LOUISVILLE, Ky.--(BUSINESS WIRE)--Humana Inc. (NYSE: HUM), a health and well-being company focused on helping people live their healthiest lives, today released its latest Value-Based Care By the Numbers Report. The findings show that value-based care helps Medicare Advantage patients receive more personalized, preventive care while improving their overall health experience. Every path in value-based care leads to one goal: helping people achieve their best health." -Alex Ding, M.D., Deputy Chief Medical Of ...

Financial Data and Key Metrics Changes - The company reported adjusted earnings per share of $16.35 for 2025, slightly ahead of expectations, with a full-year revenue of nearly $448 billion, reflecting a 12% growth from 2024 [4][23] - For 2026, the company expects adjusted earnings per share to exceed $17.75, indicating a growth of at least 8.6% [6][24] - The medical care ratio for 2025 was 89.1%, slightly better than expected, while the operating cost ratio was 13.3% [23][25] Business Line Data and Key Metrics Changes - UnitedHealthcare's medical cost trend for 2025 was approximately 7.5%, with an expectation of 10% for 2026 [9][85] - The company anticipates a contraction of 1.3 million to 1.4 million members in Medicare Advantage for 2026 due to competitive market dynamics [10][11] - Medicaid membership is expected to contract by approximately 565,000 to 715,000 members due to reduced eligibility and state funding shortfalls [11][12] Market Data and Key Metrics Changes - The company expects continued pressure in the Medicaid business in 2026, driven by state funding shortfalls and elevated medical trends [11][12] - The commercial market is expected to see a contraction in fully insured group and individual enrollment, partially offset by growth in self-funded offerings [13][14] Company Strategy and Development Direction - The company is focusing on operational discipline, leveraging technology and AI, and renewing its commitment to innovation and accountability [4][6] - There is a strategic refocus on integrated value-based care, with plans to align Optum Financial Services with Optum Insight to enhance healthcare technology and financial technology innovation [7][18] - The company aims to improve margins and operational performance through pricing adjustments and cost management efforts [12][13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to recover margins and improve performance in 2026, despite challenges in Medicare and Medicaid funding [6][10] - The company is committed to enhancing customer experience and satisfaction through AI-enabled operational improvements [14][21] - Management emphasized the importance of execution and operational focus to achieve long-term growth and stability [28][80] Other Important Information - The company plans to invest nearly $1.5 billion in technology and innovation in 2026, with expectations for continued investment in 2027 [29][30] - A significant charge of $1.6 billion in 2025 was primarily related to restructuring and optimization efforts within Optum [5][23] Q&A Session Summary Question: Decline in traditional MA lives and future margins - Management acknowledged the decline in Medicare Advantage lives and indicated that margin recovery efforts are underway, with expectations for improvement in 2026 and beyond [33][39] Question: Fourth quarter Optum Health performance - Management noted that fourth quarter results were slightly disappointing due to restructuring actions but expressed confidence in future stability and performance improvements [42][45] Question: Medicaid rate relief and margin assumptions - Management confirmed expectations for some margin contraction in Medicaid due to ongoing dislocation of rates and elevated medical trends, despite some rate relief [56][57] Question: Optum Rx membership growth and client retention - Management highlighted strong performance in Optum Rx, with a successful selling season and high retention rates, contributing to modest earnings growth expectations for 2026 [60][66] Question: Breakdown of commercial risk lives decline - Management indicated that the largest share of membership decline is connected to the exchange business, with expectations for margin recovery in 2026 [71][73]

Financial Data and Key Metrics Changes - The company reported adjusted earnings per share of $16.35 for 2025, slightly ahead of expectations, excluding a $1.6 billion net of tax charge [5][24] - For 2026, the company expects adjusted earnings per share to exceed $17.75, indicating a growth of at least 8.6% [6][25] - Revenues for 2025 were nearly $448 billion, reflecting a 12% growth from 2024 [24] Business Line Data and Key Metrics Changes - UnitedHealthcare's medical cost trend for 2025 was approximately 7.5%, with an expectation of 10% for 2026 [9][84] - The company anticipates a contraction of 1.3 million to 1.4 million members in Medicare Advantage for 2026 due to competitive market dynamics [10] - Medicaid membership is expected to contract by approximately 565,000 to 715,000 members due to reduced eligibility and state funding shortfalls [11] Market Data and Key Metrics Changes - The company expects both fully insured group and individual enrollment to contract in 2026, partially offset by growth in self-funded offerings [13] - The commercial risk lives decline is primarily attributed to the exchange business, with an expected loss of over 500,000 members [71] Company Strategy and Development Direction - The company is focusing on operational discipline, leveraging technology and AI, and aligning its services to better serve the U.S. health system [5][6] - There is a strategic refocus on integrated value-based care, with plans to enhance operational efficiencies and improve patient outcomes [20][21] - The integration of Optum Financial Services with Optum Insight aims to create a more modern healthcare transaction system [19] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in returning to historical earnings quality and growth, emphasizing the importance of operational focus and execution [30][31] - The company acknowledges challenges from Medicare funding reductions and rising medical costs but believes that strategic actions will lead to improved performance [6][10] - Management is committed to transparency and accountability, with plans to publish performance metrics and independent reviews [32] Other Important Information - The company plans to invest nearly $1.5 billion in technology and innovation in 2026 [31] - The operating cost ratio for 2026 is expected to be 12.8%, reflecting disciplined cost management and productivity initiatives [26] Q&A Session Summary Question: Decline in Medicare Advantage lives and future margins - Management indicated that the focus for 2026 is on margin recovery rather than membership targets, with expectations of a 50 basis point improvement in Medicare Advantage margins [34][40] Question: Fourth quarter performance of Optum Health - Management acknowledged underperformance in the fourth quarter due to restructuring actions but expressed confidence in a more stable performance moving forward [43][46] Question: Medicaid rate relief and margin assumptions - Management expects some margin contraction in Medicaid due to ongoing rate dislocation and elevated medical trends, projecting rate increases of 6%-7% for 2026 [57] Question: Optum Rx performance and new clients - Management highlighted strong performance in securing new clients, attributing success to affordability, transparency, and execution [65][66] Question: Breakdown of commercial risk lives decline - The largest share of the expected decline in commercial risk lives is linked to the exchange business, with a focus on margin recovery for 2026 [71][72]

InnovAge Conference Call Summary Company Overview - **Company**: InnovAge - **Industry**: Healthcare, specifically focused on value-based care for dual eligibles (Medicare and Medicaid beneficiaries) [2][3] Core Business Model - InnovAge operates a vertically integrated payer-provider platform delivering personalized value-based care to medically and socially complex dual eligibles [3] - The company takes full financial accountability for outcomes and costs across the full scope of Medicare and Medicaid services, with an average premium of approximately $9,500 per participant per month [4] Operational Highlights - InnovAge operates 20 centers across six states, with two additional centers under development, serving nearly 8,000 participants [5] - The company has invested heavily in scalable technology and operating infrastructure, enhancing payer-grade utilization management capabilities [5] - The focus is now on optimizing the platform for responsible growth, expanding margins, and leveraging data and technology [6] Financial Performance - In Q1 FY2026, InnovAge achieved a 7.5% adjusted EBITDA margin and positive operating cash flow on a trailing 12-month basis [13] - The company expects continued growth and margin expansion, with long-term potential for adjusted EBITDA margins around 10% [14] Market Position and Growth Strategy - InnovAge is the only PACE organization with significant scale and geographic diversification, positioning it as a partner of choice for health systems and communities [12] - The company is exploring joint ventures with local health systems to enhance care coordination and expand access [12] - There is a significant market opportunity for PACE programs, which remain underpenetrated, particularly among dual eligibles [11] Regulatory Environment - There is growing bipartisan recognition of the value that PACE delivers, which supports sustained growth of PACE programs [11] - InnovAge is preparing for potential changes in Medicare risk adjustment models and is taking a conservative approach to manage associated risks [41][42] Technology and Operational Improvements - Recent investments include the rollout of the Epic EMR and Oracle financial platform, aimed at improving quality, compliance, and efficiency [21][22] - The company is leveraging AI to enhance clinical decision-making and reduce costs [23][24] Enrollment and Acuity Management - InnovAge is balancing enrollment growth with acuity mix to ensure appropriate risk reflection and economic viability [27][28] - The company has successfully rebalanced its participant mix to maintain economic leverage while prioritizing patient care [28] De Novo and Acquisition Strategy - InnovAge is evaluating both De Novo center development and bolt-on acquisitions, with a focus on markets with large and growing senior populations [29][30] - The company has identified opportunities to acquire subscale PACE programs that are struggling to meet expectations [31] Lessons Learned and Future Outlook - Key lessons from recent De Novo launches emphasize the importance of strong community relationships and awareness of the PACE model [33][35] - InnovAge is well-positioned to leverage its investments and operational improvements to deliver quality care and create value for stakeholders [45] Conclusion - InnovAge's unique integrated model, operational discipline, and strategic investments position it for continued growth and success in the evolving healthcare landscape [15][45]

d JPM Healthcare Conference January 2026 2 Company highlights Disclaimer Cautionary Note Regarding Forward-Looking Statements: These presentation materials contain forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements describe future expectations, including, without limitation, estimates of and goals for future operating, financial and tax performance and results, as well as the expected execution and effect of our business str ...

Core Insights - Privia Health Group reported Q3 CY2025 revenue of $580.4 million, exceeding Wall Street expectations by 16.6% and reflecting a year-on-year growth of 32.5% [1][5] - The company raised its full-year revenue guidance to $2.08 billion, which is 3.6% above analysts' estimates and represents a 9.2% increase from previous guidance [1][5] - Non-GAAP profit per share was $0.29, surpassing analysts' consensus estimates by 33.7% [1][5] Financial Performance - Revenue: $580.4 million vs analyst estimates of $497.7 million, a 32.5% year-on-year growth [5] - Adjusted EPS: $0.29 vs analyst estimates of $0.22, a 33.7% beat [5] - Adjusted EBITDA: $38.19 million vs analyst estimates of $28.29 million, with a margin of 6.6% [5] - Operating Margin: 2.5%, up from 1.3% in the same quarter last year [5] - Sales Volumes rose 13.1% year on year [5] - Market Capitalization: $2.94 billion [5] Strategic Outlook - The raised guidance is supported by ongoing provider additions and the acquisition of Evolent Health's accountable care organization business [4] - Management emphasized the importance of entering new markets and integrating the Evolent business for expanding the company's national footprint [4] - CEO highlighted strong execution in the Medicare Shared Savings Program and operational leverage through an expanding provider network [3][4] - Management cautioned about the need for a disciplined approach to capital deployment and contract structuring due to integration challenges and headwinds in the Medicare Advantage environment [4]

Core Insights - Privia Health Group, Inc. reported strong financial results for the third quarter of 2025, with total revenue increasing by 32.5% year-over-year to $580.4 million [2][5] - The company raised its full-year 2025 guidance across all key operating and financial metrics, reflecting confidence in continued growth [5][15] Financial Performance - Total revenue for Q3 2025 was $580.4 million, compared to $437.9 million in Q3 2024, marking a 32.5% increase [2] - Gross profit rose to $122.6 million, up 22.7% from $99.9 million in the same quarter last year [2] - Operating income surged by 147.8% to $14.4 million, while net income increased by 94.1% to $6.9 million [2][5] - Non-GAAP adjusted net income for Q3 2025 was $37.3 million, a 49.1% increase from $25.1 million in Q3 2024 [2] Key Operating Metrics - The number of implemented providers grew by 13.1% to 5,250 compared to 4,642 in Q3 2024 [3] - Value-based care attributed lives increased by 12.8% to 1,406,000 from 1,247,000 [3] - Practice collections reached $940.4 million, reflecting a 27.1% increase from $739.9 million in Q3 2024 [3][5] Year-to-Date Performance - For the nine months ended September 30, 2025, total revenue was $1,581.7 million, up 24.0% from $1,275.5 million in the same period of 2024 [7] - Adjusted EBITDA for the nine months increased by 43.5% to $94.1 million compared to $65.6 million in 2024 [13] Strategic Developments - Privia Health signed an agreement to acquire an ACO business from Evolent Health, which will expand its value-based care footprint to over 1.5 million attributed lives [10][11] - The acquisition is expected to close in Q4 2025 and will positively impact adjusted EBITDA in 2026 [11] Updated Guidance - The company raised its full-year 2025 guidance for implemented providers, attributed lives, practice collections, and GAAP revenue, indicating strong growth expectations [15] - The updated guidance includes a practice collections target of $3,450 to $3,500 million and GAAP revenue of $2,050 to $2,100 million [15]

Financial Data and Key Metrics Changes - BrightSpring reported total revenue of $3.3 billion for Q3 2025, representing a 28% year-over-year growth [9][24] - Adjusted EBITDA for the quarter was $160 million, an increase of 37% compared to the same period last year, with an EBITDA margin of 4.8% [9][26] - Cash flow from operations exceeded $100 million in Q3, with leverage declining to 3.3x [10][27] Business Line Data and Key Metrics Changes - Pharmacy Solutions revenue was $3.0 billion, growing 31% year-over-year, while Provider Services revenue reached $367 million, increasing 9% year-over-year [9][24] - Within Pharmacy Solutions, infusion and specialty revenue was $2.4 billion, reflecting a 42% growth from the prior year, while home and community pharmacy revenue was approximately flat at $590 million [24][26] - Provider Services segment adjusted EBITDA grew 16%, with home healthcare revenue increasing 12% year-over-year [18][24] Market Data and Key Metrics Changes - Home healthcare average daily census was 29,592, representing a 3% increase year-over-year, with hospice revenue increasing approximately 15% [18][19] - Specialty pharmacy scripts grew approximately 40% in Q3, driven by strong performance in both brand limited distribution drugs (LDDs) and generics [15][16] Company Strategy and Development Direction - BrightSpring aims to leverage its scaled platform in home and community healthcare to differentiate itself in the market [7] - The company is focused on quality and continuous improvement, with high patient satisfaction scores across service lines [11][12] - Future growth strategies include expanding chronic infused therapy offerings and optimizing go-to-market strategies in pharmacy [17][19] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the ongoing operational execution and continuous improvement driving financial results [8] - The company anticipates closing the community living divestiture transaction in Q1 2026, which is subject to regulatory approvals [8][10] - Management expects to achieve adjusted EBITDA guidance of $605 million-$615 million for 2025, reflecting a growth of 31.5%-33.7% over 2024 [30] Other Important Information - BrightSpring will host an Investor Day on March 17 in Louisville to discuss company strategy and service line prospects [21][22] - The company is implementing operational initiatives to enhance efficiency and has seen positive impacts from targeted growth investments [25][88] Q&A Session Summary Question: On the pacing of new drug launches - Management confirmed that the pipeline remains robust, with expectations of 16 to 18 launches over the next 12 to 18 months [32][33] Question: Sources of accretion for the Amedisys transaction - Management indicated that integration of operations and applying best practices will drive incremental margin and profit [41][42] Question: EBITDA per script increase sustainability - Management noted that higher growth in specialty scripts, which have the highest gross profit, contributed to the increase [44][45] Question: Impact of community living divestiture delay - Management stated that the delay is due to regulatory processes but remains optimistic for a Q1 closure [71] Question: Future opportunities in specialty pharmacy - Management highlighted ongoing focus on rare and orphan therapies and the growth potential in both acute and chronic therapies [94][95]

Core Viewpoint - Privia Health Group, Inc. has signed a definitive agreement to acquire an Accountable Care Organization (ACO) business from Evolent Health, which will enhance its value-based care (VBC) capabilities and expand its reach to approximately 1.5 million attributed lives across various healthcare programs [1][3]. Financial Summary - The acquisition will involve an initial payment of $100 million in cash at closing, with an additional potential payment of up to $13 million based on the final performance in the Medicare Shared Savings Program (MSSP) for 2025 [2]. - The transaction is expected to close in the fourth quarter of 2025 and is projected to positively contribute to Adjusted EBITDA in 2026 [2]. Strategic Implications - This strategic acquisition will increase the number of VBC attributed lives in existing Privia states and add new lives in different states, creating synergy opportunities for ACO-participating providers to join Privia's Medical Groups [3]. - The integration of Evolent Health's ACO business into Privia's national network of ACOs will allow the company to replicate its flexible operating model with new provider partners across the U.S. [4]. Company Overview - Privia Health is one of the largest physician enablement companies in the U.S., operating in 15 states and the District of Columbia, and optimizing over 1,300 physician practices to improve patient experiences for more than 5.3 million patients [5]. - The company's mission focuses on transforming healthcare delivery to achieve better outcomes, lower costs, and enhance community health and provider well-being [6].

Group 1 - Fresenius Medical Care has invested EUR 312 million and successfully closed a share purchase agreement with all non-physician investors in Interwell Health (IWH) [1] - This investment accelerates the timeline originally set during the merger of Cricket Health, IWH, and Fresenius Health Partners, which was completed in August 2022 [1] - Tommy P. O'Connor has been appointed as CEO of Interwell Health and Operating Segment leader of Value-Based Care to enhance the benefits of vertical integration and accelerate value creation in line with the FME Reignite strategy [1]