Financial Data and Key Metrics Changes - Membership growth from Q4'23 to Q4'24 was 13%, with revenue increasing by 7% to $371 million [11] - Annual revenue for 2024 reached $1.5 billion, representing an 18% year-over-year growth [11][22] - The fourth quarter medical margin was $7 million, a decrease year-over-year due to elevated utilization trends [12] - Adjusted EBITDA for Q4 was a loss of $68 million, impacted by unfavorable out-of-period true-ups [12][25] - Full-year adjusted EBITDA loss was $167.2 million for 2024, compared to a loss of $85.5 million in the prior year [25] Business Line Data and Key Metrics Changes - At-risk membership increased to 123,800, a 14% year-over-year rise [22] - Full-year medical margin decreased by approximately 37% year-over-year to $85.5 million, driven by elevated medical expenses [24] - PMPM (per member per month) capitated revenue increased by 2.5% year-over-year [22] Market Data and Key Metrics Changes - The macro environment in the Medicare sector is improving, with positive trends expected for 2025 [9][10] - The company anticipates a $30 to $35 PMPM incremental medical margin benefit from payer benefit design changes [10] Company Strategy and Development Direction - The company is focused on strengthening its business for near-term profitability and has reaffirmed its 2025 guidance on all metrics except for total members, which is slightly raised [9][11] - A growth strategy emphasizing profitable growth is in place, with expectations to achieve profitability in 2025 [14] - The company is enhancing its leadership team with key hires to support its strategic initiatives [20] Management's Comments on Operating Environment and Future Outlook - Management noted that early indicators for 2025 are showing positive trends, with improvements in benefit design and utilization [10] - The company is optimistic about achieving its targets due to early trends observed in the first few months of the year [14] - Management expressed confidence in the accuracy of data exiting 2024, supporting effective reserve management [26] Other Important Information - The company has made significant investments in field operations for 2025, including the introduction of the P3 Restore program aimed at reducing physician burnout [19] - The company has successfully remediated seven previously identified material weaknesses in internal controls [27] Q&A Session Summary Question: Timing around reaching potential profitability - Management discussed the three major inputs for 2025 guidance, including a 7.5% revenue increase and a $16 PMPM improvement in medical costs [44][46] Question: Expectations for cash in 2025 - The company ended 2024 with $38.8 million in cash, with an additional $15 million received in early January, bringing the total to approximately $54 million [49] Question: Fourth quarter results and deviations from expectations - Management acknowledged that Q4 results were impacted by onetime negative items totaling about $17 million, which should be excluded from total Q4 EBITDA numbers [56] Question: Part D risk management - Management confirmed that about half of the Part D risk has been eliminated, with plans to address the remaining portion by January 1, 2026 [66] Question: Improving trends in utilization - Management noted slight improvements in utilization trends in Q4, with expectations that these trends will continue into Q1 of 2025 [73][75] Question: Seasonal dynamics and macro environment improvements - Management explained that the macro environment is improving due to benefit design changes and expected reductions in utilization [89]

Financial Data and Key Metrics Changes - Membership growth from Q4 2023 to Q4 2024 was 13% with revenue increasing by 7% to $371 million in Q4 2024, and annual revenue for 2024 reached $1.5 billion, representing an 18% year-over-year growth [9][17] - The fourth quarter medical margin was $7 million, a decrease year-over-year due to elevated utilization trends, while adjusted EBITDA for the quarter was a loss of $68 million [9][19] - Full year adjusted EBITDA loss was $167.2 million for 2024, compared to a loss of $85.5 million in the prior year, with a per member per month adjusted EBITDA loss of $147, a $45 change from the prior year [19] Business Line Data and Key Metrics Changes - The company reported a full year medical margin of $85.5 million, a decrease of approximately 37% year-over-year, driven by elevated medical expenses, particularly Part D expenses [18] - Capitated revenue increased by 2.5% year-over-year on a per member per month basis [17] Market Data and Key Metrics Changes - The company noted that the macro environment in the Medicare sector is improving, with positive early indicators for 2025 and favorable payer bids in CMS's 2026 advance notice [7][8] - The company expects an incremental medical margin benefit of $30 to $35 per member per month from benefit design changes [8] Company Strategy and Development Direction - The company is focused on strengthening its business for near-term profitability, with programmatic initiatives representing over $130 million of adjusted EBITDA opportunity on schedule [6] - The growth strategy emphasizes deliberate and profitable growth, with expectations to achieve profitability in 2025 [10] - The company is enhancing its senior leadership team with key hires to support its strategic initiatives [8][14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the meaningful progress towards long-term sustainable growth, with a focus on maintaining a strong control environment established in 2024 [20][21] - The company reaffirmed its 2025 guidance for revenues between $1.35 billion and $1.5 billion, with adjusted EBITDA expected to range from negative $35 million to positive $5 million [10][21] Other Important Information - The company has made significant investments in field operations for 2025 and introduced the P3 Restore program aimed at reducing physician burnout [13][14] - The company has successfully remediated seven previously identified material weaknesses in internal controls [20] Q&A Session Summary Question: Can you elaborate on the timing around reaching potential profitability? - Management indicated that the guidance for 2025 includes a 7.5% increase in revenue year-over-year and a $16 PMPM improvement in medical costs, with operational efficiencies contributing to the profitability target [31][32] Question: What are the expectations for cash in 2025? - The company ended 2024 with a cash balance of $38.8 million, with an additional $15 million received in January 2025, bringing the effective starting cash position to about $54 million [35][36] Question: Did Q4 results come in line with expectations? - Management acknowledged that Q4 results were impacted by one-time negative items totaling about $17 million, which should be excluded from total Q4 EBITDA numbers [41] Question: What are the trends in utilization? - Management reported slight improvements in utilization trends, with decreases in MIDS per 1,000 and emergency department visits per 1,000, although unit costs remained elevated [25][56] Question: Can you elaborate on the improving trends in the Medicare environment? - Management highlighted that benefit design changes from 2024 to 2025 are expected to reduce utilization, contributing to a more favorable environment [69]