Revenue increased 72% to $1.06 billion in
the fourth quarter 2023, Medicare Advantage membership increased
68% to 388,400, and total members on the agilon platform grew to
477,700 as of December 31, 2023
2023 performance impacted by acceleration in
medical costs due to macro dynamics, revised 2024 guidance assumes
continuation of higher medical cost trends
Executing targeted action plan with focus on
measured growth, Class of 2025 expected to add at least 60,000
Medicare Advantage members across 5 physician groups
agilon health, inc. (NYSE: AGL), the trusted partner empowering
physicians to transform health care in our communities, announced
results for the fourth quarter and fiscal year ended December 31,
2023.
“agilon is navigating through a complex transition period for
the Medicare Advantage industry and for our company, and we are
taking significant actions to help mitigate the impact of this
evolving environment and strengthening our reserves,” said Steve
Sell, chief executive officer. “While near-term dynamics are
negatively affecting our financial results, demand for our platform
and the fundamental drivers of our business remain strong as we
continue to deliver significant value to patients, payors, and our
PCP partners. We believe we are well positioned to accelerate
performance over the medium and long-term.”
Fourth Quarter and Fiscal Year 2023
Results:
- Total members on the agilon platform increased to 477,700 as of
December 31, 2023, including 388,400 Medicare Advantage members and
89,300 ACO REACH beneficiaries. Medicare Advantage membership
increased 68%, with 11% growth in same geographies.
- Total revenue of $1.06 billion in the fourth quarter 2023
increased 72% compared to $615 million in the fourth quarter 2022.
For the fiscal year 2023, total revenue of $4.32 billion increased
81% compared to $2.39 billion in 2022.
- Gross profit of negative $95 million in the fourth quarter 2023
compared to $16 million in the fourth quarter 2022. For the fiscal
year 2023, gross profit of $70 million compared to $111 million in
2022. Net loss of $230 million in the fourth quarter 2023 compared
to a loss of $57 million in the fourth quarter 2022. For the fiscal
year 2023, net loss of $263 million compared to a loss of $107
million in 2022.
- Medical margin of negative $102 million during the fourth
quarter 2023, compared to $63 million in the fourth quarter 2022.
For the fiscal year 2023, Medical Margin of $299 million, compared
to $291 million in 2022. Medical Margin during the fourth quarter
2023 was negatively impacted by accelerating medical costs
including prior period development from previous quarters.
- Adjusted EBITDA loss of $137 million in the fourth quarter
2023, compared to an Adjusted EBITDA loss of $32 million in the
fourth quarter 2022. For the fiscal year 2023, Adjusted EBITDA loss
of $95 million, compared to an Adjusted EBITDA loss of $45 million
in the fiscal year 2022.
Key Financial and Operating Metrics
($M):
(Fourth Quarter 2023 vs. 2022)
Three Months
Ended December 31,
Change
2023
2022
% YoY
Medicare Advantage Members1
388,400
230,800
68%
ACO REACH Members1, 2
89,300
89,000
—%
Total Members Live on Platform1, 2
477,700
319,800
49%
Avg. Medicare Advantage Members
391,700
233,300
68%
Total revenues
$1,056
$615
72%
Gross Profit
($95)
$16
NM
Medical Margin
($102)
$63
NM
Net Loss
($230)
($57)
NM
Adjusted EBITDA3
($137)
($32)
NM
Geography Entry Costs
$26
$32
(19%)
- Membership metrics reflect end of period results.
- agilon’s ACO REACH entities are not included within its
consolidated financial results.
- agilon's ACO REACH entities contributed $6 million and $8
million to Adjusted EBITDA during the fourth quarter 2023 and
fourth quarter 2022, respectively.
Key Financial and Operating Metrics
($M):
(Fiscal Year 2023 vs. 2022)
Twelve Months
Ended December 31,
Change
2023
2022
% YoY
Medicare Advantage Members1
388,400
230,800
68%
ACO REACH Members1, 2
89,300
89,000
—%
Total Members Live on Platform1, 2
477,700
319,800
49%
Avg. Medicare Advantage Members
379,400
225,100
69%
Total revenues
$4,316
$2,388
81%
Gross Profit
$70
$111
(37%)
Medical Margin
$299
$291
3%
Net Loss
($263)
($107)
NM
Adjusted EBITDA3
($95)
($45)
NM
Geography Entry Costs
$75
$68
10%
- Membership metrics reflect end of period results.
- agilon’s ACO REACH entities are not included within its
consolidated financial results.
- agilon's ACO REACH entities contributed $39 million and $14
million to Adjusted EBITDA during the fiscal year 2023 and fiscal
year 2022, respectively.
Medical Margin Performance Details
For the fiscal year 2023, Medical Margin of $299 million was
approximately $51 million below the midpoint of the company’s
guidance of range of $340 million to $360 million provided on
January 5, 2024. The company estimates approximately $38 million of
the lower Medical Margin is from costs and revenue attributable to
the fourth quarter and $13 million of the lower Medical Margin is
attributable to costs and revenue attributable previous
periods.
Relative to the company’s previous guidance, the lower Medical
Margin was primarily driven by two factors. First, as the company
completed the financial closing process in February, it received
updated data including relatively complete claims data from its
largest payors, and additional information such as seasonality
factors and census data. The company completed its analysis of this
data in mid-February, with support from internal and external
actuaries, which indicated medical claims were higher than the
company’s previous estimate. Second, in light of this new
information and the dynamic utilization environment, the company
strengthened its reserve position for incurred but not reported
medical claims. A range of reserve scenarios were developed and the
company has reserved at the high-end of its estimates. The company
believes this is a prudent approach given the environment.
Performance Action Plan
On January 5, 2024 agilon health announced a targeted action
plan to improve performance. This plan includes expanding
onboarding support for newer primary care physicians (PCPs) in
mature markets, refining payor partnerships, improving data
visibility and analytics, and accelerating operating efficiency.
Management anticipates these actions will support growth in
Adjusted EBITDA in 2024 and beyond.
The company has made solid progress on the targeted action plan.
Progress to date includes physician trainings in mature markets
with 90% of new physicians in those markets to be trained during
the first half of 2024; increased data visibility from most all
national and large regional payors as well as targeted changes to
our percentage of premium rates in key markets; onboarding of payor
data into the company’s new financial pipeline with over 55% of
membership data expected in the first quarter and over 75% of
membership data during the second quarter; and a reduction in
platform support to 3% of revenue in 2024.
Class of 2025 New Partners
agilon health anticipates the Class of 2025 new partners will
include at least 5 physician groups with more than 60,000 new
Medicare Advantage (MA) members. Beginning in 2025, the agilon
health physician network will expand to at least 36 physician
groups and 3,000 primary care physicians.
agilon health now anticipates geographic entry costs will be in
the range of $55 million to $65 million, down from the company’s
previous expectation of ~$70 million. Given the current
environment, agilon health is taking a measured approach to growth
for the Class of 2025.
Capital Position and Balance Sheet
agilon health’s balance sheet as of December 31, 2023 included
cash, cash equivalents and marketable securities of $495 million
and total debt of $39 million. In addition, agilon health has $22
million of cash associated with the company’s unconsolidated ACO
REACH entities.
Outlook for Fiscal Year 2024
($M):
agilon health’s updated guidance assumes that the higher medical
cost trend from 2023 will continue in 2024. Revised guidance
assumes a medical cost trend of approximately 6.6% in 2024 for Year
2+ markets, which is 250 bps above the company’s prior expectation
and compares to the 7.0% medical cost trend observed in 2023.
Medical cost trend includes the impact of the company’s clinical
programs and excludes the impact from non-medical costs (e.g.,
supplemental benefits), which is expected to drive less impact to
cost trend in 2024 compared to 2023.
Year Ended December 31,
2024
Updated Guidance1
Previous Guidance
Low
High
Low
High
Medicare Advantage Members1
540,000
550,000
548,000
553,000
ACO REACH Members1,2
120,000
125,000
N/A
N/A
Total Members Live on Platform1
660,000
675,000
N/A
N/A
Avg. Medicare Advantage Members
527,000
536,000
N/A
N/A
Total Revenues
$6,350
$6,465
$6,350
$6,420
Medical Margin
$400
$450
$560
$600
Adjusted EBITDA3
($60)
($15)
$40
$60
Geography Entry Costs4
$65
$55
$70
$70
- Membership reflects management’s outlook for end of
period.
- agilon’s partnered ACO REACH entities are not consolidated
within its financial results.
- Adjusted EBITDA contribution from ACO REACH is expected to be
approximately $40 million for fiscal year 2024.
- Geography Entry Costs represent the corresponding expense
included in the low-end and high-end of management’s outlook for
Adjusted EBITDA.
Outlook for First Quarter 2024
($M):
Quarter Ended
March 31, 2024
Low
High
Medicare Advantage Members1
520,000
530,000
ACO REACH Members1,2
125,000
130,000
Total Members Live on Platform1
645,000
660,000
Avg. Medicare Advantage Members
516,000
525,000
Total Revenues
$1,605
$1,630
Medical Margin
$155
$170
Adjusted EBITDA3
$15
$25
Geography Entry Costs4
$23
$20
- Membership reflects management’s outlook for end of
period.
- agilon’s partnered ACO REACH entities are not consolidated
within its financial results.
- Adjusted EBITDA contribution from ACO REACH is expected to be
approximately $14 million for the first quarter 2024.
- Geography Entry Costs represent the corresponding expense
included in the low-end and high-end of management’s outlook for
Adjusted EBITDA.
We have not reconciled guidance for Medical Margin to Gross
Profit or Adjusted EBITDA to net income (loss), the most comparable
GAAP measures, and have not provided forward-looking guidance for
net income (loss) in each case because of the uncertainty around
certain items that may impact Gross Profit or net income (loss),
including non-cash stock-based compensation.
Webcast and Conference Call:
agilon health will host a conference call to discuss fourth
quarter and fiscal year 2023 results on Tuesday, February 27, 2024
at 4:30 PM Eastern Time. The conference call can be accessed by
dialing (833) 470-1428 for U.S. participants and +1 (929) 526-1599
for international participants and referencing participant code
615568. A simultaneous webcast can be accessed by visiting the
“Events & Presentations” section of agilon’s Investor Relations
website at https://investors.agilonhealth.com. A replay of the call
will be available via webcast for on-demand listening shortly after
the completion of the call.
About agilon health
agilon health is the trusted partner empowering physicians to
transform health care in our communities. Through our partnerships
and purpose-built platform, agilon is accelerating at scale how
physician groups and health systems transition to a value-based
Total Care Model for their senior patients. agilon provides the
technology, people, capital, process, and access to a peer network
of 2,400+ PCPs that allow its physician partners to maintain their
independence and focus on the total health of their most vulnerable
patients. Together, agilon and its physician partners are creating
the healthcare system we need – one built on the value of care, not
the volume of fees. The result: healthier communities and empowered
doctors. agilon is the trusted partner in 30+ diverse communities
and is here to help more of our nation's leading physician groups
and health systems have a sustained, thriving future. For more
information visit www.agilonhealth.com and connect with us on X,
Instagram, LinkedIn and YouTube.
Forward-Looking Statements
Statements in this release that are not historical factual
statements are “forward-looking statements” within the meaning of
Section 27A of the Securities Act of 1933, as amended, and Section
21E of the Securities Exchange Act of 1934, as amended.
Forward-looking statements include, among other things, statements
regarding our and our officers’ intent, belief or expectation as
identified by the use of words such as “believes,” “expects,”
“may,” “will,” “shall,” “should,” “would,” “could,” “seeks,”
“aims,” “projects,” “is optimistic,” “intends,” “plans,”
“estimates,” “anticipates” or the negative versions of these words
or other comparable terms. Examples of forward-looking statements
include, among other things: statements regarding timing, outcomes
and other details relating to current, pending or contemplated new
markets, growth opportunities, ability to deliver sustainable
long-term value, business environment, long-term opportunities and
strategic growth plans, expected revenue, medical costs, net income
and gross profit, total and average membership, Adjusted EBITDA,
Medical Margin, geography entry costs and other financial
projections and assumptions, including our fiscal year and first
quarter 2024 guidance. Forward-looking statements reflect our
current expectations and views about future events and are subject
to risks and uncertainties that could significantly affect our
future financial condition and results of operations. While
forward-looking statements reflect our good faith belief and
assumptions we believe to be reasonable based upon current
information, we can give no assurance that our expectations or
forecasts will be attained. Forward-looking statements are subject
to known and unknown risks and uncertainties, many of which may be
outside our control. These risks and uncertainties that could cause
actual results and outcomes to differ from those reflected in
forward-looking statements include, but are not limited to: our
history of net losses and the expectation that our expenses will
increase in the future; failure to identify and develop successful
new geographies, physician partners and payors, or execute upon our
growth initiatives; success in executing our operating strategies
or achieving results consistent with our historical performance;
medical expenses incurred on behalf of our members may exceed
revenues we receive; our ability to secure contracts with Medicare
Advantage payors; our ability to grow new physician partner
relationships sufficient to recover startup costs; availability of
additional capital, on acceptable terms or at all, to support our
business in the future; significant reduction in our membership;
transition to a Total Care Model may be challenging for physician
partners; public health crises, such as COVID-19, could adversely
affect us; inaccuracy in estimates of our members’ risk adjustment
factors, medical services expense, incurred but not reported
claims, and earnings pursuant to payor contracts; the impact of
restrictive clauses or exclusivity provisions in some of our
contracts with physician partners; our to hire and retain qualified
personnel; our ability to realize the full value of our intangible
assets; security breaches, cybersecurity attacks, loss of data and
other disruptions to our information systems; our ability to
protect the confidentiality of our know-how and other proprietary
and internally developed information; reliance on our subsidiaries;
Environmental, Social, and Governance issues; reliance on a limited
number of key payors; the limited terms of contracts with our
payors and our ability to renew them upon expiration; reliance on
our payors, physician partners and other providers to operate our
business; our ability to obtain accurate and complete diagnosis
data; reliance on third-party software, data, infrastructure and
bandwidth; consolidation and competition in the healthcare
industry; the impact of changes to, and dependence on, federal
government healthcare programs; uncertain or adverse economic and
macroeconomic conditions, including a downturn or decrease in
government expenditures; regulation of the healthcare industry and
our and our physician partners’ ability to comply such laws and
regulations; federal and state investigations, audits and
enforcement actions; repayment obligations arising out of payor
audits; negative publicity regarding the managed healthcare
industry generally; our use, disclosure and processing of
personally identifiable information, protected health information,
and de-identified data; failure to obtain or maintain an insurance
license, a certificate of authority or an equivalent authorization;
lawsuits not covered by insurance; changes in tax laws and
regulations, or changes in related judgments or assumptions; our
indebtedness and our potential to incur more debt; dependence on
our subsidiaries for cash to fund all of our operations and
expenses; provisions in our governing documents; ability to achieve
a return on your investment depends on appreciation in the price of
our common stock; the material weakness in our internal control
over financial reporting and our ability to remediate such material
weakness; and risks related to other factors discussed in our
filings with the Securities and Exchange Commission (the “SEC”),
including the factors discussed under “Risk Factors” in our Annual
Report on Form 10-K for the fiscal year ended December 31, 2023,
which can be found at the SEC’s website at www.sec.gov. Except as
required by law, we do not undertake, and hereby disclaim, any
obligation to update any forward-looking statements, which speak
only as of the date on which they are made.
agilon health, inc.
Consolidated Balance
Sheets
In thousands, except per share
data
December 31,
2023
2022
ASSETS
Current assets:
Cash and cash equivalents
$
107,570
$
465,302
Restricted cash and equivalents
6,759
10,610
Marketable securities
380,773
411,901
Receivables, net
942,461
492,364
Prepaid expenses and other current assets,
net
42,513
31,572
Current assets of discontinued
operations
—
39,525
Total current assets
1,480,076
1,451,274
Property and equipment, net
27,576
19,937
Intangible assets, net
63,769
18,448
Goodwill
24,133
2,513
Other assets, net
145,312
105,861
Non-current assets of discontinued
operations
—
99,435
Total assets
$
1,740,866
$
1,697,468
LIABILITIES AND STOCKHOLDERS’ EQUITY
(DEFICIT)
Current liabilities:
Medical claims and related payables
$
737,724
$
300,798
Accounts payable and accrued expenses
233,182
177,428
Current portion of long-term debt
6,250
5,000
Current liabilities of discontinued
operations
—
51,865
Total current liabilities
977,156
535,091
Long-term debt, net of current portion
32,308
38,482
Other liabilities
70,381
82,492
Non-current liabilities of discontinued
operations
—
794
Total liabilities
1,079,845
656,859
Commitments and contingencies
Stockholders' equity (deficit):
Common stock, $0.01 par value: 2,000,000
shares authorized; 406,387 and 412,385 shares issued and
outstanding, respectively
4,064
4,124
Additional paid-in capital
1,986,899
2,106,886
Accumulated deficit
(1,326,826
)
(1,064,230
)
Accumulated other comprehensive income
(loss)
(2,298
)
(5,560
)
Total agilon health, inc. stockholders'
equity (deficit)
661,839
1,041,220
Noncontrolling interests
(818
)
(611
)
Total stockholders’ equity (deficit)
661,021
1,040,609
Total liabilities and stockholders’ equity
(deficit)
$
1,740,866
$
1,697,468
agilon health, inc.
Consolidated Statements of
Operations
In thousands, except per share
data
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2023
2022
2023
2022
(unaudited)
Revenues:
Medical services revenue
$
1,053,540
$
613,883
$
4,307,350
$
2,384,889
Other operating revenue
2,533
800
9,013
3,331
Total revenues
1,056,073
614,683
4,316,363
2,388,220
Expenses:
Medical services expense
1,155,393
551,133
4,008,659
2,093,860
Other medical expenses
(4,452
)
47,659
238,034
183,000
General and administrative (including
noncash stock-based compensation expense of $15,676, $9,873,
$69,326 and $28,069, respectively)
64,696
70,228
285,760
207,789
Depreciation and amortization
4,735
2,686
16,043
8,949
Total expenses
1,220,372
671,706
4,548,496
2,493,598
Income (loss) from operations
(164,299
)
(57,023
)
(232,133
)
(105,378
)
Other income (expense):
Income (loss) from equity method
investments
(8,018
)
7,247
16,489
10,720
Other income (expense), net
7,438
7,613
27,840
13,930
Gain (loss) on lease terminations
—
—
—
(5,458
)
Interest expense
(1,993
)
(1,668
)
(6,658
)
(4,484
)
Income (loss) before income
taxes
(166,872
)
(43,831
)
(194,462
)
(90,670
)
Income tax benefit (expense)
(267
)
(572
)
(791
)
(1,640
)
Income (loss) from continuing
operations
(167,139
)
(44,403
)
(195,253
)
(92,310
)
Discontinued operations:
Income (loss) before gain (loss) on sales
and income taxes
(15,797
)
(12,146
)
(20,002
)
(14,528
)
Gain (loss) on sales of assets, net
(47,548
)
—
(47,548
)
—
Income tax benefit (expense)
—
—
—
(26
)
Total discontinued operations
(63,345
)
(12,146
)
(67,550
)
(14,554
)
Net income (loss)
(230,484
)
(56,549
)
(262,803
)
(106,864
)
Noncontrolling interests’ share in
(earnings) loss
51
83
207
311
Net income (loss) attributable to
common shares
$
(230,433
)
$
(56,466
)
$
(262,596
)
$
(106,553
)
Net income (loss) per common share,
basic and diluted:
Continuing operations
$
(0.41
)
$
(0.11
)
$
(0.48
)
$
(0.22
)
Discontinued operations
$
(0.16
)
$
(0.03
)
$
(0.16
)
$
(0.04
)
Weighted average shares outstanding,
basic and diluted
406,477
412,103
408,917
408,154
agilon health, inc.
Consolidated Statements of
Cash Flows
In thousands
Year Ended December
31,
2023
2022
Cash flows from operating
activities:
Net income (loss)
$
(262,803
)
$
(106,864
)
Adjustments to reconcile net income (loss)
to net cash used in operating activities:
Depreciation and amortization
20,161
13,772
Stock-based compensation expense
69,495
28,381
Loss (income) from equity method
investments
(16,489
)
(10,720
)
Deferred income taxes and uncertain tax
positions
—
532
Release of indemnification assets
—
553
(Gain) loss on sale of assets, net
47,548
—
Other noncash items
(4,044
)
2,973
Changes in operating assets and
liabilities:
Receivables, net
(460,365
)
(204,167
)
Prepaid expense and other current
assets
(6,120
)
(16,620
)
Other assets
(397
)
(205
)
Medical claims and related payables
441,500
107,713
Accounts payable and accrued expenses
32,111
65,736
Other liabilities
(16,796
)
(11,892
)
Net cash provided by (used in) operating
activities
(156,199
)
(130,808
)
Cash flows from investing
activities:
Purchase of property and equipment
(15,830
)
(15,426
)
Purchase of intangible assets
(14,985
)
(17,235
)
Investment in loans receivable and
other
(19,528
)
(6,510
)
Investments in marketable securities
(114,657
)
(458,265
)
Proceeds from maturities and sales of
marketable securities and other
164,040
52,548
Net cash paid in business combination
(45,252
)
—
Proceeds from sale of business and
property, net of cash divested
2,193
500
Net cash provided by (used in) investing
activities
(44,019
)
(444,388
)
Cash flows from financing
activities:
Proceeds from equity issuances, net
11,867
33,056
Common stock repurchase
(200,000
)
—
Repayments of long-term debt
(5,000
)
(5,000
)
Net cash provided by (used in) financing
activities
(193,133
)
28,056
Net increase (decrease) in cash, cash
equivalents and restricted cash and equivalents
(393,351
)
(547,140
)
Cash, cash equivalents and restricted cash
and equivalents from continuing operations, beginning of year
475,912
1,049,373
Cash, cash equivalents and restricted cash
and equivalents from discontinued operations, beginning of year
31,768
5,447
Cash, cash equivalents and restricted
cash and equivalents, beginning of year
507,680
1,054,820
Cash, cash equivalents and restricted cash
and equivalents from continuing operations, end of year
114,329
475,912
Cash, cash equivalents and restricted cash
and equivalents from discontinued operations, end of year
—
31,768
Cash, cash equivalents and restricted
cash and equivalents, end of year
$
114,329
$
507,680
agilon health, inc.
Key Operating Metrics
In thousands
(unaudited)
GROSS PROFIT
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2023
2022
2023
2022
Total revenues
$
1,056,073
$
614,683
$
4,316,363
$
2,388,220
Medical services expense
(1,155,393
)
(551,133
)
(4,008,659
)
(2,093,860
)
Other medical expenses(1)
4,452
(47,659
)
(238,034
)
(183,000
)
Gross profit
$
(94,868
)
$
15,891
$
69,670
$
111,360
_______________
(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 December 31, 2023 and 2022, costs incurred in
implementing geographies were $13.5 million and $13.0 million,
respectively. For the twelve months ended December 31, 2023 and
2022, costs incurred in implementing geographies were $33.7 million
and $23.9 million, respectively.
GENERAL AND ADMINISTRATIVE COSTS,
INCLUDING PLATFORM SUPPORT COSTS
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2023
2022
2023
2022
Platform support costs
$
36,729
$
40,921
$
163,652
$
127,458
Geography entry costs(1)
12,192
19,434
40,812
43,890
Severance and related costs
—
—
188
2,470
Stock-based compensation expense
15,676
9,873
69,326
28,069
Other(2)
99
—
11,782
5,902
General and administrative
$
64,696
$
70,228
$
285,760
$
207,789
_______________
(1)
Represents direct geography entry costs,
including investments to develop and expand our platform and costs
in geographies that are in implementation and are not yet
generating revenue and investments to grow existing markets.
(2)
Includes transaction-related costs.
Our platform support costs, which include regionally-based
support personnel and other operating costs to support our
geographies, are expected to decrease over time as a percentage of
revenue as our physician partners add members and our revenue
grows. Our operating expenses at the enterprise level include
resources and technology to support payor contracting, clinical
program development, quality, data management, finance and legal
functions.
agilon health, inc.
Non-GAAP Financial
Measures
In thousands
(unaudited)
MEDICAL MARGIN
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2023
2022
2023
2022
Gross profit(1)
$
(94,868
)
$
15,891
$
69,670
$
111,360
Other operating revenue
(2,533
)
(800
)
(9,013
)
(3,331
)
Other medical expenses
(4,452
)
47,659
238,034
183,000
Medical margin
$
(101,853
)
$
62,750
$
298,691
$
291,029
_______________
(1)
Gross profit is defined as total revenues
less medical services expense and other medical expenses.
ADJUSTED EBITDA
Three Months Ended
December 31,
Twelve Months Ended
December 31,
2023
2022
2023
2022
Net income (loss)(1)
$
(230,484
)
$
(56,549
)
$
(262,803
)
$
(106,864
)
(Income) loss from discontinued
operations, net of income taxes
63,345
12,146
67,550
14,554
Interest expense
1,993
1,668
6,658
4,484
Income tax expense (benefit)
267
572
791
1,640
Depreciation and amortization
4,735
2,686
16,043
8,949
(Gain) loss on lease terminations
—
—
—
5,458
Severance and related costs(2)
—
—
188
2,470
Stock-based compensation expense
15,676
9,873
69,326
28,069
EBITDA adjustments related to equity
method investments(3)
14,268
749
22,694
3,737
Other(4)
(6,861
)
(3,381
)
(15,448
)
(7,967
)
Adjusted EBITDA
$
(137,061
)
$
(32,236
)
$
(95,001
)
$
(45,470
)
_______________
(1)
Includes direct geography entry costs,
including investments to develop and expand our platform and costs
in geographies that are in implementation and are not yet
generating revenue and investments to grow existing markets. For
the three months ended December 31, 2023 and 2022, (i) $13.5
million and $13.0 million, respectively, are included in other
medical expenses and (ii) $12.2 million and $19.4 million,
respectively, are included in general and administrative expenses.
For the twelve months ended December 31, 2023 and 2022, (i) $33.7
million and $23.9 million, respectively, are included in other
medical expenses and (ii) $40.8 million and $43.9 million,
respectively, are included in general and administrative
expenses.
(2)
For the year ended December 31, 2022,
includes taxes and related costs on stock option exercises for
departed executives of $2.0 million.
(3)
The three and twelve months ended December
31, 2023 includes $15.2 million of physician compensation expenses
to reduce the physician partners’ compensation percentage in
current and future years in exchange for the Company’s common
stock.
(4)
Includes interest income and
transaction-related costs.
agilon health, inc.
Supplemental Financial
Information
In thousands
(unaudited)
Three Months Ended
December 31,
2023
Twelve Months Ended
December 31,
2023
Medicare
Advantage
(Consolidated)
ACO REACH
(Unconsolidated)
Medicare
Advantage
(Consolidated)
ACO REACH
(Unconsolidated)
Medical services revenue
$
1,053,540
$
302,692
$
4,307,350
$
1,160,978
Other operating revenue
2,533
—
9,013
—
Total revenues
1,056,073
302,692
4,316,363
1,160,978
Medical services expense
(1,155,393
)
(282,716
)
(4,008,659
)
(1,024,468
)
Other medical expenses
4,452
(25,016
)
(238,034
)
(96,154
)
Gross profit
(94,868
)
(5,040
)
69,670
40,356
Other operating revenue
(2,533
)
—
(9,013
)
—
Other medical expenses
(4,452
)
25,016
238,034
96,154
Medical margin
$
(101,853
)
$
19,976
$
298,691
$
136,510
_______________
Certain of our operations are not
consolidated for the period presented because we do not have the
ability to control certain activities due to another party’s
control of the entities’ board of directors. Although revenues of
the unconsolidated operations are not recorded as revenues by us,
income (loss) from equity method investments is nonetheless a
significant portion of our overall earnings. See Note 18 to the
Consolidated Financial Statements in the Annual Report on Form 10-K
for the period ending December 31, 2023 for additional discussion
on our equity method investments.
In addition to providing results that are determined in
accordance with GAAP, we present Medical Margin and Adjusted
EBITDA, which are non-GAAP financial measures.
We define Medical Margin as medical services revenue after
medical services expense is deducted. Medical services expense
represents costs incurred for medical services provided to our
members. As our platform matures over time, we expect Medical
Margin to increase in absolute dollars. However, Medical Margin per
member per month (PMPM) may vary as the percentage of new members
brought onto our platform fluctuates. New membership added to the
platform is typically dilutive to Medical Margin PMPM. We believe
this metric provides insight into the economics of our capitation
arrangements as it includes all medical services expense directly
associated with our members’ care.
We define Adjusted EBITDA as net income (loss) adjusted to
exclude: (i) income (loss) from discontinued operations, net of
income taxes, (ii) interest expense, (iii) income tax expense
(benefit), (iv) depreciation and amortization, (v) stock-based
compensation expense, (vi) severance and related costs, and (vii)
certain other items that are not considered by us in the evaluation
of ongoing operating performance. We reflect our share of Adjusted
EBITDA for equity method investments by applying our actual
ownership percentage for the period to the applicable reconciling
items on an entity-by-entity basis.
Gross profit is the most directly comparable GAAP measure to
Medical Margin. Net income (loss) is the most directly comparable
GAAP measure to Adjusted EBITDA.
We believe Medical Margin and Adjusted EBITDA help identify
underlying trends in our business and facilitate evaluation of
period-to-period operating performance of our operations by
eliminating items that are variable in nature and not considered by
us in the evaluation of ongoing operating performance, allowing
comparison of our recurring core business operating results over
multiple periods. We also believe Medical Margin and Adjusted
EBITDA provide useful information about our operating results,
enhance the overall understanding of our past performance and
future prospects, and allow for greater transparency with respect
to key metrics we use for financial and operational
decision-making. We believe Medical Margin and Adjusted EBITDA or
similarly titled non-GAAP measures are widely used by investors,
securities analysts, ratings agencies, and other parties in
evaluating companies in our industry as a measure of financial
performance. Other companies may calculate Medical Margin and
Adjusted EBITDA or similarly titled non-GAAP measures differently
from the way we calculate these metrics. As a result, our
presentation of Medical Margin and Adjusted EBITDA may not be
comparable to similarly titled measures of other companies,
limiting their usefulness as comparative measures.
agilon health, inc.
2023 Quarterly Consolidated
Statements of Operations
In thousands, except per share
data
(unaudited)
Three Months Ended
2023
March 31
June 30
September 30
December 31
Revenues:
Medical services revenue
$
1,053,119
$
1,067,234
$
1,133,457
$
1,053,540
Other operating revenue
1,193
1,881
3,406
2,533
Total revenues
1,054,312
1,069,115
1,136,863
1,056,073
Expenses:
Medical services expense
897,572
932,823
1,022,871
1,155,393
Other medical expenses
83,617
81,716
77,153
(4,452
)
General and administrative
69,752
79,254
72,058
64,696
Depreciation and amortization
2,954
4,279
4,075
4,735
Total expenses
1,053,895
1,098,072
1,176,157
1,220,372
Income (loss) from operations
417
(28,957
)
(39,294
)
(164,299
)
Other income (expense):
Income (loss) from equity method
investments
1,376
8,472
14,659
(8,018
)
Other income (expense), net
7,892
7,087
5,423
7,438
Interest expense
(1,493
)
(1,555
)
(1,617
)
(1,993
)
Income (loss) before income
taxes
8,192
(14,953
)
(20,829
)
(166,872
)
Income tax benefit (expense)
1,759
(1,073
)
(1,210
)
(267
)
Income (loss) from continuing
operations
9,951
(16,026
)
(22,039
)
(167,139
)
Discontinued operations:
Income (loss) before gain (loss) on sales
and income taxes
6,008
(769
)
(9,444
)
(15,797
)
Gain (loss) on sales of assets, net
—
—
—
(47,548
)
Total discontinued operations
6,008
(769
)
(9,444
)
(63,345
)
Net income (loss)
15,959
(16,795
)
(31,483
)
(230,484
)
Noncontrolling interests’ share in
(earnings)
63
46
47
51
Net income (loss) attributable to
common shares
$
16,022
$
(16,749
)
$
(31,436
)
$
(230,433
)
Net income (loss) per common share,
basic and diluted:
Continuing operations
$
0.02
$
(0.04
)
$
(0.05
)
$
(0.41
)
Discontinued operations
$
0.01
$
—
$
(0.02
)
$
(0.16
)
Weighted average shares
outstanding:
Basic
413,136
410,338
405,787
406,477
Diluted
426,586
410,338
405,787
406,477
View source
version on businesswire.com: https://www.businesswire.com/news/home/20240227031960/en/
Investor Contact Matthew Gillmor VP, Investor Relations
investors@agilonhealth.com
Media Contact David Tauchen Senior Director,
Communications media@agilonhealth.com
Agilon Health (NYSE:AGL)
過去 株価チャート
から 11 2024 まで 12 2024
Agilon Health (NYSE:AGL)
過去 株価チャート
から 12 2023 まで 12 2024
