Shares of Agilon Health Inc. AGL, -0.25% were indicated down more than 1% in Friday’s premarket, after the health care services company lowered its 2023 margin outlook, citing higher costs, but provided an upbeat 2024 outlook. “Higher-than-expected costs became visible to us in mid-December during the November close process given updated data from health plans and will impact our FY2023 medical margins,” said Chief Executive Steve Sell. While the company raised its guidance range for Medicare Advantage mem ...

AUSTIN, Texas--(BUSINESS WIRE)--agilon health, Inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, today announced that Timothy Bensley has informed the company of his intent to retire from his position as Chief Financial Officer (CFO) during 2024, which agilon expects to take place within the next nine months. The search for a new CFO has been initiated, and Bensley has agreed to remain as CFO through this process and serve in a consulting role through t ...

Core Insights - Agilon Health has revised its guidance for 2023 due to higher-than-expected medical costs, impacting its financial outlook for the year and leading to an initial outlook for 2024 [1][2][3] 2023 Financial Performance - The company experienced increased medical expenses in 2023, primarily from higher specialist visits, Part B drugs, outpatient surgeries, and supplemental benefits, partially offset by lower hospital admissions [1] - Revised medical margin expectation for 2023 is set at $340 million to $360 million, which is approximately $110 million lower than previous guidance [2] - The reduction in medical margin is attributed to $90 million in higher-than-expected medical costs and a $20 million negative revenue revision from two regional health plans [2] 2024 Initial Outlook - For 2024, Agilon Health projects Medicare Advantage membership to grow to between 548,000 and 553,000 members [6] - Total revenues for 2024 are expected to be between $6.35 billion and $6.42 billion, with a medical margin forecast of $560 million to $600 million [7] - Adjusted EBITDA for 2024 is anticipated to be between $40 million and $60 million [7] Strategic Initiatives - The company has implemented several initiatives aimed at enhancing operating performance and improving financial predictability, including accelerating operational efficiency and refining payor partnerships [3] - Agilon Health is withdrawing its previously issued target for 2026 due to the lower-than-expected baseline projected for 2023 [3] Conference Call Announcement - Agilon Health will host a conference call on January 5, 2024, to discuss the updated guidance for 2023 and the initial outlook for 2024 [8]

Financial Data and Key Metrics Changes - Total membership increased by 43% to 508,000 members, with revenues rising by 75% to $1.2 billion, exceeding guidance [8][19] - Adjusted EBITDA loss was $6 million for the quarter, an improvement from a loss of $26 million year-over-year, with year-to-date adjusted EBITDA at $28 million compared to a loss of $20 million last year [23][24] - Medical margins for Medicare Advantage (MA) increased by 42% year-over-year to $108 million, while year-to-date medical margins rose by 67% to $408 million [20][24] Business Line Data and Key Metrics Changes - Medicare Advantage membership grew by 58% to 420,000, with adjusted for Hawaii, MA membership in core markets increasing by 69% to 384,000 [18][19] - ACO REACH generated $55 million in medical margin for the quarter, doubling year-over-year, with year-to-date margins at $117 million [22][24] Market Data and Key Metrics Changes - The company reported a 10% increase in revenue per member per month (PMPM) during Q3, driven by benchmark updates and membership mix [19] - The percentage of membership in four-plus star plans is expected to increase to approximately 84% for 2024 [12] Company Strategy and Development Direction - The company plans to focus on its core partner markets following the sale of its Hawaii business, which was deemed less strategic [6][7] - The leadership position in moving physicians to full risk is expected to enhance clinical and financial performance, with a strong demand from physician groups and health systems [14][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the trajectory of adjusted EBITDA inflection and the ability to manage the new risk adjustment model starting in 2024 [15][17] - The company anticipates a strong class of new partners for 2024, with expectations of 110,000 new MA members and 25,000 new ACO REACH members [14][15] Other Important Information - The company is maintaining a conservative reserving approach as it exits 2023, which is reflected in the medical margin outlook for MA [10][26] - The sale of MDX Hawaii is expected to enhance focus on core business and improve overall performance [7][28] Q&A Session Summary Question: Clarification on medical cost side and utilization trends - Management noted that they raised EBITDA guidance due to strong performance across MA and REACH, with utilization trends moderating after a spike in May and June [30][31] Question: REACH performance expectations - REACH generated $55 million in medical margin, outperforming expectations, with management confident in continued strong performance [34][37] Question: Medical margin guidance revisions - The reduction in medical margin guidance was primarily due to the removal of Hawaii's performance and a conservative approach to reserving for potential negative developments [43][44] Question: Impact of Hawaii's sale on EBITDA - The sale of Hawaii was a significant drag on EBITDA, with management explaining that seasonality affects medical margins in that region [48][49] Question: Utilization trends and Flex card discussions - Management indicated that their PPO business is performing well and that discussions regarding Flex cards have shown a reduction in total dollars across the population [54] Question: Preservation of benefits in a tough revenue environment - Management expects a net pullback on supplemental benefits but remains confident in their ability to manage the new risk adjustment model effectively [56][57]

Table of Contents UNITED STATES SECURITIES AND EXCHANGE COMMISSION 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 OR 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 ...

Financial Data and Key Metrics Changes - Medicare Advantage (MA) membership grew 57% to 409,000 members, while revenues increased 71% to $1.15 billion in Q2 2023, exceeding guidance [8][19] - Adjusted EBITDA rose significantly, reaching $10.3 million for the quarter compared to negative $2.7 million in the previous year, and year-to-date adjusted EBITDA was $34.1 million compared to $5.4 million last year [22][28] - Medical margins for MA increased 69% to $138 million in Q2, with year-to-date medical margin up 78% to $300 million [20][21] Business Line Data and Key Metrics Changes - MA medical margins increased 69% to $138 million, while ACO REACH medical margins rose 82% to $39 million [9][20] - Year-to-date medical margin PMPM for MA increased 9% to $113, driven by market maturation and member cohort performance [20] Market Data and Key Metrics Changes - Total members on the agilon platform reached approximately 496,000, with a 9% growth in existing geographies [19] - Revenue growth was primarily driven by membership gains in both new and existing geographies, with PMPM revenue increasing 11% [19] Company Strategy and Development Direction - The company aims to transform healthcare in over 100 communities by empowering primary care doctors, focusing on a high-touch, PCP-led model [7][11] - Agilon's model is designed to manage a discrete set of senior patients, allowing for better cost and quality outcomes compared to traditional fee-for-service systems [11][12] - The company is optimistic about future growth, with expectations of adding at least 145,000 new MA patients and 25,000 new REACH patients in 2024 [16][41] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the sustainability of ACO REACH results, noting improved visibility and performance against national benchmarks [35][36] - The company has raised its adjusted EBITDA outlook for 2023 and set a strong foundation for 2024, driven by strong performance in MA and REACH [15][28] - Management highlighted proactive investments in data capabilities to enhance operational efficiency and minimize risks associated with prior year claims [26][55] Other Important Information - The company has approximately $590 million in cash and marketable securities, with total debt of $41 million, indicating strong capitalization [27] - Agilon repurchased approximately 9.6 million shares for $200 million, aligning interests between key stakeholders [27] Q&A Session Summary Question: Clarification on reserve strengthening and medical cost margin guidance - Management clarified that the reserve strengthening is to cover a range of potential outcomes and minimize prior period development risks [33][34] Question: Impact of ACO REACH results on future performance - Management noted that ACO REACH is significantly outperforming national benchmarks, which supports confidence in future performance [35][36] Question: Changes in payer contracts and supplemental benefits - Management discussed ongoing discussions with payers regarding the rationalization of supplemental benefits, which could lower costs [76][78] Question: Visibility on claims data and its impact on guidance - Management confirmed high visibility on claims data, particularly for ACO REACH, and emphasized the importance of managing complex patient care [50][51] Question: Operational changes for 2024 - Management highlighted improvements in identifying complex patients and the implementation of new risk models, which are expected to enhance performance [64][66]

Table of Contents UNITED STATES SECURITIES AND EXCHANGE COMMISSION 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) Washington, D.C. 20549 _______________________________________________________ FORM 10-Q _______________________________________________________ (Mark One) x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURI ...

agilon health, inc. (NYSE:AGL) Q1 2023 Results Conference Call May 9, 2023 4:30 PM ET Company Participants Matthew Gillmor - VP, IR Steve Sell - CEO Tim Bensley - CFO Conference Call Participants Lisa Gill - JPMorgan George Hill - Deutsche Bank Ryan Daniels - William Blair Justin Lake - Wolfe Research Carol Wong - Wells Fargo Securities Jailendra Singh - Truist Adam Ron - Bank of America Sean Dodge - RBC Capital Markets Ben Mayo - SVB Securities Jamie Perse - Goldman Sachs Gary Taylor - Cowen David Larsen - ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-Q (Mark One) ☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934. For the quarterly period ended March 31, 2023 OR Delaware 37-1915147 (I.R.S. Employer Identification No.) 6210 E Hwy 290, Suite 450 Austin, TX 78723 ☐ 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. ( ...

Financial Data and Key Metrics Changes - In Q4 2022, revenue increased by 49% year-over-year to $690 million, while full-year revenue rose by 48% to $2.7 billion [21][22] - Adjusted EBITDA for the full year was positive $4.3 million, a significant improvement from negative $38.6 million in the previous year [25] - Medical margin for Q4 2022 increased by 93% year-over-year to $61 million, and for the full year, it rose by 67% to $305 million [22][25] Business Line Data and Key Metrics Changes - Medicare Advantage (MA) membership grew by 45% to approximately 270,000, while direct contracting membership increased by 72% to approximately 89,000 [21][22] - Medical margin per member per month (PMPM) increased by 15% for the full year to $96, compared to $83 in the previous year [22][23] Market Data and Key Metrics Changes - The company is serving 25 diverse geographies with 2,200 primary care doctors and nearly 500,000 senior patients, including a record addition of 130,000 new senior patients in 2023 [8][9] - The total Medicare Advantage membership is projected to double by 2024 compared to 2022 [9] Company Strategy and Development Direction - The company aims to transform healthcare by empowering primary care doctors to transition to a value-based care system, focusing on reducing wasteful health spending and improving patient outcomes [6][10] - The acquisition of mphrX is expected to enhance technology integration and accelerate onboarding processes for new partners [17][27] Management's Comments on Operating Environment and Future Outlook - Management expressed strong confidence in the growth trajectory for 2023 and beyond, citing favorable macro trends and the increasing demand for value-based care [19][45] - The company anticipates adjusted EBITDA growth driven by improvements in medical margins and operational efficiencies [30][31] Other Important Information - The company identified two material weaknesses in internal controls, which were disclosed in their 10-K filing, but these did not impact financial statements [29] - The company expects to generate positive cash flow as it moves into 2024, supported by a strong balance sheet with $909 million in cash and marketable securities [26] Q&A Session Summary Question: Revenue components for next year - Management indicated that revenue growth is driven by significant membership increases and expected improvements in risk scores and acuity levels [33][36] Question: ACO reach membership stability - Management noted that ACO reach membership remained flat due to a focus on strong implementation for existing partners, with opportunities for growth in 2024 [38][39] Question: Year 1 medical margin guidance for class of '23 - Management confirmed that the expected range for year 1 medical margin remains $30 to $60, consistent with previous classes [50] Question: Implementation timeframe with mphrX - Management highlighted that the acquisition of mphrX will significantly reduce implementation time, allowing for faster onboarding of new partners [55][56] Question: Class of 2024 membership size - Management indicated that the class of 2024 is expected to be at least 130,000 members, with potential for additional growth as new partners are onboarded [60][61]