Revenue increased 52% to $1.6 billion,
Medicare Advantage membership increased 43% to 523,000, and total
members on the agilon platform grew to 654,000
Continued progress executing performance
action plan with focus on driving profitability and enhancing
operating efficiency
Maintaining full year 2024 guidance for
Medical Margin and Adjusted EBITDA
agilon health, inc. (NYSE: AGL), the trusted partner empowering
physicians to transform health care in our communities, announced
results for the first quarter ended March 31, 2024.
“Our first quarter results were in-line with our guidance,” said
Steve Sell, chief executive officer. “We continue to make tangible
progress executing our performance action plan. As payors adjust to
the current funding environment for Medicare Advantage, we remain
well positioned as our value proposition to primary care doctors
and payors is increasingly important and well-recognized.”
First Quarter 2024
Results:
- Total members on the agilon platform increased to 654,000 as of
March 31, 2024, including 523,000 Medicare Advantage members and
131,000 ACO model beneficiaries. Medicare Advantage membership
increased 43%, with 7% growth in same partner geographies.
- Total revenue of $1.60 billion in the first quarter 2024
increased 52% compared to $1.05 billion in the first quarter
2023.
- Gross profit of $75 million in the first quarter 2024 compared
to $73 million in the first quarter 2023. Net loss of $6 million in
the first quarter 2024 compared to net income of $16 million in the
first quarter 2023.
- Medical margin of $157 million during the first quarter 2024,
compared to $156 million in the first quarter 2023. Medical Margin
for the first quarter 2024 included a negative $8.7 million net
impact from prior year claims, consisting of $16.5 million in total
prior year claims inclusive of $7.8 million in claims development
from retro members with offsetting revenue.
- Adjusted EBITDA of $29 million in the first quarter 2024
increased 21% compared to $24 million in the first quarter
2023.
Key Financial and Operating Metrics ($M): (First Quarter
2024 vs. 2023)
Three Months
Ended March 31,
Change
2024
2023
% YoY
Medicare Advantage Members1
522,800
365,700
43%
ACO Model Members1, 2
131,000
88,700
48%
Total Members Live on Platform1, 2
653,800
454,400
44%
Avg. Medicare Advantage Members
518,400
363,400
43%
Total revenues
$1,604
$1,054
52%
Gross Profit
$75
$73
3%
Medical Margin
$157
$156
1%
Net (Loss) Income
($6)
$16
NM
Adjusted EBITDA3
$29
$24
21%
Geography Entry Costs
$11
$12
(5%)
1.
Membership metrics reflect end of period
results.
2.
agilon’s ACO model entities are not
included within its consolidated financial results.
3.
agilon’s ACO model entities contributed
$10 million and $3 million to Adjusted EBITDA during the first
quarter 2024 and first quarter 2023, respectively.
Continued Progress on Performance Action Plan
agilon health continues to make progress executing its targeted
action plan to improve performance. This plan includes refining
payor relationships, expanding onboarding support for newer primary
care physicians, improving data visibility and analytics, and
accelerating operating efficiency. Management anticipates these
actions will support growth in Adjusted EBITDA in 2024 and
beyond.
During the first quarter, agilon health reached agreements with
certain payors to mitigate 2023 medical margin losses and made the
decision to exit certain unprofitable payor contracts effective
during the second quarter 2024. The company continues to deploy
structured training and education resources to physician partners
with 90% of new physicians in mature markets expected to be trained
during the first half of 2024. agilon achieved its target of
onboarding >55% of member data into the company's financial data
pipeline and expects to onboard >75% of member data during the
second quarter. The company also continues to make progress driving
operating expense efficiency; platform support represented 2.8% of
revenue in the first quarter compared to the company’s 3% target
for 2024.
Class of 2025 New Partnership Announcement
On May 7, agilon health announced the formation of long-term
partnerships with five leading physician groups: Graves Gilbert
Clinic in Kentucky, Mankato Clinic in Minnesota, Twin Cities
Network in Minnesota, and Springfield Clinic in Illinois, as well
as an independent, multi-specialty practice in North Carolina that
will be named at a later date. With these new partnerships, agilon
will enter the state of Illinois and expand its existing broad
footprint in North Carolina, Kentucky and Minnesota.
With the addition of the Class of 2025, agilon’s Physician
Network will include over 3,000 primary care physicians (PCPs) who
are delivering value-based care to more than 700,000 senior
patients in 30+ communities. The Class of 2025 is expected to add
more than 60,000 Medicare Advantage members to the agilon
platform.
Capital Position and Balance Sheet:
agilon health’s balance sheet as of March 31, 2024 included
cash, cash equivalents and marketable securities of $426 million
and total debt of $37 million. In addition, agilon health has $26
million of cash associated with the company’s unconsolidated ACO
model entities.
Outlook for Fiscal Year 2024
($M):
Year Ended December 31,
2024
Updated Guidance
Previous Guidance
Low
High
Low
High
Medicare Advantage Members1
510,000
515,000
540,00
550,000
ACO Model Members1,2
120,000
125,000
120,00
125,000
Total Members Live on Platform1
630,000
640,000
660,00
675,000
Avg. Medicare Advantage Members
510,000
514,000
527,00
536,000
Total Revenues
$6,125
$6,175
$6,350
$6,465
Medical Margin
$400
$450
$400
$450
Adjusted EBITDA3
($60)
($15)
($60)
($15)
Geography Entry Costs4
$65
$55
$65
$55
1.
Membership reflects management’s outlook
for end of period.
2.
agilon’s partnered ACO model entities are
not consolidated within its financial results.
3.
Adjusted EBITDA contribution from ACO
model is expected to be approximately $35 million for fiscal year
2024.
4.
Geography Entry Costs represent the
corresponding expense included in the low-end and high-end of
management’s outlook for Adjusted EBITDA.
Outlook for Second Quarter 2024
($M):
Quarter Ended
June 30, 2024
Low
High
Medicare Advantage Members1
513,000
518,000
ACO Model Members1,2
123,000
128,000
Total Members Live on Platform1
636,000
646,000
Avg. Medicare Advantage Members
514,000
519,000
Total Revenues
$1,550
$1,570
Medical Margin
$100
$120
Adjusted EBITDA3
($15)
$0
Geography Entry Costs4
$18
$16
1.
Membership reflects management’s outlook
for end of period.
2.
agilon’s partnered ACO model entities are
not consolidated within its financial results.
3.
Adjusted EBITDA contribution from ACO
model is expected to be approximately $10 million for the second
quarter 2024.
4.
Geography Entry Costs represent the
corresponding expense included in the low-end and high-end of
management’s outlook for Adjusted EBITDA.
We have not reconciled guidance for Medical Margin to Gross
Profit or Adjusted EBITDA to net income (loss), the most comparable
GAAP measures, and have not provided forward-looking guidance for
net income (loss) in each case because of the uncertainty around
certain items that may impact Gross Profit or net income (loss),
including non-cash stock-based compensation.
Webcast and Conference Call:
agilon health will host a conference call to discuss first
quarter 2024 results on Tuesday, May 7, 2024 at 4:30 PM Eastern
Time. The conference call can be accessed by dialing (833) 470-1428
for U.S. participants and +1 (929) 526-1599 for international
participants and referencing participant code 690899. 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 3,000+ PCPs that allow its physician partners to maintain their
independence and focus on the total health of their most vulnerable
patients. Together, agilon and its physician partners are creating
the healthcare system we need – one built on the value of care, not
the volume of fees. The result: healthier communities and empowered
doctors. agilon is the trusted partner in 30+ diverse communities
and is here to help more of our nation's leading physician groups
and health systems have a sustained, thriving future. For more
information visit www.agilonhealth.com and connect with us on
Instagram, LinkedIn and YouTube.
Forward-Looking Statements
Statements in this release that are not historical factual
statements are “forward-looking statements” within the meaning of
Section 27A of the Securities Act of 1933, as amended, and Section
21E of the Securities Exchange Act of 1934, as amended.
Forward-looking statements include, among other things, statements
regarding our and our officers’ intent, belief or expectation as
identified by the use of words such as “believes,” “expects,”
“may,” “will,” “shall,” “should,” “would,” “could,” “seeks,”
“aims,” “projects,” “is optimistic,” “intends,” “plans,”
“estimates,” “anticipates” or the negative versions of these words
or other comparable terms. Examples of forward-looking statements
include, among other things: statements regarding timing, outcomes
and other details relating to current, pending or contemplated new
markets, growth opportunities, ability to deliver sustainable
long-term value, business environment, long-term opportunities and
strategic growth plans, expected revenue, medical costs, net income
and gross profit, total and average membership, Adjusted EBITDA,
Medical Margin, geography entry costs and other financial
projections and assumptions, including our fiscal year and first
quarter 2024 guidance. Forward-looking statements reflect our
current expectations and views about future events and are subject
to risks and uncertainties that could significantly affect our
future financial condition and results of operations. While
forward-looking statements reflect our good faith belief and
assumptions we believe to be reasonable based upon current
information, we can give no assurance that our expectations or
forecasts will be attained. Forward-looking statements are subject
to known and unknown risks and uncertainties, many of which may be
outside our control. These risks and uncertainties that could cause
actual results and outcomes to differ from those reflected in
forward-looking statements include, but are not limited to: our
history of net losses and the expectation that our expenses will
increase in the future; failure to identify and develop successful
new geographies, physician partners and payors, or execute upon our
growth initiatives; success in executing our operating strategies
or achieving results consistent with our historical performance;
medical expenses incurred on behalf of our members may exceed
revenues we receive; our ability to secure contracts with Medicare
Advantage payors; our ability to grow new physician partner
relationships sufficient to recover startup costs; availability of
additional capital, on acceptable terms or at all, to support our
business in the future; significant reduction in our membership;
transition to a Total Care Model may be challenging for physician
partners; public health crises, such as COVID-19, could adversely
affect us; inaccuracy in estimates of our members’ risk adjustment
factors, medical services expense, incurred but not reported
claims, and earnings pursuant to payor contracts; the impact of
restrictive clauses or exclusivity provisions in some of our
contracts with physician partners; our to hire and retain qualified
personnel; our ability to realize the full value of our intangible
assets; security breaches, cybersecurity attacks, loss of data and
other disruptions to our information systems; our ability to
protect the confidentiality of our know-how and other proprietary
and internally developed information; reliance on our subsidiaries;
Environmental, Social, and Governance issues; reliance on a limited
number of key payors; the limited terms of contracts with our
payors and our ability to renew them upon expiration; reliance on
our payors, physician partners and other providers to operate our
business; our ability to obtain accurate and complete diagnosis
data; reliance on third-party software, data, infrastructure and
bandwidth; consolidation and competition in the healthcare
industry; the impact of changes to, and dependence on, federal
government healthcare programs; uncertain or adverse economic and
macroeconomic conditions, including a downturn or decrease in
government expenditures; regulation of the healthcare industry and
our and our physician partners’ ability to comply such laws and
regulations; federal and state investigations, audits and
enforcement actions; repayment obligations arising out of payor
audits; negative publicity regarding the managed healthcare
industry generally; our use, disclosure and processing of
personally identifiable information, protected health information,
and de-identified data; failure to obtain or maintain an insurance
license, a certificate of authority or an equivalent authorization;
lawsuits not covered by insurance; changes in tax laws and
regulations, or changes in related judgments or assumptions; our
indebtedness and our potential to incur more debt; dependence on
our subsidiaries for cash to fund all of our operations and
expenses; provisions in our governing documents; ability to achieve
a return on your investment depends on appreciation in the price of
our common stock; the material weakness in our internal control
over financial reporting and our ability to remediate such material
weakness; and risks related to other factors discussed in our
filings with the Securities and Exchange Commission (the “SEC”),
including the factors discussed under “Risk Factors” in our Annual
Report on Form 10-K for the fiscal year ended March 31, 2024, which
can be found at the SEC’s website at www.sec.gov. Except as
required by law, we do not undertake, and hereby disclaim, any
obligation to update any forward-looking statements, which speak
only as of the date on which they are made.
agilon health, inc.
Consolidated Balance
Sheets
In thousands, except per share
data
March 31, 2024
December 31,
2023
(unaudited)
ASSETS
Current assets:
Cash and cash equivalents
$
111,706
$
107,570
Restricted cash and equivalents
6,844
6,759
Marketable securities
307,359
380,773
Receivables, net
1,571,143
942,461
Prepaid expenses and other current assets,
net
39,757
42,513
Total current assets
2,036,809
1,480,076
Property and equipment, net
27,539
27,576
Intangible assets, net
72,076
63,769
Goodwill
24,133
24,133
Other assets
155,906
145,312
Total assets
$
2,316,463
$
1,740,866
LIABILITIES AND STOCKHOLDERS’ EQUITY
(DEFICIT)
Current liabilities:
Medical claims and related payables
$
1,266,651
$
737,724
Accounts payable and accrued expenses
252,497
233,182
Current portion of long-term debt
7,500
6,250
Total current liabilities
1,526,648
977,156
Long-term debt, net of current portion
29,834
32,308
Other liabilities
71,495
70,381
Total liabilities
1,627,977
1,079,845
Commitments and contingencies
Stockholders' equity (deficit):
Common stock, $0.01 par value: 2,000,000
shares authorized; 410,843 and 406,387 shares issued and
outstanding, respectively
4,108
4,064
Additional paid-in capital
2,020,803
1,986,899
Accumulated deficit
(1,332,890
)
(1,326,826
)
Accumulated other comprehensive income
(loss)
(2,747
)
(2,298
)
Total agilon health, inc. stockholders'
equity (deficit)
689,274
661,839
Noncontrolling interests
(788
)
(818
)
Total stockholders’ equity (deficit)
688,486
661,021
Total liabilities and stockholders’ equity
(deficit)
$
2,316,463
$
1,740,866
agilon health, inc.
Consolidated Statements of
Operations
In thousands, except per share
data
(unaudited)
Three Months Ended
March 31,
2024
2023
Revenues:
Medical services revenue
$
1,601,195
$
1,053,119
Other operating revenue
3,159
1,193
Total revenues
1,604,354
1,054,312
Expenses:
Medical services expense
1,443,842
897,572
Other medical expenses
85,424
83,617
General and administrative (including
noncash stock-based compensation expense of $16,909 and $13,585,
respectively)
76,422
69,752
Depreciation and amortization
5,844
2,954
Total expenses
1,611,532
1,053,895
Income (loss) from operations
(7,178
)
417
Other income (expense):
Income (loss) from equity method
investments
5,684
1,376
Other income (expense), net
5,892
7,892
Interest expense
(1,284
)
(1,493
)
Income (loss) before income
taxes
3,114
8,192
Income tax benefit (expense)
133
1,759
Income (loss) from continuing
operations
3,247
9,951
Discontinued operations:
Income (loss) before gain (loss) on
sales
(518
)
6,008
Gain (loss) on sales of assets, net
(8,763
)
—
Total discontinued operations
(9,281
)
6,008
Net income (loss)
(6,034
)
15,959
Noncontrolling interests’ share in
(earnings) loss
(30
)
63
Net income (loss) attributable to
common shares
$
(6,064
)
$
16,022
Net income (loss) per common share,
basic and diluted
Continuing operations
$
0.01
$
0.02
Discontinued operations
$
(0.02
)
$
0.02
Weighted average shares
outstanding
Basic
408,938
413,136
Diluted
413,437
426,586
agilon health, inc.
Consolidated Statements of
Cash Flows
In thousands
(unaudited)
Three Months Ended March
31,
2024
2023
Cash flows from operating
activities:
Net income (loss)
$
(6,034
)
$
15,959
Adjustments to reconcile net income (loss)
to net cash used in operating activities:
Depreciation and amortization
5,844
4,189
Stock-based compensation expense
16,909
13,672
Loss (income) from equity method
investments
(5,684
)
(1,376
)
(Gain) loss on sale of assets, net
4,996
—
Other noncash items
(472
)
(1,785
)
Changes in operating assets and
liabilities:
(63,335
)
(91,470
)
Net cash provided by (used in) operating
activities
(47,776
)
(60,811
)
Cash flows from investing
activities:
Purchase of property and equipment
(3,139
)
(3,717
)
Purchase of intangible assets
(11,438
)
—
Funding of loans receivable and other
(8,508
)
(1,301
)
Investments in marketable securities
—
(29,969
)
Proceeds from maturities of marketable
securities and other
74,523
28,540
Net cash paid in business combination
—
(44,367
)
Net cash provided by (used in) investing
activities
51,438
(50,814
)
Cash flows from financing
activities:
Proceeds from equity issuances, net
1,809
9,589
Repayments of long-term debt
(1,250
)
(1,250
)
Net cash provided by (used in) financing
activities
559
8,339
Net increase (decrease) in cash, cash
equivalents and restricted cash and equivalents
4,221
(103,286
)
Cash, cash equivalents and restricted cash
and equivalents from continuing operations, beginning of period
114,329
475,912
Cash, cash equivalents and restricted cash
and equivalents from discontinued operations, beginning of
period
—
31,768
Cash, cash equivalents and restricted
cash and equivalents, beginning of period
114,329
507,680
Cash, cash equivalents and restricted cash
and equivalents from continuing operations, end of period
118,550
397,023
Cash, cash equivalents and restricted cash
and equivalents from discontinued operations, end of period
—
7,371
Cash, cash equivalents and restricted
cash and equivalents, end of period
$
118,550
$
404,394
agilon health, inc.
Key Operating Metrics
In thousands
(unaudited)
GROSS PROFIT
Three Months Ended
March 31,
2024
2023
Total revenues
$
1,604,354
$
1,054,312
Medical services expense
(1,443,842
)
(897,572
)
Other medical expenses(1)
(85,424
)
(83,617
)
Gross profit
$
75,088
$
73,123
______________________________________________________________
(1)
Represents physician compensation expense
related to surplus sharing and other care management expenses that
help to create medical cost efficiency. Includes costs in
geographies that are in implementation and are not yet generating
revenue and investments to grow existing markets. For the three
months ended March 31, 2024 and 2023, costs incurred in
implementing geographies were $0.6 million and $2.3 million,
respectively.
GENERAL AND ADMINISTRATIVE COSTS,
INCLUDING PLATFORM SUPPORT COSTS
Three Months Ended
March 31,
2024
2023
Platform support costs
$
45,712
$
43,292
Geography entry costs(1)
10,459
9,250
Severance and related costs
2,415
188
Stock-based compensation expense
16,909
13,585
Other(2)
927
3,437
General and administrative
$
76,422
$
69,752
______________________________________________________________
(1)
Represents direct geography entry costs,
including investments to develop and expand our platform and costs
in geographies that are in implementation and are not yet
generating revenue and investments to grow existing markets.
(2)
Includes transaction-related costs.
Our platform support costs, which include regionally-based
support personnel and other operating costs to support our
geographies, are expected to decrease over time as a percentage of
revenue as our physician partners add members and our revenue
grows. Our operating expenses at the enterprise level include
resources and technology to support payor contracting, clinical
program development, quality, data management, finance, and legal
and compliance functions.
agilon health, inc.
Non-GAAP Financial
Measures
In thousands
(unaudited)
MEDICAL MARGIN
Three Months Ended
March 31,
2024
2023
Gross profit(1)
$
75,088
$
73,123
Other operating revenue
(3,159
)
(1,193
)
Other medical expenses
85,424
83,617
Medical margin
$
157,353
$
155,547
______________________________________________________________
(1)
Gross profit is defined as total revenues
less medical services expense and other medical expenses.
ADJUSTED EBITDA
Three Months Ended
March 31,
2024
2023
Net income (loss)(1)
$
(6,034
)
$
15,959
(Income) loss from discontinued
operations, net of income taxes
9,281
(6,008
)
Interest expense
1,284
1,493
Income tax expense (benefit)
(133
)
(1,759
)
Depreciation and amortization
5,844
2,954
Severance and related costs
2,415
188
Stock-based compensation expense
16,909
13,585
EBITDA adjustments related to equity
method investments
3,902
1,967
Other(2)
(4,414
)
(4,341
)
Adjusted EBITDA
$
29,054
$
24,038
______________________________________________________________
(1)
Includes direct geography entry costs,
including investments to develop and expand our platform and costs
in geographies that are in implementation and are not yet
generating revenue and investments to grow existing markets. For
the three months ended March 31, 2024 and 2023, (i) $0.6 million
and $2.3 million, respectively, are included in other medical
expenses and (ii) $10.5 million and $9.3 million, respectively, are
included in general and administrative expenses.
(2)
Includes interest income and
transaction-related costs.
agilon health, inc.
Supplemental Financial
Information
In thousands
(unaudited)
Three Months Ended
March 31, 2024
Medicare Advantage
(Consolidated)
CMS ACO Models
(Unconsolidated)
Medical services revenue
$
1,601,195
$
440,160
Other operating revenue
3,159
—
Total revenues
1,604,354
440,160
Medical services expense
(1,443,842
)
(398,792
)
Other medical expenses
(85,424
)
(25,405
)
Gross profit
75,088
15,963
Other operating revenue
(3,159
)
—
Other medical expenses
85,424
25,405
Medical margin
$
157,353
$
41,368
Certain of our operations are not consolidated for the period
presented because we do not have the ability to control certain
activities due to another party’s control of the entities’ board of
directors. Although revenues of the unconsolidated operations are
not recorded as revenues by us, income (loss) from equity method
investments is nonetheless a significant portion of our overall
earnings. See Note 14 to the Condensed Consolidated Financial
Statements in the Quarterly Report on Form 10-Q for the period
ending March 31, 2024 for additional discussion on our equity
method investments.
In addition to providing results that are determined in
accordance with GAAP, we present Medical Margin and Adjusted
EBITDA, which are non-GAAP financial measures.
We define Medical Margin as medical services revenue after
medical services expense is deducted. Medical services expense
represents costs incurred for medical services provided to our
members. As our platform matures over time, we expect Medical
Margin to increase in absolute dollars. However, Medical Margin per
member per month (PMPM) may vary as the percentage of new members
brought onto our platform fluctuates. New membership added to the
platform is typically dilutive to Medical Margin PMPM. We believe
this metric provides insight into the economics of our capitation
arrangements as it includes all medical services expense directly
associated with our members’ care.
We define Adjusted EBITDA as net income (loss) adjusted to
exclude: (i) income (loss) from discontinued operations, net of
income taxes, (ii) interest expense, (iii) income tax expense
(benefit), (iv) depreciation and amortization, (v) stock-based
compensation expense, (vi) severance and related costs, and (vii)
certain other items that are not considered by us in the evaluation
of ongoing operating performance. We reflect our share of Adjusted
EBITDA for equity method investments by applying our actual
ownership percentage for the period to the applicable reconciling
items on an entity-by-entity basis.
Gross profit is the most directly comparable GAAP measure to
Medical Margin. Net income (loss) is the most directly comparable
GAAP measure to Adjusted EBITDA.
We believe Medical Margin and Adjusted EBITDA help identify
underlying trends in our business and facilitate evaluation of
period-to-period operating performance of our operations by
eliminating items that are variable in nature and not considered by
us in the evaluation of ongoing operating performance, allowing
comparison of our recurring core business operating results over
multiple periods. We also believe Medical Margin and Adjusted
EBITDA provide useful information about our operating results,
enhance the overall understanding of our past performance and
future prospects, and allow for greater transparency with respect
to key metrics we use for financial and operational
decision-making. We believe Medical Margin and Adjusted EBITDA or
similarly titled non-GAAP measures are widely used by investors,
securities analysts, ratings agencies, and other parties in
evaluating companies in our industry as a measure of financial
performance. Other companies may calculate Medical Margin and
Adjusted EBITDA or similarly titled non-GAAP measures differently
from the way we calculate these metrics. As a result, our
presentation of Medical Margin and Adjusted EBITDA may not be
comparable to similarly titled measures of other companies,
limiting their usefulness as comparative measures.
View source
version on businesswire.com: https://www.businesswire.com/news/home/20240507422238/en/
Investor Contact Matthew Gillmor VP, Investor Relations
investors@agilonhealth.com
Media Contact Maureen Merkle Communications & Public
Affairs media@agilonhealth.com
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
