months Ended September 30,
	2023		2022
Supplemental cash flow information:
Interest paid	$	4,519	$	2,878
Income taxes paid	5,156		4,223
Supplemental disclosure of non-cash investing and financing activities:
Right-of-use asset obtained in exchange for new operating lease liability	3,612		7,288
Non-cash investment in unconsolidated subsidiaries	—		190

Summary of Restricted Cash Equivalents from Continuing Operations

The following table summarizes cash, cash equivalents and restricted cash equivalents from continuing operations (in thousands):


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	168,339	$	497,070
Restricted cash and equivalents(1)	10,204		10,610
Cash, cash equivalents and restricted cash equivalents	$	178,543	$	507,680

___________________________________________

(1)Restricted cash and equivalents primarily consist of amounts used as collateral to secure letters of credit that the Company is required to maintain pursuant to contracts with payors.

Schedule of Cash and Cash Equivalents from Continuing Operations

The following table summarizes cash, cash equivalents and restricted cash equivalents from continuing operations (in thousands):


	September 30, 2023		December 31, 2022
Cash and cash equivalents	$	168,339	$	497,070
Restricted cash and equivalents(1)	10,204		10,610
Cash, cash equivalents and restricted cash equivalents	$	178,543	$	507,680

___________________________________________

(1)Restricted cash and equivalents primarily consist of amounts used as collateral to secure letters of credit that the Company is required to maintain pursuant to contracts with payors.

Variable Interest Entities (Tables)

9 Months Ended

Sep. 30, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Summary of Consolidated Asset and Liabilities Include VIE Assets and Liabilities

agilon health, inc.’s consolidated assets and liabilities include VIE assets and liabilities as follows (in thousands):


	September 30, 2023		December 31, 2022
Assets
Cash and cash equivalents	$	86,581	$	155,819
Restricted cash equivalents	10,202		10,610
Receivables, net	1,334,394		492,077
Prepaid expenses and other current assets, net	20,781		15,515
Property and equipment, net	1,817		1,567
Intangible assets, net	20,187		17,347
Other assets, net	9,790		10,371
Liabilities
Medical claims and related payables	962,505		300,798
Accounts payable and accrued expenses	259,553		159,526
Other liabilities	4,188		2,059

Schedule of Equity Method Investments

The following table summarizes the Company’s equity method investments (in thousands):


	September 30, 2023		December 31, 2022
Equity method investments - Other(1)	$	9,114	$	8,329
Equity method investments - ACO REACH(1)	30,056		9,023
Equity method liabilities - ACO REACH(2)	—		(4,657)

___________________________________________

(1)Included in Other assets, net in the condensed consolidated balance sheets.

(2)Included in Other liabilities in the condensed consolidated balance sheets.

Summary of Operating Results

The combined summarized operating results of the Company’s ACO REACH entities are as follows (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2023		2022		2023		2022
Medical services revenue	$	296,937	$	241,408	$	858,286	$	786,171
Medical services expense	(242,431)		(231,910)		(741,752)		(735,924)
Other medical expenses(1)	(31,970)		(9,215)		(71,138)		(34,019)
Income (loss) from operations	18,330		(3,035)		31,515		6,333
Net income (loss)(2)	14,628		(4,361)		24,388		3,345

___________________________________________

(2)Included in Income (loss) from equity method investments in the condensed consolidated statements of operations.

Summarized Balance Sheet

The combined summarized balance sheet of the Company’s ACO REACH entities are as follows (in thousands):


	September 30, 2023		December 31, 2022
Current assets	$	165,257	$	70,625
Noncurrent assets	130		—
Total assets	165,387		70,625
Current and total liabilities	136,285		67,343

Business (Details)	Sep. 30, 2023 member
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of medicare advantage members enrolled with private health plans	420,300

Summary of Significant Accounting Policies (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Accounting Policies [Abstract]
Gross carrying amount of property and equipment	$ 38.6		$ 38.6		$ 29.5
Accumulated amortization	12.4		12.4		$ 9.4
Depreciation expense	$ 2.1	$ 1.4	$ 5.6	$ 2.7

Revenue, Receivables, and Concentration of Credit Risk (Details) - Medicare Advantage Payors	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Revenue from Contract with Customer Benchmark \| Payor A
Concentration Risk [Line Items]
Concentration risk, percentage	24.00%	26.00%	24.00%	25.00%
Revenue from Contract with Customer Benchmark \| Payor B
Concentration Risk [Line Items]
Concentration risk, percentage	14.00%	19.00%	15.00%	19.00%
Revenue from Contract with Customer Benchmark \| Payor C
Concentration Risk [Line Items]
Concentration risk, percentage	18.00%	14.00%	17.00%	14.00%
Revenue from Contract with Customer Benchmark \| Payor F
Concentration Risk [Line Items]
Concentration risk, percentage	10.00%		10.00%
Receivables \| Payor A
Concentration Risk [Line Items]
Concentration risk, percentage					13.00%
Receivables \| Payor B
Concentration Risk [Line Items]
Concentration risk, percentage			18.00%		20.00%
Receivables \| Payor C
Concentration Risk [Line Items]
Concentration risk, percentage			12.00%		10.00%
Receivables \| Payor D
Concentration Risk [Line Items]
Concentration risk, percentage					10.00%
Receivables \| Payor E
Concentration Risk [Line Items]
Concentration risk, percentage					11.00%
Receivables \| Payor F
Concentration Risk [Line Items]
Concentration risk, percentage			26.00%

Marketable Securities and Fair Value Measurements - Summary of Marketable Securities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Marketable debt securities [Line Items]
Amortized Cost	$ 402,196	$ 417,461
Gross Unrealized Gains	0	60
Gross Unrealized Losses	(6,318)	(5,620)
Fair Value	395,878	411,901
Corporate debt securities
Marketable debt securities [Line Items]
Amortized Cost	241,723	255,613
Gross Unrealized Gains	0	60
Gross Unrealized Losses	(3,515)	(3,240)
Fair Value	238,208	252,433
U.S. Treasury notes
Marketable debt securities [Line Items]
Amortized Cost	150,473	151,873
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(2,751)	(2,306)
Fair Value	147,722	149,567
Other
Marketable debt securities [Line Items]
Amortized Cost	10,000	9,975
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(52)	(74)
Fair Value	$ 9,948	$ 9,901

Marketable Securities and Fair Value Measurements - Additional Information (Details) - USD ($)	Sep. 30, 2023	Dec. 31, 2022
Debt Securities [Abstract]
Marketable securities in an unrealized loss position for less than twelve months	$ 373,300,000	$ 407,400,000
Allowances for credit losses	$ 0	$ 0

Marketable Securities and Fair Value Measurements - Summarizes Marketable Securities Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Amortized Cost
2023	$ 27,922
2024	155,006
2025	183,796
2026	35,472
Amortized Cost	402,196	$ 417,461
Fair Value
2023	27,826
2024	153,241
2025	179,855
2026	34,956
Fair Value	$ 395,878	$ 411,901

Marketable Securities and Fair Value Measurements - Summary of Fair Value Assets Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Securities, Available-for-Sale [Line Items]
Fair Value	$ 395,878	$ 411,901
Level 1
Debt Securities, Available-for-Sale [Line Items]
Fair Value	157,670	159,468
Level 2
Debt Securities, Available-for-Sale [Line Items]
Fair Value	238,208	252,433
Level 3
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
Corporate debt securities
Debt Securities, Available-for-Sale [Line Items]
Fair Value	238,208	252,433
Corporate debt securities \| Level 1
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
Corporate debt securities \| Level 2
Debt Securities, Available-for-Sale [Line Items]
Fair Value	238,208	252,433
Corporate debt securities \| Level 3
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
U.S. Treasury notes
Debt Securities, Available-for-Sale [Line Items]
Fair Value	147,722	149,567
U.S. Treasury notes \| Level 1
Debt Securities, Available-for-Sale [Line Items]
Fair Value	147,722	149,567
U.S. Treasury notes \| Level 2
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
U.S. Treasury notes \| Level 3
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
Other
Debt Securities, Available-for-Sale [Line Items]
Fair Value	9,948	9,901
Other \| Level 1
Debt Securities, Available-for-Sale [Line Items]
Fair Value	9,948	9,901
Other \| Level 2
Debt Securities, Available-for-Sale [Line Items]
Fair Value	0	0
Other \| Level 3
Debt Securities, Available-for-Sale [Line Items]
Fair Value	$ 0	$ 0

Other Assets, net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other Assets [Abstract]
Loans to physician partners	$ 70,475	$ 69,383
Health plan deposits	12,051	11,728
Equity method investments	39,170	17,352
Right-of-use lease assets	14,594	13,029
Other	3,894	5,432
Other assets, net	$ 140,184	$ 116,924

Medical Claims and Related Payables - Summary Changes in Medical Claims and Related Payables (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and related payables, beginning of the year	$ 339,748	$ 239,014
Components of incurred costs related to:
Current year	3,032,501	1,756,943
Prior years	53,456	14,692
Incurred cost related to claims	3,085,957	1,771,635
Claims paid related to:
Current year	(2,046,004)	(1,283,242)
Prior years	(387,161)	(236,413)
Claims paid related	(2,433,165)	(1,519,809)
Medical claims and related payables, end of the period	992,540	490,840
Discontinued Operations
Components of incurred costs related to:
Prior Year Claims And Claims Adjustment Recovery	0	0
Claims paid related to:
Discontinued operations - prior years	$ 0	$ (154)

Medical Claims and Related Payables - Additional Information (Details) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Insurance [Abstract]
Related payables associated with retained liability	$ 13.2	$ 7.0

Other Liabilities - Summary of Other Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other Liabilities [Abstract]
Other long-term contingencies	$ 49,523	$ 62,931
Lease liabilities, long-term	11,975	9,885
Equity method liabilities – ACO REACH	0	4,657
Other	8,872	5,813
Other liabilities	$ 70,370	$ 83,286
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other liabilities	Other liabilities

Other Liabilities - Additional Information (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Other Liabilities [Line Items]
Other long-term contingencies	$ 49,523	$ 62,931
Unasserted Claim
Other Liabilities [Line Items]
Other long-term contingencies	49,500	$ 62,900
Minimum
Other Liabilities [Line Items]
Estimated range of reasonably possible losses in excess of reserves accrued	0
Maximum
Other Liabilities [Line Items]
Estimated range of reasonably possible losses in excess of reserves accrued	$ 69,100

Debt (Details) - USD ($)				9 Months Ended
Debt (Details) - USD ($)	Oct. 01, 2023	May 25, 2023	Feb. 18, 2021	Sep. 30, 2023
Secured Term Loan Facility
Debt Instrument [Line Items]
Credit facility remaining borrowing capacity			$ 100,000,000
Line of credit facility, accordion feature, increase limit			50,000,000
Long-term debt				$ 40,000,000
Weighted average effective interest rate				9.349%
Secured Term Loan Facility \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.00%
Secured Term Loan Facility \| Secured Overnight Financing Rate (SOFR) \| Forecast
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	3.50%
Secured Term Loan Facility \| Secured Overnight Financing Rate (SOFR) \| Maximum
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		4.00%
Secured Term Loan Facility \| Base Rate Loans
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.00%
Secured Term Loan Facility \| Base Rate Loans \| Forecast
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	2.50%
Secured Term Loan Facility \| Base Rate Loans \| Maximum
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		3.00%
Secured Term Loan Facility \| Overnight Federal Funds Rate
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.50%
Secured Term Loan Facility \| One-month LIBO Rate
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		1.00%
Secured Revolving Facility
Debt Instrument [Line Items]
Credit facility remaining borrowing capacity			100,000,000
Credit facility remaining borrowing capacity				$ 32,900,000
Secured Revolving Facility \| Maximum
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage		0.50%
Secured Revolving Facility \| Minimum \| Forecast
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage	0.375%
Standby Letters of Credit
Debt Instrument [Line Items]
Credit facility remaining borrowing capacity			$ 100,000,000
Long-term debt				0
Total outstanding letters of credit				$ 67,100,000
Extended term of letters of credit				1 year
DCE Investment \| Standby Letters of Credit
Debt Instrument [Line Items]
Total outstanding letters of credit				$ 37,200,000

Common Stock (Details) - $ / shares shares in Thousands		3 Months Ended		9 Months Ended
Common Stock (Details) - $ / shares shares in Thousands	May 18, 2023	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
CD&R
Subsidiary Sale Of Stock [Line Items]
Sale of stock, number of shares issued in transaction (in shares)	94,600
Sale of stock, price paid per share (in dollars per share)	$ 20.80
Common Stock
Subsidiary Sale Of Stock [Line Items]
Number of shares issued under share-based awards (in shares)		600	3,500	3,200	11,600
Common stock repurchase (in shares)	9,600			9,615

Net Income (Loss) Per Common Share - Computation of Basic and Diluted EPS (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Numerator
Income (loss) from continuing operations	$ (31,483)	$ (30,503)	$ (32,319)	$ (50,815)
Noncontrolling interests’ share in (earnings) loss from continuing operations	47	71	156	228
Net income (loss) attributable to common stockholders before discontinued operations	(31,436)	(30,432)	(32,163)	(50,587)
Income (loss) from discontinued operations	0	(236)	0	500
Net income (loss) attributable to common shares	$ (31,436)	$ (30,668)	$ (32,163)	$ (50,087)
Denominator
Weighted average shares outstanding – basic (in shares)	405,787	411,065	412,077	406,823
Weighted average shares outstanding – diluted (in shares)	405,787	411,065	412,077	406,823
Net income (loss) per share attributable to common stockholders
Continuing operations, basic (in dollars per share)	$ (0.08)	$ (0.07)	$ (0.08)	$ (0.12)
Continuing operations, diluted (in dollars per share)	(0.08)	(0.07)	(0.08)	(0.12)
Discontinued operations, basic (in dollars per share)	0	0	0	0
Discontinued operations, diluted (in dollars per share)	$ 0	$ 0	$ 0	$ 0

Net Income (Loss) Per Common Share - Schedule of Antidilutive Securities (Details) - shares shares in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Stock options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	17,424	20,474
Restricted stock units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	9,183	1,908

Goodwill and Amortizable Intangible Assets (Details) - USD ($) $ in Thousands		3 Months Ended		9 Months Ended
	Feb. 28, 2023	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Indefinite-Lived Intangible Assets [Line Items]
Goodwill		$ 62,387		$ 62,387		$ 41,540
Gross carrying amount of amortizable intangible assets		165,100		165,100		130,800
Accumulated amortization		72,400		72,400		63,100
Amortization expense		3,200	$ 2,100	9,400	$ 7,200
Net cash paid in business combination				44,479	$ 0
Weighted-average life	10 years
mphrX
Indefinite-Lived Intangible Assets [Line Items]
Net cash paid in business combination	$ 44,500
mphrX \| Developed Technology
Indefinite-Lived Intangible Assets [Line Items]
Assets acquired	25,700
mphrX \| Customer Relationships
Indefinite-Lived Intangible Assets [Line Items]
Goodwill	20,600
Assets acquired	1,900
Net liabilities assumed	$ 3,700
Hawaii Reporting Unit
Indefinite-Lived Intangible Assets [Line Items]
Goodwill		$ 39,000		$ 39,000
Goodwill						$ 39,000

Supplemental Cash Flow Information - Summary of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Supplemental cash flow information:
Interest paid	$ 4,519	$ 2,878
Income taxes paid	5,156	4,223
Supplemental disclosure of non-cash investing and financing activities:
Right-of-use asset obtained in exchange for new operating lease liability	3,612	7,288
Non-cash investment in unconsolidated subsidiaries	$ 0	$ 190

Supplemental Cash Flow Information - Summary of Cash, Cash Equivalents and Restricted Cash Equivalents from Continuing Operations (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Sep. 30, 2022	Dec. 31, 2021
Supplemental Cash Flow Elements [Abstract]
Cash and cash equivalents	$ 168,339	$ 497,070
Restricted cash and equivalents	10,204	10,610
Cash, cash equivalents and restricted cash equivalents	$ 178,543	$ 507,680	$ 564,479	$ 1,054,820

Variable Interest Entities - Summary of Consolidated Asset and Liabilities Include VIE Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Assets
Cash and cash equivalents	$ 168,339	$ 497,070
Receivables, net	1,345,711	497,574
Prepaid expenses and other current assets	36,512	34,119
Property and equipment, net	26,203	20,050
Intangible assets, net	92,657	67,680
Liabilities
Medical claims and related payables	1,005,762	346,727
Accounts payable and accrued expenses	290,563	183,364
Variable Interest Entity
Assets
Cash and cash equivalents	86,581	155,819
Restricted cash equivalents	10,202	10,610
Receivables, net	1,334,394	492,077
Prepaid expenses and other current assets	20,781	15,515
Property and equipment, net	1,817	1,567
Intangible assets, net	20,187	17,347
Other assets, net	9,790	10,371
Liabilities
Medical claims and related payables	962,505	300,798
Accounts payable and accrued expenses	259,553	159,526
Other liabilities	$ 4,188	$ 2,059

Variable Interest Entities - Additional Information (Details)	3 Months Ended
	Sep. 30, 2023 partner geography investment entity
Variable Interest Entity [Line Items]
Number of geographies \| geography	10
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Number of wholly-owned risk-bearing entities	29
Number of direct contracting entities	8
Number of physician group partners \| partner	12
Variable Interest Entity, Not Primary Beneficiary
Variable Interest Entity [Line Items]
Number of equity method investments for VIEs \| investment	9

Variable Interest Entities - Schedule of Equity Method Investments (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Variable Interest Entity [Line Items]
Equity method investments	$ 39,170	$ 17,352
Equity method liabilities	0	(4,657)
Other Equity Methods
Variable Interest Entity [Line Items]
Equity method investments	9,114	8,329
ACO REACH
Variable Interest Entity [Line Items]
Equity method investments	$ 30,056	$ 9,023

Variable Interest Entities - Summary of Operating Results (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Variable Interest Entity [Line Items]
Medical services revenue	$ 1,215,660	$ 694,858	$ 3,500,859	$ 2,018,437
Income (loss) from operations	(48,971)	(29,518)	(72,531)	(51,313)
Net income (loss)	(31,436)	(30,668)	(32,163)	(50,087)
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Variable Interest Entity [Line Items]
Income (loss) from operations	18,330	(3,035)	31,515	6,333
Net income (loss)	14,628	(4,361)	24,388	3,345
Physician compensation expense	25,100	2,900	51,400	15,000
Medical services revenue
Variable Interest Entity [Line Items]
Medical services revenue	1,212,132	693,934	3,494,006	2,015,541
Expenses	(1,104,396)	(618,287)	(3,085,957)	(1,771,635)
Medical services revenue \| Equity Method Investment, Nonconsolidated Investee or Group of Investees
Variable Interest Entity [Line Items]
Medical services revenue	296,937	241,408	858,286	786,171
Expenses	(242,431)	(231,910)	(741,752)	(735,924)
Other operating revenue
Variable Interest Entity [Line Items]
Medical services revenue	3,528	924	6,853	2,896
Expenses	(80,787)	(50,659)	(249,936)	(144,512)
Other operating revenue \| Equity Method Investment, Nonconsolidated Investee or Group of Investees
Variable Interest Entity [Line Items]
Expenses	$ (31,970)	$ (9,215)	$ (71,138)	$ (34,019)

Variable Interest Entities - Summarized balance sheet (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Variable Interest Entity [Line Items]
Current assets	$ 1,956,644	$ 1,451,274
Total assets	2,278,075	1,697,468
Current and total liabilities	1,406,475	656,859
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Variable Interest Entity [Line Items]
Current assets	165,257	70,625
Noncurrent assets	130	0
Total assets	165,387	70,625
Current and total liabilities	$ 136,285	$ 67,343