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agilon health(AGL) - 2025 Q1 - Earnings Call Transcript
2025-05-06 20:30
Financial Data and Key Metrics Changes - For Q1 2025, total revenue was $1.53 billion, down from $1.6 billion in Q1 2024, primarily due to market and partnership exits, partially offset by premium growth [21] - Membership at the end of Q1 2025 was 491,000, a decrease from 523,000 in Q1 2024, reflecting a cautious approach to growth and partner exits [19] - Medical margin for Q1 2025 was $128 million, down from $157 million in Q1 2024, driven by elevated utilization and costs [21][22] - Adjusted EBITDA for Q1 2025 was $21 million, compared to $29 million in Q1 2024, reflecting ongoing elevated cost trends [23] Business Line Data and Key Metrics Changes - ACO REACH membership decreased to 114,000 in Q1 2025 from 131,000 in Q1 2024, primarily due to exiting an underperforming partnership [20] - Medical costs for Q1 2025 were in line with expectations, driven by elevated utilization and flu-related costs [22] - The medical cost trend for year two plus markets was 5.5% in Q1 2025, down from 6.7% in Q1 2024 [24] Market Data and Key Metrics Changes - The Medicare Advantage market continues to expand, with CMS data showing a year-over-year growth trend of 3.9% [10] - Overall market trends in 2025 remain consistent with the prior year, with an expected full-year trend of 5.3% [9] Company Strategy and Development Direction - The company is focused on disciplined growth, reducing exposure to costs outside of its control, and enhancing clinical and operational capabilities [6][12] - Investments in technology and clinical programs are expected to drive competitive advantages and improve quality outcomes [13][14] - The company anticipates a more favorable environment in 2026, supported by improved payer bids and final rate notices from CMS [11][18] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the final rate notice from CMS for 2026, which is expected to address high cost and utilization trends [6][18] - The company is taking a cautious approach to membership growth, with expectations for retroactive membership assignments in Q2 [5][19] - Management highlighted the importance of early identification and management of chronic diseases as a key focus of their model [7][10] Other Important Information - The company ended Q1 2025 with $369 million in cash and marketable securities, expecting to use approximately $110 million of cash in 2025 [27] - The company is maintaining a disciplined approach to capital allocation to support business objectives while aiming for cash flow breakeven in 2027 [27] Q&A Session Summary Question: Impact of V-28 risk model transition on value-based care companies - Management indicated that the risk adjustment perspective for 2025 is in line with expectations, with a 2% net increase year over year, despite a 3% headwind from V-28 [33][34] Question: Contribution from previously exited areas - Management noted that unfavorable development from exited markets would not impact 2025 significantly, with minimal remaining IBNR [37][38] Question: 2026 MA final rate notice and its flow-through - Management confirmed that 40% of membership was repriced for January 2025, with expected benefits from the average 9% increase across the network [41][42] Question: Risk scores and patient movement - Management clarified that the 2% increase in risk adjustment is on a same member basis, with some movement between payers noted but not significantly affecting care models [49][52] Question: Expectations for 2026 MA bit cycle - Management expressed optimism about the 2026 environment, with a focus on quality incentives and clinical cost-saving initiatives tracking well [58][61] Question: Medical cost trends and visibility on completed claims - Management stated that medical cost trends were in line with expectations, with improved visibility from the new financial data pipeline [65][66] Question: Potential membership reduction due to Part D - Management indicated that they are making progress in reducing Part D exposure and do not anticipate a reduction in membership for 2026 [75][76] Question: Clinical programs and their impact - Management confirmed that while 2025 is an investment year for new clinical programs, benefits are expected to materialize in 2026 and beyond [104][106]
NeueHealth(NEUE) - 2024 Q4 - Earnings Call Transcript
2025-03-20 17:14
NeueHealth, Inc (NYSE:NEUE) Q4 2024 Results Conference Call March 20, 2025 8:00 AM ET Company Participants Emily Lombardi - Assistant Vice President Mike Mikan - President & Chief Executive Officer Jay Matushak - Chief Financial Officer Operator Good morning, and thank you for joining us for the NeueHealth Q4 2024 Earnings Conference Call. My name is Carlin. I'll be coordinating the call today. And I'd like to hand over to your host, Emily Lombardi. The floor is yours. Emily Lombardi Good morning, and welco ...