agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced results for the second quarter ended June 30, 2023.
“The durability and predictability of our partnership model enabled agilon to deliver strong performance during the second quarter and first half of 2023,” said Steve Sell, chief executive officer. “Our execution this year establishes a strong foundation for success in 2024 and beyond, benefiting our physician partners, their patients, and the communities we serve.”
Second Quarter 2023 Results:
- Total members live on the agilon platform increased to 495,900 as of June 30, 2023, including 408,900 Medicare Advantage members and 87,000 ACO REACH beneficiaries. Medicare Advantage membership increased 57%, with 9% growth in same geographies.
- Total revenue of $1.15 billion increased 71% during the second quarter 2023, compared to $670 million in the second quarter 2022. Gross Profit of $57 million in the second quarter 2023, compared to $34 million in the second quarter 2022. Net loss of $17 million in the second quarter 2023, compared to a net loss of $21 million in second quarter 2022.
- Medical Margin of $138 million increased 69% during the second quarter 2023, compared to $82 million in the second quarter 2022. Medical Margin for the second quarter 2023 included a negative $7 million net impact from prior year claims and revenue, consisting of $16 million in prior year claims and $9 million in prior year revenue.
- Adjusted EBITDA of $10 million in the second quarter 2023, compared to an Adjusted EBITDA loss of $3 million in the second quarter 2022. Adjusted EBITDA included $19 million in geography entry costs in the second quarter 2023, compared to $10 million in the second quarter 2022. ACO REACH contributed $11 million to Adjusted EBITDA during the second quarter 2023, compared to $6 million in the second quarter 2022.
Key Financial and Operating Metrics:
Three Months Ended June 30, | Change | ||||
2023 | 2022 | % YoY | |||
Medicare Advantage Members | 408,900 | 261,200 | 57% | ||
ACO REACH Members | 87,000 | 90,500 | (4%) | ||
Total Members Live on Platform | 495,900 | 351,700 | 41% | ||
Avg. Medicare Advantage Members | 409,700 | 265,400 | 54% | ||
Total revenues ($M) | $1,149 | $670 | 71% | ||
Gross Profit ($M) | $57 | $34 | 69% | ||
Medical Margin ($M) | $138 | $82 | 69% | ||
Net Income ($M) | ($17) | ($21) | 19% | ||
Adjusted EBITDA ($M) | $10 | ($3) | NM | ||
Geography Entry Costs ($M) | $19 | $10 | 87% | ||
Membership reflects end of period results, unless otherwise stated. agilon’s partnered ACO REACH entities are not consolidated within its financial results.
Class of 2024 New Partnership Announcements:
Center for Primary Care (CPC) and agilon health announced the formation of a long-term partnership on May 31, 2023. CPC is an independent primary care practice operating 8 locations in the Central Savannah River Area, which includes communities in Eastern Georgia and Western South Carolina.
Capital Position and Balance Sheet:
agilon health’s balance sheet as of June 30, 2023 included cash, cash equivalents and marketable securities of $590 million and total debt of $41 million. On May 18, 2023, in connection with an underwritten secondary offering by certain selling shareholders, agilon health repurchased 9.6 million shares of common stock for approximately $200 million.
Outlook for Fiscal Year 2023:
Year Ended December 31, 2023 | |||||||
Updated Guidance | Previous Guidance | ||||||
Low | High | Low | High | ||||
Medicare Advantage Members | 412,000 | 415,000 | 405,000 | 410,000 | |||
ACO REACH Members | 85,000 | 90,000 | 85,000 | 90,000 | |||
Total Members Live on Platform | 497,000 | 505,000 | 490,000 | 500,000 | |||
Avg. Medicare Advantage Members | 409,000 | 410,000 | 405,000 | 407,000 | |||
Total Revenues ($M) | $4,525 | $4,540 | $4,410 | $4,440 | |||
Medical Margin ($M) | $500 | $530 | $535 | $560 | |||
Adjusted EBITDA ($M) | $0 | $23 | ($3) | $25 | |||
Geography Entry Costs ($M) | $75 | $68 | $78 | $65 | |||
Outlook for Third Quarter 2023:
Quarter Ended September 30, 2023 | |||
Low | High | ||
Medicare Advantage Members | 410,000 | 413,000 | |
ACO REACH Members | 85,000 | 90,000 | |
Total Members Live on Platform | 495,000 | 503,000 | |
Avg. Medicare Advantage Members | 413,000 | 416,000 | |
Total Revenues ($M) | $1,130 | $1,140 | |
Medical Margin ($M) | $110 | $125 | |
Adjusted EBITDA ($M) | ($8) | $0 | |
Geography Entry Costs ($M) | $22 | $20 | |
Adjusted EBITDA contribution from ACO REACH is now expected in a range of $30 million to $35 million for fiscal year 2023. Management’s previous outlook for Adjusted EBITDA contribution from ACO REACH was $5 million to $10 million for fiscal year 2023.
Membership reflects management’s outlook for end of period, unless otherwise stated. agilon’s partnered ACO REACH entities are not consolidated within its financial results. Management’s outlook for Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for Adjusted EBITDA.
We have not reconciled guidance for Medical Margin to Gross Profit or Adjusted EBITDA to net income (loss), the most comparable GAAP measures, and have not provided forward-looking guidance for net income (loss) in each case because of the uncertainty around certain items that may impact Gross Profit or net income (loss), including non-cash stock-based compensation.
Webcast and Conference Call:
agilon health will host a conference call to discuss second quarter 2023 results on Thursday, August 3, 2023 at 4:30 PM Eastern Time. The conference call can be accessed by dialing (833) 470-1428 for U.S. participants and +44 (208) 068-2558 for international participants and referencing participant code 946264. A simultaneous webcast can be accessed by visiting the “Events & Presentations” section of agilon’s Investor Relations website at https://investors.agilonhealth.com. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call.
About agilon health
agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups transition to a value-based Total Care Model for senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,700+ PCPs that allow physician groups to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30+ diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit www.agilonhealth.com and connect with us on Twitter, Instagram, LinkedIn and YouTube.
Forward-Looking Statements
Statements in this release that are not historical factual statements are “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include, among other things, statements regarding our and our officers’ intent, belief or expectation as identified by the use of words such as “believes,” “expects,” “may,” “will,” “shall,” “should,” “would,” “could,” “seeks,” “aims,” “projects,” “is optimistic,” “intends,” “plans,” “estimates,” “anticipates” or the negative versions of these words or other comparable terms. Examples of forward-looking statements include, among other things: statements regarding timing, outcomes and other details relating to current, pending or contemplated new markets, growth opportunities, ability to deliver sustainable long-term value, business environment, long-term opportunities and strategic growth plans, expected revenue and net income, total and average membership, Adjusted EBITDA, Medical Margin, geography entry costs and other financial projections and assumptions. Forward-looking statements reflect our current expectations and views about future events and are subject to risks and uncertainties that could significantly affect our future financial condition and results of operations. While forward-looking statements reflect our good faith belief and assumptions we believe to be reasonable based upon current information, we can give no assurance that our expectations or forecasts will be attained. Forward-looking statements are subject to known and unknown risks and uncertainties, many of which may be outside our control. These risks and uncertainties that could cause actual results and outcomes to differ from those reflected in forward-looking statements include, but are not limited to, those factors discussed in our filings with the Securities and Exchange Commission (the “SEC”), including the factors discussed under “Risk Factors” in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022, which can be found at the SEC’s website at www.sec.gov. Except as required by law, we do not undertake, and hereby disclaim, any obligation to update any forward-looking statements, which speak only as of the date on which they are made.
agilon health, inc. Consolidated Balance Sheets In thousands, except per share data | |||||||
June 30,
| December 31,
| ||||||
(unaudited) | |||||||
ASSETS | |||||||
Current assets: | |||||||
Cash and cash equivalents | $ | 190,981 | $ | 497,070 | |||
Restricted cash and equivalents | 10,204 | 10,610 | |||||
Marketable securities | 389,046 | 411,901 | |||||
Receivables, net | 1,417,052 | 497,574 | |||||
Prepaid expenses and other current assets, net | 37,560 | 34,119 | |||||
Total current assets | 2,044,843 | 1,451,274 | |||||
Property and equipment, net | 24,407 | 20,050 | |||||
Intangible assets, net | 94,185 | 67,680 | |||||
Goodwill | 62,140 | 41,540 | |||||
Other assets, net | 127,346 | 116,924 | |||||
Total assets | $ | 2,352,921 | $ | 1,697,468 | |||
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT) | |||||||
Current liabilities: | |||||||
Medical claims and related payables | $ | 1,099,533 | $ | 346,727 | |||
Accounts payable and accrued expenses | 257,819 | 183,364 | |||||
Current portion of long-term debt | 5,000 | 5,000 | |||||
Total current liabilities | 1,362,352 | 535,091 | |||||
Long-term debt, net of current portion | 36,017 | 38,482 | |||||
Other liabilities | 75,106 | 83,286 | |||||
Total liabilities | 1,473,475 | 656,859 | |||||
Commitments and contingencies | |||||||
Stockholders' equity (deficit): | |||||||
Common stock, $0.01 par value: 2,000,000 shares authorized; 405,427 and 412,385 shares issued and outstanding, respectively | 4,054 | 4,124 | |||||
Additional paid-in capital | 1,947,438 | 2,106,886 | |||||
Accumulated deficit | (1,064,957 | ) | (1,064,230 | ) | |||
Accumulated other comprehensive income (loss) | (6,369 | ) | (5,560 | ) | |||
Total agilon health, inc. stockholders' equity (deficit) | 880,166 | 1,041,220 | |||||
Noncontrolling interests | (720 | ) | (611 | ) | |||
Total stockholders’ equity (deficit) | 879,446 | 1,040,609 | |||||
Total liabilities and stockholders’ equity (deficit) | $ | 2,352,921 | $ | 1,697,468 | |||
agilon health, inc. Consolidated Statements of Operations In thousands, except per share data (unaudited) | |||||||||||||||
Three Months Ended
| Six Months Ended
| ||||||||||||||
2023 | 2022 | 2023 | 2022 | ||||||||||||
Revenues: | |||||||||||||||
Medical services revenue | $ | 1,147,044 | $ | 669,184 | $ | 2,281,874 | $ | 1,321,607 | |||||||
Other operating revenue | 2,008 | 950 | 3,325 | 1,972 | |||||||||||
Total revenues | 1,149,052 | 670,134 | 2,285,199 | 1,323,579 | |||||||||||
Expenses: | |||||||||||||||
Medical services expense | 1,008,734 | 587,140 | 1,981,561 | 1,153,348 | |||||||||||
Other medical expenses | 83,125 | 49,080 | 169,149 | 93,853 | |||||||||||
General and administrative (including noncash stock-based compensation expense of $19,572, $6,553, $33,244 and $10,523, respectively) | 81,499 | 51,924 | 148,345 | 91,758 | |||||||||||
Depreciation and amortization | |||||||||||||||
