Astrana Health (NasdaqCM:ASTH) Q3 2025 Earnings Call November 06, 2025 05:30 PM ET Company ParticipantsBrandon Sim - President and CEOChan Basho - COO and CFOConference Call ParticipantsJailendra Singh - AnalystMegan Holtz - AnalystCraig Jones - AnalystGene Mannheimer - AnalystZack Hunt - AnalystThomas Walsh - AnalystRyan Langston - AnalystMichael Ha - AnalystMatthew Mardula - AnalystDavid Larsen - AnalystOperatorGood day, everyone, and welcome to Astrana Health's third quarter 2025 earnings call. At this t ...

Accessibility StatementSkip Navigation Company to Host Conference Call on Thursday, November 6, 2025, at 2:30 p.m. PT/5:30 p.m. ET ALHAMBRA, Calif., Nov. 6, 2025 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the t ...

Financial Data and Key Metrics Changes - Privia Health reported a 27.1% year-over-year increase in practice collections, reaching $940.4 million in Q3 2025 [10] - Adjusted EBITDA increased by 61.6% to $38.2 million, with an EBITDA margin of 30.5%, reflecting a 720 basis point improvement year-over-year [5][10] - For the first nine months of 2025, practice collections rose 19.6% to $2.6 billion, while adjusted EBITDA grew 43.5% to $94.1 million [11] Business Line Data and Key Metrics Changes - Implemented provider growth was 13.1% year-over-year, reaching 5,250 providers [10] - Value-based attribution growth increased by 12.8% year-over-year, contributing to strong practice collections [4] - The total attributed lives increased by nearly 13% from the previous year, with commercial attributed lives up over 12% to 864,000 [6][7] Market Data and Key Metrics Changes - Privia managed over $2.5 billion in medical spend across nine ACOs in the Medicare Shared Savings Program (MSSP) for 2024, achieving a savings rate of 9.4%, up from 8.2% in 2023 [9] - Total shared savings reached $234.1 million, a 32.6% increase from the previous year, with gross shared savings of $160.1 million, reflecting a 36% increase over 2023 [9] Company Strategy and Development Direction - The company is focused on expanding its national footprint and enhancing its value-based care model, with an acquisition of an ACO business from Elevance Health for $100 million expected to close by year-end 2025 [5][6] - The acquisition is anticipated to add over 120,000 value-based care attributed lives and enhance operational synergies [5] - The company aims to maintain a diversified value-based care organization to build scale and profitability without reliance on any single contract [8] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in continued strong performance and momentum into 2026, with expectations for practice collections to grow 17.1% and care margin to increase by 13.2% [12] - The company plans to remain disciplined in its approach to business development and acquisitions, leveraging its strong cash position of over $400 million [39] - Management highlighted the importance of aligning interests among payers, providers, and the company for sustainable long-term growth [85] Other Important Information - The company has a balanced and diversified value-based care organization serving over 1.4 million patients through more than 100 commercial and government programs [6] - Pro forma free cash flow for the year-to-date was $104.4 million, with expectations to end the year with at least $410 million in cash [11] Q&A Session Summary Question: Future guidance on MSSP performance - Management indicated that strong results from 2024 will be factored into future planning, maintaining consistency in guidance updates based on performance relative to benchmarks [16][17] Question: Core business performance into Q4 - Management noted strong trends and momentum heading into Q4, emphasizing a focus on annual results rather than quarterly guidance [19][20] Question: Factors influencing fee-for-service growth - Management attributed strong fee-for-service growth to broad-based utilization trends and the addition of new markets, including Arizona [22][24] Question: Synergy opportunities with Evelyn Health ACO - Management discussed the potential for significant synergies and improvements in shared savings rates over time, emphasizing a gradual integration process [26][28] Question: Evolution of relationships with payers - Management highlighted ongoing discussions with payers, leveraging strong performance to negotiate favorable contracts across various payer classes [45][47] Question: Impact of new legislation on Medicaid - Management expressed that the impact of new legislation on Medicaid is expected to be minimal, given the small percentage of collections from this segment [76][77] Question: Ancillary services growth opportunities - Management indicated a focus on expanding ancillary services as the company builds density in new markets, enhancing overall cost management [60][62] Question: Future risk in MA contracts - Management reiterated a cautious approach to capitated MA contracts, emphasizing the importance of shared risk models for sustainable growth [32][34]

Clover Health Investments (NasdaqGS:CLOV) Q3 2025 Earnings Call November 04, 2025 05:00 PM ET Speaker2Hello and welcome to Clover Health's third quarter 2025 earnings call. We ask that you please hold all questions until the completion of the formal remarks, at which time you'll be given instructions for the question and answer session. Also, as a reminder, this conference is being recorded today. If you have any objections, please disconnect at this time. Ryan, you may begin.Speaker1Good afternoon, everyon ...

Financial Data and Key Metrics Changes - The company reported adjusted operating income of $3.5 billion and adjusted earnings per share (EPS) of $1.60 for the third quarter, with a 36% increase in adjusted operating income and a nearly 47% increase in adjusted EPS year-over-year [4][15] - Revenues reached nearly $103 billion, marking an 8% increase compared to the prior year quarter [15][24] - The full-year 2025 adjusted EPS guidance was raised to a range of $6.55 to $6.65, up from the previous range of $6.30 to $6.40 [4][24] Business Line Data and Key Metrics Changes - In the healthcare benefits segment, revenues were nearly $36 billion, up over 9% year-over-year, with a medical benefit ratio of 92.8%, a decrease of 240 basis points from the prior year [15][16] - The health services segment generated revenues of over $49 billion, an increase of over 11% year-over-year, although adjusted operating income decreased by 7% to approximately $2.1 billion [18][19] - The pharmacy and consumer wellness segment reported revenues of over $36 billion, a nearly 12% increase year-over-year, with same-store pharmacy sales growing nearly 17% [22][24] Market Data and Key Metrics Changes - The company ended the quarter with medical membership of approximately 26.7 million, flat sequentially but down approximately 445,000 members year-over-year [16] - The pharmacy market share grew to approximately 28.9%, reflecting strong operational performance and customer engagement [22][46] Company Strategy and Development Direction - The company is focused on becoming the most trusted healthcare company in America, emphasizing the importance of diversified business and strategic investments [4][12] - Aetna's performance is improving, with expectations of continued leadership in Medicare Advantage ratings [5][6] - The company is adapting its healthcare delivery strategy, including a reduction in the growth of Oak Street Health clinics, while maintaining a commitment to value-based care [7][21] Management's Comments on Operating Environment and Future Outlook - Management expressed a disciplined and cautious outlook for 2026, highlighting the importance of executing on commitments and adapting to market changes [5][14] - The company remains optimistic about the future, driven by strong performance across diversified business lines and strategic initiatives [13][30] Other Important Information - A goodwill impairment charge of approximately $5.7 billion was recorded in the healthcare delivery segment due to strategic changes in clinic growth expectations [7][20] - The company is actively working on recontracting efforts and improving financial performance in its healthcare delivery business [21][72] Q&A Session Summary Question: Comments on PBM side and future PBM economics - Management acknowledged headwinds in the PBM sector but emphasized the strength of a diversified company and the ongoing transition to a true cost model [32][34] - The company remains confident in delivering strong earnings and cash flow despite near-term challenges [34][41] Question: Drivers of confidence in PCW growth - Management highlighted strong execution, community pharmacy engagement, and the impact of the Rite Aid acquisition as key drivers for growth in the PCW segment [44][46] Question: Provider liabilities and impact on MBR - Management clarified that the 100 basis points of provider liabilities were related to historical matters and not expected to be a recurring issue [52][54] Question: Recontracting efforts at Oak Street - Management indicated that the focus is on ensuring sustainable agreements with payers and improving the path to profitability for Oak Street Health [71][72]

CVS Health rode double-digit sales growth from drugstores and its pharmacy benefits management business to a better-than-expected third quarter. The health care giant also hiked its 2025 forecast well above Wall Street estimates. But it booked a nearly $6-billion charge in the quarter for scaling back a care delivery business it expanded two years ago. The company said Wednesday that it filled more prescriptions at drugstores, partially due to added business from customers of the defunct Rite Aid chain. ...

Core Insights - DaVita Inc. is a leading provider of kidney care services in the U.S., specializing in dialysis treatments for chronic kidney failure patients [1] - The company is set to release its quarterly earnings on October 29, 2025, with analysts estimating an EPS of $3.17 and revenue of $3.43 billion [2][6] - DaVita has consistently exceeded earnings estimates in three of the past four quarters, with an average surprise of 4.7% [3][6] Financial Performance - DaVita's P/E ratio is 11.77, indicating the market's valuation of its earnings, while a price-to-sales ratio of 0.70 suggests a relatively low market valuation compared to revenue [4][6] - The company's debt-to-equity ratio is notably negative at -34.67, reflecting a unique capital structure, but it maintains a current ratio of 1.39, indicating solid liquidity [5][6] - An earnings yield of 8.50% highlights DaVita's financial stability and return on investment perspective [5] Strategic Focus - The company is focusing on technology-driven productivity and value-based care to address challenges such as high missed treatment rates and slow volume growth [3] - DaVita aims to leverage technology upgrades and cost management to enhance performance [2]

Financial Data and Key Metrics Changes - The company reported adjusted earnings per share of $2.92, slightly ahead of expectations [28] - Revenues exceeded $113 billion, reflecting a 12% year-over-year growth, driven by domestic membership expansion of over 780,000 lives year to date [29] - The medical care ratio was 89.9% in the quarter, compared to 85.2% in the same quarter last year, with the full year trending toward the lower end of projections [29] Business Line Data and Key Metrics Changes - UnitedHealthcare's medical cost trends remain historically high but consistent with second quarter guidance, expected to continue throughout 2025 [10] - Medicare Advantage is forecasted to have a full-year 2025 trend of approximately 7.5%, consistent with previous expectations [11] - Optum Health's performance was in line with expectations, reflecting natural seasonality and pull forward of some investments [23] Market Data and Key Metrics Changes - The company expects membership contraction of approximately 1 million in total Medicare Advantage, including individual and group markets [12] - In the ACA markets, average rate increases of over 25% have been submitted in nearly all participating states, likely reducing ACA enrollment by approximately two-thirds [14] - Medicaid funding levels are not sufficient to cover health needs, with expectations of continued challenges through 2026 [15] Company Strategy and Development Direction - The company is focused on returning to consistent enterprise-wide performance levels and is committed to value-based care [7][9] - Actions are being taken to narrow networks and emphasize appropriately aligned physicians and services [8] - The company plans to balance earnings growth ambitions in 2026 with investments for sustainable double-digit growth beginning in 2027 [9] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in returning to solid earnings growth next year, despite external challenges such as Medicare cuts and Medicaid funding pressures [8][9] - The company anticipates 2026 to be a transition year, with a focus on operational rigor and prudent pricing [17] - Management is optimistic about the long-term growth potential of Medicare Advantage, despite current pressures [62] Other Important Information - The company is investing more than $450 million in employee incentives and contributions to the UnitedHealth Foundation [30] - The debt-to-capital ratio remains stable at 44.1%, with expectations to trend closer to 40% in the second half of 2026 [31] - The company is accelerating investments in AI applications to improve enterprise performance [34] Q&A Session Summary Question: Update on sub-businesses in Optum Health - The revenue breakdown is 65% value-based care, 15% care delivery fee-for-service, and 20% payer employer services, with two-thirds of VBC serving UnitedHealthcare [40][42] Question: Competitive position of Optum Insight - Optum's competitive position is strong, with a focus on AI-first products and modernization of existing services [46][50] Question: Membership declines in Medicare Advantage - The company expects approximately 1 million membership contractions in 2026, with a disciplined approach to pricing impacting both group and individual markets [60][62] Question: Medical cost trends in the employer market - Medical cost trends are approximately 11%, with employers evaluating various strategies for 2026 [93]

Financial Data and Key Metrics Changes - The company reported adjusted EPS of $2.92, slightly ahead of expectations, with revenues exceeding $113 billion, reflecting a 12% year-over-year growth [28][29] - The medical care ratio increased to 89.9% from 85.2% year-over-year, with the full year trending toward the lower end of projections [29] - Operating cost ratio was 13.5%, reflecting larger investments in technology and personnel than originally anticipated [29] Business Line Data and Key Metrics Changes - UnitedHealthcare's medical cost trends remain historically high but consistent with previous guidance, with a forecasted full-year 2025 trend of approximately 7.5% in Medicare Advantage [10][11] - Optum Health's performance was in line with expectations, with anticipated margin improvement across all segments in 2026 despite ongoing Medicare funding cuts [24][29] - The company expects membership contraction of approximately 1 million in total Medicare Advantage, including individual and group markets, due to strategic plan exits and competitive dynamics [12][60] Market Data and Key Metrics Changes - The company anticipates continued headwinds in 2026 from nearly $50 billion in industry-wide Medicare cuts and Medicaid funding pressures [8][9] - The commercial business is expected to contract in line with broader market trends, while self-funded offerings continue to show strong traction [13][14] - The company expects to see a significant reduction in ACA enrollment by approximately two-thirds due to targeted service area reductions [14] Company Strategy and Development Direction - The company is focused on returning to consistent enterprise-wide performance levels and is committed to value-based care as a core strategy [7][8] - There is a renewed emphasis on operational discipline and strategic investments to drive higher and sustainable double-digit growth beginning in 2027 [9][34] - The company plans to reduce its footprint in international markets that do not align with U.S. healthcare needs [36][37] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in returning to solid earnings growth in 2026, despite external challenges [9][32] - The company is optimistic about executing its 2026 plans while acknowledging remaining headwinds, including the final year of V28, which represents a $6 billion headwind [32][34] - Management highlighted the importance of stability in the Medicare Advantage program for long-term growth potential [62] Other Important Information - The company is investing significantly in technology and employee incentives, with over $450 million allocated to these areas [29][30] - The debt-to-capital ratio remains stable at 44.1%, with expectations to trend closer to 40% in the second half of 2026 [31] - The company is accelerating AI applications to improve enterprise performance and enhance operational capabilities [34] Q&A Session Summary Question: Update on sub-businesses in Optum Health - The revenue breakdown is 65% value-based care, 15% fee-for-service, and 20% payer employer services, with two-thirds of VBC business serving UnitedHealthcare [40][42] Question: Competitive position of Optum Insight - Optum's competitive position is strong, with ongoing investments in AI-first products expected to drive growth [46][50] Question: Membership declines in Medicare Advantage - The company expects approximately 1 million membership contractions in 2026, with a disciplined approach to pricing impacting both group and individual segments [60][62] Question: Medicaid margin recovery - Medicaid margins are expected to be breakeven in 2025, with further degradation anticipated in 2026 due to funding mismatches [92][93] Question: Employer market medical cost trends - Medical cost trends are approximately 11%, with employers evaluating various strategies for 2026, including interest in value-based care [96]

Financial Data and Key Metrics Changes - The company reported adjusted EPS of $2.92, slightly ahead of expectations, with revenues exceeding $113 billion, reflecting a 12% year-over-year growth [25][26] - The medical care ratio increased to 89.9% from 85.2% year-over-year, with the full year trending toward the lower end of previous projections [26][27] - Operating cost ratio was 13.5%, reflecting larger investments in technology and personnel than originally planned [27] Business Line Data and Key Metrics Changes - UnitedHealthcare's medical cost trends remain historically high but consistent with second quarter guidance, with a forecasted full-year 2025 trend of approximately 7.5% in Medicare Advantage [7][8] - Optum Health's performance was in line with expectations, with anticipated margin improvement across all segments in 2026, despite ongoing Medicare funding cuts [22][23] - The company expects membership contraction of approximately 1 million in total Medicare Advantage, including individual and group markets, due to competitive market dynamics and strategic plan exits [9][10] Market Data and Key Metrics Changes - The company anticipates a challenging environment in Medicaid due to insufficient funding levels, with margins expected to decline further in 2026 [12][13] - The commercial market is expected to contract in line with broader market trends, but self-funded offerings continue to show strong traction [10][11] - The ACA markets are seeing average rate increases of over 25%, with expected enrollment reductions of approximately two-thirds [11] Company Strategy and Development Direction - The company is focused on returning to consistent enterprise-wide performance levels and enhancing operational rigor, particularly in value-based care [4][5] - There is a commitment to narrowing networks and emphasizing appropriately aligned physicians and services to improve competitiveness [5][6] - The company plans to balance earnings growth ambitions with investments that will drive sustainable double-digit growth beginning in 2027 [6] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in returning to solid earnings growth in 2026, despite external challenges such as Medicare cuts and Medicaid funding pressures [5][6] - The company is committed to engaging actively with investors and stakeholders, with plans for an investor conference in the latter half of 2026 [6] - Management highlighted the importance of operational discipline and the need to manage costs effectively in the current environment [33][36] Other Important Information - The company is investing significantly in technology and employee incentives, with over $450 million allocated to these areas [28] - The debt-to-capital ratio remains stable at 44.1%, with expectations to trend closer to 40% in the second half of 2026 [29] - The company is taking aggressive steps on affordability initiatives to improve overall medical trends relative to pricing [32] Q&A Session Summary Question: Update on sub-businesses in Optum Health - The revenue breakdown is 65% value-based care, 15% fee-for-service, and 20% payer employer services, with two-thirds of VBC serving UnitedHealthcare [38][39] Question: Competitive position of Optum Insight - Optum's competitive position is strong, with new AI-first products showing promising results and a focus on evolving traditional services to AI-based offerings [43][44] Question: Membership declines in Medicare Advantage - The company expects approximately 1 million membership contractions in 2026, with a disciplined approach to pricing impacting both group and individual segments [54][56] Question: Medicaid margin recovery - The company expects break-even margins in 2025, with further degradation in 2026 due to funding dislocation, but anticipates recovery in 2027 and 2028 [80][81] Question: Employer market medical cost trends - Medical cost trends are approximately 11%, with employers increasingly interested in value-based care and integrated solutions [83][85]