0001831097FALSE00018310972024-02-272024-02-27

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
_____________________________________________
FORM 8-K
_____________________________________________
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): February 27, 2024
_____________________________________________
agilon health, inc.
(Exact name of Registrant as Specified in Its Charter)
_____________________________________________
Delaware001-4033237-1915147
(State or Other Jurisdiction
of Incorporation)
(Commission File Number)
(IRS Employer
Identification No.)
6210 E Hwy 290, Suite 450
Austin, TX
78723
(Address of Principal Executive Offices)(Zip Code)
Registrant’s Telephone Number, Including Area Code: 562 256-3800
Not Applicable
(Former Name or Former Address, if Changed Since Last Report)
_____________________________________________
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
oWritten communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
oSoliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
oPre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
oPre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
Securities registered pursuant to Section 12(b) of the Act:
Title of each class
Trading
Symbol(s)
Name of each exchange on which registered
Common stock, par value $0.01 per shareAGLThe New York Stock Exchange
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§ 230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§ 240.12b-2 of this chapter).
Emerging growth company o
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o


Item 2.02 Results of Operations and Financial Condition.
On February 27, 2024, agilon health, inc. (“agilon” or the “Company”), a Delaware corporation, issued a press release setting forth its financial results for the three and twelve months ended December 31, 2023. A copy of the press release is furnished herewith as Exhibit 99.1 and is incorporated by reference herein.
Item 7.01 Regulation FD Disclosure.
On February 27, 2024, the Company issued an investor presentation regarding the Company’s financial results for the three and twelve months ended December 31, 2023. A copy of the investor presentation is furnished herewith.
The information set forth in Items 2.02 and 7.01 of this Current Report on Form 8-K and the related information in Exhibits 99.1 and 99.2 attached hereto is being furnished herewith, and shall not be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liabilities of that section and shall not be incorporated by reference in any filing with, the Securities and Exchange Commission under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference therein.
Item 9.01 Financial Statements and Exhibits.
(d)Exhibits
Exhibit
Number
Description
99.1
99.2
104Cover Page Interactive Data File (embedded within the Inline XBRL document)


SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
agilon health, inc.
Date:February 27, 2024By: /s/ TIMOTHY S. BENSLEY
Timothy S. Bensley
Chief Financial Officer


Exhibit 99.1
imgcover.jpg
agilon health Reports Fourth Quarter 2023 Results
Revenue increased 72% to $1.06 billion in the fourth quarter 2023, Medicare Advantage membership increased 68% to 388,400, and total members on the agilon platform grew to 477,700 as of December 31, 2023
2023 performance impacted by acceleration in medical costs due to macro dynamics, revised 2024 guidance assumes continuation of higher medical cost trends
Executing targeted action plan with focus on measured growth, Class of 2025 expected to add at least 60,000 Medicare Advantage members across 5 physician groups
AUSTIN, T.X., February 27, 2024 – agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced results for the fourth quarter and fiscal year ended December 31, 2023.
“agilon is navigating through a complex transition period for the Medicare Advantage industry and for our company, and we are taking significant actions to help mitigate the impact of this evolving environment and strengthening our reserves,” said Steve Sell, chief executive officer. “While near-term dynamics are negatively affecting our financial results, demand for our platform and the fundamental drivers of our business remain strong as we continue to deliver significant value to patients, payors, and our PCP partners. We believe we are well positioned to accelerate performance over the medium and long-term.”
Fourth Quarter and Fiscal Year 2023 Results:
•Total members on the agilon platform increased to 477,700 as of December 31, 2023, including 388,400 Medicare Advantage members and 89,300 ACO REACH beneficiaries. Medicare Advantage membership increased 68%, with 11% growth in same geographies.
•Total revenue of $1.06 billion in the fourth quarter 2023 increased 72% compared to $615 million in the fourth quarter 2022. For the fiscal year 2023, total revenue of $4.32 billion increased 81% compared to $2.39 billion in 2022.
•Gross profit of negative $95 million in the fourth quarter 2023 compared to $16 million in the fourth quarter 2022. For the fiscal year 2023, gross profit of $70 million compared to $111 million in 2022. Net loss of $230 million in the fourth quarter 2023 compared to a loss of $57 million in the fourth quarter 2022. For the fiscal year 2023, net loss of $263 million compared to a loss of $107 million in 2022.
•Medical margin of negative $102 million during the fourth quarter 2023, compared to $63 million in the fourth quarter 2022. For the fiscal year 2023, Medical Margin of $299 million, compared to $291 million in 2022. Medical Margin during the fourth quarter 2023 was negatively impacted by accelerating medical costs including prior period development from previous quarters.
•Adjusted EBITDA loss of $137 million in the fourth quarter 2023, compared to an Adjusted EBITDA loss of $32 million in the fourth quarter 2022. For the fiscal year 2023, Adjusted EBITDA loss of $95 million, compared to an Adjusted EBITDA loss of $45 million in the fiscal year 2022.


Key Financial and Operating Metrics ($M):
(Fourth Quarter 2023 vs. 2022)

Three Months
Ended December 31,
Change
20232022% YoY
Medicare Advantage Members1
388,400230,80068%
ACO REACH Members1,2
89,30089,000—%
Total Members Live on Platform1,2
477,700319,80049%
Avg. Medicare Advantage Members391,700233,30068%
Total revenues $1,056$61572%
Gross Profit ($95)$16NM
Medical Margin($102)$63NM
Net Loss($230)($57)NM
Adjusted EBITDA3
($137)($32)NM
Geography Entry Costs $26$32(19%)
1.Membership metrics reflect end of period results.
2.agilon’s ACO REACH entities are not included within its consolidated financial results.
3.agilon's ACO REACH entities contributed $6 million and $8 million to Adjusted EBITDA during the fourth quarter 2023 and fourth quarter 2022, respectively.
Key Financial and Operating Metrics ($M):
(Fiscal Year 2023 vs. 2022)

Twelve Months
Ended December 31,
Change
20232022% YoY
Medicare Advantage Members1
388,400230,80068%
ACO REACH Members1,2
89,30089,000—%
Total Members Live on Platform1,2
477,700319,80049%
Avg. Medicare Advantage Members379,400225,10069%
Total revenues $4,316$2,38881%
Gross Profit $70$111(37%)
Medical Margin$299$2913%
Net Loss($263)($107)NM
Adjusted EBITDA3
($95)($45)NM
Geography Entry Costs $75$6810%
1.Membership metrics reflect end of period results.
2.agilon’s ACO REACH entities are not included within its consolidated financial results.
3.agilon's ACO REACH entities contributed $39 million and $14 million to Adjusted EBITDA during the fiscal year 2023 and fiscal year 2022, respectively.


Medical Margin Performance Details
For the fiscal year 2023, Medical Margin of $299 million was approximately $51 million below the midpoint of the company’s guidance of range of $340 million to $360 million provided on January 5, 2024. The company estimates approximately $38 million of the lower Medical Margin is from costs and revenue attributable to the fourth quarter and $13 million of the lower Medical Margin is attributable to costs and revenue attributable previous periods.
Relative to the company’s previous guidance, the lower Medical Margin was primarily driven by two factors. First, as the company completed the financial closing process in February, it received updated data including relatively complete claims data from its largest payors, and additional information such as seasonality factors and census data. The company completed its analysis of this data in mid-February, with support from internal and external actuaries, which indicated medical claims were higher than the company’s previous estimate. Second, in light of this new information and the dynamic utilization environment, the company strengthened its reserve position for incurred but not reported medical claims. A range of reserve scenarios were developed and the company has reserved at the high-end of its estimates. The company believes this is a prudent approach given the environment.
Performance Action Plan
On January 5, 2024 agilon health announced a targeted action plan to improve performance. This plan includes expanding onboarding support for newer primary care physicians (PCPs) in mature markets, refining payor partnerships, improving data visibility and analytics, and accelerating operating efficiency. Management anticipates these actions will support growth in Adjusted EBITDA in 2024 and beyond.
The company has made solid progress on the targeted action plan. Progress to date includes physician trainings in mature markets with 90% of new physicians in those markets to be trained during the first half of 2024; increased data visibility from most all national and large regional payors as well as targeted changes to our percentage of premium rates in key markets; onboarding of payor data into the company’s new financial pipeline with over 55% of membership data expected in the first quarter and over 75% of membership data during the second quarter; and a reduction in platform support to 3% of revenue in 2024.
Class of 2025 New Partners
agilon health anticipates the Class of 2025 new partners will include at least 5 physician groups with more than 60,000 new Medicare Advantage (MA) members. Beginning in 2025, the agilon health physician network will expand to at least 36 physician groups and 3,000 primary care physicians.
agilon health now anticipates geographic entry costs will be in the range of $55 million to $65 million, down from the company’s previous expectation of ~$70 million. Given the current environment, agilon health is taking a measured approach to growth for the Class of 2025.
Capital Position and Balance Sheet
agilon health’s balance sheet as of December 31, 2023 included cash, cash equivalents and marketable securities of $495 million and total debt of $39 million. In addition, agilon health has $22 million of cash associated with the company’s unconsolidated ACO REACH entities.


Outlook for Fiscal Year 2024 ($M):
agilon health’s updated guidance assumes that the higher medical cost trend from 2023 will continue in 2024. Revised guidance assumes a medical cost trend of approximately 6.6% in 2024 for Year 2+ markets, which is 250 bps above the company’s prior expectation and compares to the 7.0% medical cost trend observed in 2023. Medical cost trend includes the impact of the company’s clinical programs and excludes the impact from non-medical costs (e.g., supplemental benefits), which is expected to drive less impact to cost trend in 2024 compared to 2023.
Year Ended December 31, 2024
Updated Guidance1
Previous Guidance
LowHighLowHigh
Medicare Advantage Members1
540,000550,000548,000553,000
ACO REACH Members1,2
120,000125,000N/AN/A
Total Members Live on Platform1
660,000675,000N/AN/A
Avg. Medicare Advantage Members527,000536,000N/AN/A
Total Revenues$6,350$6,465$6,350$6,420
Medical Margin $400$450$560$600
Adjusted EBITDA3
($60)($15)$40$60
Geography Entry Costs4
$65$55$70$70
1.Membership reflects management’s outlook for end of period.
2.agilon’s partnered ACO REACH entities are not consolidated within its financial results.
3.Adjusted EBITDA contribution from ACO REACH is expected to be approximately $40 million for fiscal year 2024.
4.Geography Entry Costs represent the corresponding expense included in the low-end and high-end of management’s outlook for Adjusted EBITDA.
Outlook for First Quarter 2024 ($M):
Quarter Ended
March 31, 2024
LowHigh
Medicare Advantage Members1
520,000530,000
ACO REACH Members1,2
125,000130,000
Total Members Live on Platform1
645,000660,000
Avg. Medicare Advantage Members516,000525,000
Total Revenues$1,605$1,630
Medical Margin$155$170
Adjusted EBITDA3
$15$25
Geography Entry Costs4
$23$20
1.Membership reflects management’s outlook for end of period.
2.agilon’s partnered ACO REACH entities are not consolidated within its financial results.
3.Adjusted EBITDA contribution from ACO REACH is expected to be approximately $14 million for the first quarter 2024.
4.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 fourth quarter and fiscal year 2023 results on Tuesday, February 27, 2024 at 4:30 PM Eastern Time. The conference call can be accessed by dialing (833) 470-1428 for U.S. participants and +1 (929) 526-1599 for international participants and referencing participant code 615568. 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 and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,400+ PCPs that allow its physician partners 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 X, 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, medical costs, net income and gross profit, total and average membership, Adjusted EBITDA, Medical Margin, geography entry costs and other financial projections and assumptions, including our fiscal year and first quarter 2024 guidance. 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: our history of net losses and the expectation that our expenses will increase in the future; failure to identify and develop successful new geographies, physician partners and payors, or execute upon our growth initiatives; success in executing our operating strategies or achieving results consistent with our historical performance; medical expenses incurred on behalf of our members may exceed revenues we receive; our ability to secure contracts with Medicare Advantage payors; our ability to grow new physician partner relationships sufficient to recover startup costs; availability of additional capital, on acceptable terms or at all, to support our business in the future; significant reduction in our membership; transition to a Total Care Model may be challenging for physician partners; public health crises, such as COVID-19, could adversely affect us; inaccuracy in estimates of our members’ risk adjustment factors, medical services expense, incurred but not reported claims, and earnings pursuant to payor contracts; the impact of restrictive clauses or exclusivity provisions in some of our contracts with physician partners; our to hire and retain qualified personnel; our ability


to realize the full value of our intangible assets; security breaches, cybersecurity attacks, loss of data and other disruptions to our information systems; our ability to protect the confidentiality of our know-how and other proprietary and internally developed information; reliance on our subsidiaries; Environmental, Social, and Governance issues; reliance on a limited number of key payors; the limited terms of contracts with our payors and our ability to renew them upon expiration; reliance on our payors, physician partners and other providers to operate our business; our ability to obtain accurate and complete diagnosis data; reliance on third-party software, data, infrastructure and bandwidth; consolidation and competition in the healthcare industry; the impact of changes to, and dependence on, federal government healthcare programs; uncertain or adverse economic and macroeconomic conditions, including a downturn or decrease in government expenditures; regulation of the healthcare industry and our and our physician partners’ ability to comply such laws and regulations; federal and state investigations, audits and enforcement actions; repayment obligations arising out of payor audits; negative publicity regarding the managed healthcare industry generally; our use, disclosure and processing of personally identifiable information, protected health information, and de-identified data; failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization; lawsuits not covered by insurance; changes in tax laws and regulations, or changes in related judgments or assumptions; our indebtedness and our potential to incur more debt; dependence on our subsidiaries for cash to fund all of our operations and expenses; provisions in our governing documents; ability to achieve a return on your investment depends on appreciation in the price of our common stock; the material weakness in our internal control over financial reporting and our ability to remediate such material weakness; and risks related to other 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, 2023, 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
December 31,
20232022
ASSETS
Current assets:
Cash and cash equivalents$107,570 $465,302 
Restricted cash and equivalents6,759 10,610 
Marketable securities380,773 411,901 
Receivables, net942,461 492,364 
Prepaid expenses and other current assets, net42,513 31,572 
Current assets of discontinued operations— 39,525 
Total current assets1,480,076 1,451,274 
Property and equipment, net27,576 19,937 
Intangible assets, net63,769 18,448 
Goodwill24,133 2,513 
Other assets, net145,312 105,861 
Non-current assets of discontinued operations— 99,435 
Total assets$1,740,866 $1,697,468 
LIABILITIES AND STOCKHOLDERS’ EQUITY (DEFICIT)
Current liabilities:
Medical claims and related payables$737,724 $300,798 
Accounts payable and accrued expenses233,182 177,428 
Current portion of long-term debt6,250 5,000 
Current liabilities of discontinued operations— 51,865 
Total current liabilities977,156 535,091 
Long-term debt, net of current portion32,308 38,482 
Other liabilities70,381 82,492 
Non-current liabilities of discontinued operations— 794 
Total liabilities1,079,845 656,859 
Commitments and contingencies
Stockholders' equity (deficit):
Common stock, $0.01 par value: 2,000,000 shares authorized; 406,387 and 412,385 shares issued and outstanding, respectively4,064 4,124 
Additional paid-in capital1,986,899 2,106,886 
Accumulated deficit(1,326,826)(1,064,230)
Accumulated other comprehensive income (loss)(2,298)(5,560)
Total agilon health, inc. stockholders' equity (deficit)661,839 1,041,220 
Noncontrolling interests(818)(611)
Total stockholders’ equity (deficit)661,021 1,040,609 
Total liabilities and stockholders’ equity (deficit)$1,740,866 $1,697,468 


agilon health, inc.
Consolidated Statements of Operations
In thousands, except per share data

Three Months Ended
December 31,		Twelve Months Ended
December 31,
2023202220232022
(unaudited)
Revenues:
Medical services revenue$1,053,540 $613,883 $4,307,350 $2,384,889 
Other operating revenue2,533 800 9,013 3,331 
Total revenues1,056,073 614,683 4,316,363 2,388,220 
Expenses:
Medical services expense1,155,393 551,133 4,008,659 2,093,860 
Other medical expenses(4,452)47,659 238,034 183,000 
General and administrative (including noncash stock-based compensation expense of $15,676, $9,873, $69,326 and $28,069, respectively)
64,696 70,228 285,760 207,789 
Depreciation and amortization4,735 2,686 16,043 8,949 
Total expenses1,220,372 671,706 4,548,496 2,493,598 
Income (loss) from operations(164,299)(57,023)(232,133)(105,378)
Other income (expense):
Income (loss) from equity method investments(8,018)7,247 16,489 10,720 
Other income (expense), net7,438 7,613 27,840 13,930 
Gain (loss) on lease terminations— — — (5,458)
Interest expense(1,993)(1,668)(6,658)(4,484)
Income (loss) before income taxes(166,872)(43,831)(194,462)(90,670)
Income tax benefit (expense)(267)(572)(791)(1,640)
Income (loss) from continuing operations(167,139)(44,403)(195,253)(92,310)
Discontinued operations:
Income (loss) before gain (loss) on sales and income taxes(15,797)(12,146)(20,002)(14,528)
Gain (loss) on sales of assets, net(47,548)— (47,548)— 
Income tax benefit (expense)— — — (26)
Total discontinued operations(63,345)(12,146)(67,550)(14,554)
Net income (loss)(230,484)(56,549)(262,803)(106,864)
Noncontrolling interests’ share in (earnings) loss51 83 207 311 
Net income (loss) attributable to common shares$(230,433)$(56,466)$(262,596)$(106,553)
Net income (loss) per common share, basic and diluted:
Continuing operations$(0.41)$(0.11)$(0.48)$(0.22)
Discontinued operations$(0.16)$(0.03)$(0.16)$(0.04)
Weighted average shares outstanding, basic and diluted406,477 412,103 408,917 408,154 


agilon health, inc.
Consolidated Statements of Cash Flows
In thousands
Year Ended December 31,
20232022
Cash flows from operating activities:
Net income (loss)$(262,803)$(106,864)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation and amortization20,161 13,772 
Stock-based compensation expense69,495 28,381 
Loss (income) from equity method investments(16,489)(10,720)
Deferred income taxes and uncertain tax positions— 532 
Release of indemnification assets— 553 
(Gain) loss on sale of assets, net47,548 — 
Other noncash items(4,044)2,973 
Changes in operating assets and liabilities:
Receivables, net(460,365)(204,167)
Prepaid expense and other current assets(6,120)(16,620)
Other assets(397)(205)
Medical claims and related payables441,500 107,713 
Accounts payable and accrued expenses32,111 65,736 
Other liabilities(16,796)(11,892)
Net cash provided by (used in) operating activities(156,199)(130,808)
Cash flows from investing activities:
Purchase of property and equipment(15,830)(15,426)
Purchase of intangible assets(14,985)(17,235)
Investment in loans receivable and other(19,528)(6,510)
Investments in marketable securities(114,657)(458,265)
Proceeds from maturities and sales of marketable securities and other164,040 52,548 
Net cash paid in business combination(45,252)— 
Proceeds from sale of business and property, net of cash divested2,193 500 
Net cash provided by (used in) investing activities(44,019)(444,388)
Cash flows from financing activities:
Proceeds from equity issuances, net11,867 33,056 
Common stock repurchase(200,000)— 
Repayments of long-term debt(5,000)(5,000)
Net cash provided by (used in) financing activities(193,133)28,056 
Net increase (decrease) in cash, cash equivalents and restricted cash and equivalents(393,351)(547,140)
Cash, cash equivalents and restricted cash and equivalents from continuing operations, beginning of year475,912 1,049,373 
Cash, cash equivalents and restricted cash and equivalents from discontinued operations, beginning of year31,768 5,447 
Cash, cash equivalents and restricted cash and equivalents, beginning of year507,680 1,054,820 
Cash, cash equivalents and restricted cash and equivalents from continuing operations, end of year114,329 475,912 
Cash, cash equivalents and restricted cash and equivalents from discontinued operations, end of year— 31,768 
Cash, cash equivalents and restricted cash and equivalents, end of year$114,329 $507,680 


agilon health, inc.
Key Operating Metrics
In thousands
(unaudited)
GROSS PROFIT
Three Months Ended
December 31,		Twelve Months Ended
December 31,
2023202220232022
Total revenues$1,056,073 $614,683 $4,316,363 $2,388,220 
Medical services expense(1,155,393)(551,133)(4,008,659)(2,093,860)
Other medical expenses(1)
4,452 (47,659)(238,034)(183,000)
Gross profit$(94,868)$15,891 $69,670 $111,360 
______________________________________________________________
(1)Represents physician compensation expense related to surplus sharing and other care management expenses that help to create medical cost efficiency. Includes costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended December 31, 2023 and 2022, costs incurred in implementing geographies were $13.5 million and $13.0 million, respectively. For the twelve months ended December 31, 2023 and 2022, costs incurred in implementing geographies were $33.7 million and $23.9 million, respectively.

GENERAL AND ADMINISTRATIVE COSTS, INCLUDING PLATFORM SUPPORT COSTS
Three Months Ended
December 31,		Twelve Months Ended
December 31,
2023202220232022
Platform support costs$36,729 $40,921 $163,652 $127,458 
Geography entry costs(1)
12,192 19,434 40,812 43,890 
Severance and related costs— — 188 2,470 
Stock-based compensation expense15,676 9,873 69,326 28,069 
Other(2)
99 — 11,782 5,902 
General and administrative$64,696 $70,228 $285,760 $207,789 
______________________________________________________________
(1)Represents direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets.
(2)Includes transaction-related costs.
Our platform support costs, which include regionally-based support personnel and other operating costs to support our geographies, are expected to decrease over time as a percentage of revenue as our physician partners add members and our revenue grows. Our operating expenses at the enterprise level include resources and technology to support payor contracting, clinical program development, quality, data management, finance and legal functions.


agilon health, inc.
Non-GAAP Financial Measures
In thousands
(unaudited)
MEDICAL MARGIN
Three Months Ended
December 31,		Twelve Months Ended
December 31,
2023202220232022
Gross profit(1)
$(94,868)$15,891 $69,670 $111,360 
Other operating revenue(2,533)(800)(9,013)(3,331)
Other medical expenses(4,452)47,659 238,034 183,000 
Medical margin$(101,853)$62,750 $298,691 $291,029 
______________________________________________________________
(1)Gross profit is defined as total revenues less medical services expense and other medical expenses.
ADJUSTED EBITDA
Three Months Ended
December 31,		Twelve Months Ended
December 31,
2023202220232022
Net income (loss)(1)
$(230,484)$(56,549)$(262,803)$(106,864)
(Income) loss from discontinued operations, net of income taxes63,345 12,146 67,550 14,554 
Interest expense1,993 1,668 6,658 4,484 
Income tax expense (benefit)267 572 791 1,640 
Depreciation and amortization4,735 2,686 16,043 8,949 
(Gain) loss on lease terminations— — — 5,458 
Severance and related costs(2)
— — 188 2,470 
Stock-based compensation expense15,676 9,873 69,326 28,069 
EBITDA adjustments related to equity method investments(3)
14,268 749 22,694 3,737 
Other(4)
(6,861)(3,381)(15,448)(7,967)
Adjusted EBITDA$(137,061)$(32,236)$(95,001)$(45,470)
______________________________________________________________
(1)Includes direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended December 31, 2023 and 2022, (i) $13.5 million and $13.0 million, respectively, are included in other medical expenses and (ii) $12.2 million and $19.4 million, respectively, are included in general and administrative expenses. For the twelve months ended December 31, 2023 and 2022, (i) $33.7 million and $23.9 million, respectively, are included in other medical expenses and (ii) $40.8 million and $43.9 million, respectively, are included in general and administrative expenses.
(2)For the year ended December 31, 2022, includes taxes and related costs on stock option exercises for departed executives of $2.0 million.
(3)The three and twelve months ended December 31, 2023 includes $15.2 million of physician compensation expenses to reduce the physician partners’ compensation percentage in current and future years in exchange for the Company’s common stock.
(4)Includes interest income and transaction-related costs.






agilon health, inc.
Supplemental Financial Information
In thousands
(unaudited)

Three Months Ended
December 31, 2023		Twelve Months Ended
December 31, 2023
Medicare Advantage (Consolidated)ACO REACH (Unconsolidated)Medicare Advantage (Consolidated)ACO REACH (Unconsolidated)
Medical services revenue$1,053,540 $302,692 $4,307,350 $1,160,978 
Other operating revenue2,533 — 9,013 — 
Total revenues1,056,073 302,692 4,316,363 1,160,978 
Medical services expense(1,155,393)(282,716)(4,008,659)(1,024,468)
Other medical expenses4,452 (25,016)(238,034)(96,154)
Gross profit(94,868)(5,040)69,670 40,356 
Other operating revenue(2,533)— (9,013)— 
Other medical expenses(4,452)25,016 238,034 96,154 
Medical margin$(101,853)$19,976 $298,691 $136,510 
________________________________________________________

Certain of our operations are not consolidated for the period presented because we do not have the ability to control certain activities due to another party’s control of the entities’ board of directors. Although revenues of the unconsolidated operations are not recorded as revenues by us, income (loss) from equity method investments is nonetheless a significant portion of our overall earnings. See Note 18 to the Consolidated Financial Statements in the Annual Report on Form 10-K for the period ending December 31, 2023 for additional discussion on our equity method investments.

In addition to providing results that are determined in accordance with GAAP, we present Medical Margin and Adjusted EBITDA, which are non-GAAP financial measures.
We define Medical Margin as medical services revenue after medical services expense is deducted. Medical services expense represents costs incurred for medical services provided to our members. As our platform matures over time, we expect Medical Margin to increase in absolute dollars. However, Medical Margin per member per month (PMPM) may vary as the percentage of new members brought onto our platform fluctuates. New membership added to the platform is typically dilutive to Medical Margin PMPM. We believe this metric provides insight into the economics of our capitation arrangements as it includes all medical services expense directly associated with our members’ care.
We define Adjusted EBITDA as net income (loss) adjusted to exclude: (i) income (loss) from discontinued operations, net of income taxes, (ii) interest expense, (iii) income tax expense (benefit), (iv) depreciation and amortization, (v) stock-based compensation expense, (vi) severance and related costs, and (vii) certain other items that are not considered by us in the evaluation of ongoing operating performance. We reflect our share of Adjusted EBITDA for equity method investments by applying our actual ownership percentage for the period to the applicable reconciling items on an entity-by-entity basis.
Gross profit is the most directly comparable GAAP measure to Medical Margin. Net income (loss) is the most directly comparable GAAP measure to Adjusted EBITDA.
We believe Medical Margin and Adjusted EBITDA help identify underlying trends in our business and facilitate evaluation of period-to-period operating performance of our operations by eliminating items that are variable in nature and not considered by us in the evaluation of ongoing operating performance, allowing comparison of our recurring core business operating results over multiple periods. We also believe Medical Margin and Adjusted EBITDA provide useful information about our operating results, enhance the overall understanding of our past performance and future prospects, and allow for greater transparency with respect to key metrics we use for financial and operational decision-making. We believe Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in our industry as a measure of financial performance. Other companies may calculate Medical Margin and Adjusted EBITDA or similarly titled non-GAAP measures differently from the way we calculate these metrics. As a result, our presentation of Medical Margin and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures.




agilon health, inc.
2023 Quarterly Consolidated Statements of Operations
In thousands, except per share data
(unaudited)
Three Months Ended 2023
March 31June 30September 30December 31
Revenues:
Medical services revenue$1,053,119 $1,067,234 $1,133,457 $1,053,540 
Other operating revenue1,193 1,881 3,406 2,533 
Total revenues1,054,312 1,069,115 1,136,863 1,056,073 
Expenses:
Medical services expense897,572 932,823 1,022,871 1,155,393 
Other medical expenses83,617 81,716 77,153 (4,452)
General and administrative69,752 79,254 72,058 64,696 
Depreciation and amortization2,954 4,279 4,075 4,735 
Total expenses1,053,895 1,098,072 1,176,157 1,220,372 
Income (loss) from operations417 (28,957)(39,294)(164,299)
Other income (expense):
Income (loss) from equity method investments1,376 8,472 14,659 (8,018)
Other income (expense), net7,892 7,087 5,423 7,438 
Interest expense(1,493)(1,555)(1,617)(1,993)
Income (loss) before income taxes8,192 (14,953)(20,829)(166,872)
Income tax benefit (expense)1,759 (1,073)(1,210)(267)
Income (loss) from continuing operations9,951 (16,026)(22,039)(167,139)
Discontinued operations:
Income (loss) before gain (loss) on sales and income taxes6,008 (769)(9,444)(15,797)
Gain (loss) on sales of assets, net— — — (47,548)
Total discontinued operations6,008 (769)(9,444)(63,345)
Net income (loss)15,959 (16,795)(31,483)(230,484)
Noncontrolling interests’ share in (earnings) loss63 46 47 51 
Net income (loss) attributable to common shares$16,022 $(16,749)$(31,436)$(230,433)
Net income (loss) per common share, basic and diluted:
Continuing operations$0.02 $(0.04)$(0.05)$(0.41)
Discontinued operations$0.01 $— $(0.02)$(0.16)
Weighted average shares outstanding:
Basic413,136 410,338 405,787 406,477 
Diluted426,586 410,338 405,787 406,477 





Contacts
Investor Contact
Matthew Gillmor
VP, Investor Relations
investors@agilonhealth.com
Media Contact
Claire Mulhearn
Chief Communications & Public Affairs Officer
media@agilonhealth.com
Source: agilon health

4Q Earnings Presentation February 2024 Copyright © 2023 agilon health. Confidential internal document containing proprietary information. Do not distribute.

 
2 Disclaimers and Forward-Looking Statements FORWARD-LOOKING STATEMENTS AND OTHER INFORMATION Statements in this presentation 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, including our guidance for the fiscal year and first quarter 2024, 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: our history of net losses and the expectation that our expenses will increase in the future; failure to identify and develop successful new geographies, physician partners and payors, or execute upon our growth initiatives; success in executing our operating strategies or achieving results consistent with our historical performance; medical expenses incurred on behalf of our members may exceed revenues we receive; our ability to secure contracts with Medicare Advantage payors; our ability to grow new physician partner relationships sufficient to recover startup costs; availability of additional capital, on acceptable terms or at all, to support our business in the future; significant reduction in our membership; transition to a Total Care Model may be challenging for physician partners; public health crises, such as COVID-19, could adversely affect us; inaccuracy in estimates of our members’ risk adjustment factors, medical services expense, incurred but not reported claims, and earnings pursuant to payor contracts; the impact of restrictive clauses or exclusivity provisions in some of our contracts with physician partners; our to hire and retain qualified personnel; our ability to realize the full value of our intangible assets; security breaches, cybersecurity attacks, loss of data and other disruptions to our information systems; our ability to protect the confidentiality of our know-how and other proprietary and internally developed information; reliance on our subsidiaries; Environmental, Social, and Governance issues; reliance on a limited number of key payors; the limited terms of contracts with our payors and our ability to renew them upon expiration; reliance on our payors, physician partners and other providers to operate our business; our ability to obtain accurate and complete diagnosis data; reliance on third-party software, data, infrastructure and bandwidth; consolidation and competition in the healthcare industry; the impact of changes to, and dependence on, federal government healthcare programs; uncertain or adverse economic and macroeconomic conditions, including a downturn or decrease in government expenditures; regulation of the healthcare industry and our and our physician partners’ ability to comply such laws and regulations; federal and state investigations, audits and enforcement actions; repayment obligations arising out of payor audits; negative publicity regarding the managed healthcare industry generally; our use, disclosure and processing of personally identifiable information, protected health information, and de-identified data; failure to obtain or maintain an insurance license, a certificate of authority or an equivalent authorization; lawsuits not covered by insurance; changes in tax laws and regulations, or changes in related judgments or assumptions; our indebtedness and our potential to incur more debt; dependence on our subsidiaries for cash to fund all of our operations and expenses; provisions in our governing documents; ability to achieve a return on your investment depends on appreciation in the price of our common stock; the material weakness in our internal control over financial reporting and our ability to remediate such material weakness; and risks related to other 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, 2023, 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. NON-GAAP FINANCIAL MEASURES This presentation includes references to non‐GAAP financial measures, including but not limited to Medical Margin and Adjusted EBITDA. We believe medical margin and Adjusted EBITDA help identify underlying trends in our business and facilitate evaluation of period- to-period operating performance of our operations by eliminating items that are variable in nature and not considered by us in the evaluation of ongoing operating performance, allowing comparison of our recurring core business operating results over multiple periods. We also believe medical margin and Adjusted EBITDA provide useful information about our operating results, enhance the overall understanding of our past performance and future prospects, and allow for greater transparency with respect to key metrics we use for financial and operational decision-making. We believe medical margin and Adjusted EBITDA or similarly titled non-GAAP measures are widely used by investors, securities analysts, ratings agencies, and other parties in evaluating companies in our industry as a measure of financial performance. Other companies may calculate medical margin and Adjusted EBITDA or similarly titled non-GAAP measures differently from the way we calculate these metrics. As a result, our presentation of medical margin and Adjusted EBITDA may not be comparable to similarly titled measures of other companies, limiting their usefulness as comparative measures. Medical Margin and Adjusted EBITDA have limitations as analytical tools and should not be considered in isolation or as an alternative to GAAP measures or other financial statement data presented in agilon’s consolidated financial statements. Information reconciling guidance for Medical Margin to Gross Profit or Adjusted EBITDA to net income (loss), the most comparable GAAP measures, and information regarding forward-looking guidance for net income (loss) is not available without unreasonable effort due to the high variability, complexity and uncertainty with respect to quantifying and forecasting certain items that may impact Gross Profit or net income (loss), including non-cash stock-based compensation. For these reasons, we are unable to compute the probable significance of the unavailable information, which could have a potentially unpredictable and potentially significant impact on our future GAAP financial results.

 
3 Key Messages 2023 Results and 2024 Guidance Impacted by Acceleration in Medical Costs ▪ Completed analysis of updated payor data in mid-February, including relatively complete data from largest payors. Analysis indicated medical costs for our members were higher than previous estimates. ▪ Strengthened reserves to high-end of internal estimates. Prudent approach given environment. ▪ Revised 2024 guidance assumes higher cost trends continue. Targeted Action Plan on Track and Business Model is Working ▪ Executing action plan discussed on January 5. ▪ Demand for platform among PCPs remains strong. ▪ Driving 4+ Star quality performance across Year 2+ market classes. ▪ Strong balance sheet with ~$500M in cash and short-term investments. Member Cohort and Market Class Medical Margin PMPM Progression ▪ Member cohort margins progressing or sustaining near ~$150 PMPM range despite elevated medical cost environment during 2023 relative to revenue benchmarks. ▪ Market class medical margins also impacted by dilution from membership and PCP growth.

 
4 2023 Medical Margin Bridge - Change from Jan 5 Guidance • $38M from higher costs and revenue attributed to 4Q23 • $11M from higher costs and revenue from prior periods Medical Margin Guidance Bridge for Full Year 2023 • Final revenue settlements and claims estimates $340M-360M Note: 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.

 
5 2024 Medical Margin Bridge Market Classes of 2018-2023 (Yr 2+) Note: 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. • Medical cost PMPM now assumes 6.6% trend including clinical program impact (7.9% before programs), compared to assumed trend in prior guidance of 4.1% including clinical program impact (5.3% before programs) • Revenue PMPM trend of 6.0% benefiting from stronger performance on BOI documentation efforts during 2H23

 
6 2022 - 2024 Adjusted EBITDA Bridge Note: 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. • Limited YoY Medical Margin improvement in Year 2+ markets, impacted by $26M of net negative PYD ($15M Adj. EBITDA impact) and higher utilization • $32M market EBITDA loss for Class of 2023 • Modest improvement to Year 2+ Medical Margin • Class of 2024 markets expected to generate positive market EBITDA

 
7 Class of 2023 and Class of 2024 Details Class of 2024 (2024 Guidance) Class of 2023 (2023 Results) • Performance driven by: ▪ Longer implementation ▪ Historical VBC experience of partners ▪ Macro environment • MA Membership: ~145K • Medical Margin PMPM: ~$52 ▪ Compares prior estimate of ~$76 • Market EBITDA: Positive ~$9M Year 1 Class Performance Expected to Significantly Improve in 2024 • Performance driven by: ▪ Shorter implementation ▪ Partner mix/less VBC experience ▪ Macro environment • MA Membership: 132K • Medical Margin PMPM: $21 • Market EBITDA: Loss of ($32)M

 
Enhancing processes and systems to address market dynamics and drive accelerated performance in 2024 and beyond Actions to Improve Performance, Balance Risk Sharing, and Enhance Predictability Action Timing Details / Milestones Physician Onboarding & Continuous Education In-Process for 2024-2025+ ▪ Reducing performance variability, especially for new PCPs in existing markets ▪ Accelerating and expanding clinical programs Payor Partnerships Executed & In- Process for 2024+ ▪ Tangible progress on strengthening relationships and outcomes Data Visibility & Analytics Executed & In- Process for 2024+ ▪ Executed changes to internal and external teams - new actuary and Milliman relationship ▪ Created better alignment with payor partners Operating Efficiency Executed for 2024 ▪ Accelerated platform support efficiency, reduce to 3% of revenues in 2024 ▪ Leveraging corporate and market investments from 2023 8

 
9 Member Cohort and Market Class Margin Progression Member Cohorts Drive Long-term Earnings and Cash Flow Trajectory 2023 Member Cohort and Market Class Margin Progression Impacted by Elevated Costs ▪ Medical cost trends were above revenue benchmarks during 2023 and this is expected to continue in 2024. ▪ Medicare Advantage program is designed to adjust to changes in utilization over time. Member Cohort Medical Margin PMPM Progressing or Sustaining Near $150+ (Slide 9-10) ▪ Member cohort analysis shows medical margin PMPMs for the same members over time, which eliminates the dilutive impact from membership and PCP growth. ▪ Progressing or sustaining member cohort medical margin PMPMs at/towards the ~$150 range despite the higher utilization environment and payor benefit changes relative to revenue benchmarks. Market Class Medical Margin PMPM Progression Details (Slides 11-13) ▪ Market class analysis shows medical margin PMPMs across entire market classes, which includes the dilutive impact from membership and PCP growth. ▪ Market class margins showing less progression in 2023, reflecting the dilutive impact from member and PCP growth combined with the higher utilization environment relative to revenue benchmarks.

 
10 $133 $143 $226 $167 $198 $142 $36 $131 $136 $188 $157 $115 $94 $143 $160 $42 $80 $109 $72 $82 $25 2018 2019 2020 2021 2022 2023 2018 Members 2019 Members 2020 Members 2021 Members 2022 Members 2023 Members Note 1: Reflects incurred results; Note 2: 2020 reflects COVID-19 impact; Note 3: Reflects full allocation of costs to member-level cohorts, including Part D and other (other risk pool, certain health plans with limited data) Medical Margin PMPM by Member Cohorts Copyright © 2023 agilon health Member Cohort Progression (Incurred Results) Elevated Medical Cost Environment Relative to Revenue Benchmarks Approximately one-third of total membership in 2023 cohort

 
11 Market Class Margin Progression Details Market Class Medical Margin Progression Includes Dilutive Impact from Growth: ▪ Over the past 6 years we have added >400 providers and >100,000 MA members to existing markets. New PCPs and members are typically dilutive in Year 1-2 and take time to mature on the platform. ▪ Medical Margin PMPM dilution from growth represents difference between margin performance of initial cohort compared to market class Medical Margin PMPM in 2023** Market Class Membership CAGR Since Go-Live Provider Adds Since Go-Live (PCPs and APPs) Market Vintage Member Vintage Est. Medical Margin PMPM Dilution from Growth** 2018 12% 125 (43% of total) 6 Years 4.01 Years ($36) PMPM 2019 24% 116 (40% of total) 5 Years 2.88 Years ($86) PMPM 2020 15% 78 (31% of total) 4 Years 2.94 Years ($44) PMPM 2021 11% 39 (20% of total) 3 Years 2.54 Years ($55) PMPM 2022 14% 72 (15% of total) 2 Years 1.84 Years ($8) PMPM

 
12 $132 $142 $201 $114 $143 $106 $35 $86 $81 $108 $79 $146 $87 $147 $130 $54 $80 $96 $61 $89 $21 2018 2019 2020 2021 2022 2023 Class 2018 Class 2019 Class 2020 Class 2021 Class 2022 Class 2023 Elevated Medical Cost Environment Relative to Revenue Benchmarks 2018: 12% 2019: 24% 2020: 15% 2021: 11% 2022: 14% Membership CAGR by Market Class (Go-Live to 2023) Note 1: Reflects incurred results; Note 2: 2020 reflects COVID-19 impact; Note 3: Reflects full allocation of costs to member-level cohorts, including Part D and other (other risk pool, certain health plans with limited data) Medical Margin PMPM by Market Class Copyright © 2023 agilon health Market Class Progression (Incurred Results) 2018 Market Class includes one large market with significant growth and physician performance variability. Deploying enhanced PCP onboarding and education during 2H24. 2019 Market Class includes one high performing market and one large, low performing market. Low performing market has experienced significant growth and PCP performance variability. Deploying enhanced PCP training during 2H24.

 
13 $132 $142 $201 $123 $143 $98 $35 $86 $91 $121 $62 $146 $107 $132 $128 $50 $101 $80 $61 $89 $21 2018 2019 2020 2021 2022 2023 Class 2018 Class 2019 Class 2020 Class 2021 Class 2022 Class 2023 Elevated Medical Cost Environment Relative to Revenue Benchmarks Note 1: Reflects incurred results; Note 2: 2020 reflects COVID-19 impact; Note 3: Reflects full allocation of costs to member-level cohorts, including Part D and other (other risk pool, certain health plans with limited data) Medical Margin PMPM by Market Class Copyright © 2023 agilon health Market Class Progression (Reported Results) 2018: 12% 2019: 24% 2020: 15% 2021: 11% 2022: 14% Membership CAGR by Market Class (Go-Live to 2023) 2018 Market Class includes one large market with significant growth and physician performance variability. Deploying enhanced PCP onboarding and education during 2H24. 2019 Market Class includes one high performing market and one large, low performing market. Low performing market has experienced significant growth and PCP performance variability. Deploying enhanced PCP training during 2H24.

 
14 Year Ending December 31, 2024 Medicare Advantage Members 540,000 – 550,000 ACO REACH Members 120,000 – 125,000 Total Members Live on Platform 660,000 – 675,000 Avg. Medicare Advantage Members 527,000 – 536,000 Total Revenues ($M) $6,350 – $6,465 Medical Margin ($M) $400 – $450 Adjusted EBITDA ($M) ($60) – ($15) Geography Entry Costs ($M) $65 – $55 Financial Outlook for Fiscal Year 2024 Note: 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.

 
15 Quarter Ending March 31, 2024 Medicare Advantage Members 520,000 – 530,000 ACO REACH Members 125,000 – 130,000 Total Members Live on Platform 645,000 – 660,000 Avg. Medicare Advantage Members 516,000 – 525,000 Total Revenues ($M) $1,605 – $1,630 Medical Margin ($M) $155 – $170 Adjusted EBITDA ($M) $15 – $25 Geography Entry Costs ($M) $23 – $20 Financial Outlook for Q1 2024 Note: 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.

 
16 Non-GAAP Reconciliations

 
17 Non-GAAP Reconciliations (Dollars in thousands) Year Ended December 31, 2023 2022 Gross profit(1) $ 69,670 $ 111,360 Other operating revenue (9,013) (3,331) Other medical expenses 238,034 183,000 Medical margin 298,691 291,029 1) Gross profit is defined as total revenues less medical services expenses and other medical expense. Medical Margin

 
18 Non-GAAP Reconciliations (Dollars in thousands) Year Ended December 31, 2023 2022 Net income (loss)(1) $ (262,803) $ (106,864) (Income) loss from discontinued operations, net of income taxes 67,550 14,554 Interest expense 6,658 4,484 Income tax expense (benefit) 791 1,640 Depreciation and amortization 16,043 8,949 (Gain) loss on lease terminations — 5,458 Severance and related costs(2) 188 2,470 Stock-based compensation expense 69,326 28,069 EBITDA adjustment related to equity method investments(3) 22,694 3,737 Other(4) (15,448) (7,967) Adjusted EBITDA $ (95,001) $ (45,470) 1) Includes direct geography entry costs, including investments to develop and expand our platform and costs in geographies that are in implementation and are not yet generating revenue and investments to grow existing markets. For the three months ended December 31, 2023 and 2022, (i) $13.5 million and $13.0 million, respectively, are included in other medical expenses and (ii) $12.2 million and $19.4 million, respectively, are included in general and administrative expenses. For the twelve months ended December 31, 2023 and 2022, (i) $33.7 million and $23.9 million, respectively, are included in other medical expenses and (ii) $40.8 million and $43.9 million, respectively, are included in general and administrative expenses. 2) For the year ended December 31, 2022, includes taxes and related costs on stock option exercises for departed executives of $2.0 million. 3) The three and twelve months ended December 31, 2023 includes $15.2 million of physician compensation expenses to reduce the physician partners’ compensation percentage in current and future years in exchange for the Company’s common stock. 4) Includes interest income and transaction-related costs. Adjusted EBITDA

 
v3.24.0.1
Document And Entity Information
Feb. 27, 2024
Cover [Abstract]  
Document Type 8-K
Document Period End Date Feb. 27, 2024
Entity Registrant Name agilon health, inc.
Entity File Number 001-40332
Entity Incorporation, State or Country Code DE
Entity Tax Identification Number 37-1915147
Entity Address, Address Line One 6210 E Hwy 290
Entity Address, City or Town Austin
Entity Address, State or Province TX
Entity Address, Postal Zip Code 78723
City Area Code 562
Local Phone Number 256-3800
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Soliciting Material false
Pre-commencement Tender Offer false
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Title of 12(b) Security Common stock, par value $0.01 per share
Trading Symbol AGL
Security Exchange Name NYSE
Entity Emerging Growth Company false
Entity Central Index Key 0001831097
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v3.24.0.1
Cover
Feb. 27, 2024
Cover [Abstract]  
Document Type 8-K
Document Period End Date Feb. 27, 2024
Entity Registrant Name agilon health, inc.
Entity Incorporation, State or Country Code DE
Entity File Number 001-40332
Entity Tax Identification Number 37-1915147
Entity Address, Address Line One 6210 E Hwy 290
Entity Address, Address Line Two Suite 450
Entity Address, City or Town Austin
Entity Address, State or Province TX
Entity Address, Postal Zip Code 78723
Written Communications false
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Pre-commencement Tender Offer false
Pre-commencement Issuer Tender Offer false
Title of 12(b) Security Common stock, par value $0.01 per share
Trading Symbol AGL
Security Exchange Name NYSE
Entity Emerging Growth Company false
Entity Central Index Key 0001831097
Amendment Flag false
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